TIA Ministrokes Can Lead to a Major Stroke! Pay Attention to the Symptoms

 
Three years before he died, my husband had a major stroke while playing golf.  He was rushed to the hospital, treated quickly, and had minimal lasting effects from it.  However, we did not realize at the time that this would be the beginning of many more such events. Over the next few years, he suffered through a number of mini-strokes or TIAs.  In his case, they often took the form of losing his vision in one eye for a few minutes.  Because of other medical problems he had, the doctors were limited in the ways they could treat him, and they could not put him on blood thinners. After one of his mini-strokes, a year after that first major one, a surgeon cleared out his right carotid artery, although that was a dangerous surgery for my husband.

Meanwhile, all we could do was keep track of his blood pressure, limit the salt in his diet, and try to minimize the frequency of these mini-strokes.  We also attempted to learn everything we could about these small strokes.

Transient Ischemic Attack (TIA), often referred to as a "ministroke," is a medical condition that demands immediate attention and understanding. While it may seem less severe than a full-blown stroke, TIAs should not be taken lightly. Let's explore what a TIA is, its symptoms, causes, and available treatments.

What is a TIA (Ministroke)?

A Transient Ischemic Attack (TIA), commonly called a "ministroke," occurs when there is a temporary disruption of blood flow to a part of the brain. Unlike a full-blown stroke, which frequently causes permanent brain damage, a TIA usually resolves itself within minutes to hours, leaving no lasting damage. Sometimes, people do not even realize they have had one. However, it is essential to recognize them, as they can often be a warning that a more severe stroke may be imminent.  Looking back, I have often wondered if we missed the signs of mini-strokes which might have occurred before my husband's major stroke.  He often complained of headaches, visions problems, and vertigo.  Could that have been the beginning?  I'll never know.

Symptoms of TIA

The symptoms of a TIA are similar to those of a stroke but are temporary and typically last for a short period, usually less than 24 hours. Common TIA symptoms include:

Sudden Weakness or Numbness: This may affect the face, arm, or leg, often on one side of the body.

Difficulty Speaking or Understanding Speech: TIAs can cause slurred speech or difficulty in finding the right words.

Loss of Coordination or Balance: Patients may experience unsteadiness or difficulty in walking.

Vision Problems: Blurred or double vision, sudden loss of vision in one or both eyes, or difficulty seeing clearly may occur.

Severe Headache: A sudden, severe headache might develop in some cases.

My husband suffered from all four of the above symptoms, and they would happen suddenly, without warning.  Often they happened when we were simply relaxing, watching television together.  At other times, they happened when he was pushing himself to use his walker to get into a doctor's office.  Those events sometimes caused him to fall. 

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Causes of TIA

The root cause of a TIA is a temporary disruption in blood flow to the brain, usually caused by one of the following factors:

Atherosclerosis: The buildup of fatty deposits (plaques) in the arteries can lead to narrowing or blockage of blood vessels, reducing blood flow to the brain. This is what they believed was causing the mini-strokes which my husband experienced. 

Blood Clots: A blood clot can form and temporarily block an artery in the brain.

Emboli: Small clots or debris from elsewhere in the body can travel to the brain and block a blood vessel.

Vasospasm: Spasms in blood vessels can constrict and temporarily reduce blood flow to the brain.

Cardiovascular Conditions: Conditions like atrial fibrillation, heart valve disorders, and heart infections can increase the risk of blood clots, which can lead to TIAs.

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Treatment and Prevention

Prompt medical attention is crucial when experiencing any type of stroke symptoms, including TIA symptoms. Even though the symptoms may resolve on their own, the underlying causes need to be addressed to prevent a full-blown stroke. Treatment options include:

Medications: Doctors may prescribe anti-platelet drugs (e.g., aspirin) or anticoagulants (blood thinners) to reduce the risk of blood clots.

Surgery: In some cases, surgical procedures such as carotid endarterectomy (to remove plaque from the carotid artery) or angioplasty (to open narrowed arteries) may be recommended.

Lifestyle Changes: 

Patients are often advised to make lifestyle changes such quitting smoking, adopting a heart-healthy diet, exercising regularly, and managing conditions like high blood pressure and diabetes.

Medication for Underlying Conditions: Treating underlying conditions such as high blood pressure and high cholesterol can help reduce the risk of future TIAs.

Conclusion

While TIA symptoms may be temporary, they should not be ignored. TIAs serve as crucial warning signs for potential future strokes, which can be debilitating or fatal. Seeking immediate medical attention, understanding the underlying causes, and adopting preventive measures can greatly reduce the risk of experiencing a full-blown stroke. In the face of TIA symptoms, quick action can make all the difference in preserving your health and well-being.  

Check out the sources at the end of this article to learn more about ministrokes.  In addition, talk to your health care provider about any symptoms you may have, no matter how minor they may be.

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Sources:

Mayo Clinic: The Mayo Clinic website provides comprehensive and up-to-date information on TIA symptoms, causes, and treatment. You can find information at www.mayoclinic.org.

American Stroke Association: The American Stroke Association, a division of the American Heart Association, offers valuable resources on strokes and TIAs. Visit their website at www.stroke.org.

National Institute of Neurological Disorders and Stroke (NINDS): NINDS, a part of the National Institutes of Health (NIH), provides detailed information on TIAs and related research. You can explore their content at www.ninds.nih.gov.

WebMD: WebMD is a reputable health information website that covers a wide range of medical topics, including TIAs. Their page on TIAs can be found here.

You Can Also Learn More from Your Healthcare Provider: Always consult with a qualified healthcare professional or neurologist for personalized information and guidance regarding your specific health condition and any recent developments in the field of stroke and TIA management.

Please verify the most current information from these sources or consult with a healthcare provider for the latest updates on TIA symptoms, causes, and treatment options.

If you are interested in learning more about saving money, financial planning, Social Security, Medicare, where to retire, common medical issues as you age, travel and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.

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Expand Your Home and Welcome Family Members

 

With the high cost of housing in much of the United States (as well as other countries), many people are looking for ways to accommodate more family members in their existing properties.  Whether your new college graduate has returned home (but unhappy living in their childhood bedroom), or your aging parents are no longer able to live on their own, you may be wondering how you can find a way for multiple generations to live happily together in one house.  

There are many more choices available today than in the past.  In fact, some home builders are building new homes which contain a private apartment with a separate entrance for other additional relatives. I have a friend who moved into her own separate apartment in her adult daughter's home, and it has worked out well. She loves having a separate life, while being close to her daughter and grandchildren. However, if you do not want to sell your current home and move to a new location, how can you make the best use of the home and property you currently own?  Here are some ideas to get you started.

Accessory Dwelling Units (ADUs)

Many cities have now altered their zoning laws to allow people to build an accessory dwelling unit on a single family lot.  This has resulted in a new industry of "tiny homes" which even be purchased on sites like Amazon or from companies like Home Depot, although you have to arrange to have someone pour a slab or build a foundation, in advance, and then finish out the interior.  

Some people who are skilled at do-it-yourself work, can finish out the structures on their own.  However, most of us will need to hire a contractor to finish these buildings, including hooking up the plumbing and electricity.  

These small, backyard homes, sometimes called "granny flats" can be the perfect solution for a young adult who has returned home, or for an older family member who wants to live close to the family, but cannot afford to buy a home in the same neighborhood.  Depending on the size and amenities, they can be built and finished for about $60,000 to $250,000.

Creating a Guest Suite Inside Your Current Home

If you do not have a backyard large enough to accommodate an additional housing unit, you may be able to carve out an apartment inside your existing home.  For example, do you have an unused bedroom, dining room or formal living room next to a bedroom with a bath?  With a little redesigning, you could convert this combination into a nice little private apartment inside your current home.  Add a separate entrance and a little kitchenette, and everyone could have both the independence and the privacy they want, at an affordable price.  Many such conversions can be done for under $25,000 to $30,000, depending on how elaborate they are. 

Garage Conversions into Housing Units

If your zoning laws permit it, you may be able to convert a garage into a secondary housing unit.  This is more likely to be allowed if the garage is detached.  However, in some circumstances, even an attached garage might be converted into a cozy 300 sq. foot apartment for a family member.  Since a garage already has easy access to electricity, and plumbing is probably not too far away, the conversion could be less complicated than building an entirely new building.  The amount you spend depends on the current condition of the garage, and how fancy you wish to make it.  However, it can be a convenient way to accommodate additional family members. 

Basement Conversions

Even when I was a young woman living in the Midwest in the 1960s and 1970s, many parents set up space in their finished basement for an adult child to have their own space.  This choice is better suited to young adults, because of the stairs.  However, a healthy older person might also be able to navigate a staircase.  If the basement has an outdoor entrance, this can be particularly appealing, since it will allow for them to come and go, or entertain friends, without the need to walk through the main living area upstairs.  This is a great solution for a young adult who is just starting out and trying to save money for their own place.  In addition, many families have already finished out at least part of their basement, plus the electricity and plumbing is already available, and it may take very little effort to turn the space into a cozy apartment. 

Get Professional Design and Construction Help

Once you realize that it is possible to carve out some unused space within your home, garage, basement, or backyard for a separate apartment or housing unit, it is smart to get some professional help.  You will want to maximize the space, give everyone a sense of privacy, and make sure the new housing unit has safety features, especially if it is going to accommodate someone who is aging.  Ask about things like grab bars in the shower, or a walk-in bathtub.  You may want to have an intercom system between the two housing units, or a fall alert system.  The safer the new housing unit is, the more comfortable everyone will be. 

Include Study Area or Workspace

In addition to making sure that your new living quarters have space for cooking, eating, sleeping and watching television, make sure it also includes a small office space for studying or working.  Many people are able to work from home today.  Even if they do not officially work at home, almost everyone needs access to WiFi and plenty of electrical outlets for their computer and charging all their electronic devices. Whether the space is intended for a young adult starting out in life, or a senior citizen, it is important to make sure their living quarters have everything they need, including a workspace.  If you can accommodate a favorite hobby, or space for plants, a pet, or other activities, they will be even happier and more comfortable during the time they live there.

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Dangerous Healthcare Aide Shortages in Private Homes and Skilled Nursing Homes

 About two years before my husband died of kidney disease, he reached the point in his health decline where we decided to hire an aide to help him.  It took four tries before we found an aide who met our needs and our schedule ... someone who could take care of my husband's personal needs, and also drive him to his many medical appointments.  One of the reasons it was so difficult was because there is such a serious shortage of healthcare aides, not just in our area but across the country. 

The demand for healthcare services has risen as the population has gotten older and healthcare needs have become more complex. This has resulted in a shortage of healthcare aides in both homecare settings and skilled nursing facilities. The problem has become so severe that a June, 2022 survey of 759 nursing home providers by the American Health Care Association showed that 60% of them have had to limit new admissions because of staffing shortages. They are competing against companies such as fast food restaurants, and stores like Target and Walmart for the same pool of employees.  It is hard to attract employees because many young people would rather not work with the sick, elderly and dying.

This is especially unfortunate because healthcare aides play a vital role in providing essential care and support to individuals with physical or cognitive limitations.  This is a serious problem for people who do not have a spouse or other relative who is able to help care for them.  I do not think I could have handled all my husband's physical needs without our aide.  Many other sick and elderly caregivers feel the same way.  What is causing this shortage of healthcare aides, and what are some of the possible solutions?

Causes of Healthcare Aide Shortages: 

Aging Population: The aging population is the major reason for our shortage of healthcare aides. We simply do not have enough young people to handle all the jobs expected of them, and most of them prefer to go into better paying occupations when they can. At the same time, Americans are living longer and the demand for long-term care services, including home care and skilled nursing facilities, has increased significantly. According to the U.S. Census Bureau, the number of Americans aged 65 and older is projected to reach 98 million by 2060, nearly doubling the current 2024 population in this age group. 

High Turnover Rates: The healthcare aide profession often experiences high turnover rates. Factors such as physically demanding work, low wages, and limited career advancement opportunities contribute to this issue. Many healthcare aides find it challenging to sustain their careers over the long term, leading to increased vacancies and understaffing.  I understand this problem.  Our current aide works for us five hours a day, three to four days a week, but he also works nights several times a week in a skilled nursing facility.  He is forty years old.  How long will he be able to maintain a schedule like that?  If a better opportunity becomes available to him, he is certain to take it. 

Inadequate Training and Education: Inadequate training programs and limited educational opportunities also contribute to healthcare aide shortages. The lack of standardized training programs in different regions of the country reduces the availability of qualified healthcare aides.  Many people do not want to pay to take the necessary basic classes to become a healthcare aide, when they can start work immediately at a department store or fast food restaurant without spending their own money to get trained.

The Emotional Toll on Caregivers: When my husband died, our caregiver told one of our daughters that he did not think he could ever take on another private patient.  In the nearly two years that he worked with my husband, they had become very attached to each other. He would take my husband to Starbucks for a treat.  Sometimes, he would take him for a drive along the beach.  Our caregiver lost more than a part-time job when my husband died.  He lost a friend.  It was as devastating for him as it was for our family.

As a result of these problems, some people resort to hiring poorly trained or untrained aides, often just an unemployed friend who knows nothing about caregiving.  This may be OK if the patient only needs someone to watch over them, help them dress, or fix their lunch.  However, in an emergency, you need to be certain they will know what to do.  You need to be sure they know CPR, how to take someone's blood pressure, keep track of medications, bath them, keep the patient from falling, be able to transfer them to a wheelchair, and when to call 9-1-1 when something seems wrong.  For that, you need a trained healthcare aide, and they can be difficult to find.

Consequences of Healthcare Aide Shortages: 

Decreased Quality of Care: The national shortage of healthcare aides can result in a lower quality of care for patients who need assistance, either at home or in a skilled nursing facility. With inadequate staffing levels, healthcare providers such as skilled nursing homes may struggle to meet the needs of their patients or residents, leading to compromised care and reduced patient satisfaction. While my husband has me, our daughters, and his aide to provide him with the care he needs, skilled nursing homes may have one aide who works with several different people.  When they are short-handed, or a caregiver becomes ill and cannot show up to work, it creates a problem for all these patients.

Increased Workload for Existing Staff: Staff shortages place an additional burden on the existing healthcare aides and other staff members, leading to increased workload and stress. Overworked healthcare providers may become more prone to burnout, potentially compromising their own well-being and job performance. They may also be more likely to leave their jobs, which will only make the staff shortages worse.

Higher Healthcare Costs: The shortage of healthcare aides may eventually drive up healthcare costs, because the higher demand for services can result in higher costs for both home care and skilled nursing services as they both compete for the same workers. This can increase the financial strain on individuals, families, and the healthcare system as a whole. 

Potential Solutions

Increased Training Opportunities: One way to solve this problem is by expanding affordable, convenient training programs for healthcare aides. State and federal governments and healthcare organizations should work together to develop standardized training programs and increase funding for education in this field so that the necessary training is free and easy to obtain. Then, people who are interested in becoming healthcare aides can learn the skills they need to meet the growing demand.  

Improved Pay and Benefits: Offering competitive wages and benefits to healthcare aides would enhance their job satisfaction and help keep them working in the field. Adequate pay would attract more people to pursue careers in this field and encourage the existing healthcare aides to stay in their jobs. In addition, skilled nursing facilities need to provide opportunities for career advancement, such as helping their workers obtain more education and specialized certifications, including working towards becoming vocational nurses.  This would make the aides more useful to the facilities where they work, and help ease shortages in other healthcare positions. 

Seek Young, Healthy Immigrants Who are Interested in Healthcare Careers:  Another option is to recruit immigrants from other countries who are interested in being trained and working in this field. Currently, 28% of U.S. doctors and surgeons, and 24% of U.S. nurses and home health aides are immigrants.  This number may need to be expanded in order to provide enough caregivers for our aging population.  We may need to actively solicit and recruit caregivers in foreign countries. Our caregiver was from the Philippines, and he was very compassionate and good at his job.

Utilizing Technology and Automation: Although many Baby Boomers and older Americans will groan and resist this suggestion, it could be helpful if more healthcare facilities and patients would embrace technological advances, such as assistive devices and remote monitoring systems.  Automation can streamline many tasks, and allow healthcare aides to focus more on direct patient care. 

Using technology in homes and skilled nursing facilities would also increase efficiency and improve the quality of the care provided, potentially reducing the need for additional staffing.  One example of this is giving patients a fall monitor they can wear.  My husband wore one whenever I left the house if he was going to be left home alone.  I would be alerted if he fell, and the device automatically would call 9-1-1, unless he was conscious and pushed a button to stop the alarm. This brought us both peace of mind. 

Other types of technology include using Tiles or Apple tags on the belongings of senior citizens, so they can quickly be found if they wander away from their home or skilled nursing facility.  Door alarms can also notify workers if an outside door is opened unexpectedly.   Technology can make it easier for a senior citizen to be taken care of at home, or for one healthcare aide to supervise more patients in a facility at the same time.

By implementing these potential solutions, we can ensure adequate staffing levels, enhance the quality of care provided, and meet the growing healthcare needs of our aging population. 

Enjoyed this post? Never miss out on future posts by following us.  You will receive one weekly email containing the most current post. 

If you are interested in learning more about financial planning, Social Security, Medicare, where to retire, common medical issues as you age, travel and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.

Disclosure: This blog may contain affiliate links. If you decide to make a purchase from an Amazon ad, I'll make a small commission at no extra cost to you.

You are reading from the blog:  http://www.baby-boomer-retirement.com

Photo credits: Pixabay Images and the author's Etsy store.

Citations:

U.S. Census Bureau. (2018). Older People Projected to Outnumber Children for First Time in U.S. History. 

Centers for Disease Control and Prevention. (2019). The Burden of Chronic Diseases and Their Risk Factors: National and State Perspectives. 

Buerhaus, P. I., et al. (2009). Implications of an Aging Registered Nurse Workforce. JAMA, 304(11), 1148–1155.

Buerhaus, P. I., et al. (2020). The U.S. Nursing Workforce: Trends in Supply and Education. Health Affairs, 39(8), 1345–1352.

Stimpfel, A. W., et al. (2019). A Multistate Examination of Nurse Staffing Levels, Nurse Workforce Composition, and Hospital-Acquired Conditions. Medical Care, 57(5), 372–379.

Hsiao, C. J., et al. (2014). Costs Associated with Health Care–Associated Infections in Veterans Affairs Hospitals. JAMA Internal Medicine, 174(5), 770–776.

Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. National Academies Press.

Stone, R. (2019). Expanding and Strengthening the Direct Care Workforce for the Elder Boom. Journal of Aging & Social Policy, 31(5), 430–450.

Hwang, J., et al. (2019). The Benefits of Health Information Exchange: An Updated Systematic Review. Journal of the American Medical Informatics Association, 26(10), 1087–1092.

Applebaum, R., et al. (2012). Nurse Burnout and Patient Safety Outcomes: Nurse Safety Perceptions Matter. American Journal of Infection Control, 40(6), 596–603.

Oldenburg, Ann (2022) Worker Shortage Crisis Hits Home, AARP Bulletin, November 2022