Senior Health Fair at the Elk’s

Join Elite Home Health & Hospice in partnership with the Lewiston Elks Lodge No. 896

Together, we proudly present the 2022 LC Valley Senior Health Fair.

This event takes place on Wednesday, September 14, 3:00 – 6:00pm at the Lewiston Elks Lodge, 3444 Country Club Drive, Lewiston.

During the event there will be senior health screenings, senior health related vendors and presentations, plus refreshments and a giveaway.

The event is open to the community and FREE of charge. For more information or to RSVP 509-758-2568.

August is Psoriasis Awareness Month

According to Psoriasis.org, psoriasis does not have a clear origin. However, what results is an inflammatory response that demonstrates dysfunction of the immune system. The physical signs of the inflammation such as raised plaques and scales may result from an overactive immune system. This changes the speed of cell growth and impacts the life cycle of skin cells from weeks down to days. Doctors have to manage additional complexities in seniors when considering treatment (Balato et al., 2014). Managing comorbidities, the challenges with taking multiple medications, and progressive functional impairment of body systems impact what treatment options are available. The first strategy is to use a topical treatment (Balato et al., 2014).

Inflammation caused by psoriasis can impact other organs and tissues in the body (psoriasis.org). Other conditions may co-exist, such as arthritis which can result in permanent joint damage. A significant concern for seniors is in the overall management and strategy as these conditions can go undiagnosed and therefore untreated (Butler and Koo, 2015). Increasing awareness and understanding of this disease is critical for effective management.

Resources:

https://www.psoriasis.org/about-psoriasis/

https://link.springer.com/article/10.1007/s40266-014-0156-6

https://link.springer.com/chapter/10.1007/978-3-319-18380-0_5#citeas

August is National Health Center Month

National Health Center Week is an opportunity to acknowledge the work of local health clinics. These local clinics support over 27 million patients in the United States and build systems to provide care to individuals who may not typically access comprehensive care. These clinics allow patients with limited resources to collaborate with supports internal to the clinic and external to the community. These clinics are critical to supporting comprehensive care and are partners in the care of our highest risk patients. These clinics are also supportive in providing primary care for patients who may not have an established relationship. Establishing care is critical for accessing home health services to support recovery from acute illness and support comprehensive chronic care management.

For more information, check out https://healthcenterweek.org/

August is National Immunization Awareness Month

The National Immunization Awareness Month (NIAM) is an opportunity to learn and better understand the role of vaccines in your healthcare plan. According to the Center for Disease Control and Prevention, this annual observance highlights the importance of getting recommended vaccines throughout your life. The COVID 19 pandemic has impacted all aspects of life. There have been known challenges with patients’ ability to attend important appointments and receive routine vaccinations. There has been significant questions raised about vaccines and how they work which has created delays in how people are accessing and scheduling immunizations.

During NIAM, we encourage you to talk to your doctor, nurse or healthcare provider to ensure you and your family are protected against serious diseases by getting caught up on routine vaccination. If you have questions, ask your provider. If you are on our home health, palliative, or hospice services, ask one of your clinicians for information and resources.

June is Migraine & Headache Awareness Month

Our role in home health and hospice is to meet the needs of our patients where they are and help them achieve their goals. Managing the debilitating side effects of chronic headaches and migraines in the elderly is a unique skill that requires our attention for home health recovery and supporting the patient through symptoms while on hospice.  In the realm of home health, successful management of migraines is critical as there is an increased risk for stroke and other neurological symptoms if left untreated; in fact, poorly treated migraines often resulting in the severity intensifying which impacts quality of life (Curto et al., 2018).  Part of the management involves assessment of body weight, hydration needs, muscle/fat ratios, and albumin levels; each of these is vital in advocating for pharmacological solutions and identifying environmental factors which may be impacting the patient’s management of their condition (Wijeratne et al., 2019; Curto et al., 2018). Further, routine medication reviews address common challenges in the geriatric population for low treatment adherence resulting in suboptimal health outcomes (Wang & Wang, 2021). Addressing these concerns may result in further determination of other underlying conditions that may be a cause for headaches, such as elevated blood pressures (Wang & Wang, 2021).  Knowing these elements, aids providers in creating comprehensive strategies for their patients. Finally, medication reviews also help to address misuse of prescribed medications in the management of migraines in the elderly (de Rijk et al., 2017).  Home health completes regular medication reviews and access to healthcare professionals to train proper dosing and administration.

If you are looking to learn more, check out these resources:

https://headachejournal.onlinelibrary.wiley.com/doi/abs/10.1111/head.13247

https://link.springer.com/article/10.1007/s11916-021-00976-x#citeas

https://www.karger.com/Article/Abstract/494758

https://www.tandfonline.com/doi/full/10.1080/14656566.2018.1543660

June is Myasthenia Gravis Awareness

Myasthenia gravis is an autoimmune disease that affects the muscle, specifically resulting in fluctuations in strength with worsening upon exertion and improvement with rest. This feature is critical in the management of the disease and directs rehabilitative efforts to support functional recovery and optimize return to muscle function. Exercise-based interventions have been assessed on individuals with motoneuron disease, peripheral nerve disease, neuromuscular transmission disease, and muscle disease (Cun et al, 2007).  Critically, interventions that targeted specific muscle groups by implementing strategic exercises and modalities resulting in improvement in bodily functions, activities, and participation as defined by the International Classification of Functioning, Disability and Health (ICF) (Cun et al., 2007). Therefore, addressing disease which impact the neuromuscular junction may consider the role of rehabilitative professionals in physical and occupational therapy to optimize recovery according to the ICF model (Cun et al., 2007).  Exercises that have proven most impactful include a combination of aerobic and resistance training (Westerberg et al., 2018).  Additional research is needed to investigate the benefits of modalities, such as ultrasound. However, the measurements for success in treatment reviewed elements of fall risk and safety in transferring positions (Westerberg et al., 2018). Myasthenia gravis is a disease process with 5 main classifications which identify specific areas of the body most affected (Trouth et al., 2012).  While classes 3 and 4 may most benefit from physical and occupational therapy, classes affecting oropharyngeal and respiratory muscles, 2 and 5, may benefit from speech pathology to aid in strategies for safe swallowing (Trouth et al., 2012). The role of therapy in supporting functional outcomes is critical in any phase of myasthenia gravis which impacts the patient’s ability to engage in activities of daily living.  

For more information, read the following articles:

https://www.hindawi.com/journals/ad/2012/874680/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081147/

https://www.sciencedirect.com/science/article/abs/pii/S0003999307014517

June is Aphasia Awareness

Aphasia is an acquired language disorder that is relatively unknown in the general population. Speech and language therapy are often prescribed by physicians and incorporate the unique skills and training of speech-language pathologists in the rehabilitative realm (Doogan et al., 2018). Beyond the actual presence of aphasia, the severity and clinical complexity impact the patient’s outcomes and the overall prognosis for language recovery. The highest negative relationship is related to any underlying neurological condition, such as dementia, and global illnesses, such as cancer (Doogan et al., 2018).  The amount of therapy a patient has access to is directly related to the outcomes observed such that higher doses of treatment result in better outcomes, holding all things equal (Doogan et al., 2018).  Timing of intervention and the patient’s baseline prior to the event causing aphasia, such as stroke or brain injury, are also critical pieces to determining recovery (Ali et al., 2021). Essentially, access to early intervention is critical for outcomes from the hospital phase into rehabilitation where dosage of intervention then becomes the next critical element (Ali et al., 2021).  Further, the components of language that are recovered are dependent on the intensity of stimulation to the respective region of the brain (Stefaniak et al., 2022).  The unique role of speech language pathologists in this recovery is in understanding the specific area of the brain affected and its connection to the language system. Treatment is then created to target stimulation to this area (Stefaniak et al., 2022).  The role of respective therapists in this space is in the sharing of treatment strategies and carryover to support recovery. Aphasia is a condition that impacts quality of life to a level that creates isolation and can have significant impact on a patient’s mood. Effective treatment is not only critical but essential for a return to social engagement and overall quality of life.

For more information, check out…

https://link.springer.com/article/10.1007/s11910-018-0891-x

https://academic.oup.com/brain/article/145/4/1354/6546042?login=true

https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.120.031162

June is Alzheimer and Brain Awareness

Collaborative care is a frequently used term within the management of cognitive decline and Alzheimer’s care planning. However, what is meant by the term is often vague and non-descriptive. Outcomes do not often reflect what the contributions of each of the members is providing and how this shapes the patient experience. Creating an effective strategy requires collaboration through the diagnostic process with the active sharing of information to support practitioners in the treatment and management of the disease complexities (Clare et al., 2019). Further, collaborative strategies should engage the latest research and approaches to support patients and families in their collective goals for treatment and quality of life (Clare et al., 2019). When interventions are truly collaborative, patients experience a lower hospitalization rate, and for the specific management of dementia, they experience a delay in institutionalization which improves quality of life measures and the family experience with interventions (Heintz et al., 2020). With the increasing number of individuals diagnosed with mild cognitive impairment, which is often a precursor but not always to dementia, our approach as providers needs to be collaborative to support early identification and subsequent treatment plans that address patient and family desires (Hlavka et al., 2019).

The Dementia Care Practice Recommendations (Fazio et al., 2018) identify the goals of quality dementia care should address:

  • Person-centered care
  • Detection and diagnosis
  • Assessment and care planning
  • Medical management
  • Information, education and support
  • Ongoing care for behavioral and psychological symptoms of dementia and support for activities of daily living
  • Staffing
  • Supportive and therapeutic environments
  • Transitions and coordination of services

Part of this dynamic is a shift in working with the patient and their families in the planning of these needs which is often not of immediate concern once the diagnosis is given. Often, there is a push for a medication-driven solution which is only a small piece of a much larger picture.

https://content.iospress.com/articles/journal-of-alzheimers-disease/jad190146

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557037/

https://academic.oup.com/gerontologist/article/58/suppl_1/S1/4816759?login=true

https://www.sciencedirect.com/science/article/abs/pii/S1064748119304609

June is Cancer Survivor Awareness!

In June, we have the opportunity to celebrate with cancer survivors. Recognizing the journey these individuals have taken and supporting them through phases of diagnosis, recovery, rehabilitation, and a return to “normal” is often our focus as healthcare providers. However, moves in medical literature are beginning to address the need for a healthcare framework that addresses survivorship. What does this look like? Where is our role as healthcare providers in meeting these survivors on the different phases of their journey? How do we change our approach?

At the core, cancer survivorship must address the likelihood of recurrence and new cancers, the physical effects on the individual, the psychosocial effects on the patient and family, management of general health, and maintaining a plan for other chronic conditions (Nekhlyudov et al., 2019).  There is a concern that the burden of a comprehensive approach is allocated to a specific provider, be it the primary care or even the oncologist. However, the approach, to be effective, should surpass the practitioner’s specific area of expertise. In understanding a health history, the consideration of survivorship is critical in building a care plan. This fact means that all healthcare professionals need to build a survivorship plan. For these care plans to demonstrate effective outcomes, the role of counseling cannot be minimized. Adherence to comprehensive survivorship plans is directly related to the supports in following the plan while addressing the likelihood of recurrence or complications from other health conditions (Jacobsen et al, 2018). Measurements of quality of life are integral in measuring the effectiveness of the plan and play a role in the patient’s adherence. Assuring critical issues, such as neuropathy and joint pain, which are often concerns voiced in accessing activities that are meaningful generate from conversations that identify what is of value to the patient and their family (van Leeuwen et al., 2018). Building these directly expressed concerns from quality of life measures into the care plan supports the shift for patients that are survivors and challenges practitioners to create comprehensive treatments that meet this unique need.

For more information, check out these articles:

https://academic.oup.com/jnci/article/111/11/1120/5490202?login=true

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036622/

https://hqlo.biomedcentral.com/articles/10.1186/s12955-018-0920-0