The Role Of Heart Failure In Older Adults

Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,

An elderly male with congestive heart failure was brought to a clinic because he was experiencing atrial fibrillation and had a ventricular response of 110 beats/min with palpitations and shortness of breath1. Medications that he was taking includes angiotensin-converting enzyme inhibitor, Lisinopril, Carvediol, Digoxin, and Furosemide1. His left ventricular ejection fraction has been reduced to 25%1. Further examinations showed that he had edema in his legs and crackles at the base of his lungs1. He was then told to increase the dosage of Furosemide by taking the drug twice daily instead of once, and doubling the dose per administration1. One week later, the electrocardiogram revealed that he had ventricular arrhythmias such as premature

Congestive Heart Failure (CHF) and Heart Failure (HF) are serious problems in regards to hospital re-admissions especially regarding the sixty-five year old population. Data demonstrates approximately over 670,000 individuals each year are diagnosed with CHF, along with that there are 6 (six) million Americans affected with CHF. Hersh, Masoudi, and Allen (2013) described readmissions of patients with CHF is increasing by 25% within thirty days of discharge from the hospital. This creates a huge impact on the taxpayers and patients due to the increasing percentages being re-admitted into the hospitals (Post discharge Environment Following Heart Failure Hospitalization: Expanding the View of Hospital Re-admission, 2013). The problem is to identify a plan to decrease the CHF/HF hospital re-admissions into the especially regarding the 65 (sixty-five) year olds and older, in spite of efforts from the hospital staff providing guidelines and nursing education regarding CHF/HF signs and symptoms.

According to the Centers for Disease Control and Prevention (CDC) there are an estimated 5.1 million adults suffering from heart failure (2013). As the prevalence of heart failure continues to rise, one out of every nine deaths occur as a result of this chronic condition. Studies conducted at Yale found in Medicare age patients with heart failure, there is a median 30-day mortality rate of 11.1% and 5-year rate of approximately 50% (Alspach, 2014). According to Desai & Stevenson (2012), rising costs of care are in direct correlation to the number of hospital admissions related to a primary diagnosis of heart failure especially among adults age 65 years or older. The national rate for readmissions within 30 days is approximately 24.7%, consequently having

Mountings of evidence exist on the benefits of physical activity and exercise for patients who have experienced a heart failure (HF) in recent years. HF occurs irrespective of age, therefore there will be no age categorisation within this report even though it is decidedly prevalent in older people, however, distinction will be made in relation to the group most likely to experience an event where pertinent. Owing to that, the intent of this report will be to asses the impact of physical activity and exercise on mortality and morbidity outcomes of those who have experience an event, as well as the advancement of quality taking into account the prognosis of the patients and their ability to undergo a particular exercise prescription.

Heart Failure is a progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).

Keywords: Heart failure symptoms, heart failure management, adults and heart failure, Lenz’s Theory of Unpleasant Symptoms, heart failure outcomes.

Heart failure is more commonly diagnosed in the elderly population. There are ways to help manage heart failure like lifestyle modifications and use of pharmacology, and assessment for surgical intervention. Treatment of heart failure requires intensive medical, dietary, behavioral, and lifestyle modification to achieve improved quality of life, fewer hospitalizations, and decreased mortality (Singh, H., McGregor, Nigro, Higginson, and Larsen, 2014).

Heart failure is a syndrome that involves dysfunction of the cardiac muscle that results in or increase the risk of developing manifestations of low cardiac output and/or pulmonary or systemic congestion (Grossman & Porth, 2014). The National Heart, Lung, and Blood Institute estimate that about 5.8 million people in the United States have heart failure. Even though heart failure can occur in any age group, it primarily affects older adults. Although morbidity and mortality rates from other cardiovascular diseases have decreased over the past several decades, the incidence of heart failure is increasing at an alarming rate. Approximately 400,000 to 700,000 people are diagnosed with heart failure each year (Grossman &

As the population of persons age 65 and greater continues to rise so does the number of individuals suffering from heart failure. With an estimated 5.1 million adults with the diagnosis of heart failure it is currently the number reason for hospital admissions for the Medicare eligible population. Readmission within 30 days occurs in approximately 25% of this population, resulting in a significant financial burden to the health care delivery system. There is substantial literature supporting strategies to help reduce the number of readmissions and moreover cost of care. Addressing patient and family needs to provide self-management has proven to reduce readmissions by comprehensive care coordination, supportive home care visits

Based on Goodman and Fuller (2015), it was estimated that the annual population in the United States with (CHF) congestive heart failure is about five hundred fifty thousand, and approximately five million male and female elderly individual (65 years old and above) is the leading cause of hospital admission. Moreover, heart failure has a significant twenty percent of an estimated death rate and fifteen percent survival rate of patients diagnosed with CHF (Bocchi, Vilas-Boas, Perrone, Caamaño, Clausell, Moreira et al., 2005; Hunt, Abraham, Chin, Feldman, Francis, Ganiats et al., 2005).

When looking at age, recent studies in the US showed the prevalence of heart failure was increased form 0.7- 2.2% in people aged from 45-54 and a massive increase to 8.4% in persons above the age of 75 (Redfield,

Congestive heart failure is a chronic condition that is responsible for the highest number of hospitalizations among adults. Readmission rates after hospitalization also remain high, with 50% of patients being readmitted within 6 months of discharge. (Desai & Stevenson, 2012). The Affordable Care Act penalizes hospitals with readmissions within 30 days after discharge, making readmissions a focus of hospitals nationwide. Several factors including discharge planning, patient education, diet restrictions, and early follow up appointments can help to reduce readmissions, but continuous monitoring is necessary to catch early signs of decompensation. (Desai & Stevenson, 2012).

Congestive heart failure is a chronic disease that requires daily monitoring and life style management. Affecting the elderly, and their family the adjustment is a challenge. Daily life skills include the monitoring of daily weights, intake and output, and a low sodium diet. The person with congestive heart failure is generally admitted to the hospital for medication adjustments when their symptoms increase. The patient is often times short of breath, with a decrease in energy and an increase in their weight. The patients are generally elderly 60-65 years of age or older, and when comparing African Americans to Caucasians the African Americans have a 1.5 greater chance of developing heart failure ("Heart Failure," 2017). The

hospital in Ohio is currently looking at a program to help educate their heart failure patients, and to establish measures to ensure that the patient is following up after discharge. This paper will give the finding of the literature research and share a plan to improve the education for the heart failure patient.