By Dana Pavelock, Director of Home Care Operations
With the significant aging trend of the U.S. population, many of us soon will be grappling with serious decisions with care and assistance for our elderly parents, relatives or even ourselves. I welcome the opportunity to sort out and address the complexities of the home health care industry. I hope to provide valuable information to assist you in making informed decisions for accessing services for yourselves or a loved one.
As you may already be aware, home health care is the fastest growing industry nationally. The service is most appropriate for those individuals that require a variety of skilled nursing or therapy and/or paraprofessional support. For some, that may mean short term care if recuperating from a recent hospitalization, injury or illness. For others, it may mean making arrangements for long-term care needs or extended hours of care. In all cases, and especially when in doubt about what level of care is needed, it is important to consult with the treating physician. One of the greatest benefits of this industry growth for all of us is that there are many choices and more options for elder care that never existed before. The home care industry offers a great alternative to institutional placement and the opportunity to remain living safely in the privacy of our homes and function as independently as possible for as long as we may choose.
Given our own agency experience there has been a significant request for live-in caregivers. Up until the past few years a majority of home care needs have been delivered on an hourly basis. Hourly home health aide services certainly make sense when an individual might need some basic help with personal care (morning or evening care, assistance with bathing, dressing, grooming, meal preparation, medications etc.) and for the most part still are relatively independent. When an individual’s health needs become more complex or are at significant risk for falls, when memory impairments or increased frailness occur, more hours of care may be required so that they can live safely at home. Up until the past decade, many people requiring more significant care at home were either cared for by immediate family members or placed in nursing homes.
The decision of when or why to switch from hourly to live-in services is very individual in nature and often a decision made by family members and/or the patient. We recommend live-in care when a patient’s care needs exceed 8 to 10 hours of care daily and for those desiring to remain at home vs. placement in skilled nursing care or other institutional facilities.
The benefits of accessing live-in aide:
· Cost savings: more affordable than hourly care or skilled nursing facilities.
· Continuity: one aide to provide care vs. two or three staff.
· Consistency: reliability of consistent coverage without interruption.
· Quality: Live-in caregivers dedicate their lives to provide excellent patient care
· Living at home
How does one make arrangements in finding a live-in aide? Accessing this level of service may be easier than you think. In fact, in some cases it might be easier for an agency to place a live-in caregiver than arranging hourly coverage. Also, it is important to note that this service may be appropriate for short term or respite care as well. In choosing an agency consider the following. Is the agency licensed by the state Dept. of Health? Accredited by JCAHO? Insured?
· How long has the agency been providing live-in care service?
· Does the agency conduct thorough criminal background checks and drug screens?
· What type of nursing oversight is provided to the patient and the aide?
· The level of training, experience and skills of the aide.
· Can the agency accept long-term insurance (if applicable).
· Reputation of the agency? Ask around, check the Better Business Bureau.
One last thing to consider. Please remember that when making arrangements for the care of a loved one at home that the cost associated with the delivery of care should not be the primary reason for making your decision. Also remember that you are purchasing more than just the hours the aide provides, you are entering into a relationship with a service agency to provide the best care and oversight possible so that the person receiving the care can remain living at home with dignity and respect!
Wednesday, December 19, 2007
Friday, December 7, 2007
DVT Learning Experience
By Susan Hecht, R.N.
A Deep Vein Thrombosis (DVT) is a blood clot that forms in a deep vein, usually in the leg. It is possible for this clot to break away and travel throughout the body to vital organs causing severe damage. Some of the risk factors for DVT are surgery, hereditary blood-clotting disorders, increasing age, hospitalization, and prolonged sitting – like when you drive or fly long distances.
American Airlines, among others airlines, has recognized this prolonged sitting risk factor. They are presently educating their passengers prior to departures. They go on to explain in their airline magazine, “American Way,” what a DVT is, the risk factors, possible symptoms, ways to reduce risk and, most importantly, In-Flight Exercises that can be done to continue to keep the blood circulating during long flights and prolonged sitting.
Some of these exercises are ankle circles, foot pumps, knee lifts, and knee to chest exercises. It is very pleasing to see that the awareness and education of DVT is being presented to the community. Several months ago, Saint Francis Hospital presented a free community seminar on the topic. Our speaker was Melanie Bloom, whose husband, NBC News Correspondent David Bloom, died from DVT complications.
Educating people regarding health issues is the first step to prevention. Recently, Arizona Diamondbacks player Chad Tracy had knee surgery. Not knowing the risk factors, he was already at risk for DVT related to the surgery, but he then traveled from his home in North Carolina home to Phoenix to have his knee examined by team doctors.
After flying home he began to experience calf pain that “he didn’t think much about” because he thought it was related to the surgery. This pain became more intense and he went to a hospital emergency room.
“The doctors think the flight brought it out,” Tracy topld the Associated Press. “Some people get clots from flying – deep vein thrombosis they call it – and others can get it from surgery. It could have been a combination of the two for me.”
Tracy is recovering without any difficulties because he received the treatment he needed. Possible symptoms of DVT include leg or calf pain, swelling, and redness. Any concerns should be addressed to your primary care physician, immediately.
A Deep Vein Thrombosis (DVT) is a blood clot that forms in a deep vein, usually in the leg. It is possible for this clot to break away and travel throughout the body to vital organs causing severe damage. Some of the risk factors for DVT are surgery, hereditary blood-clotting disorders, increasing age, hospitalization, and prolonged sitting – like when you drive or fly long distances.
American Airlines, among others airlines, has recognized this prolonged sitting risk factor. They are presently educating their passengers prior to departures. They go on to explain in their airline magazine, “American Way,” what a DVT is, the risk factors, possible symptoms, ways to reduce risk and, most importantly, In-Flight Exercises that can be done to continue to keep the blood circulating during long flights and prolonged sitting.
Some of these exercises are ankle circles, foot pumps, knee lifts, and knee to chest exercises. It is very pleasing to see that the awareness and education of DVT is being presented to the community. Several months ago, Saint Francis Hospital presented a free community seminar on the topic. Our speaker was Melanie Bloom, whose husband, NBC News Correspondent David Bloom, died from DVT complications.
Educating people regarding health issues is the first step to prevention. Recently, Arizona Diamondbacks player Chad Tracy had knee surgery. Not knowing the risk factors, he was already at risk for DVT related to the surgery, but he then traveled from his home in North Carolina home to Phoenix to have his knee examined by team doctors.
After flying home he began to experience calf pain that “he didn’t think much about” because he thought it was related to the surgery. This pain became more intense and he went to a hospital emergency room.
“The doctors think the flight brought it out,” Tracy topld the Associated Press. “Some people get clots from flying – deep vein thrombosis they call it – and others can get it from surgery. It could have been a combination of the two for me.”
Tracy is recovering without any difficulties because he received the treatment he needed. Possible symptoms of DVT include leg or calf pain, swelling, and redness. Any concerns should be addressed to your primary care physician, immediately.
Wednesday, November 28, 2007
Holiday Feasting Underway!
By Sarah Daubman, Registered Dietician
Thanksgiving for many people is the beginning of the holiday season and a time to reflect on their blessings. People gather together from near and far in celebration of family, tradition, love, gratitude and … okay, let’s not forget about the food. No doubt some of us are still loosening our belt buckles from last week’s Thanksgiving dinners. It’s not surprising with all the feasting associated with thanks and celebration that some of us escape the winter months with a few added pounds.
Unfortunately, year after year of seasonal overeating can contribute to obesity, as pounds gained are not always lost with the warmer months’ return. With more holidays on the way, temptation may still get the best of us – unless we prepare ourselves. This is not to say that special foods cannot be consumed in moderation. The difference is between enjoying and overindulging. Here are a few tips for holiday eating without the weight or the guilt.
On the day of a big dinner, don’t skip meals in preparation for an evening binge. Eat a healthy breakfast and lunch as you would everyday. This way hunger won’t lead to poor food choices and excessive portions.
Be careful of beverage choices as calories can quickly add up. Eight ounces of wine contains up to 160 calories, a serving of regular beer provides 150, 8 ounces of champagne yields 200, soda gives 136 and a cup of eggnog has nearly 350 calories!
If you’re hosting an event or bringing a dish to pass, substitute ingredients with healthier alternatives. Ideas include lower fat dairy choices for milk, sour cream and cheeses and sugar substitutes such as Splenda for baking. For meal preparation, try cooking sprays instead of butter, shortening and oil for greasing pans and cookware.
Bake only the sweets that you need for gifts or single occasions.
If turkey is on the menu again, try basting with low fat stock. Prepare gravy with the same. When enjoying it later, eat it without the skin.
This winter, get active by signing up for a 5K walk/run or similar fitness event, perhaps even for charity. Or make a contract with a friend to walk together during your lunch hour and after work. This kind of commitment provides motivation when exercise becomes less appealing with the colder months.
Enjoy healthfully prepared salads and vegetables as their high fiber content can help you feel fuller longer.
Experiment with new recipes. I’m a big fan of browsing web sites such as www.allrecipes.com and www.epicurious.com for their healthy living recipe collections.
Instead of food, focus on the real reason for the holidays: family.
Thanksgiving for many people is the beginning of the holiday season and a time to reflect on their blessings. People gather together from near and far in celebration of family, tradition, love, gratitude and … okay, let’s not forget about the food. No doubt some of us are still loosening our belt buckles from last week’s Thanksgiving dinners. It’s not surprising with all the feasting associated with thanks and celebration that some of us escape the winter months with a few added pounds.
Unfortunately, year after year of seasonal overeating can contribute to obesity, as pounds gained are not always lost with the warmer months’ return. With more holidays on the way, temptation may still get the best of us – unless we prepare ourselves. This is not to say that special foods cannot be consumed in moderation. The difference is between enjoying and overindulging. Here are a few tips for holiday eating without the weight or the guilt.
On the day of a big dinner, don’t skip meals in preparation for an evening binge. Eat a healthy breakfast and lunch as you would everyday. This way hunger won’t lead to poor food choices and excessive portions.
Be careful of beverage choices as calories can quickly add up. Eight ounces of wine contains up to 160 calories, a serving of regular beer provides 150, 8 ounces of champagne yields 200, soda gives 136 and a cup of eggnog has nearly 350 calories!
If you’re hosting an event or bringing a dish to pass, substitute ingredients with healthier alternatives. Ideas include lower fat dairy choices for milk, sour cream and cheeses and sugar substitutes such as Splenda for baking. For meal preparation, try cooking sprays instead of butter, shortening and oil for greasing pans and cookware.
Bake only the sweets that you need for gifts or single occasions.
If turkey is on the menu again, try basting with low fat stock. Prepare gravy with the same. When enjoying it later, eat it without the skin.
This winter, get active by signing up for a 5K walk/run or similar fitness event, perhaps even for charity. Or make a contract with a friend to walk together during your lunch hour and after work. This kind of commitment provides motivation when exercise becomes less appealing with the colder months.
Enjoy healthfully prepared salads and vegetables as their high fiber content can help you feel fuller longer.
Experiment with new recipes. I’m a big fan of browsing web sites such as www.allrecipes.com and www.epicurious.com for their healthy living recipe collections.
Instead of food, focus on the real reason for the holidays: family.
Tuesday, November 27, 2007
Looking for Challenging Work?
By Dana Pavelock, Dir. Home Care Operations
Personal Care Aide (PCA) and Home Health Aide (HHA) occupational shortages in the Hudson Valley region have increased as we experience significant aging trends for those in need of home care. In 2000, 12 percent of New York's residents citizens were 65 or older, a 3.6 percent increase since 1990. The U.S. Census Bureau estimates that by 2030 New York's elder population will increase by 60 percent to almost 4 million. By that year the traditional caregiving workforce (women aged 25 to 44) will decrease by 13 1/2 percent.
The U.S. Department of Labor recognizes Home Health Aides as the fastest growing of all occupations having expected a 56 percent growth in new jobs between 2004-2014. Bureau of Labor studies indicate national health care jobs are expected to grow by over 27 percent (twice the rate of other occupations). The industry certainly has its own challenges, experiencing a turnover rate of between 30 percent to 60 percent depending on what study you read. At the same time, the aging population wishing to remain at home requires more complex care that necessitates advanced training of Personal Care Aides (PCAs) to the Home Health Aide (HHA) level.
Finding, hiring, training and keeping PCA & HHA level staff has become one of the major focuses of all home health agencies throughout the state. Due to high volumes of turnover, enhanced supervision directives regulated by the state Department of Health, increasing salaries of nursing staff that are required to provide training and supervision accompanied by low and sometimes delayed reimbursement from contracts, agencies have had to adjust budgets accordingly in efforts to meet the increasing demands for services. Likewise, it has forced agencies to re-evaluate their recruiting practices and how to work with and retain aides after they are hired.
Since the beginning of 2007, our agency has hired over 70 new employees and has been fortunate to have received a grant that offers free PCA & HHA training classes on a monthly basis. This grant expects to train close to 300 students looking to re-enter the health care industry over the course of the one-year grant cycle. Part of the grant involves working collaboratively with the state Department of Labor, Dutchess County BOCES and other collaborators, to assist in helping the students secure work following training. Many of our new staff start out performing homemaker & companion duties, such as cleaning, cooking and shopping, and then attend a training course so they can take on personal care duties. Jobs created by the increase in demand for these workers are expected to produce numerous openings. Persons who are interested in this work and suited for it should have excellent job opportunities, particularly those with personal experience as a caregiver or those who have already participated in training as PCA/HHA or CNA.
The HHA/PCA’s daily routine may vary. Aides may be placed on assignments on a long-term basis (working with the same patient for months or years), some aides will work with several patients a day on a short-term basis and having access to reliable transportation is a necessity. Aides may spend a portion of the working day traveling from one client to another (travel time is usually not compensated but several agencies pay mileage reimbursement). The home environment varies as well with some assignments in upscale private homes while some others might be untidy or depressing. Most patients are pleasant and cooperative while others may be more challenging. Aides work somewhat independently having periodic supervised visit by registered nurses. They receive detailed instructions of when to visit patients and services to deliver. Aides can work anywhere from 2 hours to 40 hours weekly, depending on availability.
Successful aides like to help people and do not mind hard work. Unlike national trends 63 percent of our current workforce is over 45, with 29 percent 25 to 44 and just 8 percent 18 to 24. Twenty-five percent of our staff is over age 60 and one third are over 70, seniors assisting seniors. All aides need to be responsible, respectful, honest, compassionate and cheerful. In New York State, aides are required, at minimum, to have a complete physical exam, be in good health and required to have a criminal history record check.
Anyone interested in working with and supporting our aging population with a few extra hours a day available should contact a local home care agency to check employment opportunities. You couldn’t even begin to imagine the difference you can make in someone’s life and how rewarding this type of work really is!
Personal Care Aide (PCA) and Home Health Aide (HHA) occupational shortages in the Hudson Valley region have increased as we experience significant aging trends for those in need of home care. In 2000, 12 percent of New York's residents citizens were 65 or older, a 3.6 percent increase since 1990. The U.S. Census Bureau estimates that by 2030 New York's elder population will increase by 60 percent to almost 4 million. By that year the traditional caregiving workforce (women aged 25 to 44) will decrease by 13 1/2 percent.
The U.S. Department of Labor recognizes Home Health Aides as the fastest growing of all occupations having expected a 56 percent growth in new jobs between 2004-2014. Bureau of Labor studies indicate national health care jobs are expected to grow by over 27 percent (twice the rate of other occupations). The industry certainly has its own challenges, experiencing a turnover rate of between 30 percent to 60 percent depending on what study you read. At the same time, the aging population wishing to remain at home requires more complex care that necessitates advanced training of Personal Care Aides (PCAs) to the Home Health Aide (HHA) level.
Finding, hiring, training and keeping PCA & HHA level staff has become one of the major focuses of all home health agencies throughout the state. Due to high volumes of turnover, enhanced supervision directives regulated by the state Department of Health, increasing salaries of nursing staff that are required to provide training and supervision accompanied by low and sometimes delayed reimbursement from contracts, agencies have had to adjust budgets accordingly in efforts to meet the increasing demands for services. Likewise, it has forced agencies to re-evaluate their recruiting practices and how to work with and retain aides after they are hired.
Since the beginning of 2007, our agency has hired over 70 new employees and has been fortunate to have received a grant that offers free PCA & HHA training classes on a monthly basis. This grant expects to train close to 300 students looking to re-enter the health care industry over the course of the one-year grant cycle. Part of the grant involves working collaboratively with the state Department of Labor, Dutchess County BOCES and other collaborators, to assist in helping the students secure work following training. Many of our new staff start out performing homemaker & companion duties, such as cleaning, cooking and shopping, and then attend a training course so they can take on personal care duties. Jobs created by the increase in demand for these workers are expected to produce numerous openings. Persons who are interested in this work and suited for it should have excellent job opportunities, particularly those with personal experience as a caregiver or those who have already participated in training as PCA/HHA or CNA.
The HHA/PCA’s daily routine may vary. Aides may be placed on assignments on a long-term basis (working with the same patient for months or years), some aides will work with several patients a day on a short-term basis and having access to reliable transportation is a necessity. Aides may spend a portion of the working day traveling from one client to another (travel time is usually not compensated but several agencies pay mileage reimbursement). The home environment varies as well with some assignments in upscale private homes while some others might be untidy or depressing. Most patients are pleasant and cooperative while others may be more challenging. Aides work somewhat independently having periodic supervised visit by registered nurses. They receive detailed instructions of when to visit patients and services to deliver. Aides can work anywhere from 2 hours to 40 hours weekly, depending on availability.
Successful aides like to help people and do not mind hard work. Unlike national trends 63 percent of our current workforce is over 45, with 29 percent 25 to 44 and just 8 percent 18 to 24. Twenty-five percent of our staff is over age 60 and one third are over 70, seniors assisting seniors. All aides need to be responsible, respectful, honest, compassionate and cheerful. In New York State, aides are required, at minimum, to have a complete physical exam, be in good health and required to have a criminal history record check.
Anyone interested in working with and supporting our aging population with a few extra hours a day available should contact a local home care agency to check employment opportunities. You couldn’t even begin to imagine the difference you can make in someone’s life and how rewarding this type of work really is!
Wednesday, November 14, 2007
Trip To Italy A Culinary Treat
By Joanne Chaconis, RD
I have been absent from this blog site for a while. One reason is that I have lacked any creative ideas and the other reason is that I recently spent eight days vacationing in Italy.
Aside from the many ancient sites and beautiful natural landscapes I witnessed, a high point of this trip was sampling the foods. I visited many regions and cities – Rome, Florence, Venice, Naples and Capri, to name a few. All offered an abundance of foods to try. Every meal included one to two courses of fresh pastas, each served in a light red or white sauce. The pasta was thin, a true melt-in-your mouth feel. Prosciutto was served most nights, either with melon or fresh bread. I decided that too much of a good thing was not always good and I soon tired of it.
Main entrée choices always included fish, and the calamari in Venice was delightful, gently breaded and fried. Prior to that Venetian lunch I had not had calamari in 20 years and it was definitely worth that two decade wait.
The salmon served our last night in Rome was seared perfectly. Meat dishes always included a choice of veal. Since I never cook that at home, I always opted for it and was never disappointed with that decision. Desserts were fantastic and included the second best tiramisu that I ever tasted. My friend, Patty Sonsiadek from Fords, N.J., makes the best, hands down.
Earlier I mentioned prosciutto and “too much of a good thing.” That wasn’t the case with the wines. The red wines were light and complemented many meals!
I couldn’t help but notice that despite the abundance of good food and wine that seemed to be prevalent everywhere, there did not seem to be much obesity among the population. Many people seemed to get their exercise by walking a lot (with gasoline over $8 a gallon, I guess that’s a good reason).
My trip was wonderful. A smorgasbord for the mind, eyes and, of course, stomach!
Caio!
I have been absent from this blog site for a while. One reason is that I have lacked any creative ideas and the other reason is that I recently spent eight days vacationing in Italy.
Aside from the many ancient sites and beautiful natural landscapes I witnessed, a high point of this trip was sampling the foods. I visited many regions and cities – Rome, Florence, Venice, Naples and Capri, to name a few. All offered an abundance of foods to try. Every meal included one to two courses of fresh pastas, each served in a light red or white sauce. The pasta was thin, a true melt-in-your mouth feel. Prosciutto was served most nights, either with melon or fresh bread. I decided that too much of a good thing was not always good and I soon tired of it.
Main entrée choices always included fish, and the calamari in Venice was delightful, gently breaded and fried. Prior to that Venetian lunch I had not had calamari in 20 years and it was definitely worth that two decade wait.
The salmon served our last night in Rome was seared perfectly. Meat dishes always included a choice of veal. Since I never cook that at home, I always opted for it and was never disappointed with that decision. Desserts were fantastic and included the second best tiramisu that I ever tasted. My friend, Patty Sonsiadek from Fords, N.J., makes the best, hands down.
Earlier I mentioned prosciutto and “too much of a good thing.” That wasn’t the case with the wines. The red wines were light and complemented many meals!
I couldn’t help but notice that despite the abundance of good food and wine that seemed to be prevalent everywhere, there did not seem to be much obesity among the population. Many people seemed to get their exercise by walking a lot (with gasoline over $8 a gallon, I guess that’s a good reason).
My trip was wonderful. A smorgasbord for the mind, eyes and, of course, stomach!
Caio!
Thursday, November 1, 2007
What to Know About Strokes
By Susan Hecht, RN
Stroke.
Why is it important to know your risk factors for a stroke?
Prevention and education! Knowing your risk factors and understanding them is the key to prevention. We are all aware that there are some things that we are unable to modify in our lives; however let’s just talk a little about the things that can be modified by your physician, lifestyle modifications or possibly even medication if necessary.
A regular medical checkup with your primary physician is the first step. This visit can be used for education purposes as well as preventable measures if needed. The single most important thing to know is your blood pressure. Monitoring your blood pressure is the most preventative measure one can take. If it is high (140/90) notify your physician for medical follow up. Those with diabetes mellitus, heart disease, or other health issues should always follow up with their physician.
Some lifestyle modifications we are able to make are tobacco use, obesity, and excessive alcohol intake. Some signs and symptoms of a stroke are as follows: sudden numbness or weakness of the face, arm, or leg (especially one side of the body); sudden visual problems (difficulty seeing in one or both); sudden dizziness or difficulty walking or loss of balance; severe headache with no known cause; sudden difficulty speaking; and sudden difficulty in understanding something.
If experiencing any of the above symptoms, don’t take a chance dial 911 immediately. For further information regarding strokes and or further signs and symptoms; discuss them with your primary physician or call the American Stroke Association at 1-800-4STROKE.
Stroke.
Why is it important to know your risk factors for a stroke?
Prevention and education! Knowing your risk factors and understanding them is the key to prevention. We are all aware that there are some things that we are unable to modify in our lives; however let’s just talk a little about the things that can be modified by your physician, lifestyle modifications or possibly even medication if necessary.
A regular medical checkup with your primary physician is the first step. This visit can be used for education purposes as well as preventable measures if needed. The single most important thing to know is your blood pressure. Monitoring your blood pressure is the most preventative measure one can take. If it is high (140/90) notify your physician for medical follow up. Those with diabetes mellitus, heart disease, or other health issues should always follow up with their physician.
Some lifestyle modifications we are able to make are tobacco use, obesity, and excessive alcohol intake. Some signs and symptoms of a stroke are as follows: sudden numbness or weakness of the face, arm, or leg (especially one side of the body); sudden visual problems (difficulty seeing in one or both); sudden dizziness or difficulty walking or loss of balance; severe headache with no known cause; sudden difficulty speaking; and sudden difficulty in understanding something.
If experiencing any of the above symptoms, don’t take a chance dial 911 immediately. For further information regarding strokes and or further signs and symptoms; discuss them with your primary physician or call the American Stroke Association at 1-800-4STROKE.
Thursday, October 18, 2007
Of and About Fiber Consumption
By Sarah Daubman, Registered Dietician
According to the American Heart Association the average American consumes about 15 grams of fiber per day. What is the actual goal for fiber consumption? The recommended intake for men is 30 -38 grams per day, 21-25 grams per day for women. Reaching this goal is not as hard as you may think, but first let’s talk about what fiber is and why it’s important.
Fiber is a carbohydrate that can not be broken down by digestion therefore it provides no calories or nutrients. Fiber is found in plant foods such as fruits, vegetables, whole grains, legumes (beans and peas), nuts and seeds. The two kinds of fiber are soluble and insoluble. Soluble fiber, which dissolves in fluids, thickens substances. Inside the body this type of fiber binds with fatty acids and prolongs stomach emptying time. Oats, peas, beans, apples, corn, carrots, citrus fruits and potatoes are sources of soluble fiber. Insoluble fiber does not dissolve in fluids and provides bulk inside the intestines, resulting in softer bowel movements. Higher intake may help relieve constipation. Insoluble fiber is found in whole grains, brown rice, seeds, nuts, leafy green vegetables and seeds.
Both types of fiber are important and adequate intake is associated with many health benefits. It can help with weight control as fiber makes you feel fuller for a longer period of time making overeating less likely. High fiber foods also tend to have fewer calories per serving than less fibrous foods. Fiber can also prevent and treat constipation by helping form softer, bulkier stools. Less straining during bowel movements may reduce the instances of hemorrhoids and diverticular disease. Additionally, high fiber diets may help with elevated cholesterol because soluble fibers bind with cholesterol as they pass through the intestinal tract, reducing the amount in the bloodstream.
So how much fiber are you consuming? You can check the nutrition facts label on most foods or check the link for a fun fiber intake calculator. A few words of caution: If you are going to increase your fiber intake, do so gradually. Too much fiber at once can cause bloating and gas. Also be sure to drink enough fluids, 8 – 10 cups per day.
http://www.fiberchoice.com/eating/calculator.asp
According to the American Heart Association the average American consumes about 15 grams of fiber per day. What is the actual goal for fiber consumption? The recommended intake for men is 30 -38 grams per day, 21-25 grams per day for women. Reaching this goal is not as hard as you may think, but first let’s talk about what fiber is and why it’s important.
Fiber is a carbohydrate that can not be broken down by digestion therefore it provides no calories or nutrients. Fiber is found in plant foods such as fruits, vegetables, whole grains, legumes (beans and peas), nuts and seeds. The two kinds of fiber are soluble and insoluble. Soluble fiber, which dissolves in fluids, thickens substances. Inside the body this type of fiber binds with fatty acids and prolongs stomach emptying time. Oats, peas, beans, apples, corn, carrots, citrus fruits and potatoes are sources of soluble fiber. Insoluble fiber does not dissolve in fluids and provides bulk inside the intestines, resulting in softer bowel movements. Higher intake may help relieve constipation. Insoluble fiber is found in whole grains, brown rice, seeds, nuts, leafy green vegetables and seeds.
Both types of fiber are important and adequate intake is associated with many health benefits. It can help with weight control as fiber makes you feel fuller for a longer period of time making overeating less likely. High fiber foods also tend to have fewer calories per serving than less fibrous foods. Fiber can also prevent and treat constipation by helping form softer, bulkier stools. Less straining during bowel movements may reduce the instances of hemorrhoids and diverticular disease. Additionally, high fiber diets may help with elevated cholesterol because soluble fibers bind with cholesterol as they pass through the intestinal tract, reducing the amount in the bloodstream.
So how much fiber are you consuming? You can check the nutrition facts label on most foods or check the link for a fun fiber intake calculator. A few words of caution: If you are going to increase your fiber intake, do so gradually. Too much fiber at once can cause bloating and gas. Also be sure to drink enough fluids, 8 – 10 cups per day.
http://www.fiberchoice.com/eating/calculator.asp
Wednesday, October 17, 2007
Geriatric Case Management: Do I Really Need Direction
By Dana Pavelock
Are the problems that you or your loved ones are facing becoming larger and more complete than you can comfortably manage? Are other demands and responsibilities now so great that you are not able to provide the desired level of supervision and attention to your loved one’s
problems.
For the past two decades, Geriatric Care Management has been a popular services that has been well utilized; especially in more urban and metropolitan areas. Understanding the complexities of the health care system and finding the time to coordinate care for a loved one can be a very overwhelming task. In communities such as ours we have been fortunate in being able to navigate through most of the planning and care needs via services from the Dutchess County Office of the Aging, Home Care agencies and knowledgeable hospital and nursing facility social work and discharge planning staff.
However, in just the past few years we have begun to see a significant shift with more individuals requiring additional assistance and ongoing support as the health care industry continues to diversity. Fortunately, information available now through the Internet makes navigation somewhat easier than in the past but still, lifestyles of the sandwich/baby boomer generation often leave very little time to thoroughly assess medical conditions, home safety considerations and how to access appropriate services for a loved one.
What can a Geriatric Care Manager do for you? How do you find a Geriatric Care Manager, and how much will it cost? Are Home Care agencies equipped to handle Geriatric Care Management services? Typically agencies and individuals offering Care Management may include but are not limited to the following services:
Conduct comprehensive health assessments to identify problems and to provide solutions; screen, arrange, and monitor in-home help or other services; provide short or long-term assistance for caregivers living near or far away; review financial, legal, or medical issues and offer referrals to geriatric specialists; provide crisis intervention; act as liaison to families overseeing care, and quickly alerting families to problems; assist with moving to or from a retirement complex, assisted care home, or nursing home; provide consumer education and advocacy; offer individual and/or family counseling and support; 24 hour crisis intervention; coordinate practical daily services, paying bills and daily money
Are the problems that you or your loved ones are facing becoming larger and more complete than you can comfortably manage? Are other demands and responsibilities now so great that you are not able to provide the desired level of supervision and attention to your loved one’s
problems.
For the past two decades, Geriatric Care Management has been a popular services that has been well utilized; especially in more urban and metropolitan areas. Understanding the complexities of the health care system and finding the time to coordinate care for a loved one can be a very overwhelming task. In communities such as ours we have been fortunate in being able to navigate through most of the planning and care needs via services from the Dutchess County Office of the Aging, Home Care agencies and knowledgeable hospital and nursing facility social work and discharge planning staff.
However, in just the past few years we have begun to see a significant shift with more individuals requiring additional assistance and ongoing support as the health care industry continues to diversity. Fortunately, information available now through the Internet makes navigation somewhat easier than in the past but still, lifestyles of the sandwich/baby boomer generation often leave very little time to thoroughly assess medical conditions, home safety considerations and how to access appropriate services for a loved one.
What can a Geriatric Care Manager do for you? How do you find a Geriatric Care Manager, and how much will it cost? Are Home Care agencies equipped to handle Geriatric Care Management services? Typically agencies and individuals offering Care Management may include but are not limited to the following services:
Conduct comprehensive health assessments to identify problems and to provide solutions; screen, arrange, and monitor in-home help or other services; provide short or long-term assistance for caregivers living near or far away; review financial, legal, or medical issues and offer referrals to geriatric specialists; provide crisis intervention; act as liaison to families overseeing care, and quickly alerting families to problems; assist with moving to or from a retirement complex, assisted care home, or nursing home; provide consumer education and advocacy; offer individual and/or family counseling and support; 24 hour crisis intervention; coordinate practical daily services, paying bills and daily money
Tuesday, October 16, 2007
Understanding Acute Rehabilitation
By Susan Hecht, RN
A family member asked recently what exactly we do on our rehabilitation unit. I thought for a minute about how best the community would understand the importance of a Comprehensive Integrated Inpatient Rehabilitation Program. So I explained to this family member that our mission is to assist individuals with achieving their highest potential for recovery and enable them to return to their homes and communities.
After a few minutes, she asked me what types of services we offer. I explained that we offer many including physical therapy, occupational therapy, speech therapy, pet therapy, family education services, home assessments, support groups and many more. She was impressed with the services I mentioned. “I had no idea you offered all those services on that unit,” she said. I explained that we are also accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). I offered to take her as well as other family members on a tour of the unit. They agreed, I showed them around and they were very impressed.
About three months later I was called on a consult for a patient who was recommended for our acute rehab here at Saint Francis. It happened to be the husband of the family member who had asked me about our services. He was admitted to our unit for rehabilitation after a stroke. He participated in three hours of therapy daily, and also in our Stroke Support Group. While he has returned home, he continues to come in on Fridays to our Stroke Support Group.
His wife very grateful for that one day someone took the time to explain what the Rehabilitation Unit is all about. Little did she know, at that time, that she and her husband would have need of our services just a few months later.
Education is a very important part of nursing today. Making sure the community understands how and what we do here at Saint Francis is and will continue to be a very important role for me. And, yes, that education can include your relatives.
A family member asked recently what exactly we do on our rehabilitation unit. I thought for a minute about how best the community would understand the importance of a Comprehensive Integrated Inpatient Rehabilitation Program. So I explained to this family member that our mission is to assist individuals with achieving their highest potential for recovery and enable them to return to their homes and communities.
After a few minutes, she asked me what types of services we offer. I explained that we offer many including physical therapy, occupational therapy, speech therapy, pet therapy, family education services, home assessments, support groups and many more. She was impressed with the services I mentioned. “I had no idea you offered all those services on that unit,” she said. I explained that we are also accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). I offered to take her as well as other family members on a tour of the unit. They agreed, I showed them around and they were very impressed.
About three months later I was called on a consult for a patient who was recommended for our acute rehab here at Saint Francis. It happened to be the husband of the family member who had asked me about our services. He was admitted to our unit for rehabilitation after a stroke. He participated in three hours of therapy daily, and also in our Stroke Support Group. While he has returned home, he continues to come in on Fridays to our Stroke Support Group.
His wife very grateful for that one day someone took the time to explain what the Rehabilitation Unit is all about. Little did she know, at that time, that she and her husband would have need of our services just a few months later.
Education is a very important part of nursing today. Making sure the community understands how and what we do here at Saint Francis is and will continue to be a very important role for me. And, yes, that education can include your relatives.
Thursday, September 27, 2007
Understanding Vegetarian Diet(s)
By Sarah Daubman, R.D., Staff Dietician
In June of this year I decided to adopt a vegetarian diet. I had attempted the same a few years ago, but did not stay with it in the long run. My interest was renewed after reading T. Colin Campbell’s The China Study, which I would recommend to anyone interested in nutrition research, vegetarianism or disease prevention.
Initially, I challenged myself to stick with it for 30 days. Thirty days has turned into three months and I still remain committed. The benefits of a vegetarian diet have long been clear. In 1997, the American Dietetic Association released their position paper on vegetarian diets stating “that appropriately planned vegetarian diets are healthful, are nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases.”
The paper goes on to describe the lower incidence rate of diseases in vegetarians than non-vegetarians. Specifically, vegetarians are less likely to have coronary artery disease, type II Diabetes Mellitus and lung and colorectal cancer. Also, vegetarians often have lower cholesterols and blood pressure and weigh less than their meat-eating counterparts.
There are different types of vegetarians. Vegans consume no animal products, including meat, poultry, seafood, dairy, eggs and honey. Lacto-vegetarians eat dairy but no meat, seafood or eggs. Ovo-vegetarians eat eggs but no dairy, meat or seafood. You may have heard some newer terms such as “flexitarian” or “semi-vegetarian.” These persons may limit their intake of certain types of meats or seafood, or only eat meat at limited times, for example, red meat once a week. Whether this reflects the true ideal of vegetarianism can be debated.
As noted in my earlier posting I am a lover of the culinary arts as well as nutrition. Trying new recipes is my favorite part of the new lifestyle and I hope to share some with you as this blog progresses. My goal is not to convert the reader, but rather encourage some new dishes at the dinner table. I promise they will not all be about rutabagas.
About The China Study:
http://www.amazon.com/China-Study-Comprehensive-Nutrition-Implications/dp/1932100660/ref=pd_bbs_sr_1/002-6800051-2080043?ie=UTF8&s=books&qid=1189043289&sr=8-1
American Dietetic Association Position Paper on Vegetarian Diets:
http://www.vrg.org/nutrition/adapaper.htm
In June of this year I decided to adopt a vegetarian diet. I had attempted the same a few years ago, but did not stay with it in the long run. My interest was renewed after reading T. Colin Campbell’s The China Study, which I would recommend to anyone interested in nutrition research, vegetarianism or disease prevention.
Initially, I challenged myself to stick with it for 30 days. Thirty days has turned into three months and I still remain committed. The benefits of a vegetarian diet have long been clear. In 1997, the American Dietetic Association released their position paper on vegetarian diets stating “that appropriately planned vegetarian diets are healthful, are nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases.”
The paper goes on to describe the lower incidence rate of diseases in vegetarians than non-vegetarians. Specifically, vegetarians are less likely to have coronary artery disease, type II Diabetes Mellitus and lung and colorectal cancer. Also, vegetarians often have lower cholesterols and blood pressure and weigh less than their meat-eating counterparts.
There are different types of vegetarians. Vegans consume no animal products, including meat, poultry, seafood, dairy, eggs and honey. Lacto-vegetarians eat dairy but no meat, seafood or eggs. Ovo-vegetarians eat eggs but no dairy, meat or seafood. You may have heard some newer terms such as “flexitarian” or “semi-vegetarian.” These persons may limit their intake of certain types of meats or seafood, or only eat meat at limited times, for example, red meat once a week. Whether this reflects the true ideal of vegetarianism can be debated.
As noted in my earlier posting I am a lover of the culinary arts as well as nutrition. Trying new recipes is my favorite part of the new lifestyle and I hope to share some with you as this blog progresses. My goal is not to convert the reader, but rather encourage some new dishes at the dinner table. I promise they will not all be about rutabagas.
About The China Study:
http://www.amazon.com/China-Study-Comprehensive-Nutrition-Implications/dp/1932100660/ref=pd_bbs_sr_1/002-6800051-2080043?ie=UTF8&s=books&qid=1189043289&sr=8-1
American Dietetic Association Position Paper on Vegetarian Diets:
http://www.vrg.org/nutrition/adapaper.htm
Wednesday, September 26, 2007
Care-Givers! Give Yourself A Break
By Dana Pavelock, Director of Home Care Operations
10 Commandments for Care-Givers
1. Be True To Yourself 2. Know Your Limits 3. Make Time for Yourself 4. Know When to Say No 5. Know When To Ask For Help 6. Know When To Get Counseling 7. Have Empathy, Not Sympathy For Your Care Recipient 8. Have Compassion olr Them And Yourself 9. Enlist Your Family Support 10. Create Support for Yourself
Roughly 25 percent of families are relying on informal family caregivers to bridge the needs of caring for a loved one at home. Today, 30 million households are providing care for an adult over the age of 50 and this number is expected to double over the next 25 years. This informal and highly motivated workforce of caregivers often find themselves struggling to navigate a very complex system of health care and are under a great deal of stress. Informal caregivers tend to be family members, mostly women between age 45 and 65, attempting to balance the needs of parents and grandparents with children and grandchildren. Often these individuals find themselves suddenly immersed in the role of caregiver without warning, preparation and/or training and are at risk of compromising their own health care and social needs. Rarely is there a support system for them. As the aging population continues to grow at a very fast rate there will be more and more demands placed upon family caregivers. Combined also with a higher life expectancy and with the trend for the aging population to want to remain at home, we will need ongoing support from local county, government and private agencies.
Some of you reading this may not be in a care-giving role at this time. While you might not be thinking about it now, being proactive and establishing a plan now, in anticipation you will soon be launched into caring for a family member may help avoid some of the stress and other tensions that materialize both at work and at home. The first step should begin with discussing with having a conversation with your and the person you expect will require more care and support to live safely at home, identifying potential support and services that are readily available, anticipating care needs and establishing a plan. All too often, one person takes on the primary role as caregiver which often leads to physical and emotional exhaustion and can result in development of increased health risks to the caregiver.
Fortunately there is help available for individuals who find themselves suddenly in that care-giving role. The best resource is to start by contacting your counties Office for the Aging, surfing the internet and reaching out to home care agencies for help. There is a wealth of information that will provide you with the necessary tools and support you may need so that you can take good care of a loved one and at the same time help maintain your own quality of life. As you might expect, it takes a very special person to fulfill the role of caregiver. In our particular agency, we have long recognized the value of both paid and unpaid family caregivers, recently obtaining a grant through the Dutchess County Office of the Aging to lead a Caregiver Support, Training and Counseling program that provides various workshops, trainings and even an employee to provide one on one visitation in the home, free of charge for caregivers.
When it comes to paid caregivers, please do not underestimate their genuine concern and passion for what it is they do every day. Relationships that are formed between patients and our caregivers is priceless and can be captured by quoting a few words taken from a poem written by Sharon Greene, Home Health Aide; “I am a health care worker, I enjoy my job and this is what I do best. Put a smile on someone’s face, making their day and just being there for them.”
10 Commandments for Care-Givers
1. Be True To Yourself 2. Know Your Limits 3. Make Time for Yourself 4. Know When to Say No 5. Know When To Ask For Help 6. Know When To Get Counseling 7. Have Empathy, Not Sympathy For Your Care Recipient 8. Have Compassion olr Them And Yourself 9. Enlist Your Family Support 10. Create Support for Yourself
Roughly 25 percent of families are relying on informal family caregivers to bridge the needs of caring for a loved one at home. Today, 30 million households are providing care for an adult over the age of 50 and this number is expected to double over the next 25 years. This informal and highly motivated workforce of caregivers often find themselves struggling to navigate a very complex system of health care and are under a great deal of stress. Informal caregivers tend to be family members, mostly women between age 45 and 65, attempting to balance the needs of parents and grandparents with children and grandchildren. Often these individuals find themselves suddenly immersed in the role of caregiver without warning, preparation and/or training and are at risk of compromising their own health care and social needs. Rarely is there a support system for them. As the aging population continues to grow at a very fast rate there will be more and more demands placed upon family caregivers. Combined also with a higher life expectancy and with the trend for the aging population to want to remain at home, we will need ongoing support from local county, government and private agencies.
Some of you reading this may not be in a care-giving role at this time. While you might not be thinking about it now, being proactive and establishing a plan now, in anticipation you will soon be launched into caring for a family member may help avoid some of the stress and other tensions that materialize both at work and at home. The first step should begin with discussing with having a conversation with your and the person you expect will require more care and support to live safely at home, identifying potential support and services that are readily available, anticipating care needs and establishing a plan. All too often, one person takes on the primary role as caregiver which often leads to physical and emotional exhaustion and can result in development of increased health risks to the caregiver.
Fortunately there is help available for individuals who find themselves suddenly in that care-giving role. The best resource is to start by contacting your counties Office for the Aging, surfing the internet and reaching out to home care agencies for help. There is a wealth of information that will provide you with the necessary tools and support you may need so that you can take good care of a loved one and at the same time help maintain your own quality of life. As you might expect, it takes a very special person to fulfill the role of caregiver. In our particular agency, we have long recognized the value of both paid and unpaid family caregivers, recently obtaining a grant through the Dutchess County Office of the Aging to lead a Caregiver Support, Training and Counseling program that provides various workshops, trainings and even an employee to provide one on one visitation in the home, free of charge for caregivers.
When it comes to paid caregivers, please do not underestimate their genuine concern and passion for what it is they do every day. Relationships that are formed between patients and our caregivers is priceless and can be captured by quoting a few words taken from a poem written by Sharon Greene, Home Health Aide; “I am a health care worker, I enjoy my job and this is what I do best. Put a smile on someone’s face, making their day and just being there for them.”
Friday, September 21, 2007
Let's Get Drunk and Drive
By Cynthia Leslie, MD, FACS
Drinking and driving is as American as baseball and apple pie. Alcohol is our drug of choice and boy do we abuse it. Most of the time we’re lucky and people don’t get hurt. But, people who aren’t so lucky end up in the Trauma Center.
Think about it this way, Most of the people we know are fine, upstanding citizens that happily look down their noses at IV drug abusers. Most of those very same people have gotten very drunk. Not only have they gotten drunk, they’ve driven drunk to boot. We hear it all the time- “I only had two beers,” “I know how to handle my liquor,” and “I’m not an alcoholic.” The blah and the blah and the blah, never seem to end. But guess what fine, upstanding? You were drinking and someone is dead.
Here at the Trauma Center, we see patients in distress. We hear screaming and crying, pleading and dying and everything in between. We know that a lot of patients are unfortunate, innocent victims. But many of our unfortunate patients were drunk and incredibly stupid. We see every type of drunkenness that drinking has ever produced, but the drinker we see most often is The Drunk Who Isn’t Drunk. This amazing human being is a marvel to behold. He’s too drunk to tell you his name. He’s too drunk to tell you his age and when you ask him where he lives, he can’t remember that either. He took out a tree at a high rate of speed, and he killed his childhood friend. He’s The Drinker Who Isn’t Drunk and he doesn’t know how it happened.
We also take care of the drinker who’s Only An After Work Drinker. As soon as this drinker leaves her job, she drinks herself to sleep. From 6 p.m. through 6a.m., she’s as drunk as drunk can be and whenever she goes for a drive, bad things tend to happen. When she ends up in the trauma room, she asks the age-old question. But, I’m Only An After Work Drinker – how could this have happened?
And then there is the ultimate drinker, The Drinker Who Knows How To Kill. They murder your sweetheart, or husband. They murder your wife and kids. They also dismember your mother and leave your father face down in a ditch. The Drinker Who Knows How to Kill, look like normal people. They binge on booze on weekends, or they drink throughout the week. However they choose to do it, they’re drinking to get drunk and every time they tie one on, they always want to drive.
Now the last thing a drinker should do is go for a drive while drunk, but no matter how often we say it, no one seems to listen. People get on their ATVs and ride their motorcycles. They jump into their motorboats and rev up the engines. It almost makes me wonder why the trauma team makes a fuss. Perhaps we should all start drinking, just like out drunken patients.
So here’s to driving drunk and not caring about our children. Here’s to driving drunk and murdering all our neighbors. Here’s to driving drunk and becoming a quadriplegic. Here’s to driving drunk and learning to be a widow. Every time we drink and drive, we’re sure to have some fun. Here’s to drinking and driving and killing the people we love.
Drinking and driving is as American as baseball and apple pie. Alcohol is our drug of choice and boy do we abuse it. Most of the time we’re lucky and people don’t get hurt. But, people who aren’t so lucky end up in the Trauma Center.
Think about it this way, Most of the people we know are fine, upstanding citizens that happily look down their noses at IV drug abusers. Most of those very same people have gotten very drunk. Not only have they gotten drunk, they’ve driven drunk to boot. We hear it all the time- “I only had two beers,” “I know how to handle my liquor,” and “I’m not an alcoholic.” The blah and the blah and the blah, never seem to end. But guess what fine, upstanding? You were drinking and someone is dead.
Here at the Trauma Center, we see patients in distress. We hear screaming and crying, pleading and dying and everything in between. We know that a lot of patients are unfortunate, innocent victims. But many of our unfortunate patients were drunk and incredibly stupid. We see every type of drunkenness that drinking has ever produced, but the drinker we see most often is The Drunk Who Isn’t Drunk. This amazing human being is a marvel to behold. He’s too drunk to tell you his name. He’s too drunk to tell you his age and when you ask him where he lives, he can’t remember that either. He took out a tree at a high rate of speed, and he killed his childhood friend. He’s The Drinker Who Isn’t Drunk and he doesn’t know how it happened.
We also take care of the drinker who’s Only An After Work Drinker. As soon as this drinker leaves her job, she drinks herself to sleep. From 6 p.m. through 6a.m., she’s as drunk as drunk can be and whenever she goes for a drive, bad things tend to happen. When she ends up in the trauma room, she asks the age-old question. But, I’m Only An After Work Drinker – how could this have happened?
And then there is the ultimate drinker, The Drinker Who Knows How To Kill. They murder your sweetheart, or husband. They murder your wife and kids. They also dismember your mother and leave your father face down in a ditch. The Drinker Who Knows How to Kill, look like normal people. They binge on booze on weekends, or they drink throughout the week. However they choose to do it, they’re drinking to get drunk and every time they tie one on, they always want to drive.
Now the last thing a drinker should do is go for a drive while drunk, but no matter how often we say it, no one seems to listen. People get on their ATVs and ride their motorcycles. They jump into their motorboats and rev up the engines. It almost makes me wonder why the trauma team makes a fuss. Perhaps we should all start drinking, just like out drunken patients.
So here’s to driving drunk and not caring about our children. Here’s to driving drunk and murdering all our neighbors. Here’s to driving drunk and becoming a quadriplegic. Here’s to driving drunk and learning to be a widow. Every time we drink and drive, we’re sure to have some fun. Here’s to drinking and driving and killing the people we love.
Thursday, September 13, 2007
DVT: The Silent Killer
By Susan Hecht, RN, Nursing Rehabilitation Liaison
Deep vein thrombosis affects up to 2 million Americans each year. DVT is a blood clot that forms in the deep veins of the legs, usually leading to either partially or completely blocked circulation. If untreated, this clot has the potential to travel to the lungs and block circulation to vital organs.
Learning the preventable measures and becoming aware of the disease will decrease the possibility of having a DVT. I have taken a special interest in this topic because I do not feel there is enough education in the community regarding deep vein thrombosis. Most people have never heard of DVT. The key prevention is AWARENESS. Learning who is at risk and why is a very important step in learning how to prevent becoming a DVT victim.
DVT is often caused by immobilization, trauma and surgery. Some of the more common symptoms are pain and swelling in the legs. Preventative measures include early mobilization, compression devices to promote blood flow and/or anti-coagulation therapy prescribed by your physician.
At Saint Francis Hospital, we’ve taken on the challenge of spreading awareness about DVT. We will be hosting a DVT Awareness Day on Thursday, Sept. 20. We will be joined by Melanie Bloom, widow of the late NBC Correspondent David Bloom who died in the early stages of the Iraq War from DVT complications. Melanie Bloom, the national spokesperson for the Coalition to Prevent DVT, will participate in a DVT Awareness presentation and question and answer session from 11:30 a.m. to 12:30 p.m. at our Atrium Community Conference Center.
This event is free and open to the public, but registration is encouraged. Please RSVP at 845-483-5777.
Deep vein thrombosis affects up to 2 million Americans each year. DVT is a blood clot that forms in the deep veins of the legs, usually leading to either partially or completely blocked circulation. If untreated, this clot has the potential to travel to the lungs and block circulation to vital organs.
Learning the preventable measures and becoming aware of the disease will decrease the possibility of having a DVT. I have taken a special interest in this topic because I do not feel there is enough education in the community regarding deep vein thrombosis. Most people have never heard of DVT. The key prevention is AWARENESS. Learning who is at risk and why is a very important step in learning how to prevent becoming a DVT victim.
DVT is often caused by immobilization, trauma and surgery. Some of the more common symptoms are pain and swelling in the legs. Preventative measures include early mobilization, compression devices to promote blood flow and/or anti-coagulation therapy prescribed by your physician.
At Saint Francis Hospital, we’ve taken on the challenge of spreading awareness about DVT. We will be hosting a DVT Awareness Day on Thursday, Sept. 20. We will be joined by Melanie Bloom, widow of the late NBC Correspondent David Bloom who died in the early stages of the Iraq War from DVT complications. Melanie Bloom, the national spokesperson for the Coalition to Prevent DVT, will participate in a DVT Awareness presentation and question and answer session from 11:30 a.m. to 12:30 p.m. at our Atrium Community Conference Center.
This event is free and open to the public, but registration is encouraged. Please RSVP at 845-483-5777.
Monday, August 27, 2007
My Father’s Daughter or, the Importance of Proper Hydration
By Joanne Chaconis, R.D.
I think I am a lot like my dad…same sense of humor, just as stubborn and we both love sweets. Practically a carbon copy, with a few exceptions. One of those exceptions? I drink fully enough fluids daily to keep me well hydrated. My dad, on the other hand, is not as diligent. Every conversation that I have with him always includes reminders (some gentle, some not-so-gentle) of the importance of drinking enough fluids.
This seemed to be an important and timely topic to discuss. Timely because of the summer season we are now enjoying. There are many factors that increase our need for fluids and they include: excessive perspiration, fever, vomiting, diarrhea and hyperventilation. I should also mention here that under some medical conditions (such as certain cardiac and renal diseases) your fluid needs may actually decrease. Always check with your physician.
A general rule to follow when determining fluid needs for a healthy individual (according to the Committee on Dietary Reference Intakes) is:
Age in years ml/kg (wt)
Young, active (16-30) 40
Average activity (25-54) 35
Older (55-65) 30-35
Older (>65) 25-30
Here is an example: To convert ml to ounces, divide by 30.
To convert kg to pounds, divide by 2.2.
A 50 year-old adult weighing 150 pounds:
150 pounds divided by 2.2 kg = 68 kg
68 kg x 30-35 ml = 2040-2380 ml
2040 – 2380 ml divided by 30 ml = 68-79 ounces, which translates to between 8 ½ to 10 eight ounce servings daily.
Best beverage choices are water, sugar-free juices and sodas and decaffeinated beverages. Also fruits are a good choice because they are about 20 percent water-packed.
So…toast a loved one (here’s to you dad!) with an eight ounce glass of cool water and stay hydrated!
I think I am a lot like my dad…same sense of humor, just as stubborn and we both love sweets. Practically a carbon copy, with a few exceptions. One of those exceptions? I drink fully enough fluids daily to keep me well hydrated. My dad, on the other hand, is not as diligent. Every conversation that I have with him always includes reminders (some gentle, some not-so-gentle) of the importance of drinking enough fluids.
This seemed to be an important and timely topic to discuss. Timely because of the summer season we are now enjoying. There are many factors that increase our need for fluids and they include: excessive perspiration, fever, vomiting, diarrhea and hyperventilation. I should also mention here that under some medical conditions (such as certain cardiac and renal diseases) your fluid needs may actually decrease. Always check with your physician.
A general rule to follow when determining fluid needs for a healthy individual (according to the Committee on Dietary Reference Intakes) is:
Age in years ml/kg (wt)
Young, active (16-30) 40
Average activity (25-54) 35
Older (55-65) 30-35
Older (>65) 25-30
Here is an example: To convert ml to ounces, divide by 30.
To convert kg to pounds, divide by 2.2.
A 50 year-old adult weighing 150 pounds:
150 pounds divided by 2.2 kg = 68 kg
68 kg x 30-35 ml = 2040-2380 ml
2040 – 2380 ml divided by 30 ml = 68-79 ounces, which translates to between 8 ½ to 10 eight ounce servings daily.
Best beverage choices are water, sugar-free juices and sodas and decaffeinated beverages. Also fruits are a good choice because they are about 20 percent water-packed.
So…toast a loved one (here’s to you dad!) with an eight ounce glass of cool water and stay hydrated!
It Only Takes A Second
By Cynthia Leslie, M.D.
Most people would probably tell you that a second is very short, but I think time is relative and it depends on what you do. I work in Saint Francis Hospital’s very busy Trauma Center, and I am constantly reminded that seconds are very precious. The trauma team treats thousands of patients who have been harmed in different ways. Some have been injured in car crashes and some have been shot or stabbed. A number of our elderly neighbors require treatment due to falls. Whatever the injuries are, there is always a common denominator. Patients need our help and we have seconds in which to give it.
When patients arrive in the trauma room, the trauma team is ready. We first look for life-threatening injuries that require immediate treatment. If a patient has trouble breathing, her lung could be collapsed. If the patient has internal bleeding, he may present with signs of shock. When the body is oxygen deprived, the brain is extremely vulnerable and brain death can occur in as little as four to six minutes. The trauma team’s job is to immediately assess, resuscitate and treat and we do all of that very quickly because we know that seconds count.
Trauma is the number one killer of our youngest and healthiest neighbors. It is also a merciless scavenger that maims the old and frail. Heart disease and cancer are widely known public health problems, but the grisly toll that trauma takes frequently goes un-noticed. Hundreds of thousands of people have died on U.S. highways. Hundreds of people die every day as the result of senseless violence. Trauma is more than an injury. It is a national epidemic and until we acknowledge the damage it does, we won’t do much about it. People are driving way too fast and people are much too angry. If you think that rage and speed don’t kill you need to think again. Trauma is killing our youngest, our oldest, our best and our brightest. We need to address the problems and we need to do it now.
It only takes a second to crash into a tree, but that second could be avoided by driving a bit more slowly. It only takes a second to hit and kill a child, but that second could be avoided by refusing to drink and drive. It only takes a second to remember to use your seatbelt and it takes another second to tell your children to do the same. If we use our seconds wisely we will save our neighbors’ lives. What better way to use them when it takes so little time
Most people would probably tell you that a second is very short, but I think time is relative and it depends on what you do. I work in Saint Francis Hospital’s very busy Trauma Center, and I am constantly reminded that seconds are very precious. The trauma team treats thousands of patients who have been harmed in different ways. Some have been injured in car crashes and some have been shot or stabbed. A number of our elderly neighbors require treatment due to falls. Whatever the injuries are, there is always a common denominator. Patients need our help and we have seconds in which to give it.
When patients arrive in the trauma room, the trauma team is ready. We first look for life-threatening injuries that require immediate treatment. If a patient has trouble breathing, her lung could be collapsed. If the patient has internal bleeding, he may present with signs of shock. When the body is oxygen deprived, the brain is extremely vulnerable and brain death can occur in as little as four to six minutes. The trauma team’s job is to immediately assess, resuscitate and treat and we do all of that very quickly because we know that seconds count.
Trauma is the number one killer of our youngest and healthiest neighbors. It is also a merciless scavenger that maims the old and frail. Heart disease and cancer are widely known public health problems, but the grisly toll that trauma takes frequently goes un-noticed. Hundreds of thousands of people have died on U.S. highways. Hundreds of people die every day as the result of senseless violence. Trauma is more than an injury. It is a national epidemic and until we acknowledge the damage it does, we won’t do much about it. People are driving way too fast and people are much too angry. If you think that rage and speed don’t kill you need to think again. Trauma is killing our youngest, our oldest, our best and our brightest. We need to address the problems and we need to do it now.
It only takes a second to crash into a tree, but that second could be avoided by driving a bit more slowly. It only takes a second to hit and kill a child, but that second could be avoided by refusing to drink and drive. It only takes a second to remember to use your seatbelt and it takes another second to tell your children to do the same. If we use our seconds wisely we will save our neighbors’ lives. What better way to use them when it takes so little time
Honoring Home Care's Unsung Heroes
By Dana Pavelock
We often get calls and questions about Personal Care Aides and Home Health Aides. The general public has developed their own perception based on a slew of articles that may or may not really capture the essence of who these people are and how important the work is that they do. This has often led to misconceptions about the level of training or skills of these workers.
For the most part, individuals performing this level of para-professional health care service consist of a group of people who have a commitment to caring for others. They are men and women of varying ages and backgrounds who understand the vital role that they serve. They provide services and care to individuals on either a short term or long-term basis to improve quality of life, preserve dignity of self and maintain patient’s ability to remain home for as long as they choose. Services range from companionship to total care, one hour a day to live in aides, with settings ranging from plush private homes to inner city projects. Home Health Aides and Personal Care Aides experience much satisfaction providing care and develop wonderful relationships with patients and family members alike, and at the same time often are under appreciated for who they are and what they do.
PCA’s and HHA’s are required to complete training classes ranging from seven days to two weeks in length through a health training curriculum that is approved by the Department of Social Services and the NYS Department of Health. Some of the training consists specifically on working with children and disabled population, meal preparation, complex diets and nutrition, spending & budgeting, care of the home & personal belongings, infection control, personal care related to bathing, dressing, grooming, ambulating and transferring patients, use of mechanical lifts and other medical equipment, and assisting with medications.
HHA’s receive enhanced training in areas such as how to measure vital signs, prepare complex modified diets, assist with prescribed exercise programs, use other prescribed medical equipment, provide special skin care, and assist with dressing changes. The training is very detailed and students not only have to complete the training, they need to pass academic testing and demonstrate competency in each module. They are also required to participate in on-going in-service training throughout the year and demonstrate competency in the field under the direct supervision of a Registered Nurse. For more information regarding the training curriculum and to see exactly what services and activities are permissible by a Home Health Aide please visit the following site: www.nyhealth.gov/ and search Home Health Aide Training.
Like other agencies that deliver HHA & PCA services, every week we receive positive feedback from patients we serve who express high levels of satisfaction in for the services of our aides, who routinely go above and beyond the call of duty. HHA & PCA staff never cease to amaze us with their focus on providing exceptional care and customer service, doing so from the heart without seeking recognition. In many ways they are the unsung heroes in our health delivery system.
Please help the health care community recognize the valuable and important role our home care aides provide. We ask that you simply understand the work they do and whenever you have the opportunity, let them know how appreciated they are for what they do.
We often get calls and questions about Personal Care Aides and Home Health Aides. The general public has developed their own perception based on a slew of articles that may or may not really capture the essence of who these people are and how important the work is that they do. This has often led to misconceptions about the level of training or skills of these workers.
For the most part, individuals performing this level of para-professional health care service consist of a group of people who have a commitment to caring for others. They are men and women of varying ages and backgrounds who understand the vital role that they serve. They provide services and care to individuals on either a short term or long-term basis to improve quality of life, preserve dignity of self and maintain patient’s ability to remain home for as long as they choose. Services range from companionship to total care, one hour a day to live in aides, with settings ranging from plush private homes to inner city projects. Home Health Aides and Personal Care Aides experience much satisfaction providing care and develop wonderful relationships with patients and family members alike, and at the same time often are under appreciated for who they are and what they do.
PCA’s and HHA’s are required to complete training classes ranging from seven days to two weeks in length through a health training curriculum that is approved by the Department of Social Services and the NYS Department of Health. Some of the training consists specifically on working with children and disabled population, meal preparation, complex diets and nutrition, spending & budgeting, care of the home & personal belongings, infection control, personal care related to bathing, dressing, grooming, ambulating and transferring patients, use of mechanical lifts and other medical equipment, and assisting with medications.
HHA’s receive enhanced training in areas such as how to measure vital signs, prepare complex modified diets, assist with prescribed exercise programs, use other prescribed medical equipment, provide special skin care, and assist with dressing changes. The training is very detailed and students not only have to complete the training, they need to pass academic testing and demonstrate competency in each module. They are also required to participate in on-going in-service training throughout the year and demonstrate competency in the field under the direct supervision of a Registered Nurse. For more information regarding the training curriculum and to see exactly what services and activities are permissible by a Home Health Aide please visit the following site: www.nyhealth.gov/ and search Home Health Aide Training.
Like other agencies that deliver HHA & PCA services, every week we receive positive feedback from patients we serve who express high levels of satisfaction in for the services of our aides, who routinely go above and beyond the call of duty. HHA & PCA staff never cease to amaze us with their focus on providing exceptional care and customer service, doing so from the heart without seeking recognition. In many ways they are the unsung heroes in our health delivery system.
Please help the health care community recognize the valuable and important role our home care aides provide. We ask that you simply understand the work they do and whenever you have the opportunity, let them know how appreciated they are for what they do.
Thursday, August 23, 2007
A Visit With Mom And Rutabagas
By Sarah Daubman, R.D.
Not too long ago I sat with my mother at her kitchen table drinking coffee. Somehow the conversation turned to childhood memories, particularly those involving food and favorite recipes. “Do you know what I haven’t had in almost twenty years?” she asked. “Rutabagas.”
She went on to describe how much she loved the mashed rutabagas she enjoyed as a child. Being a dietitian and lover of food in all ways, my curiosity was piqued. Though I pride myself on the willingness to try just about any exotic, gourmet food, I could not recall ever having a rutabaga, a simple, humble vegetable at best. I questioned my mother: Is a rutabaga the same as a turnip? How do you cook it? What does it taste like?
Of course I had to research some of this information on my own. As it turns out, the rutabaga is not the same as a turnip, though they are closely related and rutabagas may be referred to as “yellow turnips.” Rutabagas are round root vegetables with yellow-orange flesh around the top and white/yellow skin around the bottom. If searching for them in the grocery store, which I later found myself doing, you will likely find them next to the turnips. Their color and larger size should help differentiate the two.
Upon returning home with the newly purchased vegetable, I set upon making mashed rutabagas for my mother. The rutabagas had a waxy covering that easily peeled away with the skin using a vegetable peeler. The next task was not as easy – cutting the rutabagas. I used a large chef’s knife to slice the root vegetable in half and then into smaller and smaller pieces. I added the 1-inch cubes to a pot of water, brought the water to a boil and cooked them until easily pierced with a fork.
Based on the recommendations of my mother and other researched recipes, I treated the cooked rutabagas much like potatoes. As many ways as there are to make mashed potatoes, so there are for mashed rutabagas. My mother’s preference was milk, butter, salt and pepper. Upon presenting the dish to her she was delighted to find them as a good as she remembered. I have since discovered other methods of preparation: mashed alone or with potatoes, turnips or squash, roasted with olive oil and herbs, grated into salads or cole slaw, diced into soup or caramelized with onions.
I find the rutabaga to have a distinct flavor, tastier than the mild turnip in my opinion. Of course, the nutritious side of rutabagas should also be mentioned (see link: http://www.vegparadise.com /highestperch4.html). I encourage you to experiment with your own recipes. If taken the time, I’m sure you will find the rutabaga a wonderful addition to your family’s meals and discover, as I did, it is a vegetable not only your mother will love.
Not too long ago I sat with my mother at her kitchen table drinking coffee. Somehow the conversation turned to childhood memories, particularly those involving food and favorite recipes. “Do you know what I haven’t had in almost twenty years?” she asked. “Rutabagas.”
She went on to describe how much she loved the mashed rutabagas she enjoyed as a child. Being a dietitian and lover of food in all ways, my curiosity was piqued. Though I pride myself on the willingness to try just about any exotic, gourmet food, I could not recall ever having a rutabaga, a simple, humble vegetable at best. I questioned my mother: Is a rutabaga the same as a turnip? How do you cook it? What does it taste like?
Of course I had to research some of this information on my own. As it turns out, the rutabaga is not the same as a turnip, though they are closely related and rutabagas may be referred to as “yellow turnips.” Rutabagas are round root vegetables with yellow-orange flesh around the top and white/yellow skin around the bottom. If searching for them in the grocery store, which I later found myself doing, you will likely find them next to the turnips. Their color and larger size should help differentiate the two.
Upon returning home with the newly purchased vegetable, I set upon making mashed rutabagas for my mother. The rutabagas had a waxy covering that easily peeled away with the skin using a vegetable peeler. The next task was not as easy – cutting the rutabagas. I used a large chef’s knife to slice the root vegetable in half and then into smaller and smaller pieces. I added the 1-inch cubes to a pot of water, brought the water to a boil and cooked them until easily pierced with a fork.
Based on the recommendations of my mother and other researched recipes, I treated the cooked rutabagas much like potatoes. As many ways as there are to make mashed potatoes, so there are for mashed rutabagas. My mother’s preference was milk, butter, salt and pepper. Upon presenting the dish to her she was delighted to find them as a good as she remembered. I have since discovered other methods of preparation: mashed alone or with potatoes, turnips or squash, roasted with olive oil and herbs, grated into salads or cole slaw, diced into soup or caramelized with onions.
I find the rutabaga to have a distinct flavor, tastier than the mild turnip in my opinion. Of course, the nutritious side of rutabagas should also be mentioned (see link: http://www.vegparadise.com /highestperch4.html). I encourage you to experiment with your own recipes. If taken the time, I’m sure you will find the rutabaga a wonderful addition to your family’s meals and discover, as I did, it is a vegetable not only your mother will love.
Bright Sunshine Equals Horrible Sunburn
By Susan Hecht, R.N.
I have to tell you, at times this summer it has been extremely hot. During one of those hot spells I had an experience with my friend, Ryan, and the hot weather. I work inside so I am fortunate enough to have an air conditioner to keep me cool. Anyone that works outdoors that I know I always express my concerns regarding sunburns and heat exhaustion. Those things that go with this wonderful summer-time weather.
Ryan is in the process of building a house. Well, he tells me that he is going to work on his house the following day. I watch the weather and see the forecast calls for a high temperature of 96 degrees. Keeping in mind that the work he is preparing to complete is OUTSIDE work, I explain to him about making sure he has plenty of water, sun block and to wear a shirt to prevent sunburn.
I must say that men are the worst when it comes to wearing sun block. I expressed my concerns about heat exhaustion, having plenty of water, taking breaks out of the sun – in an air conditioned area, if at all possible – and wearing light clothing. I would love to hear of any man who would listen to all these instructions before going outdoors to work!
Well, I must say that evening after spending a day with NO shirt on, very little to drink (I’m sure) and working on the outside deck of the house for about 5 straight hours - with no break from the sun – my friend began to complain about having the chills. You could feel the heat coming off his back.
So I asked – did you drink enough water? Did you wear a shirt? Did you take breaks out of the sun? His reply was that he needed to get the house done and I don’t have time for breaks. And, of course, he had taken off his shirt because it was so hot!
Needless to say, Ryan spent the next two days in pain with discomfort and NO work was done on the house during that time.
When he did get back to working on the house he was well armed with sun block, a jug of water and wore a light shirt. He took frequent breaks during which he applied more sun block.
It is summer time, let’s remember the things we don’t focus on with the nice weather. The sun burns so use sun block. To combat dehydration drink plenty of water or other non-alcoholic beverages. Take breaks out of the sun, preferably in air-conditioned areas. If you feel dizzy or faint see a doctor immediately. As for Ryan, he continues to work on the house but he hasn’t burned since that day.
I have to tell you, at times this summer it has been extremely hot. During one of those hot spells I had an experience with my friend, Ryan, and the hot weather. I work inside so I am fortunate enough to have an air conditioner to keep me cool. Anyone that works outdoors that I know I always express my concerns regarding sunburns and heat exhaustion. Those things that go with this wonderful summer-time weather.
Ryan is in the process of building a house. Well, he tells me that he is going to work on his house the following day. I watch the weather and see the forecast calls for a high temperature of 96 degrees. Keeping in mind that the work he is preparing to complete is OUTSIDE work, I explain to him about making sure he has plenty of water, sun block and to wear a shirt to prevent sunburn.
I must say that men are the worst when it comes to wearing sun block. I expressed my concerns about heat exhaustion, having plenty of water, taking breaks out of the sun – in an air conditioned area, if at all possible – and wearing light clothing. I would love to hear of any man who would listen to all these instructions before going outdoors to work!
Well, I must say that evening after spending a day with NO shirt on, very little to drink (I’m sure) and working on the outside deck of the house for about 5 straight hours - with no break from the sun – my friend began to complain about having the chills. You could feel the heat coming off his back.
So I asked – did you drink enough water? Did you wear a shirt? Did you take breaks out of the sun? His reply was that he needed to get the house done and I don’t have time for breaks. And, of course, he had taken off his shirt because it was so hot!
Needless to say, Ryan spent the next two days in pain with discomfort and NO work was done on the house during that time.
When he did get back to working on the house he was well armed with sun block, a jug of water and wore a light shirt. He took frequent breaks during which he applied more sun block.
It is summer time, let’s remember the things we don’t focus on with the nice weather. The sun burns so use sun block. To combat dehydration drink plenty of water or other non-alcoholic beverages. Take breaks out of the sun, preferably in air-conditioned areas. If you feel dizzy or faint see a doctor immediately. As for Ryan, he continues to work on the house but he hasn’t burned since that day.
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