Atrial Fibrillation is a troublesome condition which is common in elderly people. AF affects 5% of the population aged over 65 years old and 10% of those over 75. There is an increased risk of stroke for these older patients so it’s important that AF is properly managed.
How to manage atrial fibrillation in the elderly?
If you have AF, your heart beats irregularly and doesn’t pump blood through your heart and body the way it should. Because of this, blood can pool in certain parts of your heart and form a blood clot. If a blood clot breaks away from your heart and gets stuck in a blood vessel in your brain, it can cause a stroke. Alternatively, if the clot gets stuck in a blood vessel in an arm or leg, it can stop blood reaching those tissues, known as a peripheral embolus.
To prevent clots and strokes in people with AF, doctors often prescribe medications known as “anticoagulants”. These drugs include rivaroxaban, apixaban, dabigatran, edoxaban and the older drug warfarin. These drugs help prevent blood clots from forming and may help prevent existing clots from growing larger.
Tips for Atrial Fibrillation Caregivers
Check if heart rate and rhythm are under control
Two primary approaches to treating atrial fibrillation are making sure the heart rate is not too fast, and checking to see if the heart is in normal rhythm (out of atrial fibrillation). To do this requires a pulse check.
If you are caring for someone being treated for AFib using rate controlling medication like beta or calcium channel blockers, or digoxin, ask clinic staff to teach you how to perform a manual radial pulse check or a check of the pulse in the neck (the carotid pulse). This helps to identify whether treatment is controlling AFib or the heart rate in AFib.
Know the signs of a stroke
As the likelihood of having atrial fibrillation increases with age, so does the risk of AF related stroke. For this reason, cardiology specialists emphasise how critical the early detection of stroke is. As a caregiver, you are well places to spot a stroke and get help F-A-S-T.
Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have dropped.
Arms – the person with a suspected stroke may not be able to lift both arms and keep them there because of arm weakness or numbness in one arm.
Speech – their speed may be slurred or garbles, or the person may not be able to talk at all despite appearing to be awake.
Time – it is time to dial 999 immediately if you see any of these signs or symptoms.
Avoid Medication Overload
As a caregiver, you are often responsible for helping patients keep up with their medications. But this task can be challenging. Many patients with Atrial Fibrillation will be taking other prescription medications for additional conditions too like diabetes or hypertension.
Try the following measures to help avoid the risk of dangerous drug interactions:
- Keep a detailed list of the patients medication, including information about dose and frequency.
- Report any drug side effects to the patient’s healthcare practitioner
Keep up with lifestyle adjustments
Many things can influence treatment for atrial fibrillation. Some foods e.g. spinach, avocado & grapefruit juice and supplements like fish oil or can affect the anticoagulant effect of warfarin, a common blood thinner used in atrial fibrillation treatment. The following lifestyle adjustments are recommended for people with atrial fibrillation that caregivers can support:
- Avoid or reduce intake of alcohol and caffeine
- Reduce or maintain weight
- Follow a low sodium and low fat diet
- Be as active as possible
- Engage in activities that reduce stress, like yoga, breathing exercises, since stress is also a trigger for atrial fibrillation. (Find out more unexpected triggers for atrial fibrillation here)
- Stop smoking