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AAA Warman Home Care’s E-Update is intended to bring to you timely and useful articles and information at the click of the mouse. It is sent monthly in an effort to keep you apprised of what is happening across the healthcare continuum of care effecting hospital, hospice and rehabilitation social workers and case managers, as well as Assisted Living, Independent Living and Skilled Nursing facility executives. Warman understands that time is limited and has undertaken to share with you important industry information without your having to search for it.
Just three months of physical activity reaps heart health benefits for older adults with type 2 diabetes by improving the elasticity in their arteries - reducing risk of heart disease and stroke, Dr. Kenneth Madden told the 2009 Canadian Cardiovascular Congress, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.
Dr. Madden studied adults between the ages of 65 to 83 with controlled Type 2 diabetes, high blood pressure, and high blood cholesterol to see how increased activity might affect stiffness of the arteries.
"The theory is that aerobic activity makes your arteries less stiff and makes artery walls more elastic," says Dr. Madden, a geriatric specialist at the University of British Columbia.
An improvement was seen in the elasticity of the arteries of the group that performed the activity compared to those who didn't exercise. "There was an impressive drop in arterial stiffness after just three months of exercise. In that time we saw a 15 to 20 per cent reduction."
The subjects were divided into two groups to either receive three months of vigorous physical activity (one hour, three times per week) or to get no aerobic exercise at all. Subjects were classified as sedentary at the beginning of the study but gradually increased their fitness levels until they were working at 70 per cent of their maximum heart rate, using treadmills and cycling machines. They were supervised by a certified exercise trainer.
Dr. Beth Abramson, spokesperson for the Heart and Stroke Foundation, stresses the importance of lifestyle factors on heart health, especially with our aging population. "Almost everyone can benefit from active living," she says. "The Foundation recommends that, like adults of any age, older adults - with the consent of their physicians - need 30 to 60 minutes of moderate activity most days of the week."
Dr. Madden says that the exercise requirements may be viewed as controversial because of the age of the participants but the exercise level was safe and well tolerated. "There seems to be a knee-jerk reluctance to getting these older adults to exercise yet we used a vigorous level of activity and didn't have any trouble keeping participants in our study. They enjoyed the activity," Dr. Madden says. "People always underestimate what older adults can do."
Dr. Madden notes that realistically, seniors need someone to help them get started. "We need to learn how to do it effectively and how to do it safely," he says. "It could mean visiting your family doctor to find out about provincially funded programs, or joining programs for seniors that are offered at many local community centres."
Dr. Abramson recommends that seniors choose activities they enjoy, such as walking, gardening, golfing, dancing, or joining a yoga or tai chi class. If weather is a barrier, she suggests climbing stairs at home, joining a mall-walking group, or strolling the halls of their apartment building or retirement residence.
In his next project, Dr. Madden wants to find out if there is a less expensive but equally effective way to reduce the stiffness of arteries in older adults. "Our first step was to prove that it was at all possible for older adults to have reduced narrowing in their arteries due to exercise," he says. "Now we want to find out just how rigorous the levels of activity need to be to demonstrate the same results. The next step is to try studying a home-based walking program using pedometers. This is something easy for doctors to prescribe and cheap and easy for participants."
The HeartWalk Workout, a special activity program developed by the Heart and Stroke Foundation to help people with cardiovascular problems get regular, healthy physical activity is available online at heartandstroke.ca. It helps people slowly build up exercise tolerance until they can walk at least 30 minutes, five times a week.
SOURCE: Heart And Stroke Foundation Of Canada, October 26, 2009
Hospital-at-home care may be a practical alternative to traditional hospital inpatient care for patients with acutely decompensated (suddenly worsening) chronic heart failure, according to a report in the September 28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Nearly 7 million Europeans and 5 million North Americans are affected by chronic heart failure, a progressive and disabling syndrome, according to background information in the article. Hospitalization for chronic heart failure for older patients has increased and occurs in 2 percent to 3 percent of patients over age 85 every year. In the United States, decompensation (worsening) of chronic heart failure leads to more than 1 million hospital admissions per year and a 50 percent risk of subsequent hospitalization within six months of discharge. "Although the hospital is the standard venue for providing acute medical care, it may be hazardous for older persons, who commonly experience iatrogenic illness [complications due to treatment], functional decline and other adverse events."
Vittoria Tibaldi, M.D., Ph.D., and colleagues at the University of Torino, San Giovanni Battista Hospital, Torino, Italy, compared the effectiveness of a physician-led hospital-at-home service for elderly patients with acute decompensation of chronic heart failure with traditional hospital inpatient care. Patients age 75 or older with decompensation of chronic heart failure were randomly assigned to either a general medical ward (53 patients) or to the Geriatric Home Hospitalization Service (48 patients) between April 2004 and April 2005. The Geriatric Home Hospitalization Service provided diagnostic and therapeutic treatments by hospital health care professionals in the home of the patient.
At six months, 15 percent of all patients had died, with no significant differences between the two groups. "The number of subsequent hospital admissions was not statistically different in the two groups, but the mean [average] time to first additional admission was longer for the Geriatric Home Hospitalization Service patients (84.3 days vs. 69.8 days). Only the Geriatric Home Hospitalization Service patients experienced improvements in depression, nutritional status and quality-of-life scores," the authors write.
"Recent trends in health care favor alternatives to traditional acute care in hospitals. These trends include advancement in telehealth technologies and increased demand for treatment at home," the authors conclude. "Further development of hospital-at-home care will require additional research and dedicated resources to support dissemination."
SOURCE: Archives of Internal Medicine, September 29, 2009
Willpower tends to take a back seat during the holidays, but for people with hypertension, the damage of unhealthy eating can have particularly negative consequences.
About one in four Americans has hypertension, a disease that elevates blood pressure and can lead to a host of serious problems including heart attacks and strokes.
"I tell patients to allow themselves one special meal for a holiday, but not to continue unhealthy eating habits for several days or weeks," said Dr. Shawna Nesbitt, hypertension specialist at UT Southwestern Medical Center. "Leftovers are what sabotage people."
People with hypertension also need to take prescribed medication throughout the holidays, and not skip doses.
"Holidays are a time of tradeoffs. If you know you're going to have an ample dinner with a lot of salt, you need to have a very low-sodium breakfast and lunch," Dr. Nesbitt said. "And be sure you don't go over your daily salt limit."
Those with hypertension should eat no more than about 1,500 milligrams of salt each day.
SOURCE: UT Southwestern Medical Center, October 24, 2009
It's just like something you'd see in an old movie heading off into the hills with the kids to cut down a Christmas tree to bring home. But doctors at UT Southwestern Medical Center at Dallas say if you choose the wrong tree, you could make the holiday season miserable.
About one in ten people are allergic to mountain cedar pollen, and these trees release their pollen just at the time you'd be bringing them indoors to decorate. If someone in your home is allergic to mountain cedar pollen, they're in for weeks of sneezing and sniffling.
Fortunately, this is only a real risk for people who like to go out into the wild and cut their own trees. The Scotch pines and Douglas firs you find at most Christmas tree lots or cut-it-yourself Christmas tree farms don't pollinate during the winter.
But Dr. Dave Khan, a UT Southwestern allergy expert, says you may still have some allergy issues. Anything brought in from outdoors is likely to bring mold spores with it. A lot of people are allergic to mold. You can have a live tree treated with fungicide to kill off the mold spores.
If you have allergy sufferers in your family, Dr. Khan says an artificial tree may be your best bet.
SOURCE: UT Southwestern Medical Center, October 24, 2009
AAA Warman Home Care is a family-owned Residential Service Agency which has been providing in-home health care services to thousands of clients for the past twenty years. Warman specializes in providing the highest quality of private duty, non-medical care and companionship for the elderly, those recuperating after hospitalization / rehabilitation, the terminally ill, disabled, alone or at-risk. It is our goal to assist our clients in living the most independent, healthy and comfortable lives in the privacy of their own homes.
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