Editor`s Page: Quality of Life

Many factors can affect an individual’s quality of life, from medical problems to other life factors, such as social bonds and hobbies. The articles in this month’s issue of Annals of Long-Term Care: Clinical Care and Aging (ALTC) focus on reports that touch upon various aspects of quality of life.

Many of us take basic abilities/functions for granted, at least until these abilities/functions become impaired. In “Treating Intermittent Claudication Caused by Peripheral Arterial Disease,” Wilbert S. Aronow, MD, CMD, an ALTC editorial advisory board member, discusses the case of an elderly woman whose mobility was significantly impaired by intermittent claudication from her peripheral arterial disease (PAD). Aronow uses this case to discuss how to evaluate patients with PAD and intermittent claudication, and outlines steps that can be taken to reduce leg pain, which can help restore a patient’s mobility. While not all patients with PAD will have leg symptoms, a study from 2004 showed that many persons with PAD will have impaired function and a reduced quality of life (www.ncbi.nlm.nih.gov/sites/entrez/15280343), highlighting the importance of assessing for PAD, especially in high risk patients, such as those with diabetes.

For those facing the end of life, quality of life may be neglected. In “Hospice as a Care Option in Long-Term Skilled Nursing Care,” the authors emphasize the importance of increasing the awareness of the Medicare Hospice Benefit (MHB) among those serving the long-term care community, as the MHB is currently being underutilized, but can significantly improve the quality of life of terminally ill residents. For example, the authors note that hospice patients will have access to medications and pain-relieving therapies that may not otherwise be available to them, and the hospice patient’s family can receive up to 13 months of bereavement counseling following the patient’s death; thus, the MHB can help ensure access to dignified care at the end of life for patients, while helping the family to cope with the loss of their loved one.

One thing many of us delight in, especially around the holidays, is the gastronomic experience. In “Alpha-1-glucosidase Inhibitor Prevents Syncope Associated with Postprandial Hypotension,” the authors report the case of an elderly female patient who suffered from syncope following meals, which caused her to feel weak and to spend a considerable amount of time in bed. After all approved treatments failed, the authors conducted an off-label N of 1 trial of miglitol to treat her postprandial hypotension, which was associated with her syncope. Following this treatment, the patient experienced no further syncopal or presyncopal episodes, her alertness and level of interaction with the nursing home staff improved, and her appetite returned, allowing her to enjoy her meals once again.

As clinicians, we often work in harried and stressful environments, which can impact our quality of life. Having a hobby can provide us with enjoyment and allow us a healthy outlet to relieve stress. In our last article, “Doctor Guitar,” the author talks about his love of playing the guitar and how this hobby allowed him to recapture his youth, at least for one night.

As this year concludes, the staff of ALTC would like to wish you a joyous holiday season and much health and happiness in the coming year. We hope you enjoy this issue of ALTC and, as always, we appreciate hearing from our readers. Feedback on the articles in this issue or suggestions for topics you would like to see covered in future issues can be sent via e-mail to our editorial director, Christina Loguidice, at cloguidice@hmpcommunications.com.