Managing High Blood Pressure With In-Home Care
Following the doctor's instructions helps keep blood pressure at a healthy level.
To most of us, blood pressure is a bit of a mystery! We go to the doctor, the doctor puts a cuff on our arm, inflates it, listens, and jots down a set of numbers. Then we're told that everything is fine—or, if we are getting older, more likely we are told that we have high blood pressure, also called hypertension.
High blood pressure raises the risk of heart-related problems, stroke, kidney disease, vision loss and even cancer. The Centers for Disease Control and Prevention (CDC) tells us that more than 1,000 deaths each day are related to hypertension. Up to one-third of all American adults have this condition—yet only half of them have it under control. High blood pressure can be managed with a combination of medications and lifestyle choices such as a healthy diet, exercise, quitting smoking and limiting alcohol.
We're always learning more.
Medical research continues to refine our understanding of hypertension. For example, here's an interesting update about white coat hypertension, a topic that previously appeared in the Caring Right at Home newsletter. "White coat hypertension" occurs when a patient, feeling anxiety about being at the doctor's office, has higher-than-normal blood pressure during the appointment. (Perhaps not surprisingly, a UK study from a few years ago showed that the effect is somewhat less if a nurse is doing the measuring rather than the doctor.) The white coat effect generally has been considered harmless, but the American College of Cardiology recently reported that in older patients, blood pressure that spikes during stressful events could indicate an increased risk for developing heart disease.
And the American Heart Association reports that some patients exhibit the opposite problem! Rather than "white coat hypertension," they have "masked hypertension," with normal blood pressure at the doctor's office, but a higher level elsewhere. In either case, the doctor may recommend the use of a home blood pressure monitor to get a more accurate idea of what's going on.
Another topic of recent research is the ideal target blood pressure level for patients who are being treated for hypertension. The American Heart Association recently reported that if patients were to keep their number lower, more than 100,000 deaths could be prevented each year. On the other hand, in January 2017, the American College of Physicians and the American Academy of Family Physicians recommended less aggressive treatment for certain older adults. And while hypertension raises the risk of cognitive impairment caused by strokes and vascular dementia, the Alzheimer's Association recently suggested that people who develop high blood pressure in their 80s or later actually might be at lower risk of Alzheimer's disease.
What's a layperson to do? We can be forgiven if we're confused! Medical research is always a work in progress, as studies refine other studies and researchers continually look for the best treatments. Bottom line, these studies bring home how important it is for people with hypertension to see their doctor regularly, and to carefully follow the doctor's recommendations about medications and lifestyle.
Home care helps seniors manage their hypertension.
It can be challenging to manage high blood pressure. One big obstacle: Hypertension seldom has any outward symptoms, so patients have to provide their own motivation to stick to their treatment plan. Or family members might find themselves forever reminding Mom to take her medications. If your family has hired in-home care to help keep a senior loved one safe and well-cared for at home, the caregiver can be an important part of the hypertension management team. Professional in-home caregivers can:
- Remind your loved one to check and record blood pressure using a home monitor, as recommended by the doctor.
- Take your loved one to the pharmacy or pick up prescriptions, and provide medication reminders to encourage your loved one to take medications at the right time.
- Report possible side effects from medications, such as dizziness or sleep problems.
- Go grocery shopping and prepare delicious meals and snacks that comply with the doctor's prescribed diet.
- Support your loved one's exercise routine with encouragement, and a steadying arm to reduce the risk of falls.
- Help your loved one keep track of doctor's appointments, and provide transportation to these visits.
- Provide companionship to ward off loneliness, which, as we saw in "Growing Awareness of a Senior Epidemic," is stressful enough to raise a senior's blood pressure.
For More Information
The National Institutes of Health has just created a new web resource, Mind Your Risks, to help consumers prevent and manage hypertension.
For information on topics related to home care and healthcare, visit our Home Care and Healthcare Advocacy group on LinkedIn.