Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly stops beating and consequently leading blood to stop flowing to the brain and other vital organs. If not treated within minutes it usually causes death. It is one of the major causes of mortality in the elderly individuals owing to a high prevalence of coronary heart disease, systolic dysfunction, and congestive heart failure (CHF).
Although the incidence of the sudden cardiac death increases with age, the proportion of sudden cardiac deaths decreases due to the high numbers of other cardiac causes of death in the elderly individuals. The implantable cardioverter-defibrillator (ICD) therapy has proven to improve survival and prevent SCD in selected patients with systolic dysfunction and congestive heart failure.
However the ICD therapy does not seem to be effective in the elderly patients mainly because of greater rate of pulseless electrical activity underlying the SCD and other competing non-arrhythmic causes of death in this population. Cardiac resynchronization therapy (CRT), which has been demonstrated to reduce mortality in selected populations with heart failure, is also more commonly used in this group of patients than in younger individuals.
Heart failure is a frequent cause of hospitalization and mortality among the elderly individuals older than 65 years of age with nearly 340,000 of them being hospitalized each year and approximately 54000 deaths among individuals older than 65 years of age. Although the relative incidence of heart failure is lower in women than men, women constitute at least half of the cases due to longer life expectancy. Sudden death is usually because of the heart disease.
Obstructive sleep apnea is a disorder that happens when breathing is briefly and repeatedly interrupted during sleep causing fragmented sleep and the low blood oxygen levels. For people with sleep apnea the combination of sleep deprivation and oxygen starvation may lead to hypertension, heart disease and memory problems.
During sleep, most of us have brief pauses in our breathing pattern called apneas that are quite normal. But sometimes these pauses get prolonged and happen more often that can make our breathing pattern irregular and abnormal. Abnormal sleep apnea might actually cause decreased oxygen levels in the body thereby disrupting sleep. A high prevalence of sleep apnea exists in the elderly, presumably because of changes in pharyngeal collapsibility. Elderly patients may be less likely to seek medical attention for this condition, because they are less likely to be symptomatic.
Sleep apnea basically refers to a breathing pause that can last as long as at least ten seconds. Obstructive sleep apnea occurs when the muscles in the back of the throat fail to keep the airway open, despite efforts to breathe. It can deprive the brain and the other organs of the oxygen they need and can trigger declination of a person’s cognitive disability.
According to the US doctors, thousands of adults unnecessarily take tablets for high blood pressure that can trigger other health issues. But does it lead to more falls, especially in the elderly? Usually falling down and the injuries associated seem trivial and benign part of our lives’, but can turn into daunting and life-threatening situations for the older adults.
Even the most common daily activities like cooking, climbing and descending the stairs can significantly drop blood pressure and be potentially dangerous as it reduces the blood flow to the brain leading to loss of consciousness. This could be one of the reasons that many older adults are intimidated of doing any activity that can lead to fall.
The reason attributed to this is that most of the elderly population takes a number of medications to treat different health conditions. Taking four or more medications increases the risk of falling because there are several side effects associated with the use of multiple medications that also are more intense.
Similarly various interactions between medications can also cause side effects. In the older people the medications react differently that increases their risk for falling. Uncontrolled high blood pressure is a very serious health concern that can lead to heart disease and increased risk for stroke and also falling down with the elderly. But you can take control of it by optimizing your dietary intake, exercising and effectively managing your stress, the odds of lowering your blood pressure are greatly in your favor.
The bankrupt city of Detroit and its retirees have reached a tentative agreement in a health insurance dispute that may end a lawsuit against the city so as to limit planned cuts to retiree health care coverage, and thereby potentially resolving one of the most expensive issues in the city’s bankruptcy case.
The retirees had filed a suit in November 2013 to stop the city from shifting them to Medicare and giving those under age 65 a $125.00 monthly stipend so that they can buy their own insurance. The retirees were negotiating with the city over retiree health care cuts and reached a deal with the city last month that would provide benefits through the end of 2014.
But according to attorney for the pensioners Ryan Plecha – “ This resolves health care benefits, it’s only for 2014. It does not address 2015 and beyond nor does it address any claims pending prior to 2014.”
Joan Mondale’s family has announced that she has entered Hospice Care today. She is the wife of former Vice President of United States Walter Mondale, who served with Jimmy Carter as President.
Joan is 83. A statement released by Westminster Presbyterian Church in Minneapolis seeks privacy and informs that the family and loved ones are with her in the hospice.
End of life care at hospice should be considered by everyone. Hospice is not expensive, as Medicare and private insurance generally covers hospice care with some exceptions such as intravenous nutrition. However, many Americans end up in hospital ICUs and emergency rooms instead of a peaceful end under hospice care.
One recent survey found that 98 percent of family members said they would strongly recommend hospice care to others in need. And hospice isn’t just focused on cancer patients. According to the National Hospice and Palliative Care Organization, about 40 percent of U.S. hospice admissions now involve patients with end-stage heart disease, dementia, lung disease or stroke. Experts predict that the current baby boomer generation will start utilizing hospice care effectively.
Update: Joan’s family announced that she died today (02/03/2014) three days after she was admitted to the hospice.