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VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mom (97 yr old) says that it hurts when Dr or anyone tries to take her blood pressure as the cuff is pumped up? I can't do it, the nurse can't do it. She won't let us. Now what?
Hi needtowashhair, yep you are correct then- the people using the wrist cuff do not follow those directions-that could be it. But in my experience no, the wrist monitors were not correct.
Shane1124, I have a variety of blood pressure meters including wrist meters. The wrist meters are just as accurate if used properly. A basic understanding of physics helps. In order to get the same reading in a pipe, you have to measure it at the same elevation. In the case of blood pressure, that's at the same elevation as the heart. For an arm cuff, that's easy. Where the cuff is on a hanging arm just happens to be at the same elevation as the heart. So to get the same reading with a wrist meter, you have to hold the meter at the same elevation as the heart. Most people don't do that. They just let their wrist fall down to a comfortable spot. Used properly, a wrist meter is just as accurate as an arm cuff. I can take a measurement with an arm meter and get the same reading with a wrist meter within a few points. No two readings will be exactly the same even on the same meter.
I’m interested in the posters’ questions about why this is necessary at all. I was diagnosed with high blood pressure, had lots of monitoring both at home and with the doctor (including one that went automatically for 24 hours and woke me up every hour in the night). I was put on medication that took a while to stabilise without causing other problems, but then got me down to ‘tolerable’. Since then I check occasionally at home to see if things are within my ‘normal’ range, and both myself and the doctor have stopped bothering much about it. My sister has been on similar drugs for about 30 years, and never checks at all herself. My mother had similar issues, including high cholesterol, so it appears to be genetic.
Checking blood pressure is one of those things that happens in hospital automatically, presumably because hospital patients are more likely to have a dangerous sudden change. I would ask more questions about why your mother needs to go through this frequently. Among other things, fear of pain is likely to put blood pressure through the roof all by itself!
I sympathize with mom! I have a fat upper arm with plenty of "waddle" under it. When that skin gets doubled over, it sends me over the top in agony. A large cuff helps as does not pumping it up so high - an automatic machine works much better for me because it does not keep going. These young assistants can't believe that my blood pressure is not sky high and try to pump it up to 200 and I end up screaming and in tears, which really does nothing for my bp accuracy. I'm interested in trying the cut off sleeve.
The wrist BP monitors are not accurate, in my experience. When I was a HomeCare RN I used to check mine against the wrist monitor’s reading and the wrist measurement was never correct. Also I didn’t have a BP machine working home care; I took all my pressures manually the “old fashioned” way. While I wasn’t always sure the patient’s BP machine was accurate I was happy if the family had a BP machine as at least they were trying to monitor BP. Many cardiologists take the patient’s blood pressure manually on office visits as well. Taking a blood pressure correctly is an art.
Thank you for your answers. I will check on a monitor that only goes a little higher than her pressure seems to be. She does have frail skin and I have wondered about the wrist cuff. I even thought of a FitBit type of thing, but don't know about the accuracy of them. I do know she has done some things for "attention," too so I wonder about the seriousness of the "pain." Sometimes she says it hurts before the nurse pumps the bulb twice. Bev
I think CW makes an excellent point, there. Unless you're in the middle of a crisis and your mother's BP has been rocketing around lately, I really would ask her doctor if these readings are worthwhile.
One other practical thing to mention - frail elderly skin on (sorry to be so disrespectful) often rather withered arms can easily get pinched in the cuff, and then of course it hurts like heck when the thing inflates. Jeanne's knitted sleeve should sort that out, but if it has happened before it might be that your mother is understandably anxious now and needs extra reassurance.
Uhm, at 97 what are you hoping to accomplish by taking her BP? When my mom had her medication changed I took readings often because I was afraid the doctor had made a mistake and her high BP would return and lead to a heart attack or stroke, but her doctor told me to stop worrying about it At that point - several years ago - mom was already considered palliative... she's 98 yrs old now.
People with Dementia or Alzheimer's often DO NOT LIKE having their blood pressure checked. They tend to get upset if anything is put on their arm that squeezes their arm; so part of your problem might be that your Mom's Dementia/Alzheimer's is causing her to complain that the BP cuff hurts. Many Memory Care Units use the wrist monitors knowing that the BP results that they get will most likely never be accurate, but that it gives them a general idea of what the persons BP might be.
Are you using a electronic BP monitor that automatically takes a blood pressure, do you do it the "old fashion way" with a BP cuff and stethoscope. If you are using an electronic BP monitor, you want to use a monitor that you can change how high the BP cuff is inflated--for example, on some models you can choose "120, 140, 170, or 200" as the highest number that the monitor will inflate to. Choose the number that is slightly higher than your Mom's usual BP results. Some monitors will re-inflate to a higher number if the number that you have chosen is not high enough to "read" your Mom's current BP.
I have had the same problem with wrist BP monitors as Jeanne has. They are not as accurate as a regular BP cuff/monitor and as MargaretMcKen states, they have to be held in a certain position.
Another suggestion, similar to what Jeanne experienced, is that you put a cut off shirt sleeve over your Mom's arm before checking her blood pressure. Use a light weight long shirt sleeve that is cut off at the shoulder (or a light weight long sock with the foot cut off), put it on your Mom's arm, and then place the blood pressure cuff on her arm. Make sure that the shirt sleeve is under the entire cuff and that the cuff is ABOVE the elbow.
Sometimes a person's upper arm is short and when a BP cuff is placed on the upper arm, the bottom of the cuff is either over the elbow or just slightly above the elbow. When the BP cuff is inflated, the pressure from the BP cuff pinches the elbow and it feels like you hit your "funny bone"-- only more painful and the pain lasts as long as the cuff in inflated. Have your Mom rest her arm on the arm of a chair or on the table while you are checking her blood pressure.
When I complained about the automatic blood pressure monitor in the ICU they brought me a soft knit tube to place on my arm under the cuff. I don't know if it really helped or just satisfied me that they were taking me seriously. This was device left on my arm and automatically squeezed every so-many minutes. I hated it! I asked if someone could just come in and manually take the measurement. No. They didn't have time for that, and they didn't even have a stethoscope in the unit. This was how they did it. Oh well. I lived through it.
I took my new wrist monitor into the doctor's office. After several tries I did not once get a reading remotely close to what the nurse and then the doctor got. Maybe I got a lemon.
As others have pointed out, use a wrist meter. Much more comfortable but it is much more sensitive to positioning. Also look into getting a meter that measures while it's inflating instead of an older style one that inflates and then meters while it deflates. Measuring when it's inflating is much quicker and more comfortable since it doesn't inflate up to an arbitrary pressure but only goes as high as is needed.
I use a wrist cuff monitor myself, top quality in our pharmacy, and it is far less uncomfortable than the doctor’s upper arm band. The monitor needs to be at the same height as the heart – automatic with the upper arm monitor, but you need to pick your hand up to heart level with the wrist monitor. It may not give exactly the same reading as the doctor’s monitor – after all the readings are different simply when you are lying down in bed. But if you use the same monitor consistently, it will show if things are different from ‘normal’, which is what really matters.
Sometimes if the blood pressure cuff is TOO SMALL it will squeeze the arm harder than if you use a LARGE size cuff. Also, if a person has REALLY HIGH blood pressure readings, then the cuff has to be pumped to a higher number which results in squeezing of the arm. There are wrist BP monitors, but they are not as accurate as the regular BP cuffs. Sometimes you have to hold your arm in a certain position to get an accurate reading.
You might try putting the blood pressure cuff on your Mom's forearm and see if it hurts when you attempt to check her blood pressure. Put stethoscope on inside of wrist over pulse.
I have a blood pressure cuff that works on my wrist - studies show it is very accurate. It is much more comfortable that the arm cuff. Just go to Amazon and search for wrist blood pressure.
I take my own each day, and it does hurt! The cuff gets so tight my arm just aches! It’s only for a few seconds, but it does hurt. If she has thin skin and skinny arms, it’s even more uncomfortable. Is this a daily thing? Does she suffer from low or high pressure?
Ask your doctor or nurse if there’s any other meter you can use. I seem to recall a wrist meter at one time. It may not be exactly on target, but if Mom is not in pain, it may be worthwhile.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Checking blood pressure is one of those things that happens in hospital automatically, presumably because hospital patients are more likely to have a dangerous sudden change. I would ask more questions about why your mother needs to go through this frequently. Among other things, fear of pain is likely to put blood pressure through the roof all by itself!
Also I didn’t have a BP machine working home care; I took all my pressures manually the “old fashioned” way. While I wasn’t always sure the patient’s BP machine was accurate I was happy if the family had a BP machine as at least they were trying to monitor BP.
Many cardiologists take the patient’s blood pressure manually on office visits as well.
Taking a blood pressure correctly is an art.
One other practical thing to mention - frail elderly skin on (sorry to be so disrespectful) often rather withered arms can easily get pinched in the cuff, and then of course it hurts like heck when the thing inflates. Jeanne's knitted sleeve should sort that out, but if it has happened before it might be that your mother is understandably anxious now and needs extra reassurance.
Are you using a electronic BP monitor that automatically takes a blood pressure, do you do it the "old fashion way" with a BP cuff and stethoscope. If you are using an electronic BP monitor, you want to use a monitor that you can change how high the BP cuff is inflated--for example, on some models you can choose "120, 140, 170, or 200" as the highest number that the monitor will inflate to. Choose the number that is slightly higher than your Mom's usual BP results. Some monitors will re-inflate to a higher number if the number that you have chosen is not high enough to "read" your Mom's current BP.
I have had the same problem with wrist BP monitors as Jeanne has. They are not as accurate as a regular BP cuff/monitor and as MargaretMcKen states, they have to be held in a certain position.
Another suggestion, similar to what Jeanne experienced, is that you put a cut off shirt sleeve over your Mom's arm before checking her blood pressure. Use a light weight long shirt sleeve that is cut off at the shoulder (or a light weight long sock with the foot cut off), put it on your Mom's arm, and then place the blood pressure cuff on her arm. Make sure that the shirt sleeve is under the entire cuff and that the cuff is ABOVE the elbow.
Sometimes a person's upper arm is short and when a BP cuff is placed on the upper arm, the bottom of the cuff is either over the elbow or just slightly above the elbow. When the BP cuff is inflated, the pressure from the BP cuff pinches the elbow and it feels like you hit your "funny bone"-- only more painful and the pain lasts as long as the cuff in inflated. Have your Mom rest her arm on the arm of a chair or on the table while you are checking her blood pressure.
I hope that these suggestions help.
I took my new wrist monitor into the doctor's office. After several tries I did not once get a reading remotely close to what the nurse and then the doctor got. Maybe I got a lemon.
You might try putting the blood pressure cuff on your Mom's forearm and see if it hurts when you attempt to check her blood pressure. Put stethoscope on inside of wrist over pulse.
Ask your doctor or nurse if there’s any other meter you can use. I seem to recall a wrist meter at one time. It may not be exactly on target, but if Mom is not in pain, it may be worthwhile.