News/Blog

Communicating with a Family Member in Critical Care

Sometimes it’s hard enough to say what we mean. So what do we do if we have a family member in critical care? Rest assured, communicating is an important part of the healing process for your loved one as well as your family.

Here are 5 tips to help you out:

  1. Even if your loved one is on a ventilator, he or she will most likely be able to hear you. Speak in a calm, clear manner in a normal tone of voice. There’s no need to speak loudly. Read your family member a favorite poem, book, or prayer. If the staff says it’s OK, you could even play some music.
  2. Use short, positive statements. Reassure your loved one that you’re there, and that everyone is taking good care of him or her. Help orient your family member to the surroundings by sharing the date, day of week and time of day. Help describe the noises in the room.
  3. It’s OK to acknowledge that your family member may be experiencing discomfort. You can help by explaining what is going on, “That tube is helping you breath.” Remind your loved one that this is just temporary and helping him or her to get better.
  4. Don’t ask questions that can’t be answered. Make it simple. Suggesting hand gestures to communicate may be helpful. For example, a thumbs up or thumbs could indicate pain level. A small dry erase board may also be helpful in communicating as well. You could write words that your family member could point to, or possibly your loved one can write a few words as well.
  5. Human touch goes a long way. Ask the hospital staff first, but holding a hand or touching your family member gently is a great way to express your love and concern.

If you’re unsure about the best way to communicate, don’t hesitate to ask a member of the hospital staff for help. If one way doesn’t seem to be working, there likely will be another way that can be more effective.

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6 Things to Expect When Your Loved One is in Critical Care

It’s difficult to imagine a loved one being ill or injured enough to require critical care. But being prepared for what to expect can help you manage the situation.
Here are 6 important things to know:

  1. You have an experienced team on your side. The hospital staff that’s caring for your loved one is highly trained and prepared to treat the sickest – and most medically complex – patients. From the physicians and nurses to the respiratory therapists and dietitians – they all are specially trained to care for your loved one.
  2. The tubes and equipment in a critical care unit can be intimidating. But, they all have a role and purpose in providing your loved one with the intensive healthcare that he or she needs. The healthcare team will be able to explain the role of any equipment to help you better understand what it happening.
  3. Information overload can – and most likely will – occur. Everything will be new to you from the equipment and noises to the procedures and health professionals. Take a deep breath. Once you get your bearings, think of how you can best keep track of information. Write in a notebook. Keep notes on your phone. Jot down items like key information, questions you want to ask, purpose of treatments, and names of hospital personnel.
  4. Expect peaks and valleys. Critical care can be a bumpy ride. Some days will be better than others. As much as possible, try to be patient and keep perspective.
  5. Talk to your loved one. Communicating with your loved one is important for not only him or her, but for your entire family. Often patients can hear while in critical care. Speak calmly and clearly, and make short, positive statements. Hold your loved ones hand or touch them gently if a member of the healthcare team says it’s OK.
  6. Take care of yourself. It may be a long road to your loved one’s recovery, so be sure to take time to do things like sleep, eat, and shower. Don’t be afraid to leave the room for a bit. The healthcare team will be there 24/7 to provide care.
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5 Benefits of Walking

There’s nothing quite like a good walk. It doesn’t require a gym membership or a bunch of equipment, and often gets you into the great outdoors.

It’s also very good for you, both physically and mentally. Indeed, all of the benefits of walking would make for a long list, but here are five main benefits that can inspire you to lace up your walking shoes and get moving.

1. Walking Improves Your Mood

You know how it is at the end of a long, trying day. You get home and are looking for something to help take the edge off a little bit. And a great way to do just that – is by taking a walk.

Studies show that walking affects our nervous system, so that we’ll feel a decrease in anger and hostility. Furthermore, walking outside exposes you to sunlight, which helps you cope with Seasonal Affective Disorder.

2. Walking Combats the Effects of Too Much Sitting

It has become clear in recent years that prolonged sitting has many negative health effects, including the damage it causes to leg arteries. But one study showed that taking even three, five-minute walks a day can reverse this damage.

If your job entails prolonged sitting, it’s helpful to take a short break every hour and go for a quick stroll.

3. Walking Boosts Your Immune System

We’ve already mentioned how great walking is as a stress-reliever, but it also improves your circulation, and helps give you a sense of overall calm. In turn, these factors boost your immune system – which helps your body fight diseases; from the common cold, up to more serious health problems.

Walking has even been shown to lessen menopause symptoms for older women.

4. Walking Lowers Your Risk of Chronic Disease

We’ve already touched on the positive impact walking has on your immune system and fending off diseases, but it’s worth a closer look:

  • Walking lowers your blood sugar levels and your overall risk for diabetes (according to the American Diabetes Association).
  • Another study showed that regular walking lowered blood pressure, and may significantly reduce the risk of stroke.
  • Studies also show that those who walked regularly, and met minimum physical activity guidelines had a lowered risk of cardiovascular disease.

5. Walking Helps Improve Your Creativity

The research is in: Walking and other physical activities will improve your creativity and help you find solutions – like those often faced at work –  to tricky problems. A study showed that walking produced twice as many creative responses in participants that walked, than those who were sitting for long periods.

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What is Occupational Therapy?

When it comes to health and rehabilitation professions, occupational therapists are truly a valuable resource.

Occupational therapy helps people optimize their ability to accomplish daily activities, through improving life skills following an injury or physical impairment. But there’s much more to occupational therapy than meets the eye – and in honor of National Occupational Therapy Month – let’s take a closer look.

What Do Occupational Therapists Do?

An occupational therapist works with people of all ages who are in need of specialized assistance because of physical, social, developmental, or emotional impairments. The occupational therapist helps patients lead more independent and productive lives by using daily activities such as self-care, work, play, and leisure as part of the therapeutic process.

A primary goal of an occupational therapist is to help patients improve their ability to carry out daily tasks. The occupational therapist will assess the patient’s home and work environment, and provide recommendations for how to adapt and lead a better quality of life. In short, occupational therapists help people with injuries, illnesses, and disabilities to live better lives.

What are Some Common Occupational Therapy Services?

  1. Occupational therapists often work with children with disabilities to help them participate fully in school and social activities.
  2. An occupational therapist may help someone who is recovering from an injury to regain needed day-to-day skills.
  3. The occupational therapist may provide support for older adults who are going through cognitive and physical changes.
  4. Occupational therapists will also do individualized evaluations, provide a customized rehabilitation plan, and ensure that outcomes are met throughout the rehabilitation process.
  5. While occupational therapists will sometimes directly treat injuries, they focus more often on helping the patient improve his or her life skills, while also incorporating adaptive tools that are sometimes created by the therapist.

Where Do Occupational Therapists Work?

An occupational therapist may work in a variety of settings, including: rehabilitation hospitals, nursing facilities, acute-care hospitals, outpatient clinics, home health, school systems, industry settings, and more. The types of places where an occupational therapist may work are growing annually.

In honor of National Occupational Therapy Month, we would like to thank all occupational therapists for what they do to help rehabilitate patients. We understand and appreciate the unique services that you provide!

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National Doctors’ Day

The world of medicine was changed forever on March 30, 1842, with the first documented use of anesthesia during surgery.

While the accomplishments of doctors has continued to evolve  – and amaze – since then, March 30 remains a special day in the world of medicine. After all, it’s now considered National Doctors’ Day – a day to recognize physicians and their countless contributions to society and their communities.

The first observance of National Doctors’ Day was in 1933, in Winder, Georgia. The wife of a local doctor wanted to have a day to honor physicians, and with the help of others, sent greeting cards and placed flowers on the graves of deceased doctors. Today, the red carnation is considered the symbolic flower for Doctors’ Day.

In 1991, President George H. Bush signed a bill that made National Doctors’ Day a day of celebration in the United States.

We’ll celebrate by giving thanks to the incredible doctors in our Inpatient Rehabilitation Facilities and Long-Term Acute Care Hospitals. In both settings, our physicians are an integral part of the team that works with patients and their families to deliver the highest quality care possible.

Former Polish Prime Minister Eva Kopacz – who’s also a physician – wonderfully described the role of doctors as “a special mission, a devotion,” while saying that it called for “involvement, respect, and willingness to help all other people.”

Let’s all help celebrate National Doctors’ Day by giving physicians in our community a sincere word of thanks for their long hours, hard work, and constant care.

You can also observe this special day by using #NationalDoctorsDay to post on social media.

 

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The Role of Social Workers in the Long-Term Acute Care Setting

There’s no better time than now to highlight the role of social workers in the Long-Term Acute Care (LTACH) Setting. March, after all, is National Social Worker Month.

But the importance of the role and function of social workers in a LTACH is worthy of attention year-round. A social worker is a vital member of any health care team and serves in many different capacities, including as a liaison between the patient and the care community.

Let’s take a closer look:

Social Workers in the LTACH

  • Making the Transition
    The social worker helps the person entering a long-term acute care facility to help them make a transition to the LTACH from an acute care hospital. Once the patient is in their new setting at the LTACH, the social worker continues to see that his or her needs are met, and that they are participating in planning for continued care now and in the future.
  • Identifying Resources
    Social workers help patients identify resources to meet their individual needs. They also serve as the patient’s advocate in dealing with insurance providers to secure the most comprehensive coverage possible.
    In fact, serving as the patient’s advocate is one of the most important roles.
  • Working with Patients’ Families
    A social worker in an LTACH setting spends much of their time with a patient’s family and friends, and must always be aware of factors that have an impact on the patient’s well-being.
    Patients and families deal with many aspects of a specific illness, including learning more about it, the diagnosis, and the steps in the recovery process. A social worker helps them deal with each step that hopefully leads to a safe recovery.
  • A Wide Range of Tasks
    Typical duties for social worker may include: interaction with potential residents and their families, pre-admission and discharge planning, and assessment and completion of the part of the minimum data required for each patient.

The LTACH social worker will also:

  • Contact and utilize community resources on the resident’s behalf.
  • Ensure that the social and emotional needs of each patient are met.
  • Promote the maximum level of independence for each resident.
  • Participate fully in resident care planning as part of an interdisciplinary team.

In all cases, the social worker provides a physical environment that is supportive while fostering a positive self-image for residents through social contact, independence, and decision-making opportunities.

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A Heart Attack’s Effect on the Brain

It’s estimated that someone suffers a heart attack approximately every 40 seconds in the United States – or about 720,000 people each year. While many heart attack victims recover and resume their normal lives, others have to deal with lingering physical effects, such as changes in the brain.

Specifically, heart attacks and other forms of heart failure can cause a loss of gray matter in the brain, and a decline in mental processes.

What Happens During a Heart Attack

A heart attack occurs when blood that brings oxygen to the heart is cut off, or severely reduced. Coronary arteries that supply blood to the heart can narrow because of fat buildup and other substances. When an artery breaks, a clot forms around the substance and blood flow is restricted to the heart muscle.

Oxygen and the Brain

The brain needs adequate oxygen to function normally. Research has shown that brain cells begin to die when oxygen levels drop significantly low for several minutes or longer. After an extended period, a permanent brain injury may occur. This type of injury is known as an anoxic brain injury, or also cerebral hypoxia.

There are four types of anoxia – with each potentially leading to brain damage – including stagnant anoxia, in which an internal condition (such as a heart attack) blocks oxygen-rich blood from reaching the brain.

Cognitive Issues Associated with Heart Attacks

A recent study by Sweden’s Lund University said that half of all heart attack survivors experience memory loss, attention problems, and other cognitive issues. Lasting effects on the brain’s mental functions could even lead to possible dementia.

Brain scans done in similar studies showed that heart disease and heart failure might lead to losses of gray matter in the brain that are important for a variety of cognitive functions, which in turn lead to issues such as:

  • Memory Loss
    Most people who suffer an anoxic brain injury experience some short-term memory loss. The hippocampus, the part of the brain responsible for learning new information, is extremely sensitive to a lack of oxygen.
  • Anomia
    Anomia refers to difficulty in using words, or processing the meaning of words. The patient may not remember the right word, or use a word out of context.
  • Poor Performance in Executive Functions
    Executive functions include reasoning, processing information, judgment, etc. For instance, the patient may become impulsive and indecisive.
  • Visual Issues
    Patients also may have trouble processing visual information.

Treatment

Immediate treatment is essential when dealing with cerebral hypoxia. The sooner the normal oxygen supply is restored to the brain, the lower the risk of brain damage. The type of treatment depends on the cause of the anoxic injury and may include:

  • Breathing assistance via mechanical ventilation and oxygen.
  • Controlling the heart rate and rhythm.
  • The use of medicines such as phenytoin, phenobarbital, valproic acid, or general anesthetics.

The patient’s recovery depends on how long the brain lacked oxygen. The patient might have a full return to function if the oxygen supply to the brain was blocked only for a short time. The longer a person lacks this oxygen supply, the higher the risk for serious consequences, including death, and severe brain injury.

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10 Things to Know if Your Loved One is On a Ventilator

For patients who are unable to breathe on their own, mechanical ventilation is used to provide life-sustaining oxygen. Ventilation is a process that requires the diligent care of a medical team and a weaning process.

If you have a family member or loved one on a ventilator, here are some things you should know:

1. What is a Ventilator?

A ventilator is a machine that supports breathing, and is used mainly in a hospital or rehabilitation setting. Medical issues or conditions that make it hard for the patient to breathe necessitate that a ventilator is used to aid the breathing process.

2. How Does a Ventilator Work?

A ventilator helps get oxygen into the lungs of the patient and removes carbon dioxide (a waste gas that can be toxic). It is used for life support, but does not treat disease or medical conditions.

3. Who Needs a Ventilator?

Many conditions, such as pneumonia, COPD, brain injuries, and strokes require the use of a ventilator. If you have a loved one with a disease or condition that impairs their lung function, a ventilator will be employed. The use of a ventilator is also common when someone is under anesthesia during general surgery. A patient may not even know they were connected to a ventilator after the completion of the surgery or medical procedure.

4. Risks of Being on a Ventilator

Patients on ventilators run a higher risk of developing pneumonia because of bacteria that enters through the breathing tube. It can also make it difficult for them to cough and clear airways of irritants that can cause infections.

5. Eating While on a Ventilator

The breathing tube will prevent the patient from eating normally, so a different tube that provides nutrients, may be inserted into their vein. Patients who are on long-term ventilation may require a feeding tube directly inserted into the nose or mouth, or through a hole made in the stomach.

6. When Sedation is Used

Sedation is often used for patients on long-term ventilation, although there’s plenty of debate in medical circles concerning the over-use of sedation. The use of sedation often depends on the patient; a patient who is calm during normal life is usually calm on a ventilator while in an ICU unit.

7. A Ventilator Restricts Your Movement

A patient’s activity and movement are significantly limited while on a ventilator. While they may be able to sit up in bed or in a chair, their mobility is otherwise limited.

8. Your Care Will Involve a Team Approach

The medical team that closely monitors patients on a ventilator includes: doctors, nurses, respiratory therapists, X-ray technicians, and more.

9. Will the Ventilator be Painful?

There’s usually little or no pain when on a ventilator.

10. Ventilator Weaning Process

Weaning is the process of taking someone off of a ventilator, so that they may begin to breathe on their own. The process usually begins with a short trial, in which they’re still connected to the ventilator, but allowed to breathe on their own. The ventilator is removed once it’s clear that the patient can breathe on their own.

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Flu Complications: The Importance of Immunizations

The flu is much more than an illness that simply leaves you bedridden for a few days. In some cases, it can lead to hospitalization and even death; in fact, estimates by the Centers for Disease Control say that flu-related hospitalizations since 2010 number in the hundreds of thousands.

With numbers like those, the importance of immunizations is obvious.

What is The Flu?

Influenza is a respiratory infection that can cause moderate to severe health complications – from ear infections to pneumonia while triggering other severe issues such as inflammation of the heart and multi-organ failure. Typical flu symptoms include:

  • Fever
  • Cough
  • Sore throat
  • Muscle and body aches
  • Headaches
  • Fatigue
  • Vomiting and diarrhea, particularly in children

How Does The Flu Vaccine Work?

Flu vaccines cause antibodies to develop in the body that protect against infections caused by the disease. Vaccines are available both by injection and nasal spray, although the CDC recommends not using the nasal spray as protection against the flu in 2016-17.

There are two types of flu vaccines available, trivalent and quadrivalent. Trivalent vaccines are so named because they consist of three components, and includes a high-dose shot that’s approved for people 65 and over. Quadrivalent vaccines consist of four components.

Trivalent vaccines are considered more traditional and protect against the H1N1 and H3N2 viruses and an influenza B virus. Quadrivalent vaccines protect against an additional B virus.

Who Should Get The Flu Vaccine?

The CDC recommends that everyone six months or older should get an annual flu shot. The vaccination is important for everyone, but especially so for those who are at high risk for influenza complications – including pregnant women, older adults, and young children.

Also, certain chronic medical conditions can increase your risk of serious flu complications, such as asthma, cancer, chronic obstructive pulmonary disease and other respiratory complications, diabetes, cystic fibrosis, HIV/AIDS, obesity, and kidney or liver disease.

Why Should I Get A Flu Shot Every Year?

The flu virus changes every year, and new vaccines designed to keep with those changes are released annually. Last year’s vaccine might not protect you from this year’s virus, while antibodies produced by your immune system decline over time.

Who Shouldn’t Be Vaccinated?

You should check with your physician before getting the flu vaccine if you’re allergic to eggs (most flu vaccines contain a small amount of egg protein), or if you’ve had a severe reaction to a previous flu vaccine.

When Should I Get The Vaccine?

You should get immunized as soon after the latest flu vaccine becomes available, which is typically in early fall. But vaccinations are usually offered as long as viruses are circulating. Most flu seasons usually peak in January and even later.

The bottom line is that the flu shot is the single best way to protect yourself from the flu and potentially serious complications that come with it. And flu shots are now widely available – including at pharmacies – and don’t require an appointment.

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7 Ways to Tame COPD Flare-Ups in Winter Months

If you’re a COPD sufferer whose symptoms are worse in the winter, you’re not alone. Studies show that the number of patients needing treatment for COPD exacerbations is twice as high in the winter as during the summer.

Why is this so? One reason is that cold weather affects the lungs by causing dramatic changes to the respiratory system. For some individuals, breathing cold, dry air forces their body to produce more shifts in temperature and moisture in the airway because there is a greater volume of air that needs to be warmed and humidified.

No matter the exact cause, the bottom line is that COPD sufferers need to take extra precaution in the winter to avoid serious flare-ups – not the least of which is avoiding the frigid air as much as possible. Here are some strategies:

  • Always Cover Your Nose and Mouth

Covering your nose and mouth while outdoors in the winter is essential if you’re a COPD sufferer. A scarf works well, as does a painter’s mask. At the least, cup your hands and use them to cover your nose and mouth.

  • Get Flu and Pneumonia Shots
    Viruses and infections will make your COPD symptoms worse. Make sure you get a flu shot annually and consult with your physician about getting a pneumonia shot.
  • Wash Your Hands
    Your mother was right – you need to wash your hands! Seriously, a strong defense against germs and COPD symptoms is a high standard of hygiene. Carefully wash your hands before touching your eyes, nose, or mouth. It’s even more important when you’re in public places.
  • Stay hydrated
    Drinking plenty of water will make it easier for you to breathe, especially if you have a respiratory infection.
  • Avoid People Who Are Sick
    It’s sometimes easier said than done, particularly in a workplace (or if you work with and around children), but it’s important to avoid sick people whenever possible. If you do catch a cold or the flu, it’s important to seek treatment as soon as possible.
  • Add Humidity To Your Air
    Keeping your home from becoming too dry during the winter months is also essential if you suffer from COPD. Use a humidifier and clean it every other day to keep it functioning at its optimal level.
  • Avoid Smoke and Fumes
    This is an important strategy at any time of the year, but take extra caution in the winter if you’re heating your home with a fireplace, kerosene, or by other means. Lung irritants such as wood smoke can cause COPD exacerbations.

How to Know That You’re Having a Flare-Up

There are numerous signs that indicate when you’re having a COPD flare-up:

  • Your shortness of breath is suddenly worse and you experience wheezing.
  • You’re coughing more – with or without mucus.
  • If you have mucus, the amount or color may change.
  • You have a fever.
  • You suddenly feel very tired.
  • You become confused or depressed.

No matter what your symptoms are, it’s always important to see your doctor when they get worse. Prevention strategies combined with prompt action will help you stay healthy throughout the winter months.

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