Syncope in older adults

 Syncope in Older Adults - What You Need to Know

Or why are you fainting?

What is syncope?

Syncope is also called fainting or passing out. Syncope is a sudden, temporary loss of consciousness, followed by a fall from a standing or sitting position. A syncope episode is usually short.

What causes or increases my risk for syncope?

Syncope is caused by a decrease in blood flow to the brain. When blood flow to the brain decreases, oxygen to the brain also decreases. Any of the following conditions may cause syncope:

Medicines such as blood pressure medicine or antidepressants, or use of multiple medicines

A medical condition such as severe anemia, a nerve disorder, asthma, or hyperventilation (breathing too quickly)

A heart condition, such as a narrow artery or an irregular heartbeat

Dehydration

Problems with the blood vessels of your brain

Bleeding, especially in your stomach or intestines, or a blood clot that passes through your lungs

A rapid drop in blood pressure after a body position change, such as moving from lying to sitting or standing

Straining during bowel movements, a cough or sneeze, or a stressful or fearful situation

What signs and symptoms may occur before syncope?

Cold, clammy, and sweaty skin

Fast breathing and a racing, pounding heartbeat

Feeling more tired than usual

Nausea, a warm feeling, sweating, and lightheadedness

A headache or dizziness

Tingling sensation or numbness

Spots in front of your eyes, blurred vision, or double vision

How is the cause of syncope diagnosed?

Your healthcare provider will examine you and ask about your symptoms. Tell your provider everything you know about your syncope episode. Include where you were when you fainted and what you were doing before symptoms started. Your provider will ask about your medical history, including any heart conditions in your family. Ask anyone who saw you faint to come with you to tell the provider details of what happened. Your provider may order the following tests to find out what is causing your symptoms:

Blood tests may be done to find the cause of your syncope.

Telemetry is continuous monitoring of your heart rhythm. Sticky pads placed on your skin connect to an EKG machine that records your heart rhythm.

An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart.

A stress test may show the changes that take place in your heart while it is under stress. Stress may be placed on your heart with exercise or medicine. Ask for more information about this test.

A Holter monitor is also called a portable electrocardiography (EKG) monitor. It shows your heart's electrical activity while you do your usual activities. The monitor is a small battery-operated device that you wear. It will show how fast your heart beats and if it beats in a regular pattern. Your provider may recommend this if you have syncope often over 2 to 3 days.

How is syncope treated?

Treatment depends on the cause of your syncope. To prevent syncope from happening again, you may need any of the following:

Medicines may be needed to help your heart pump strongly and regularly. Your healthcare provider may also make changes to any medicines that are causing syncope.

Tilt training involves training yourself to stand for 10 to 30 minutes each day against a wall. This helps your body decrease the effects of posture changes and reduces the number of fainting spells.

What can I do to manage syncope?

Keep a record of your syncope episodes. Include your symptoms and your activity before and after the episode. The record can help your healthcare provider find the cause of your syncope and help you manage episodes.

Sit or lie down when needed. This includes when you feel dizzy, your throat is getting tight, and your vision changes. Raise your legs above the level of your heart. Your provider may also recommend that you keep the head of your bed elevated. This can help keep your blood pressure from dropping too low.

Check your blood pressure often. This is important if you take medicine to lower your blood pressure. Check your blood pressure when you are lying down and when you are standing. Ask how often to check during the day. Keep a record of your blood pressure numbers. Your provider may use the record to help plan your treatment.

Use assistive devices as directed. Your provider may suggest that you use a cane or walker to help you keep your balance. You may need to have grab bars put in your bathroom near the toilet or in the shower.

What can I do to prevent a syncope episode?

Know and avoid your triggers. Certain events may bring on syncope. These events may cause you to feel under pressure, upset, or fearful. When you feel the symptoms, you can make movements to prevent a syncope episode. For example, make a fist, cross your legs, squeeze your thighs together, or tighten your arm muscles.

Move slowly and let yourself get used to one position before you move to another position. This is very important when you change from a lying or sitting position to a standing position. Take some deep breaths before you stand up from a lying position. Stand up slowly. Sudden movements may cause a fainting spell. Sit on the side of the bed or couch for a few minutes before you stand up. If you are on bedrest, try to be upright for about 2 hours each day, or as directed. Do not lock your legs if you are standing for a long period of time. Move your legs and bend your knees to keep blood flowing.

Follow your healthcare provider's recommendations. 

Your provider may recommend that you drink more liquids to prevent dehydration. You may also need to have more salt to keep your blood pressure from dropping too low and causing syncope. Your provider will tell you how much liquid and sodium to have each day. Your provider will also tell you how much physical activity is safe for you. This will depend on what is causing your syncope.

Watch for signs of low blood sugar. These include hunger, nervousness, sweating, and fast or fluttery heartbeats. Talk with your provider about ways to keep your blood sugar level steady.

Do not strain if you are constipated. You may faint if you strain to have a bowel movement. Walking is the best way to get your bowels moving. Eat foods high in fiber to make it easier to have a bowel movement. Good examples are high-fiber cereals, beans, vegetables, and whole-grain breads. Prune juice may help make bowel movements softer.

Be careful in hot weather. Heat can cause a syncope episode. Limit activity done outside on hot days. Physical activity in hot weather can lead to dehydration. This can cause an episode.

Advice about nutrition from Tufts

Advice from the Tufts Health and Nutrition Letter (Aug. 22) 

I think these are probably correct--I've known a long time that plant burgers are processed food, and that lunch meat wrapped in anything contains a lot of sodium, and that granola bars are really candy bars, but they are all on our senior living company's recommended diet.

PLANT-BASED BURGERS

Plant-based burgers that look and taste like meat are all the rage. But the truth is these "meat" products are highly-processed foods that bear resemblance to the plant foods from which they come. [These are served in hospitals and retirement and nursing homes and schools.]

TURKEY IN A SPINACH WRAP

Contrary to what you’ve read, turkey in a spinach wrap is not a wise choice. Deli turkey is sky-high in sodium and the wrap typically contains refined grains and only trace amounts of spinach.

GRANOLA BARS

Granola bars seem healthy, but many are just crunchy delivery mechanisms for sugar. Chocolate and other coatings can easily bring the total to 20 grams per bar – the same as a Snicker’s Bar!

BUT, I really wish I could find out what Tufts advised about Covid and what money it took or whose careers were ruined 5 years ago. I haven't been able to dig it out. 

Jim Wigtil, a friend met late

 About 9 years ago I began chatting with a woman at the gym and we became friends.  We started having long talks about our careers at Ohio State, our childhood years (we were the same age,) and faith, and I often went out for coffee with her and her husband, Jim.  They had a full and active life. In recent years be had periodic illnesses and JoAnne, his wife, turned her time to care giving. Then we moved a year ago to a senior retirement community, and meeting became difficult. Recently he died and I'll be attending his funeral. We met late, but it was a good friendship.

James Wigtil Obituary - Columbus, OH

Should it be so hard to buy Folex?

I wonder why people buy on-line. Well, I know why, but the math doesn't work.

 If I drive to Lowe's and buy one bottle 32 oz of  (carpet spot cleaner) I don't know exactly what it costs, but recall it's about 6 or 7 dollars. On line one 32 oz is $6.88 (although it varies), and on line 3 bottles same size are $34. Let's round up--I'm not the best in math--but isn't $21 less than $34? Couldn't I buy 5 singles for about the same as 3 singles if sold together?

 
Are customers so math challenged that they think larger or packaged together is cheaper? And why if I specifically ask the AI whozit "cost of Folex at Lowe's" I first get every imaginable product and size I don't want not in Lowe's and not in the store?

Who is dumb? Customer? Algorithm? AI?

Although I can't verify each claim, I've read about most in "updated" science articles

If you had trusted the settled science of the day, here is how it would have gone.

1890s: you dose the baby with Bayer's new cough syrup, the non-addictive alternative to morphine, marketed for children. It was heroin. They named it after the German for heroic.

1900s: you rub calomel teething powder on your infant's gums. It is a mercury compound, and it leaves a generation with pink disease. Swollen, peeling hands and feet, screaming for months, and some of them died.

1910s: you cook in Crisco, launched by a soap and candle company, because cottonseed oil is modern and lard is what your mother used. The process that made it solid produced trans fat, banned outright a century later.

1920s: you drink Radithor, certified radioactive water, on prescription. Eben Byers took fourteen hundred bottles for his vitality. His jaw was removed in pieces and he was buried in a lead coffin.

1930s: a chemist dissolves a new sulfa drug in diethylene glycol, which is antifreeze. It kills 107 people, mostly children, and only then does America give the FDA power to demand safety testing.

1940s: your doctor lights a Camel in the surgery. More doctors smoke them than any other brand, and the advert runs in the Journal of the American Medical Association, which sold him the page.

1950s: DDT is sprayed over your kitchen, your garden and your children at school. The man who found its insecticidal properties has already been given a Nobel Prize.

1960s: your wife takes thalidomide for morning sickness because it is remarkably safe. More than ten thousand children are born with missing and shortened limbs.

1970s: the country puts down the butter and picks up the margarine, on the instruction of the American Heart Association. The fat everybody switched to was banned in 2015 as unsafe at any level.

1980s: the fat comes out of everything and sugar goes back in to make it edible. Obesity begins a climb it has never come off.

1990s: your father is prescribed OxyContin, because fewer than one per cent get addicted. The company later pleads guilty to criminal misbranding, and the overdose count runs into hundreds of thousands.

2000s: you take Vioxx for your knee. It is pulled in 2004, and the FDA's own safety officer estimates tens of thousands of excess heart attacks.

Not one of those was fringe. Every one had a professional body, a literature and a man in a white coat standing behind it.

Nobody who followed that advice was stupid. They were obedient, to the most qualified people available.

Settled is a word about money. It means the questions stopped being funded, so they stopped being asked.

So which of today's instructions will your grandchildren read out in disbelief.

The oil washed in hexane and built into every cell you own. The statin that blocks the pathway making your hormones, to prevent one heart attack per hundred people. The injection where a third of the loss is muscle. The infant formula built out of vegetable oil.
All settled. None of it funded to be otherwise.

https://x.com/samahoole/status/2088832696155820150?s=46
See less

Sama Hoole on X

Remember what we were told about butter, coffee, and eggs? And look what has happened to the obesity rate based on "science" and "nutritionist" advice,

Women being assaulted by women in WNBA

I've been watching the latest WNBA antics and the Sophie Cunningham neck chop. Bunch of violent lesbian owners and players. And back in the day when you could trust domestic violence statistics, it was clearly reported 2 decades ago that rate of domestic violence was highest among lesbians/bisexuals within all the combinations--but that includes verbal assault. Today no one can define a woman, including a DEI appointee Scotus justice (the president even said that), and their idiocy has come home to roost on the basketball court.

 
There are former NBA gentlemen who have decided to step up to demonstrate the silliness of the women, On August 7, 2026, Enes Kanter Freedom announced via X that he is “officially declaring myself a WNBA prospect” for the 2027 draft, saying he has “carefully examined” the WNBA’s eligibility criteria and believes he meets all requirements. They were outdone years ago by Zuby, a professional British weightlifter who entered competition as a female, and no one could stop him. He cleaned house, just to prove a point about "trans." He's an author, podcaster and musician. I adore him. He was born in England, raised in Saudi Arabia and is a graduate of Oxford University. His parents are ethnic Nigerian, and he has an American accent. He's definitely a man.

https://www.thegatewaypundit.com/2026/08/updates-sophie-cunningham-speaks-after-chicago-sky-player/

Enes Kanter Freedom Declares For The 2027 WNBA Draft: "I Meet Every Requirement Necessary" | Video | RealClearPolitics

About | ZUBY: Independent Rapper

Fauci got the rights we didn't

I believe Dr. Fauci should have pled the 5th. And he did. He destroyed our Constitutional Rights but that's no reason to return the crime. It doesn't solve what we will do the next time the government and the media collude. And will our churches stand up and object the next time?

"What we do know, though, is that Anthony Fauci has finally come to see the value in the Bill of Rights, having spent the COVID years routinely trying to trample the First Amendment rights of those who would dare publicly disagree with him.

His ire was routinely on display whenever the Great Barrington Declaration reared its ugly head. The authors of that declaration simply asserted that “Adopting measures to protect the vulnerable should be the central aim of public health responses to COVID-19.” Fauci and his merry band, on the other hand, pushed for and got lockdowns. The healthy and the sick, the strong and the vulnerable, all fell into the same bucket, and that bucket was placed behind a locked door.

And anyone who disagreed was to be silenced, First Amendment be damned." 

Anthony Fauci (Finally) Discovers the Bill of Rights

Medicare increases for 2027

Notes from Kiplinger's on the 2027 Medicare increases

https://hwww.kiplinger.com/retirement/medicare/medicare-2027-how-much-premiums-are-set-to-rise

"Medicare premiums are set to rise again for 2027. The latest Social Security and Medicare Trustees Report (page 207) estimates that Part B premiums will climb 3.5% in 2027, reaching $209.50 per month, up $6.60 from 2026. While another price hike is never good news for retirees, the increase is a relief compared to the almost 10% spike experienced in 2026.

Unlike Part B, Medicare Part D is sold through private insurance companies, either as a standalone drug plan alongside traditional Medicare or as part of a Medicare Advantage policy.

Because individual plan costs vary, the average premium enrollees pay is typically lower than the base beneficiary premium. According to the latest Trustees Report, the Part D base premium is projected to reach $41.33 per month in 2027.

Medicare Part B pays for doctor visits, outpatient care and some home healthcare. When enrolled, you pay both a deductible and a monthly premium. For 2027, the premium is currently projected to rise 3.5% to $209.50, up $6.60 from $202.90 in 2025.

The Part B deductible is projected to reach $292 in 2027, a $9.00 increase from $283.00 in the previous year. On a percentage basis, it's an increase of 3.2%, in line with the estimated increase of the Part B premium.

The projected Part B increase impact on Social Security benefits

The 2027 Social Security COLA is projected to rise 3.8%, after accounting for the June CPI. In terms of dollars, if implemented now, that would translate into an increase of $79.14 per month or $949.68 per year, when using the average Social Security check amount for May 2026 ($2,082.76) as the base amount.

The Social Security Administration (SSA) automatically deducts the Part B premium cost from the Social Security benefits of most Medicare recipients. For 2027, the average Social Security check would fall from $79.14 to $72.54, subtracting the projected Part B increase ($6.60) from the projected COLA raise (79.14). In that scenario, the Part B increase would consume approximately 8.3% of the monthly increase.

Understanding Medicare Part D premiums

Unlike Part B, there isn't a single "standard" Part D premium, as it varies by plan. The Centers for Medicare & Medicaid Services (CMS) establishes a standardized base premium amount used to calculate late enrollment penalties and to determine Part D IRMAA surcharges. For 2027, the base premium is $41.33.

Most final premium and deductible amounts won't be announced until late October or early November; however, most of the Part D amounts have been finalized.

Annual deductible: The standard Part D deductible will increase to $700 in 2027, up from $615 in 2026. That's a steeper increase than in 2026, when the deductible rose to $615 from $590 in 2025, a $25 increase.

Out-of-pocket spending cap: On a positive note for 2027, Medicare Part D's annual out-of-pocket prescription cap will rise to $2,400, up $300 from the $2,100 limit in 2026. Once beneficiaries reach this cap, they no longer pay out-of-pocket costs for covered prescription drugs for the rest of the year.

Premium protections and stabilization: To shield enrollees from steep rate hikes, the premium stabilization provision of the Inflation Reduction Act (IRA) caps annual base beneficiary premium (BBP) growth at 6% yearly through 2029, while limiting how much extra cost plan sponsors can pass along.

While an IRA demonstration program previously stabilized average monthly premiums, CMS scaled back that support in 2026, stating in a memo that reducing federal subsidies is meant to help the Part D program "return to operating under regular market conditions."

Notes from Newsweek

https://www.newsweek.com/medicare-update-new-estimate-of-how-much-premiums-will-increase-12256344

Five Star no longer exists; we are now part of Sinceri

https://www.mcknightsseniorliving.com/news/sinceri-discovery-tutera-among-operators-assuming-management-of-116-five-star-communities/

"AlerisLife/Five Star was one of the largest senior living community operators in the United States.

In the 2025 ASHA 50 list of largest operators, AlerisLife was listed in eighth place, with 132 properties and a total of 19,056 units as of June 1.

AlerisLife/Five Star also appeared in sixth place on Argentum’s 2025 list of largest senior providers. That list, released in July with data current as of June 30, 2023, reported that AlerisLife/Five Star had 9,836 employees and 19,492 total units across 138 communities, including 10,123 for independent living, 7,539 for assisted living and 1,830 for memory care.

AlerisLife filed a Worker Adjustment and Retraining Notification (WARN) Act notice with the state of Massachusetts on Sept. 3 [2025] indicating that 179 employees would be laid off between Nov. 3 and Dec. 31. In an updated notice filed Sept. 30, the company indicated that the layoffs would take place through March 31, 2026."

Senior Living REITs are hot.

Looking back a 2022 and Five Star/Aleris

"A news-filled 2022

News of the acquisition at the beginning of 2023 comes after a news-filled 2022 for AlerisLife:In January 2022, Five Star Senior Living announced a new name, AlerisLife, for a parent company under which the Five Star name would continue to be used for a senior living management services division and the Ageility name would continue to be used for its rehabilitation / fitness services division. AlerisLife also announced plans to expand into active adult management services and home care and concierge services.

In February 2022, AlerisLife announced that it had closed on a $95 million senior secured term loan to obtain “increased liquidity to use at our discretion and additional flexibility for the coming years as we execute on our strategic business plan,” then-President and CEO Katie Potter said at the time.
In May, AlerisLife announced that Potter had resigned and that Chief Financial Officer Jeff Leer had been appointed to succeed her on an interim basis as the company hired a consulting group to review operations.

Leer’s appointment was made permanent in June as the company announced plans to cut costs and make operational changes to try to increase occupancy. In August, Leer said that AlerisLife would reduce costs by approximately $14 million and invest approximately $4 million under recommendations made by the consulting firm it had hired, to “drive efficiencies and standardize processes that will enable us to better serve our residents and customers and stabilize our financial performance.”
In November, Leer said that continuing progress on the company’s restructuring plan had resulted in occupancy gains in the third quarter that were the largest in recent years.

Also in November, AlerisLife reported that it faced possible delisting by Nasdaq because the bid price for shares of the company’s common stock had closed at less than $1 for the past 30 consecutive business days. The company was given until May 8, 2023, to come into compliance with the minimum bid price continued listing standard.

AlerisLife was No. 6 on the 2022 American Seniors Housing Association’s ASHA 50 list of largest senior living operators, falling from No. 5 in 2021 and No. 4 in 2020. But the company moved from No. 5 in 2021 to No. 4 in 2022 on Argentum’s list of largest operators."

Trump's role in the Fauci downfall

Although I think Fauci is guilty of all they accuse him of, I also believe President Trump put him in power hoping to be the hero of a virus no one understood. Trump was right in the beginning calling it the Wuhan virus, but he appointed the man he thought would be best qualified to control it. He was wrong; his usual good instincts about people failed him and us. Fauci got rid the other advisors who would contradict him.

 
Trump was also the godfather of PPP which was to replace incomes during the shutdowns, which was ripe for fraud and even compromised churches and non-profits. Fauci was then a gift to the Democrats from Trump. Children have lost years of schooling, the elderly died alone, people lost jobs and careers for refusing unsafe "vaccines," and millions of people learned the government should take care of them.

Democrats may be dysfunctional, insane and suckers for falling for Communism, but the Republicans during a crisis were just sloppy and disorganized, terrorized by social media and the traditional media and fractured by their own internal problems.

I also think Fauci should continue to rely on the 5th Amendment. Let that remind us that the "Democratic Socialists" aka Communists, want to dump the Constitution.