As you may know, this week is National Nursing Home Week. This is OUR week to shine! Every skilled nursing care center embodies a unique and vibrant spirit and community for residents, volunteers and staff alike. Acts of kindness, generosity and compassion from proud veterans, immigrants, and hardworking people of different faiths fill the walls of each center. The theme this year for nursing home week is “The Spirit of America.” This theme underscores the bond between staff, volunteers, and residents that capture the American spirit. Yesterday was our largest celebration of the week; our carnival! We had a live band, food, drinks, lots of fun games, local assisted living residents, seniors, young children, local home health and hospice agencies, and families galore! Our parade began at 1:00 and included a local fire truck, vintage cars, sports cars, horses, and our float that carried our Mr. and Mrs. Mitchell-Hollingsworth, prom king, and queen. This is such a great event for our residents and we are happy to be able to bring this carnival to them because we are honored to serve them. Thank you to our residents and to their loved ones for connecting with us. Thank you to our staff, volunteers, and local agency volunteers. It takes special people to be able to do this work, and we are especially grateful to have people who go above and beyond to connect with our residents. They make impactful connections with our residents and that is something that can never be taken away. If you missed it this year, then be sure to mark it on your calendar for next year. This is an event is one you won’t want to miss. Check out just a few of our staff pictures from our big event! Source: https://www.ahcancal.org/events/national_nursing_home_week/Pages/default.aspx

This week is Nurse’s Week. It’s a very important week for our facility because of the important role nurses play here at Mitchell-Hollingsworth. Nurses are the caregivers, communicators, patient/resident advocates, and decision makers. They are the hand-holders, the calming voice, the familiar face, and the bedside best friend. To many of our residents, nurses are guardian angels. The nursing profession can be physically exhausting and emotionally draining. It is a demanding profession filled with very little thank yous. Let’s lift our nurses up this week and thank them for the pivotal role they play in the healing process. Let’s thank them for their passion and for their compassion. Thank them for their kindness, dedication, and healing touch. Let’s show them that their profession has meaning and is truly …life changing. Being A NURSE Means… You will never be bored. You will always be frustrated. You will be surrounded by challenges, So much to do and so little time. You will carry immense responsibility And very little authority. You will step into people’s lives And you will make a difference. Some will bless you. Some will curse you. You will see people at their worst- And at their best. You will never cease to be amazed At people’s capacity for Love, courage, and endurance. You will see life begin- and end. You will experience resounding triumphs And devastating failures. You will cry a lot. You will laugh a lot. You will know what it is to be human- And to be humane. -Melodie Chenevert

This Friday is World Hand Hygiene Day! What better time to educate on the importance of hand washing and reducing antibiotic resistance. Hand hygiene is a great way to prevent infections. It is the first line of defense against the spread of many illnesses ranging from the common cold to more serious infections such as meningitis, the flu, and most types of infectious diarrhea. It’s such an easy way to help prevent infection, yet many still do not wash their hands. While it’s extremely important for healthcare workers to maintain good hand hygiene, it’s also important for the patients in hospitals and you at home. Most germs that cause serious infections are spread by people’s actions. Keeping hands clean through proper hand hygiene is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases are spread simply because of a lack of proper washing with soap, and clean running water. Due to the high volume of infectious germs in hospitals, nurses and healthcare employees have to be especially vigilant in their hand washing procedures otherwise every patient in the hospital is at risk of getting an infection while they are being treated for something else. Proper hygiene reduces respiratory illnesses, like colds, as well as diarrheal infections, and preventing sickness will in turn reduce the amount of antibiotics people use and the likelihood that antibiotic resistance will develop. Antibiotics are often prescribed unnecessarily for these health issues and we want the antibiotics to work when they are truly in need. Hand washing can also prevent people from getting sick with the germs that are already resistant to antibiotics and that are difficult to treat. Healthcare providers should clean their hands before and after every patient contact to protect themselves as well as their patients from infections. They should also clean in between different procedures so to not spread germs. Patients should clean their hands frequently and ask their visitors to do so as well. People often forget to wash their hands after they use the restroom and then touch doorknobs, light switches, handrails, table tops, phones, food, and other objects. Germs from unwashed hands can get into foods and drinks and can often multiply in these environments and then are ingested and make people sick. Germs can be transferred to individuals’ hands after touching an object and they then touch their eyes, nose, and mouth without realizing it and the germs have entered the body. Always wash your hands: Before, during, and after preparing food Before eating food Before and after caring for someone who is sick Before and after treating a cut or wound After using the toilet After changing diapers or cleaning up a child who has used the toilet After blowing your nose, coughing, or sneezing After touching an animal, animal feed, or animal waste After handling pet food or pet treats After touching garbage The proper way to clean your hands is to: Wet your hands with clean, running water and apply soap. Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, wrists, and under your nails. Scrub your hands for at least 20 seconds. Need a timer? Hum the "Happy Birthday" song from beginning to end twice. Rinse your hands well under clean, running water. Dry your hands using a clean towel or air dry them. If soap and water are unavailable, use an alcohol-based hand sanitizer that contains at least 60% alcohol to clean hands. Alcohol-based hand sanitizer kills most of the bad germs that make you sick and is the preferred way to clean your hands in healthcare settings unless visibly dirty or before or after a procedure. Alcohol-based hand sanitizer does not eliminate all types of germs such as C. diff, a common healthcare-associated infection that causes severe diarrhea. Patients with C. diff should wash their hands with soap and water and make sure their healthcare providers always wear gloves when caring for them. When using Alcohol-based hand sanitizer, put product on hands and rub together covering backs of hands and in between fingers. Continue covering all surfaces until hands are dry. This should take around 20 seconds. Hand hygiene is all about education. Know that it's ok to ask your nurse and family members about hand hygiene and remind them to wash regularly. You never know when you might prevent that next big infection! Source: https://www.cdc.gov/features/handhygiene/

This week is National Volunteer Week! This is such a great opportunity to recognize and thank our volunteers at Mitchell-Hollingsworth, the hospitals, and all over the community for lending their time, talent, voice, and support to causes they love and care about. They certainly inspire with their kind and giving hearts and we are so grateful for them. Have you ever thought about volunteering, but didn’t know what, how, or where to go to begin? We can be of assistance! If you’re on the fence, please know and understand that as a volunteer, you have the ability to spark change and improve the world. You have the ability to completely alter someone’s life. Life experiences are indispensable. Sometimes the life altered might be your own. If you’re running low on ideas on how to volunteer, here are some ideas: Spend quality time with a resident- It is such a meaningful experience to the resident. Learn about them, discover their passion, their skills, and absorb their memories and wisdom. If you don’t already know a senior at our facility, we may be able to find one or two that appreciate the time spent with a kind heart. Bingo volunteer- You could call out numbers and help players find their called numbers on their cards. Manicures- Residents love to feel beautiful! What’s better than beautiful freshly painted nails? Four legged volunteers- Did you know we allow you to bring a friendly dog or cat? Speak with one of our resident representatives beforehand and schedule a time to come so residents can enjoy some pet therapy! Transporting- Lend a hand and transport residents back and forth to their rooms. It’s a great opportunity for a quick chat. Singing- Do you have a nice singing voice? The residents adore hearing all kinds of music! Crafts- Have a craft in mind? We will help you put it in action. Our residents love doing something new and fun and are very open minded in trying new things. Parties- We are always having parties! We host a monthly birthday party at the end of the month and could always use a hand handing out cupcakes and food, and keeping drinks filled. If you’re still unsure of how you might be able to help out, then reach out to our Activity Director. She is the one who plans our calendar and will know where help and assistance is most needed. You might not think that volunteering at a nursing home would be all fun and games, but you’d be surprised! Source: https://ww2.pointsoflight.org/nvw

Good nutrition adds years to life and life to your years. As people age, their diets may need to change, especially if their diets are not well-balanced. Doctors generally recommend a well-balanced diet for older adults that include a variety of fruits, vegetables, proteins, and whole grains to maintain and improve overall health. The benefits from eating a healthy diet can include increased mental acuteness, higher energy levels, resistance to illness, and better management of chronic health problems. In addition to eating a healthy variety of foods, there are also a few specific things a caregiver can incorporate into their loved one’s diet to boost his or her health. Some older adults may even have different challenges to face such as a loss of appetite with unhealthy weight loss, problems chewing, or a need to reduce fat and sugar with certain chronic conditions and we hope to provide some assistance to those challenges. Here are some tips to remember for a healthy diet: Increase fruits and vegetables. – The fiber, vitamins, and enzymes present in fresh plants are best for all of us. For those with chewing or dental issues, try steaming the vegetables to make them softer. Make lunch the big meal of the day. – Often by dinner, older adults are too tired to finish meals. They are also more prone to digestive issues and a large meal late in the evening might interfere with a good night’s rest. Doctor’s often recommend putting on more calories earlier in the day rather than in the evening or before bed. Stay hydrated. – Water is an important nutrient too! It’s important to maintain the body’s fluid levels. This can be done by sipping on liquids throughout the day. Water, tea, and coffee are better choices than fluids containing sugar or salt. Fruits and vegetables also naturally hydrate. Eat whole grains. – When making a decision about which breads to choose, always go for the one higher in whole grains. These take longer to digest and will keep your blood sugar levels more stable. Don’t skip meals. – Skipping meals usually makes someone eat more at the following meal and can drop blood sugar levels causing dizziness. Eat smaller meals more often. – It is better for older adults to eat 5-6 small meals a day because this can reduce the highs and lows of insulin levels, encourage more calorie intake for those who have lost their appetites, assist with those who find it painful eating large meals or who have difficulty swallowing or breathing, and offer more opportunities to socialize with others. For those needing to gain weight, increase calories in snacks. One idea is to make shakes with peanut butter, bananas, or chocolate! Include healthy nutrients. Speak with your doctor about any necessary nutrients you should be adding to your diet. They can also be taken as a supplement with the correct dosage prescribed by your doctor. Omega 3 fatty acids- These acids have been proven to reduce inflammation, which can cause heart disease, cancer, and arthritis. They can be found in flaxseeds and flaxseed oil, walnuts, and different types of fish. Calcium- The need for calcium increases as we age. This is primarily to preserve bone health. It can also help lower blood pressure. Calcium can be found in orange juice, dairy milk, and leafy greens like kale and turnip greens. Eat with your loved one. – No one likes to eat alone. It is possible there is a lack of interest in eating because a person is bored, lonely, or distracted by TV and could be a reason for weight loss. Stay with them and don’t rush them. For those who eat slowly, reheating food may help them to finish a meal that has cooled. Incorporate softer foods for those with dental, chewing, or swallowing problems. – Make chunky stews that are soft and easy to eat. Shredded pork or chicken is a good option, but keep in mind that cutting up food before serving may increase the dignity of the meal. Smoothies are also a great choice for breakfast and are great for adding vitamins and nutrients. A general rule of thumb is to stick to foods in their “whole” or natural state. Speak with your doctor about specific meal plans if you are having health issues. For some heart-related conditions, a reduced sodium (salt) diet may be needed. For those with diabetes, counting carbohydrates and looking for hidden sugar may be needed. Most of the time, a little sweet treat every now and then won’t hurt a thing. Dark chocolate is even actually good for you. Remember, you don’t have to change all of your eating habits at once. Start with small steps and try to make one good change per meal. Source: http://www.sageminder.com/Caregiving/ElderlyNutrition.aspx

Easter is right around the corner! Regardless of religious beliefs, the Easter season is a great time to reconnect with family and friends and take part in many fun Easter crafts and traditions. We know how important it is to keep our residents socializing and continuing to live the life they loved before requiring professional care, therefore we always have a variety of on-site activities planned, from games and puzzles, to stories and singing. Spring and Easter themed activities will also be included this month. While we keep our calendars full of fun activities, we want you to know we welcome you in sharing and keeping your own traditions with your loved ones. If you don’t currently share any regular Easter traditions with your loved one, there are many things you can begin this year. A couple of ideas include: Color or decorate eggs- This is a fun activity for all ages and gives you “something to do” while you spend time with one another. There are a variety of decorating kits available such a paint, markers, or stickers on hardboiled or plastic eggs. Bake a treat- Speak with a resident representative about assisting in a baking activity. There are many online resources such as Pinterest or google with hundreds of ideas for easy baking. Another option is to bake cookies at home and share the time together decorating the cookies. Crafts- Does your loved one have grand or great grandchildren? Get them involved in Easter crafts for the children. Let them join in on the fun of organizing and filling the Easter baskets! Flowers- Our residents love to show off flowers from their loved ones! They will especially love the brand new beautiful beginning of Spring flowers! Organize a gathering- If your loved one cannot leave the facility, bring the family to them. We offer dining and living areas just for family gatherings. Surprise your loved one with his or her favorite dish as well as all of the family in one room. Speak with your resident representative about reserving one of these rooms for your function. Listen to stories of the past- Your loved one has lived a full life and has attained much wisdom. Give them the opportunity to just speak. You will be amazed at what you might learn. There may be funny stories you have never heard because you didn’t ask! Easter basket- While you may have thought to prepare the children an Easter basket, don’t forget your loved one in the nursing home. After all, Easter is a family holiday for many, and you don’t want your loved one feeling forgotten in the rush of Easter celebrations for the children. Who doesn’t love a free basket full of food, candy, knick-knacks, and household items? If you’re super crafty and able, why not assemble treat bags or baskets for your loved one’s friends as well? The more the merrier! It’s such an easy craft and the simple gesture could mean more than you might ever imagine. Enjoy outside time- With Easter comes warmer temperatures and our residents love the opportunity to get out and enjoy the sunlight just like the rest of us. Enjoy the view from the patio or even under our pavilion! We love sharing with you creative ideas for ways to spend time with your loved ones. If you ever have any unique ideas of your own that you may need assistance with, please let us know! As mentioned before, we want our residents to continue to live the life they had before needing professional care! Happy Easter to you all!

Statins are one of the most commonly prescribed medications used by primary care physicians and cardiologists to treat high cholesterol. Not only are they good for lowering cholesterol, but they also fight inflammation in the arteries. This is good because inflammation in the arteries can lead to plaque buildup and heart attacks. However, there have been concerns over their side effects. Some statin users have reported that they experienced memory loss while taking the medication. Is this true? The Food and Drug Administration (FDA) updated its safety information for statins to include memory loss, forgetfulness, and confusion as possible risks. But is there really a link between taking statins and memory loss? Statins are a medication that blocks the substance in your liver that the body uses to make low-density lipoprotein (LDL) cholesterol, often called “bad cholesterol.” Your body needs some cholesterol, but having high levels of LDL cholesterol puts your health at risk. It is this cholesterol that can cause the blockages in your blood vessels and lead to a heart attack or stroke. Some types of statins even help your body reduce the amount of bad cholesterol that has already built up in your artery walls. If your LDL cholesterol levels are above 100 mg/dL, and you aren’t able to lower those levels with lifestyle changes, your doctor may prescribe a statin. Keep in mind, different types of statins vary in their potency. Your doctor is most likely to prescribe statins if you: have a history of heart attack, stroke, or heart disease have a high risk of having a heart attack or stroke within 10 years are 21 or over with an LDL cholesterol level of 190 mg/dL or higher are age 40 to 75 and have diabetes While statin users have reported memory loss to the FDA, studies haven’t found evidence to support these claims. Just because someone happened to be taking a certain medicine when they developed memory loss does not prove that the medication caused the effect. Research has actually suggested that statins may help prevent Alzheimer’s disease and other forms of dementia. This is possibly because the most common cause of dementia is vascular dementia, which is dementia caused by strokes and “mini-stokes” due to small blockages in the arteries that carry blood to the brain. High cholesterol is a major risk factor for strokes so by cutting down the number of strokes, statin medications may actually reduce the frequency of vascular dementia. Always talk with your doctor if you are taking statins and experiencing unpleasant side effects no matter what they are. All medications have a few side effects, but they should not be interfering with your daily life. You should not stop taking the medication on your own. There are other medications that may cause memory loss or a combination of medications that could be having that affect. Never diagnose yourself. Always talk with your doctor about any and all concerns. We are not here to diagnose, only to educate. Source: http://www.healthline.com/health/high-cholesterol/link-between-statins-and-memory-loss#statins-pros-and-cons9

Today is Diabetes Alert Day! It is observed annually on the 4th Tuesday in March as a 1-day wake up call to inform the American public about the seriousness of diabetes, particularly when diabetes is left undiagnosed or untreated. Below is a quick test we would like to share with you to see if you may be at risk for diabetes or prediabetes. The higher you score on the test, the higher your risk is. While this test is not a substitute for a physician diagnosis, it may be a good tool to bring with you to your physician appointment. Are you at risk for Type 2 Diabetes? Find out by clicking here. Source: www.niddk.nih.gov

Many of us have heard blood pressure being referred to as “the silent killer.” High blood pressure, or hypertension, is a dangerous condition that affects approximately 30% of Americans, causing up to 60,000 deaths per year according to The Society for Cardiovascular Angiography and Interventions. It is often called “the silent killer” because it typically has no symptoms until after it has done damage to the heart and arteries. Many of us may have high blood pressure and not even know it and therefore, do not understand the risks for heart attack, stroke, circulation problems, heart failure, kidney diseases, and eye disease to name a few are greatly increased. Blood pressure is the force of blood pushing against the inside of the arteries as the heart pumps the blood through your body. Blood pressure readings are recorded with two numbers, with the top number (systolic pressure) relating to the force of blood when your heart beats, and the bottom number (diastolic pressure) relating to the force of blood against the artery walls when your heart rests. A normal blood pressure reading is one that is typically less than 120/80 millimeters of mercury (mmHg). Prehypertension refers to blood pressure that is raised enough to be a warning sign for developing hypertension. These numbers will be anything above normal up to 139/89 mmHg. At this range, most of the damage can be maintained or possibly reversed. Hypertension is 140/90 mmHg and above. You will require treatment for this high blood pressure and most often the treatment will be medication and lifestyle changes. These numbers are a roundabout and the diagnosis of hypertension will be made by your physician based on other factors as well such as your age and other medical conditions. The only way to truly know if you have high blood pressure is to have a physician test it. Typically three elevated readings will signify the need for medication. You may be asked to purchase a blood pressure cuff and machine for home use and keep a log of your readings throughout the day. However, if someone with very high blood pressure does not regularly see their physician and has not had their blood pressure checked or treated for years and suddenly notices their urine output is much less than normal, a lot of kidney damage may have already occurred and may not be reversible. This scenario and many more are why it’s important to have regularly scheduled visits with your physician before the silent killer can state its claim. It is recommended to have your blood pressure screened at least on yearly visits with your primary care doctor if you are 40 and above. If you are 18-39, it should be monitored every 1-5 years depending on whether you are high risk for developing high blood pressure or if you have symptoms such as a headache. If you are diagnosed with hypertension, your physician may suggest some or all of the following: Regular blood pressure monitoring. You may need to have your blood pressure tested periodically to make sure your treatment is keeping it in a healthy range. Lifestyle changes. Exercise, weight loss, salt reduction, quitting smoking, and stress reduction can all help lower your blood pressure. Medications. Your physician may prescribe medications such as diuretics, beta blockers, or other medication. These medications work in various ways to reduce the pressure of blood against artery walls and the workload of the heart. While we are here to educate, we are not a substitute to your regularly scheduled physician appointment. Always make time to see your physician and ask any questions that you may have. We hope that if you haven’t seen your physician lately, that this post encourages you to do so. Source: www.secondscount.org

Last week was all about sleep awareness. We now understand how important sleep is to our bodies due to the need to repair and reset. While it’s easy to understand that we need sleep, it sometimes is more difficult to actually make ourselves shut down for the day and go to bed. Here are a few tips to help you get a good night’s sleep. Set a sleep schedule. Go to bed at a set time each night and get up at the same time each morning. This regulates your body and eliminates sleep deprivation. Exercise. Try to exercise 20-30 minutes a day. Exercise helps people sleep especially when it is done 5-6 hours before going to bed. Avoid caffeine, nicotine, and alcohol. Caffeine acts as a stimulant and can keep you awake at night. Smokers tend to sleep very lightly and do not receive their full sleep benefit because they are often awoken due to nicotine withdrawal. Alcohol robs people of deep sleep and REM sleep and also keeps them in the lighter stages of sleep. Relax before bed. A warm bath, reading, or other relaxing activity can help wind your body down and make it easier to fall asleep. Sleep until sunlight. If possible, wake up in the sun. Sunlight helps the body’s internal biological clock reset itself each day. Don’t lie in bed awake. If you can’t get to sleep, try doing something else such as reading or watching television until you feel tired. The anxiety of trying to fall asleep can actually make falling asleep more difficult. Control your room temperature. Maintain a comfortable room temperature in the bedroom. Extreme temperatures may disrupt sleep or prevent you from falling asleep. See a doctor if sleeping problems continue. If you have difficulties falling asleep or are always feeling tired during the day, then there may be something else going on in your body. Always see a physician when there is something that is not right with your body. Source: www.ninds.nih.gov

National Sleep Awareness week is this week! Sleep is so often underrated. It really is true what they say..."Sleep better. Feel better." So you might wonder why sleep actually makes us feel so much better. Why do we really need so much of it? What exactly is happening when we sleep? Let's start with the basics. At first glance, it may seem obvious what sleep is. We know that we lie down at night and close our eyes when we go to sleep. According to the Oxford English Dictionary, sleep is a "condition of body and mind which typically recurs for several hours every night, in which the nervous system is inactive, the eyes closed, the postural muscles relaxed, and consciousness practically suspended." Until the 1950's, most people thought of sleep as a passive, dormant part of our daily lives. We now know that our brains are very active during sleep. Nerve-signaling chemicals called neurotransmitters control whether we are asleep or awake by acting on different groups of nerve cells, or neurons, in the brain. There are chemicals that keep our brain active while we are awake such as serotonin and nor epinephrine. Then there is a chemical called adenosine that builds up in our blood while we are awake and causes drowsiness. Neurons at the base of our brain begin signaling when we fall asleep and therefore "switch off" the signals that keep us awake. The chemical adenosine also begins to break down while we are sleeping. During sleep, we usually pass through five stages of sleep: 1, 2, 3, 4, and REM (rapid eye movement) sleep. The stages progress in a cycle and then start over again at stage 1. We spend about 50% of our total sleep time in stage 2, 20% in REM, and the remaining 30% in the other stages. Infants, however, spend most of their time in REM sleep. Stage 1- This stage is light sleep. We can be awakened very easily in this stage. Our eyes move very slowly and our muscle activity slows. Many even experience sudden muscle contractions. Stage 2- Our movements stop and our brain waves become slower with occasional bursts of rapid waves. Stage 3 & 4- These two stages are considered deep sleep. It's more difficult to wake someone in these stages. There is no eye movement or muscle activity. REM- When we switch to REM sleep, our breathing becomes more rapid, irregular, and shallow, our eyes jerk rapidly in various directions, and our limb muscles become temporary paralyzed. Our heart rate and blood pressure increase, and this is where dreams occur. The first REM occurs about 70-90 minutes after we fall asleep and as the night progresses and we go through the cycle of stages, our REM stage increases in length while deep sleep decreases. The amount of sleep each person needs depends on many factors, including age. For most adults, 7-8 hours appears to be the best amount, but if sleep deprived the amount should be increased. Your body demands sleep and will demand more if starved. Our judgment, reaction time, concentration, memory, and other functions will be impaired if sleep deprived. Our immune system is detrimentally affected without sleep and could therefore open doors for diseases to occur. Hallucinations and mood swings can also occur if sleep deprived. If you fall asleep within 5 minutes of lying down, then you are probably sleep deprived. Scientists are still trying to learn exactly why people need sleep and so much of it. We truly need sleep to live and survive. Sleep appears to be necessary for our nervous systems to work properly. It is thought that those neurons used while we are awake actually need to be “switched off” and “shut down” in order to repair themselves for a new active state. They can become depleted in energy and polluted with byproducts of normal cellular activities that they begin to malfunction. Sleep also gives the brain a chance to exercise important neuronal connections that might otherwise deteriorate from lack of activity. Deep sleep actually coincides with the release of growth hormone in children and young adults. Many of the body’s cells also show increased production and reduced breakdown of protein during sleep and this is important because proteins are the building blocks needed for cell growth and repair. Turning off the active parts in the brain that control emotion and decision making processes may even help people maintain optimal emotional and social functioning while they are awake. While there is so much involved while we sleep and how it can affect our bodies, there is still a lot we do not know and a lot that cannot be easily covered. Sleep research is ongoing and is a key component in scientists truly understanding the brain. It’s important to listen to your body and sleep when it is telling you it is deprived. Better yet, maintain a set routine of good quality sleep to help your body feel its best. Sleep can help keep you healthy, prevent many diseases, and make you look and feel better too. Sources; www.howsleepworks.com www.ninds.nih.gov

As American Heart Month comes to a close, we want to bring light to a common form of heart disease in the elderly; congestive heart failure. The American Heart Association reports that in the U.S., congestive heart failure (CHF) is the leading cause of hospitalization in people over the age of 65. To improve the effectiveness of care for those with CHF, we not only react and intervene at Mitchell-Hollingsworth when one becomes ill, but we also proactively focus on keeping patients as healthy as possible to prevent unnecessary hospital admissions. We identify those most at risk for hospitalization and target our efforts to improve outcomes. Risk factors for CHF may include: A hospital admission (non-elective) during the last 12 months Admission to the emergency room for cardiovascular symptoms during the last 12 months Prescriptions for more than nine medications Diagnosis of diabetes, chronic skin ulcers, pressure ulcers, or COPD Signs of dyspnea or edema Non-ambulatory or ambulating only short distances Assistance with activities of daily living Nutritional concerns identified on assessment Depression Individuals identified with three or more of these risk factors can alert the need of a more focused interdisciplinary approach for CHF disease management. Effective management of CHF requires monitoring and responding to symptoms on a regular basis. Care plans developed with the individual and primary care providers identify when additional assessments and interventions need to be done (lung assessment, administration of oxygen, medications, etc.). Management of CHF requires regular assessments which include: A review of weight and weight trends Blood pressure, pulse, respiratory rate Lung assessment/ breath sounds in all lung fields Presence of jugular vein distention Peripheral edema: location and grade Abdominal assessment that includes measurement of girth and presence of pain/tenderness in upper right quadrant Oxygen saturation level with activity and at rest Nail bed color and capillary refill Presence of dyspnea including paroxysmal nocturnal (note number of pillows, sleeping in recliner, need for elevation of head of bed.) Review of medication use including PRN Urine output or voiding pattern changes Regular exercise and activity are important in CHF management to maintain or increase muscle tone, increase heart function, and improve energy. Therapy staff assists in assessing a current level of function and exercise, identifying goals, and developing exercise and activity plans to meet goals while increasing or maintaining strength and function. In collaboration with the dietician and the individual, a specific diet plan is also developed that includes education and identification of diet and nutritional needs. Working together with residents, rehab patients, their families, the facility interdisciplinary team, and other care providers will improve the effectiveness of the care and services we provide. Having a plan that demonstrates positive outcomes and satisfaction are also key for ensuring our part in care delivery. Source: http://www.heart.org/HEARTORG/