CAREGIVERS GUIDE

Practical advice to help caregivers with the day-to-day challenges of caring for a heart patient

We understand. At a moment’s notice, you joined millions of Americans filling the role of caregiver for a parent, a spouse, or a close relative. Caregiving is an increasingly common experience in middle and older adults that cuts across demographic groups. For those caring for a heart patient, providing support can seem like a part-time job that could be required for six months or more during recovery from a heart attack or stroke or more for heart failure patients. At Capital Cardiology Associates, you can count on our team of physicians and providers to provide the highest quality of care for your loved one. We understand the challenges that caregivers experience at home. To help, we have compiled this collection of advice, resources, and tips on how to take care of your loved one with heart problems.

Life after a heart attack

There is a common misconception that a heart attack is a singular event. About one in five people who have had a heart attack will have a second one within five years. According to the American Heart Association, each year, there are about 335,000 recurrent heart attacks in the United States. It’s vital for family and friends to identify the warning signs associated with heart trouble — chest pain, shortness of breath, difficulty breathing, and leg swelling — are all abnormal after a heart attack. If you observe these symptoms, get medical attentional immediately.

It’s not uncommon for patients to describe their heart attack as a “life-changer.” For many heart attack survivors, their heart attack prompted major lifestyle changes. Dr. Robert Benton, a board-certified cardiologist at Capital Cardiology, points out that during these first few days or weeks after a heart attack, it’s critical to have a caretaker with the patient. “Family members need to understand what this person is going through because some people have never been sick in their lives, they’ve never been to the doctor or hospital for treatment, and suddenly, it’s a big game-changer. You’ve gone from taking no medicines to taking five different prescriptions. Beforehand you ate everything you wanted, and now you are limited. You were smoking cigarettes; you’re not. You didn’t exercise, you are. You haven’t taken any time off from work to take care of yourself; we teach you to have to put things into priority.”

Grandfather with family

Cardiac rehab is one of several steps necessary to come to terms with life after a heart attack. After your hospital visit, you will meet with your cardiologist to begin, “something called cardiac rehabilitation, which we recommend to all heart attack patients,” said Dr. Benton. Heart patients accept that they will now have a working relationship with their cardiologist that starts as regular office visits. “It’s about two to three times a week for about six weeks. You’ll do exercises and learn about diet and stress management. Those are things that we, the medical profession, provide.” At home, your loved one will rely on you to help them get exercise, eat healthier, manage their stress, take their medications, and make any lifestyle changes their doctor recommends.

Life after stroke

According to the Centers for Disease Control and Prevention (CDC), every year, more than 795,000 people in the United States have a stroke. Of those cases, about 140,000 Americans are killed by stroke each year — that’s 1 out of every 20 deaths. For survivors, there is also a 23% chance of a second stroke. What makes stroke unique from a heart attack is that it is an event that interrupts blood flow to the brain or when an artery in the brain leaks blood or ruptures. Caregivers need to be aware of warning signs that show you a stroke is happening. The timepiece of identifying stroke is so important because the longer that part of the brain goes without blood and oxygen supply, the worse the outcome is.

While the risk of stroke is often included with heart attack prevention, stroke affects your brain, which brings a different set of recovery needs. Dr. Alan Boulos is Chair of the Department of Neurosurgery, Director of the Neurovascular Section, and Associate Professor of Neurosurgery and Radiology at Albany Medical Center. He explained how a stroke damages the brain. “The brain is a complicated electrical organ/system. If the connections can be re-established, if other parts of the brain can take over function, then we can see patients recover their abilities despite their being an area of the brain that was damaged.” It is encouraging that recovery from a stroke event is possible; this involves dedication to rehabilitation and time. Change occurs very slowly, up to two years in some cases. Unfortunately, due to the severity of the stroke, there may debilitating or life-altering injury.

Living with heart failure

More than 200,000 US cases of heart failure are diagnosed per year, typically affecting patients between the ages of 41-60, and those above 60 years old. Most of these people are men. However, women are more likely to die from heart failure when the condition goes untreated. The term “heart failure” makes it sound like the heart is no longer working at all, and there’s nothing that can be done. Actually, heart failure is a term used to describe a heart that cannot keep up with its workload. “One question I get from patients is, ‘Is heart failure the same as congestive heart failure?’ Yes, it is,” shared Dr. Benton.

Heart failure leads to congestive heart failure, which brings an increased danger of heart attack. Because heart failure is most often a chronic condition, your symptoms will likely get worse over time. Since heart failure is a long-term disease, daily activities like walking up the stairs, carrying groceries, or even walking from your car to your home can, over time, become a challenge. “The situation could have to do more with being overweight or out of shape, it could be the coronary arteries — if there is a blockage it can cause a lack of blood flow, starving the heart from oxygen and that cause much bigger problems,” states Dr. Benton.

There are many different treatment options depending on your loved one’s overall health and how far their condition has progressed.
“We can treat certain types with medicines like a water pill (diuretic); there are drugs (ACE inhibitors and beta-blockers) that help with blood flow or lower pressures in the heart, helping the heart muscle function more efficiently,” stated Dr. Benton. There are also surgical options. A balloon angioplasty is a non-surgical procedure where a balloon is inflated inside the narrowed aorta to expand the blood vessel. Your cardiologist may also suggest a coronary stent (a tube) placed in the coronary arteries that supply the heart, to keep the arteries open in the treatment of coronary heart disease. Interventional cardiologists can place a mitral clip, a procedure to cinch a very leaky heart valve. For heart failure patients that have developed heart valve disease, a Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive surgical procedure. This option repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place.

Heart-healthy eating

Diet is the cornerstone for every heart patient as it is the one area of health that all patients can follow. Your healthcare provider will prescribe a diet low in saturated fat and salt. They will insist on incorporating a variety of fruits and vegetables, whole grains, lean meats, fish, and low-fat dairy products into everyday meals. There are two diets that are recommended by the American College of Cardiology, the American Heart Association, and the healthcare community: the DASH diet and the Mediterranian Diet.

DASH stands for Dietary Approaches to Stop Hypertension. The DASH eating plan has been proven to lower blood pressure in just 14 days, even without lowering sodium intake. The DASH diet can help lower cholesterol, and with weight loss and exercise, can reduce insulin resistance and reduce the risk of developing diabetes. The DASH eating plan includes whole grains, poultry, fish, and nuts, and has low amounts of fats, red meats, sweets, and sugared beverages. It is also high in potassium, calcium, and magnesium, as well as protein and fiber. Eating foods lower in salt and sodium also can reduce blood pressure.

A majority of the meal planning for the Mediterranean diet consists of fresh fruits and vegetables. A sample-day meal menu consists of: a pumpkin-gingerbread smoothie for breakfast, Macaroni with Milk (Macaroni oil-Hali) for lunch, and Trout with Wilted Greens for dinner. Your suggested snacks during the day: Mango-Pear Smoothie, cashews and raisins, low-fat ricotta cheese with peaches, hummus, and seed and nut snack bars. The diet also recommends four ounces of red wine in the evening with your meal. Red wine contains flavonoids, which help reduce your risk of developing cardiovascular disease.

Exercise

It’s really not that hard to fit in fitness. Every time you stand up and do something, you’re taking a step in the right direction. For heart patients, thinking of exercise as another medication that will be “taken” daily will have many positive health benefits. Keep in mind, the “best” form of aerobic exercise is the one that keeps you motivated, and the one you will continue to complete every day.

The American Heart Association encourages all adults to seek 30-minutes of daily activity or exercise. And what is the simplest form of exercise? Walking. “One of the best exercises for people is to walk. It’s an activity that people can get started easily, and it has the highest record for people being able to continue it. Often times we stop doing an exercise out of boredom, but walking is one of those exercises that you can do and have a high success rate,” states Dr. Benton. Walking for as little as 30 minutes a day can reduce your risk of coronary heart disease, improve your blood pressure and blood sugar levels, elevate your mood and reduce your risk of osteoporosis, cancer, and diabetes.

After a heart patient has been cleared by their physician to begin physical activity, an exercise physiologist will design a safe and valid exercise prescription. Most cardiac rehab programs focus on 5-6 weeks of building up to a goal of 30 minutes a day. Many heart patients have claudication, cramping of the leg muscles. For those individuals, we recommend walking as far as they can tolerate, stop, sit down and rest, and, when recovered, do it again. For a more detailed breakdown of what exercises and training would be recommended, click on the button below.

Communicate with your heart team

The doctor visits after a cardiac event are when caregivers can help their loved one either remember the questions they have about returning to work, eating, or activity. Caregiver, you should also prepare your own list of questions for the physician or care providers. It’s perfectly acceptable for you to share any concerns or changes you have observed in your loved one since their last visit. Your loved one may rely on you to help them recall points made during their appointment or discuss the treatment plan offered by the cardiologist.

Medications

It is important that heart patients adhere to medication regimens and as their doctor any questions. Capital Cardiology Associates offers Heart to Heart consultations, one-on-one meetings with a clinical pharmacist, Dr. Kate Cabral. Dr. Cabral can help your loved one remember to take medication by creating simple routines like a reminder on their phone or using a pill organizer. Heart patients and their caretakers can also use this time to ask questions on their medication if their pills are safe to take with over the counter supplements or learn about possible side effects. To make an appointment ask your doctor or call 518-292-6004.

Our patient portal offers you a way to stay connected with your loved one’s physician and care team without having to make a phone call. With an internet connection, you will have virtual access to your cardiologist and our cardiac team, who can answer questions on your medical records and prescriptions through a secure messaging platform.

A telehealth appointment is just like a regular appointment. Instead of visiting face-to-face, we use video cameras and monitors to connect, meaning you don’t have to travel to get the care you need. You will be able to see, hear, and talk to a cardiologist, advanced care provider, or cardiac specialist at our location through video-conferencing, allowing you to be at a medical facility, your home, or another location.

Care for yourself

According to the American Heart Association, caregivers have a higher risk for health and emotional problems. That’s because caregivers are less likely to focus on their own health by eating a healthy diet, being physically active, and addressing physical and emotional problems. Make sure that you are taking quality time for you. When you are overwhelmed or need help, there are resources!

Palliative care is a team assembled depending on your loved one’s needs, location, and situation. “The beautiful thing about palliative care is that it is not just one staff person or provider. It’s the amazing coupling of a nurse practitioner, physician assistant, or registered nurse and also a social worker,” notes Catherine Markey, Social Worker. A palliative team looks beyond the diagnosis to help patients live their best life while living with their disease. Dr. George Giokas is the chief medical officer of St. Peter’s Health Partners (SPHP) palliative care service line. “It’s rare for us to treat just one condition, like heart disease. Patients often have a mild element of emphysema, COPD, diabetes, or arthritis. As a team, we work with the provider to treat all of the patient’s problems.”

The American Heart Association has an excellent online support page for caregivers. Use the link below to find free support from other caregivers, read the stories of survivors, and share emotional support with others that have a loved one with a heart condition or stroke.