When you think about nursing home food, what comes to mind? Candlelight dinners, menus you can vote on and Thanksgiving dinner on the patio? Probably not. But at a five-star skilled nursing facility, that’s exactly what you’ll get. When choosing a skilled nursing or rehabilitation facility for your loved one to recover in, it is always important to take a good look at the food. Read more
Archive for year: 2016
It was Henry Miller who once said, “It is a very limited concept of medicine that strives to understand disease, but not the needs of sick people.”
Nowhere is that need greater than the care of our elderly. Fortunately, the healthcare industry is taking steps toward recognizing the unique needs of our senior loved ones by providing specialized care that meets the healthcare needs of the patients as well as the emotional and supportive needs of those who love them.
Commonly known as “comfort care,” palliative care provides a team of specialists who cater to the varying healthcare needs of a patient. That team often includes a physician, nurse, pharmacist, a social worker, chaplain and volunteers. Read more
True or false: Midwives deliver babies at home without advanced medical care available.
The answer? A resounding false! While more than 90 percent of births in the U.S. are delivered by physicians, a growing minority of women rely on midwives to provide their prenatal care and delivery. These women use state-of-the-art technology and best practices in medicine combined with a patient-centric philosophy to give expecting mothers what they believe is the highest-quality healthcare with the best overall outcomes.
I had the opportunity to interview Diana Lee, a certified nurse midwife and a women’s health nurse practitioner at Revere Health to find out more. Read more
What do Loni Anderson, Christy Turlington, King Edward VII, Johnny Carson and more than 12 million Americans have in common? They have been diagnosed with chronic obstructive pulmonary disease, or COPD. Another 12 million have it but don’t know it. COPD is now the third leading cause of death in America, yet many people are unaware of COPD and its devastating effect on the lungs.
What’s the leading cause of injury in older adults? It’s not what you think…
If I were to ask you, “What is the most likely cause of injury death for older adults?” what would you say? Car accident? Bike accident? Yoga accident?
Falls are surprisingly the leading cause of injury death for adults ages 65 years and older. The Centers for Disease Control reports over 2.5 million older adults are treated in emergency rooms for fall injuries each year. Among those that fall, 20 to 30 percent suffer moderate to severe injuries, such as head trauma and fractures.
More than one-third (34.9 percent) of American adults are obese, according to the 2011-2012 National Health and Nutrition Examination Survey. A person is clinically obese if their body mass index (BMI) level is 30 or more. Overweight and obesity have become pressing global health concerns. With a higher number of bariatric and aging patients comes an increased demand for skilled nursing and rehabilitation facilities that can accommodate their unique care needs. Historically, bariatric patients have faced challenges when trying to find long-term care. Skilled nursing facilities (SNFs) and assisted living facilities (ALFs) are having to innovate to accommodate these patients and provide high-quality care.
There are facilities that can accommodate obese patients and provide excellent care, but they may require a bit more effort and research to find. There are a few things to keep in mind when trying to locate a skilled nursing, rehab or assisted living care for a bariatric patient.
Specialized Equipment for Bariatric Patients
Ask if the facility has bariatric equipment. The Occupational Safety and Health Administration (OSHA) limits how much healthcare workers are allowed to lift, so if the patient needs help getting in and out of bed toileting or bathing, special equipment will be necessary. This can include larger beds (a standard hospital bed can only hold up to 350 pounds), chairs, wheelchairs and mobility aids, and shower and bath equipment, depending on you or your love one’s needs. A heavier individual may require an electric patient lift instead of manual equipment such as a classic Hoyer lift.
Because these items are extremely expensive, the number of beds available to accommodate heavier residents at any given location will be extremely limited. Waiting lists are typically quite long, since nursing facilities are not obligated to accept patients like hospitals are.
Patient transfers can be tricky and dangerous for individuals of an average weight, so great care must be taken when caregivers assist heavier residents. This is for the patient’s safety and that of the facility’s employees.
“The largest risk is the issue of injuring patients and caregivers from improper transfer,” says Jeff Oldroyd from Holladay Healthcare, a nursing home located in Salt Lake City, Utah. “We do give additional training in these specific transfers to our caregivers. This training is usually provided by experienced nurses and physical therapists.”
Do not be afraid to ask the facility about special training and experience requirements for any staffers who may be caring for you or your loved one. Frequent transfers and repositioning are crucial for proper hygiene and prevention of bedsores or compression ulcers.
Adequate Space in Living Areas
A larger room or apartment is ideal for larger patients in care facilities, but do not forget to inspect communal areas such as dining rooms and activity rooms as well. Isolation can be a real concern for these patients since their mobility is typically limited. Make sure there is enough space to maneuver a larger wheelchair in the facility so you or your loved one can interact with staff and other guests outside of their room. Creating opportunities for a patient to engage and participate in social and recreational activities will improve their quality of life and may even result in weight management or even weight loss.
While resident involvement is important, bariatric patients have specific health and activity needs. In many cases, “regular” exercise is not possible or safe for them. Make sure to ask the facility about modified activities for patients, especially if they have recently undergone surgery. This is especially important in a rehabilitation setting where a patient is working to heal and regain or improve their functional abilities. For instance, a facility with a pool and a water therapy program can provide activity options that are more conducive than typical weight-bearing and high-impact exercise programs. An experienced physical therapist will be able to adapt a PT regimen to make sure they meet their health care goals.
Overweight patients are likely accustomed to comments about weight and physical activity. But, beyond the equipment and therapy, it’s important to know that the staff will see a bariatric patient as more than just a number on the scale. It can be difficult for anyone to find placement in a facility, and you want to make sure any special needs will be taken care of.
Ask Your Physician
Physicians often have contacts at many skilled nursing, assisted living, and rehabilitation facilities in their area. In many cases, they may be your best resource when it comes to finding a reputable facility. Communication between the facility and a physician will be key for ongoing care, so receiving a referral from your doctor will be an added bonus.
“We do have additional communication with physicians for patients with specialized needs such as obesity,” said Mark Hymas from Copper Ridge Health Care, a SNF in West Jordan, Utah. “There are specific protocols for each diagnosis, and those symptoms are monitored and shared with physicians in real time. Physicians are then able to make determinations to monitor and adjust treatments.”
Patients of any size may encounter significant obstacles and frustrations related to their healthcare. Finding a facility with the proper equipment and training, adequate space, appropriate exercise and activity programs, and compassionate staff can be difficult. However, these important tips will help you select the right care setting for yourself or your loved one.
This article was originally published by AgingCare.com. It has been republished here with permission.
Wondering what that bump on the back of your wrist might be? Chances are, it’s a ganglion cyst. In earlier days, people would treat them by smacking the lump with a heavy book (often the Bible) — hence the name “Bible bumps.”
“It’s a common problem,” explained Dr. M. Shane Frazier, orthopedic surgeon at Revere Health. “It is by far the most common tumor of the hand or wrist. Besides carpal tunnel syndrome, the next most common ailment is a ganglion cyst.”
Typically, ganglion cysts fluctuate in size and may even disappear on their own. While these cysts are not necessarily harmful and can be left alone, the main motivators for removing the cysts are their location and appearance.
Ganglion Cyst Location
As stated in an article on WebMD, the cause of ganglion cysts is unknown, however, they occur most often in women. Seventy percent of ganglion cysts occur in people between the ages of 20 to 40.
Even though these cysts are often painless, their location can create discomfort or pain. Ganglion cysts can be painful if they press on a nearby nerve, and they can sometimes interfere with joint movement.
Ganglion Cyst Appearance
For many, the size of the cyst creates unwanted attention with an awkward conversation often following. Let’s face it, a golf ball-sized lump on the top of your wrist is certain to spur a conversation among strangers.
“For some people, ganglion cysts are very small,” said Dr. Frazier. “But others can be painful and unsightly. A little while ago, I treated one approximately the size of a golf ball.”
Ganglion Cyst Treatment
If your ganglion cyst is causing pain, the treatment options may include aspiration or surgery.
Aspiration involves placing a needle into the cyst and drawing out the jelly-like soft liquid that comprises the cyst. Then an anti-inflammatory solution may be injected into the lump.
Surgery is often recommended when painful cysts interfere with normal function, attract undue attention or cause numbness or tingling.
“It’s a same-day, outpatient procedure. Usually the scar looks pretty good, the pain goes away almost immediately and most people report motion returning quickly following surgery,” said Dr. Frazier.
Although not life-threatening, ganglion cysts can be physically painful and lead to a number of painful, embarrassing conversations. When in doubt, it is always a good idea to have your doctor check it out. This can help ensure that you receive a proper diagnosis and can discuss treatment options — apart from the Bible smacking, which is strongly discouraged.
Whether it’s carpal tunnel syndrome or a ganglion cyst, you do not need to endure the discomfort of these common “bumps in the road.” Surgical specialists such as Dr. Frazier and others with Revere Health Hand, Wrist and Elbow Center can provide effective treatment for these and other common hand and wrist conditions.
This article was originally published by The Daily Herald. It has been republished here with permission.
Many people who employ in-home caregivers think of them like teenage babysitters: You agree on a price (perhaps $40 for the evening), and when you return home a few hours later, you slip them the cash and send them on their way. You likely don’t bother to report the payment to the IRS.
Although in-home caregivers have been historically treated like babysitters, recently enacted federal regulations have clarified that they have little in common with babysitters and cannot be treated as such. Home healthcare aides are, for legal classification purposes, domestic service workers who must be paid an hourly wage for all of the hours they’re providing services to your loved one. They must be paid the minimum wage, and if they work longer than 40 hours a week, you are required to pay them overtime.
Homecare agencies typically handle these technicalities for their clients and employees, but if a family decides to hire an independent caregiver, then they are responsible for making sure that these laws are correctly observed. Although hiring a private individual who has no connection to an agency is thought to be less expensive, there are some very important factors that you must take into consideration as an employer.
Tafa Jefferson, CEO of Amada Senior Care, breaks down some of the key rules and regulations that determine when your independent aide qualifies for overtime:
Does your caregiver qualify legally as a domestic service worker? As Tafa explained, the fundamental first question is critically important, but not always clear. “Only a home that is legally deemed a private home can employ a domestic service worker as a caregiver,” he said. For example, was your loved one living in the place where he or she is now receiving care? If not, the place is probably not legally a private home. What happens if your loved one does not live alone? If it’s a group setting, it may not legally be a private home.
Does your caregiver work 40 hours a week? Although we might not think of a caregiver as being on the clock whenever they are in the home with your loved one, the law makes it clear that in most cases, they are working and must be compensated like any non-exempt worker. That means they must earn a minimum wage and be paid overtime when they qualify for it. Thus, it’s critically important to keep track of all hours on a written timesheet and account for meal and sleep breaks when the caregiver is legally not entitled to compensation.
Does your caregiver stay overnight or through meal breaks? Caregivers often spend considerable time in a home, and they typically are so self-sufficient that they can take care of fitting their own meals and rest breaks into the care services they provide. Tafa explained that, as an employer, “you are obligated to keep track of these breaks in writing because it affects the hours they are considered to be working and entitled to compensation.” If your caregiver takes breaks to eat meals on the premises or to sleep on the premises, you must document when they do this and give them adequate time to have a bona fide break from work. If a caregiver’s services are needed while they are supposed to be on a break period, and they must interrupt this break period to perform duties, this time can no longer legally be considered a break—and the caregiver is entitled to compensation for the duration of what was intended to be a break period, even if overtime pay is triggered.
Is your caregiver primarily a companion? One of the most common exemptions that can be used to preclude in-home workers from minimum-wage and overtime eligibility is the “companionship services” exemption. Individuals whose primary job is to provide fellowship and protection to an elderly or sick person fall under this exemption, as long as they spend at least 80% of their time serving as a companion and no more than 20% of their time providing any kind of “care” services. Once this threshold is crossed, the worker is legally reclassified as a domestic service worker and must be compensated at least the minimum wage, plus overtime as necessary.
In many situations, it’s not always easy or realistic to understand when to pay overtime to a caregiver. But, it is your job as a private employer to determine whether your caregiver qualifies legally as a domestic service worker, to keep track of hours worked, to understand what constitutes a bona fide break, and to distinguish between an in-home companion and a true caregiver. If you feel unsure about taking on all of these responsibilities on your own, you can turn to the services of a professional home care agency.
For the past three years, I have been trying to lose the same five pounds.
I’ll lose a couple pounds, feel like I’m doing really well, and then celebrate by going out for ice cream. I know I need to get back to the gym, beat the scale and (more importantly) develop good exercise habits, but I’m just not motivated.
According to R.J. Shephard’s article, “Aging and Exercise,” in the Encyclopedia of Sports Medicine and Science, I am in good company: It is difficult to motivate the vast majority of older adults to exercise regularly. But after doing some research, I’ve discovered ways to get recommitted.
Weigh yourself daily. In a study at the University of Minnesota, Twin Cities, of 3,026 dieting adults, those who weighed themselves more frequently lost more weight over two years or regained fewer pounds. That makes sense to me. I got frustrated at not losing the pounds, so I quit weighing myself to avoid having a bad day. I need to force myself to look at those numbers.
Stick a model on your fridge. Seriously, this works. But you have to choose people based on your motivational style. In a series of three studies, Penelope Lockwood and colleagues discovered that some people are motivated by success and others are motivated by failure. So, if you’re motivated to succeed, put a slim model on your fridge. If you’re motivated to avoid failure, put an example of a failed dieter where you can see it. I’m not sure which strategy works best for me, so I’m going to pin up Gisele Bundchen and a close-up of my cellulite.
Get rid of the candy jar. Why, oh why, do I keep filling up my candy jar with my favorite chocolate treats? A Wall Street Journal article reported that in a four-week study of 40 secretaries, when candy was visible in a clear, covered dish, participants ate 2.5 pieces of chocolate on top of the 3.1 candies they would have eaten had the chocolates been in an opaque container. Moving the dish closer, so the subjects could reach the candy while at their desks, added another 2.1 candies a day to their intake. I keep the candy jar handy to increase the esprit de corps at work, but I am sabotaging myself in the process.
If all else fails, imagine yourself as a weightlifter. Believe it or not, there is something to visualization – even when it comes to exercise. Guang Yue, an exercise psychologist from Cleveland Clinic Foundation in Ohio, compared “people who went to the gym with people who carried out virtual workouts in their heads.” He found that the group of participants who conducted mental exercises of the weight training increased muscle strength by almost half as much (13.5 percent) as those who went to the gym (30 percent). So, if I can’t get to the gym, it helps to know that mental practices are almost as effective as true physical practice and that doing both is more effective than either alone.
Now that I am recommitting myself to exercising, I have a few things to do: get back on the scale, pin up some motivating pictures, get rid of my office candy jar and imagine myself thin and fit. Now, I need an exercise partner.
This article was originally published in the OCRegister.com. It has been republished here with permission.
It’s been called a silent epidemic, a woefully underdiagnosed disease with a whopping 40 percent mortality rate that only seems to be increasing with time.
Hepatitis C infections can cause chronic liver disease, liver cancer, a swollen abdomen, gastrointestinal bleeding, skin yellowing and fatigue. Yet many of the 4 million patients infected with Hepatitis C do not learn of their diagnosis for decades until they begin showing end-stage symptoms that are typically irreversible and difficult to manage and treat.
Why is this deadly disease not being diagnosed much earlier in its progression? The fact is that most people don’t get tested because they don’t realize they’re at risk. That means education and awareness are the most important weapons we have to stop Hepatitis C from inflicting this pain and suffering.
I sat down with Dr. Mohammad Alsolaiman, a gastroenterologist at Central Utah Clinic, to learn the key things we need to know to protect ourselves and our loved ones:
Older folks are at the highest risk
Alarmingly, it’s the baby boomer generation that comprises the vast majority of undiagnosed Hepatitis C patients — and yet they’re likely to not realize the need to be tested. Dr. Alsolaiman’s patients are always surprised to learn that many Hepatitis C infections occurred decades ago.
Undiagnosed Hepatitis C also comes at a very high price tag for society
Individuals who develop cirrhosis and end-stage liver cancer from Hepatitis C infection typically require a liver transplant, adding to an already overburdened list of patients waiting for a donor. And the cost of medical care for patients living with Hepatitis C is expected to nearly triple in just two decades, to $85 billion by 2027 if no intervention is undertaken.
There are many routes to infection
The leading risk factors for Hepatitis C are unprotected sex, drug use (including intra-nasal), blood transfusions prior to 1992, incarceration, tattoos, occupational exposure, and surgeries performed prior to the implementation of universal precautions. Patients who undergo hemodialysis or were born to an infected mother also are at risk.
Hepatitis C is fully curable in most of the patients
Unlike HIV infections, a Hepatitis C infection can be cured in most of the patients. In fact, even oral medication is an option, and newly available medications have made it possible to be free of the virus in 8-12 weeks. The success rate is more than 90 percent.
Hepatitis C drugs are far more advanced now
We’ve come a long way since the first Hepatitis C drug, Interferon, was introduced with a paltry 10 to 20 percent success rate with a very bad reputation for intolerable side effects. This has been replaced today with more powerful oral and effective drugs.
There’s no reason for people to suffer and die from a disease that is highly treatable when caught early. To find out more about Dr. Alsolaiman or to schedule an appointment to find out more, connect with Central Utah Clinic for information on services, locations, events and more.
This article was originally published in The Daily Herald. It has been republished here with permission.