Better Understanding of Strokes Can Help Seniors Protect Their Health

Published in Pawtucket Times on May 19, 2003

Even if Americans know about the negative impact of their lifestyle choices, that knowledge may not be enough to change their behaviors, especially those behaviors that lead to strokes.

According to a new survey released by the National Council on Aging (NCOA), Americans understand that those who have had a stroke are at a greater risk for a future one, ye stroke survivors are not taking all the possible steps to protect their health.

Strokes can result from a sudden interruption of blood flow to any part of the brain, which can ultimately injure or kill brain tissue.

Strokes can lead to severe impairments, including debilitation from paralysis, short-term memory loss and even speech and vision problems. About one-third of all strokes are recurrent, even though there are lifestyle changes and medications available today that can help to reduce that risk.

In this telephone survey, which was funded by a grant from Sanofi=Synthelabo and Bristol-Myers Squibb, 66 percent of the survey respondents said they knew someone who had suffered a stroke, but many of those who survived were not exercising regularly (32 percent), refraining from smoking (19 percent) or watching their diet (18 percent). These simple lifestyle changes are known to help prevent future strokes.

“Those who have already had a stroke can make changes to their everyday routines  to lower their risk for a second stroke or heart attack,” Mark Alberts, M.D., professor of neurology, at Northwestern University Medial School in Chicago, stated in a NCOA release.

“It is particularly important that stroke survivors and their families or caregivers work closely with their physicians to develop an individualized treatment plan, which will often include medication,”  says Alberts.

Along with the basic lifestyle changes, taking appropriate medications can also reduce the risk of recurrent strokes.

For instance, the researchers say many patients may benefit from antiplatelet therapy that prevents blood platelets from sticking together and clotting, helping to reduce stroke risks.

According to the NCOA study, after surviving a stroke, men have a 42 percent chance of having another within five years, and women a 24 percent chance during that same time period.

The general public seems to be confused regarding what stroke risks factors and symptoms are, the researchers found.

The NCOA survey findings indicate that many Americans incorrectly identified excessive stress (87 percent), overexertion while exercising (56 percent), dehydration (38 percent), asthma attacks (24 percent) and wearing constrictive clothing (16 percent) as risks factors for stroke.

Additionally, survey respondents also mistakenly selected shortness of breath (53 percent) and heart palpitations (50 percent) as stroke symptoms. Nearly two-thirds of those surveyed failed to recognize that age increases stroke risk, especially for those over age 65.

Although seniors are at the greatest risk of having a stroke, they seem to show little concern, researchers noted. While two-thirds of all strokes occur among those ages 65 and older, only 12 percent of those surveyed in that age group noted they are more concerned about suffering a stroke, given other choices like Alzheimer’s disease and diabetes.

A whopping 70 percent of the olde respondents told researchers they never talked to their doctors about stroke risk.

”For older Americans, strokes pose a significant health risk so it is alarming to us that so few seniors have discussed their personal risk for stroke with their doctors,” said James P. Firman. NCOA’s president and CEO. “Better education is clearly needed to help all Americans understand their risks of stroke to protect their health.”

Robert Marshall, Ph.D., who serves as assistant director of health at the state Department of Health, gave All About Seniors his thoughts about the NCOA research study.

He said strokes are the number-three killer in Rhode Island – in 2000, 964 Rhode Islanders age 50 and over died of stroke.

“We call these preventable deaths’ because we know that by reducing risk, such as smoking, obesity, lack of exercise, uncontrolled high blood pressure, many  people can avoid death and disability from stroke, adds Marshall.

“It is unfortunate, but not surprising, that so many strokes are recurrent,” said Marshall. “Human nature being what it is, many people find it difficult to change the behaviors that got them into trouble in the first place- things like smoking and lack of exercise,” he notes.

“We all need to do a better job supporting stroke survivors and helping them use the experience as a springboard to a longer healthier and happier life,” Marshall added.

Older Rhode Islanders can easily take charge of reducing their chances of having a stroke or a recurrent stroke.  Positive lifestyle changes (e.g., more exercise, a better diet, giving up cigarettes, and taking prescribed medications are key lifestyle changes to protecting your health.

The Best Of…Seniors Can follow Steps to Avoid Heat-Related Illnesses

Published July 8., 2002, Pawtucket Times

On July 3rd, it was so hot you could fry an egg on the pavement outside of McCoy Stadium.

Although more than 10,500 fans had bought tickets to watch the PawSox game against the Ottawa Lynx, which concluded with a 45-minute fireworks display, only 8,300 fans showed up, according to Ken McGill, co-chair of teh Pawtucket Fireworks Committee.

There were even smaller crowds who set up chairs in the parking lots and on sidewalks in the surrounding neighborhoods around McCoy Stadium to watch the much-awaited fireworks display, McGill said.

But despite the searing heat that evening it was clear that some just like it hot.

As the PawSox game was winding down, Ray Ethier, 60, a former union electrician, chatted with his friend, George Panas, 59, of Spumoni’s Restaurant.

“I don’t mind the heat.  I just don’t like this humidity,” he candidly admitted.  However, Ethier acknowledged that the heat has slowed him down a bit, because “it’s too hot to play golf.”

Panas doesn’t mind the searing outside heat either, or even working in a hot kitchen.

“When people are sweating buckets in the kitchen, I feel as cool as a cucumber,” he said.

Fifty-seven-year old Stan Lachut, a retired Pawtucket school teacher, waited with his wife Beverly, for darkness and for the fireworks show to begin. Standing by the barbecue tent and surrounded by more than 200-plus guests of the Pawtucket Firework’s Committee, the Cumberland residents said the heat’s not a problem for him, either.

“Being outside in summer is a time you can spend with your family and friends,” he said, whereas “colder temperatures force people to stay inside buildings.”

On the other hand, not everybody like summer’s hot days

Ttemperatures in the mid-90s, combined with high humidity, can become uncomfortable and a serious health hazard for seniors.  And many are heeding the advice of experts gleaned from radio, television, and local newspaper articles about how to cope with the scorching summer heat.

Patricia A. Nolan, M.D.,  the state’s top health official, gave her advise on surviving Rhode Island’s current heat wave.

Seniors, small children and the mentally ill are the most susceptible to health problems from searing summer heat waves, said Nolan, who serves as the director of Rhode Island’s Department of health.  High temperatures can be especially dangerous to persons’ with cardiac and respiratory probems and to mentally ill patients taking psychotropic medications, she said.

She noted that psychotropic medications make it harder for an individual to cool down.

According to Noran, the early symptoms of heat-related illnesses include muscle cramps in the arms, hands, abdomen and legs.  Muscle cramps are a result of dehydration and salt loss, primary problems associated with heat stress.  Additionally, Nolan said that fainting in the heat is another early symptom

If someone faints because of the heat, take the person into a cool place and cool them off by using a wet, cool cloth, Nolan recommends.

“You want to sponge people down and fan them to reduce their body heat,” she says.

Heat exhaustion, or heat-stork, is a more serious problem related to dehydration caused from high temperatures Nolan stated.  “Feelings of complete exhaustion, confusion, nausea or vomiting are real danger signs,” she said, adding, “If this occurs, you must get the body temperature down by addition fluids through intravenous methods.”

To successfully beat the heat, seniors should cut back on outside physical activities and drink plenty of water, Nolan recommends.

While water is the best fluid to drink on a hot day, fruit juice can also be considered a viable substitute.

“Cooling off with a cold beer is not the best plan,” Nolan said, noting that alcohol coffee, tea and soda are loaded with caffeine, which can increase the changes of dehydration.

“Seniors who tend to be most vulnerable to heat are those who don’t have a way to get cool for a part of the day,” Nolan said.  “One of the reasons heat waves affect the elderly more than the general population is because seniors are isolated, can’t get to a cool place, don’t have air conditioning and are afraid to open their windows at night when it finally cools down.”

Nolan warned that with temperatures in the mid-90s, staying indoors in a really hot house or apartment is not the best thing for seniors to do.

“Go to an air-conditioned shopping mall, see a movie, visit a restaurant, or get yourself into an air-conditioned space,” she recommended.  “If you can do this for an hour on a really hot day, you can protect yourself from serious health-related problems.”

Sometimes seniors get into trouble during days with high temperatures because they just don’t realize the danger,” Nolan noted.

During these days, it becomes important to monitor elderly parents or older friends, she says.

“Call on them every day to make sure they are coping with the heat.  Take them out to a cool place, like a shopping mall, a library, or a restaurant to let them cool off.”

In Rhode Island, some seniors tend not to adjust their behaviors to the heat because it’s only going to be hot for a few days,” Nolan says.

However, adjustments are fairly easy to make, she noted, stating that not making them can be hazardous to their health, and perhaps even deadly.

Herb Weiss is a Pawtucket-based freelance writer who writes about aging, health care and medical issues. He can be reached at hweissri@aol.com.

Today’s Seniors are Healthier, But More Are Uninsured

Published in Pawtucket Times on May 27, 2002

Three years ago, Alice, 60, lost her job as a graphic designer along with 143 co-workers when the Providence-based company closed. Corporate management had made the decision to  move South to tap into a cheaper labor pool.

The Pawtucket resident considered her full-time job to be a fulfilling one. Most important, she had good health insurance coverage with a very nominal monthly cop-pay of $ 80. Although she received coverage under COBRA, Alice’s monthly health care premium shot up to $ 256. When the federally mandated health insurance coverage ended, her monthly health insurance premium almost double to $ 600.

Alice never went back to full-time employment, choosing to take partial retirement in order to collect a pension. To make ends meet, she is currently teaching art classes and working part-time for a nonprofit art group. When her COBRA coverage ran out, Alice signed up for health insurance coverage from the National Association of Self-Employed. This reduced her monthly premium to $ 253; however she was left with a $ 10,000 deductible per year.

At age 60, Alice recently had a hip replacement surgery. Before the operation, the hospital required a $ 5,000 down payment, forcing her to withdraw money from her several saving accounts. Now recuperating from surgery that costs more than $ 10,000, she is about $ 5,000 in debt.

According to a new AARP report, seniors age 50 and over may be healthier and living longer overall, but their long-term health security remains at risk. In the Ocean State, Alice and other seniors have lived the findings of the report. They struggle to maintain their costly health insurance  coverage.

The report, “Beyond 50: A Report to the Nation on Trends in Health Security” is the most comprehensive picture to date of the state of health care for older Americans.

Changes in health security during the last 20 years have been driven by increased reliance on prescription drugs and other innovative technologies, changes in chronic disease and challenges in chronic care, greater longevity and functional limitations patients’ roles and responsibilities as consumers and fluctuating cost growth, the AARP report finds.

“Americans age 50-plus have the chance to capitalize on wonderful advances in longevity. But they need a chain of dominoes to fall right – initial good health, adequate health care coverage, affordable quality care that’s easy to access and a system that encourages informed decision making,” said AARP CEO Bill Novelli.

“Missing one of these dominoes puts a person’s – and a generations – whole health security at risk,” says Novelli.

At age 50, Americans can expect to live another 30 years, the report notes, almost nine years longer than expected in 1900, and fewer are suffering disabilities. The aging baby boomers are healthier with fewer smoking and more using preventative services and trying to exercise.

The AARP report also found that more people age 50-64 are uninsured than in the past and those with insurance are worried about losing what coverage they have or receiving fewer benefits in the future because Medicare doesn’t cover prescription drugs and few Americans have long-term care insurance.

“It’s a good news/bad news report,” said Novelli. “Personal behavior can make a positive difference in people’s health and longevity, but health care for Americans age 50-plus is harder to get, to pay for and to manage. The health care system is a non-system.”

The AARP report calls for the public health system to continue to promote positive health behaviors.

In addition, the general lack of long-term care coverage and the increasing inadequacy and instability of health care coverage for portions of the 50-plus population must be addressed by policy makers.

In 2000, 39 million Americans were uninsured. Out of this number, 5.2 million were seniors between  ages 50 to 64. With the graying of America’s population, the Rhode Island congressional delegation must work closely together to craft meaningful legislation that will create a safety net for the underinsured and uninsured. It’s now time to fix this long-debated policy problem once and for all.

Every senior must have access to affordable health care services. For me, that right is as American as apple pie.