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As caregivers, you may find yourself feeling like you need to be a medical expert in a very complex situation. Not only do you care for a loved one with dementia, but they may also have other medical problems requiring doctors’ visits, medications, and maybe even daily blood pressure or blood sugar checks.
Here, we’ll break down some of the basics of medical diagnoses that can help you manage doctor’s appointments and your loved one’s many needs.

First, a quick review of the body: Oxygen is what gives us life. We get oxygen from the air we breathe through our lungs. The heart is what connects to your lungs to obtain oxygen for the body to use, then sending that blood out through the entire body through tubes called arteries. Once your body uses the oxygen, other tubes, called the veins, transport the blood back to the heart to get oxygen again. Arteries have a stronger pressure system, while veins have a weaker pressure system. Therefore, anything affecting your lungs, heart, veins, or arteries is going to affect your entire body.

Heart Specific Issues

The heart is comprised of four chambers and four valves. Blood is pumped between each chamber. The top two chambers are the atria. The bottom two chambers are the ventricles. These parts work together to obtain oxygen from the lungs and send it out to your body.

Atrial Fibrillation (A Fib)

Fibrillation is when upper chambers of the heart pump too fast to keep up with the lower chambers of the heart.

Mitral Valve Prolapse (MVP)
Valve issues occur when the valve is not opening or closing all of the way between the chambers of the heart. This can happen to any of the valves, but MVP is very common to find.

With both A Fib and MVP, blood pools because it’s not moving through the heart properly, increasing the risk for clots to form. Thus, a loved one may need a medication such as Warfarin or Clopidogrel to prevent blood clots.

Another thing to remember is that the heart itself as a whole organ is a muscle and must also be nourished by special arteries called coronary arteries which bring oxygen to the heart muscle to help it work. These live on the outside of the heart muscle. Unfortunately, disease can affect coronary arteries at times, too.

Coronary Artery Disease (CAD) and Congestive Heart Failure (CHF)

CAD is when the arteries that bring oxygen to help the heart muscle work are clogged or stiff making the blood flow insufficient for what the heart needs. This can lead to a heart attack (Myocardial Infarction or MI) which can cause certain parts of the heart muscle to stop working. This can be life threatening and cause lifelong changes to how well the heart works in the future. This issue can also lead to Congestive Heart Failure or CHF, which is when the heart is too weak to pump out blood to the body effectively. It can affect either side of the heart and each side can present different symptoms.

Lung Issues

Lungs are two large sacs that connect via different tubes to where air comes in through the mouth. Inside the lungs veins and arteries grab oxygen and take that blood to the heart to then take that oxygenated blood throughout the body. In addition, the lungs have their own system of tubes that look like trees with many small branches that take the air we breathe in. There are a few diseases that affect those tubes.

COPD: Chronic obstructive pulmonary disease (COPD) and Asthma

COPD, often caused by smoking, is a disease when lung tubes are swollen or clogged making breathing difficult and the body struggles to get oxygen. Medication may help with this issue, but the tubes stay in a diseased state.

Asthma differs since medication can correct the issue helping the tubes open back up fully. Medication may be prescribed daily or as needed depending what factors cause the tubes to swell.

Sleep Apnea

When someone’s breathing frequently pauses during sleep occur, this is known as Sleep Apnea. This is usually due to dysfunction of throat muscles, which decreases the amount of oxygen you are able to take in.

Circulatory Issues

Let’s talk about diseases or temporary conditions of the veins and arteries that can affect the amount of oxygen different parts of the body receive.

Hypertension (HTN)

Blood pressure refers to the pressure your arteries use to push blood out from the heart to other parts of your body.

Hypertension: Blood Pressure is too high in arteries

Hypotension: Blood Pressure is too low in arteries

How to read a blood pressure reading:

• Systolic/Diastolic = Top number/bottom number
• Normal blood pressure is less than 120/80 but greater than 90/60

When checking blood pressure, ensure the person is seated without legs or ankles crossed. If a regular cuff seems tight when wrapping it around the arm, or keeps popping off when the cuff inflates, try a larger cuff. Some monitors come with two size cuff options.

Chronic Kidney Disease

When blood flow is impaired to the kidneys due to HTN or heart issues, this will affect the body’s total fluid balance and ability to filter waste material from the body into the urine.

Clots Category

Clots can form when blood pools anywhere in the body. Types of clots vary depending on where they reside in the body or if they travel to different parts of the body. A thrombus is a clot that has not moved from where it started. An embolus is when the clot breaks free and travels away from where it started.

• TIA (Transient Ischemic Attack) is a “mini stroke” that usually does not cause severe lasting effects and can be short lived when a clot travels to the brain
• CVA (Cerebrovascular Accident) is the classic stroke we think of that can be life threatening and generally causes lasting effects to cognition or mobility dependent on what part of the brain the clot effects (strokes can also be caused by weakened vessels in the brain)
• DVT (Deep Vein Thrombosis): this type of clot does not move and is usually found in the leg veins. It blocks blood flow locally but can easily travel and turn into an embolus.
• Pulmonary Embolus (PE): when a clot travels to the lungs

Veins are a low-pressure system that takes blood back to the heart. Walking is so important, because it provides more momentum for the blood to move its way back to your heart through the veins and not sit and pool. Walking or pumping your feet and calves can help with clot prevention in a big way!

Common Hormonal Diseases

Hypothyroidism

The thyroid isn’t producing enough thyroid hormone to maintain a healthy metabolism which affects skin, hair, digestion, and energy levels.

Diabetes-Type 2

This is when the body is unable to process blood sugar effectively and is related to a hormone called insulin, produced by the pancreas.

Insulin works as a key to let blood sugar go where it needs to. With diabetes, the sugar builds up and causes damage to the veins, arteries, and kidneys trying to manage the large amount of sugar. Diabetes can be maintained but varies greatly from person to person on proper treatment. Some may need insulin injection replacements.

As you navigate the medical challenges for your loved one, please remember we are here to help. Keeping regular doctor’s checkups and making sure to walk are some of the general best steps you can take to help manage most medical issues. Make sure you have a doctor who listens and understands. Check out our blog post on how to communicate at the doctor’s office.

WRITTEN BY KATIE FOWLER, NURSE