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 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

Weekly Pulse for May 30, 2022

Home Health
(Therapy)
Start Date
Hospice
(Nursing)
Start Date
Clarkston5/315/30
Lewiston5/315/30
Moscow6/15/31
Orofino6/15/31
***Start Dates are contingent on receiving a complete referral***

Clinical Focus

Thank you for joining us this month on our journey exploring asthma and allergy awareness, the importance of air quality and its impact on our respiration, lessening the stigma of mental illness in our practice and outreach to patients, optimizing treatments for osteoporosis and arthritis management, and creating frameworks for patient’s understanding of stroke risk. We also had the opportunity to recognize the work of our speech-language pathologists, nurses, and administrative professionals. Thank you for joining us!

Question Corner

What does an occupational therapy assessment look like?

Of all the professions involved in home health services, occupational therapy is the one that is uniquely trained for assessing patients’ capacity for optimal living in their home setting. Occupational therapists complete a comprehensive health history review, as well as a medication review, to identify the health related obstacles. They then engage in a review of the patient’s necessary and chosen activities. They assess how the patient is completing these tasks and the obstacles the patient is encountering in completing each of the components. They will then perform a physical assessment to review the patient’s capacity for movements and the bodily limitations that may impede certain positions and actions. They will review adaptations already in place and assess the effectiveness. They will assess the environment to identify the setup that best optimizes the setting or hinders a chosen activity. They will assess the patient’s learning style to identify changes in cognition and supportive systems for learning and using new processes. They will engage in a psychosocial review to identify support systems and involved parties. They then collaborate with the patient and family to identify treatment targets and create a plan of care. The certified occupational therapy assistant may lead some treatment sessions in collaboration with the occupational therapist during the home health course. If you have questions about occupational therapy and home health, reach out to us at info@EliteHHH.com

People to know

Clarkston Liaison/Lifeline – Angie (509) 780-8097

Lewiston Liaison – Beth (509) 254-1381

Moscow & Orofino Liaison – Scott (509) 234-3102

Business Development – Ashley (509) 843-7605

May is Stroke Awareness Month!

Rehabilitation in stroke recovery engages in multiple approaches for neurological remapping. This approach is dependent on the brain’s ongoing plasticity despite insult. The evidence for these rehabilitative approaches lies in activity-dependent changes in the brain (Braun, et al., 2021). Research is actively exploring the role of dose in recovery with stroke. This discussion becomes critical when advocating for ongoing patient-directed interventions, such as rehabilitative services. Identifying the right frequency of visits and the right duration of practice for a particular skill set to engage neurological remapping is critical in achieving results (Hayward, et al., 2021). Professionals in physical therapy, speech-language pathology, and occupational therapy are engaged in this dynamic when addressing motor challenges and rehabilitating individuals at the various phases of recovery often driving the changes in placement and therapy access (Hayward, et al., 2021). The continuum of service delivery from the acute care setting through skilled nursing and home health are directed by anticipated improvements given treatment at a specified dosage (Braun, et al., 2021). The complexities of this recovery are becoming increasingly diverse with considerations related to pharmacological intervention and timing, nutritional intake and management, and inflammatory responses in the system that impact recovery (Couch, et al., 2021). The reality for recovery from stroke is the complex approach employed by multiple professionals who engage in the rehabilitative process.

Home health services are often a supportive step in the transition home for many patients who have experienced stroke. Efforts in creating modifications and setting-up the home environment are a focus at this phase and often involve a different skill set from those in the acute care hospital setting or rehabilitative skilled nursing setting. We encourage our rehabilitative professionals to train and employ these unique skills to optimize outcomes for our patients recovering from stroke.

Resources for stroke awareness include:

https://www.sophe.org/

https://www.cdc.gov/stroke/communications_kit.htm

https://www.ninds.nih.gov/News-Events/Events-Proceedings/Events/Stroke-Awareness-Month

https://www.stroke.org/en/about-the-american-stroke-association

https://www.hap.org/blog/2021/05/may-is-national-stroke-awareness-month

Recovery from stroke is a long process, likened often to a marathon. The role of healthcare professionals in the rehabilitative space is to continue building and supporting the optimal exercises and environment to gain returns. While progress can feel limited in the later phases, understanding that stroke recovery is ongoing after the acute stage is critical for families and patients in pursuing the right resources. Professionals in rehabilitation are able to support strategic goals within the home setting to aid patient’s participation in life tasks of choice. Ask us how we can help your patients at the various phases of recovery to support their daily living.