Tag: regency nursing and rehab

First Day of Fall: Do You Know How to Prevent Falls?

Posted on by Judah
Photo of Autumn leaves hanging on tree branch in park
The start of Fall reminds us to be aware of falls.

The nights are turning cooler, the air is crisper, and the leaves are changing colors.

Fall is definitely here. That means it’s time for Falls Prevention Awareness Day.

Tomorrow is the Fall Equinox, otherwise known as the first day of Autumn.

The National Council on Aging has taken this opportunity to remind seniors about fall prevention and safety.

This week, in an interesting coincidence, is also National Rehabilitation Awareness Week. One of the main reasons patients join our rehabilitation program at Regency Nursing and Rehab is for post-fall rehabilitation.

Falls are the leading cause of injury among older adults. They are also a major cause of hip fractures, and cause more than half of all fatal head injuries.

Because our bones weaken as we age, seniors are much more likely to sustain serious injuries from falling. Sustaining a hip or knee fracture in old age can cause significant long-term disability. Very often, the fall victim can not regain their previous level of functioning and may require full-time help for the rest of their life.

At Regency Rehab, our goal is help our patients regain as much function as possible, so they can return to their homes, communities, and independent lifestyles. Of course, preventing the injury—by preventing the fall—is better than any therapy we can offer.

Here is a resource you need to help you and your loved ones prevent falls:

How To Prevent Senior Falls—The Regency Nursing Centers Checklist

This is a useful checklist for fall prevention and safety. Print it out and tour your (or your elderly parent’s) home, noting what needs to be updated. The main points to keep in mind are:

  • Keep hallways and living areas free of clutter.
  • Use enough lighting around your home to reduce shadows and dark areas. Place night lights in strategic areas around the house.
  • Store the things you use often within arm’s reach, and save the hard-to-reach cabinets for items you rarely or never use.
  • Bathrooms can be a real falling hazard. Use non-skid surfaces, grab bars, and any other safety mechanisms that can help prevent falls.

You may also want to review your loved one’s medications with his or her doctor, to check if any of them cause loss of balance or dizziness.

Falling can happen to anyone, even young and healthy adults. Minimize your chances by setting up your living space properly, and reducing tripping hazards.

Happy Fall! (The season, we mean.)

Long-Term Care Hospitals: Wonderful or Waste?

Posted on by Judah

Among the alphabet soup of medical abbreviations, you may have heard of an LTACH and wondered what that was.

Long-term acute care hospitals (LTACH), also known as Long-term Care Hospitals (LTCH) are hospitals specializing in patients who require extended hospitalization. The legal definition of an LTACH is “a hospital that has an average inpatient length of stay of greater than 25 days.”

Patients commonly stay at an LTACH for care when they’re on a ventilator long-term, or when they’re battling more than one condition. Patients with very complicated illnesses that require extended hospital stays are also referred to LTACHs. Very often, their families are told they can get much better care at an LTACH than at a short-term hospital or long-term skilled nursing facility.

But is that really true?

There isn’t a lot of evidence supporting better outcomes for LTACHs. In fact, new research suggests the opposite.

The study, authored by a team from Standford, MIT, and University of Chicago respectively, found that “substitution to LTCHs leaves patients unaffected or worse off on all measurable dimensions.” The study also suggested that Medicare could save 4.6 billion dollars a year by reimbursing long-term hospitals at the same levels as skilled nursing facilities.

In fact, their data showed that LTACHs didn’t produce statistically significant declines in patient mortality over a 90-day period, nor did they improve the odds that a resident would eventually return home.

Most of the services offered at a long-term acute care hospital can also be received at a skilled nursing facility like Regency Nursing and Rehabilitation. At Regency, we offer all skilled nursing services, including IV and oxygen therapy.

Some individuals, such as some ventilator-dependent patients, may require extended acute care. But according to this study, most patients—and Medicare—may be better off with skilled nursing.

September: National Atrial Fibrillation Awareness Month

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America observes AFib Awareness Month in September. Many people are not aware of this relatively common condition that makes strokes five times more likely.

Today we’ll talk about Atrial fibrillation, its symptoms, and how to catch it early.

What is Atrial Fibrillation?

Atrial fibrillation is often referred to as AF or AFib. It’s an irregular heartbeat, or arrhythmia, that can cause your heart to beat as high as 175 times every minute. By contrast, a healthy adult’s heart rate ranges between 60 and 100 beats per minute.

A sobering statistic from the American Heart Association says untreated atrial fibrillation could double your risk of heart-related deaths. Shockingly, less than half of all people with  AFib believe they are at increased risk.

Sustained AFib can cause strokes, heart failure, and other complications, so it’s important to take it seriously and treat it right away.

Symptoms of Atrial Fibrillation

Many people actually feel their elevated heart beat on their own. According to the Heart Rhythm Society, you may have one of the following feelings in your chest:

  • Pounding drums
  • Rumbling thunder
  • Flopping fish

Besides for the quivering, fluttering, or pounding heartbeat, there are other symptoms common to AFib, including:

  • Anxiety
  • Confusion
  • Dizziness
  • Exhaustion
  • Faintness
  • Shortness of breath

If you have any of these symptoms, especially if your heartbeat feels strange, see your doctor as soon as possible.

Treatment of Atrial Fibrillation

Not every case of AFib needs immediate treatment, and treatment will depend on many factors. The main goals in treating AFib are to lower the risk of stroke by preventing blood clots, and to treat any  underlying conditions that have caused the AFib.

If the arrhythmia is severe and/or affecting your quality of life, you will also need to control your heart rate via medication.

To learn more about Atrial Fibrillation, visit www.alittlefib.org for information and resources.

New Jersey Residents Receiving New Medicare Cards this Month

Posted on by Judah

Hey, New Jersey Medicare beneficiaries. As we mentioned in a previous post, you should soon be receiving your new Medicare cards if you haven’t already.

Here are some things you should know:

Your new card contains a new, eleven-character Medicare Beneficiary Identifier, consisting of both numbers and letters. The new identifier is completely random and is not associated with your social security number.

Besides for an update to the overall design, only your identifier number is changing. Your coverage and benefits, and social security number remain the same.

Beware of scammers asking for money or bank information over the phone. The new cards are free, and Medicare will NEVER call you and ask for your personal information without you asking them to call. If you receive a call from “Medicare” asking for your information or money, or threatening to cancel your healthcare benefits, hang up and call Medicare at 1-800-633-4227.

Your new card will arrive in the regular mail. You can check with Social Security by calling 1-800-772-1213 to make sure your mailing address is up to date. You can also visit your online account at ssa.gov/myaccount. Don’t worry if your neighbor receives their card before you do. Yours is on the way.

Your new card can be used as soon as you receive it. Make sure to destroy your old red, white, and blue Medicare card. Keep any Medigap, Part D, Medicare Advantage or retiree health plan cards—those did not change.

Starting January 1, 2020, only the new card and new identifier can be used. If you forget to bring your card with you, your health care providers can look up the number for you.

Medicare began mailing the cards at the beginning of the month, and they say it can take over a month to mail replacement cards to every beneficiary in the state. If you still haven’t received your new card by September 15, call Medicare’s office at 1-800-633-4227.

Adults and Seniors: Are You Up To Date With This Booster?

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August is National Immunization Awareness Month, a project of the CDC and National Public Health Information Coalition.

Immunizations are a public health concern because un-immunized people can spread diseases to their loved ones, neighbors, and co-workers. Vaccines are especially important for seniors, because their bodies are often frailer and more susceptible to complications of various diseases.

Here at Regency Nursing, we take vaccines very seriously for our residents and staff. If you visit loved ones at a Regency facility often, we request you stay up to date on your vaccines. The last thing you want to do is infect your elderly loved one or her roommate.

In honor of National Immunization Awareness Month, today we’re going to talk about a booster shot every single adult should get every 10 years.

national immunization awareness month logo

The Tdap Vaccine and Td Booster

The Tdap vaccine immunizes you against three diseases; tetanus, diphtheria, and pertussis.

  • Tetanus, also called lockjaw, is an infection that causes severe muscle spasms. Symptoms usually start in the jaw and spread to the rest of the body. The illness can last a month, and it can take many more months to fully recover. The disease is fatal in about 10 percent of cases.

    The bacteria that cause tetanus are commonly found in soil, saliva, dust, and manure. People can contract tetanus through a cut or puncture wound by a contaminated object. After getting any kind of puncture wound, you should immediately get a tetanus shot if you are not up-to-date. Being immunized is the best way to prevent tetanus.

  • Diphtheria is a highly contagious infection of the mucus membranes in the throat and nose. Untreated diphtheria can cause severe damage to the kidneys, nervous system, and heart.

    Diphtheria is common in undeveloped countries, and rare in the United States. However, anyone who isn’t up to date on immunization is at risk of contracting the disease from someone else.

  • Pertussis is also known as whooping cough. It’s a respiratory disease that can cause serious illness in people of all ages, although it is most fatal for babies. Seniors are also at higher risk of complications from pertussis.

The Tdap vaccine is usually given to children. The CDC recommends that if you did not receive the immunization as a child, you should get the Tdap as early as possible.

In addition, all adults should get a Td booster—a formula that boosts your immunity to tetanus and diphtheria—every 10 years.

If you have not gotten the booster in the last 10 years, speak with your doctor about getting it today.

 

All About the Shingles Vaccine

Posted on by Judah

August is National Immunization Awareness Month, a project of the CDC and National Public Health Information Coalition.

Immunizations are a public health concern because un-immunized people can spread diseases to their loved ones, neighbors, and co-workers. Vaccines are especially important for seniors, because their bodies are often frailer and more susceptible to complications of various diseases.

Here at Regency Nursing, we take vaccines very seriously for our residents and staff. If you visit loved ones at a Regency facility often, we request you stay up-to-date on your vaccines. The last thing you want to do is infect your elderly loved one or her roommate.

In honor of National Immunization Awareness Month, we’ll highlight a different vaccine every week on our blog. There are specific vaccines that are recommended specifically for seniors, so today we’ll talk about a vaccine you should take if you’re over 50.

national immunization awareness month logo

Shingles

Shingles is acute, painful nerve inflammation. It is caused by the varicella-zoster virus, the same virus as chickenpox. If you have ever had chickenpox, the varicella-zoster virus remains, dormant, in your body. It can reappear at any time in the form of shingles.

Debilitating pain is the main symptom of shingles. A blistering rash usually begins 1–5 days after the pain begins, often on one band of skin. The outbreak can last between 2 and 4 weeks, and can completely devastate daily function, especially in the elderly.

Other symptoms include:

  • fever
  • headache
  • malaise
  • nausea
  • muscle pain and weakness
  • chills
  • upset stomach
  • difficulties with urination
  • fatigue
  • joint pain
  • swollen glands

Shingles can cause complications such as skin infection, inflammation of the brain, eye problems, nerve damage, and weakness.

Your risk of a shingles outbreak goes up exponentially after 50. Therefore, the CDC recommends all individuals age 50 and up receive the singles vaccine.

Shingles Vaccine

A new vaccine called Shingrix received FDA approval last October. It involves two doses, given 2–6 months apart. The vaccine is 90 percent effective against shingles and postherpetic neuralgia—a painful nerve condition that is a known complication of shingles.

The previous shingles vaccine, Zostavax, only reduced your risk of shingles by 51 percent, so this is clearly the better option. The CDC says you should take Shingrix even if you’ve already gotten Zostavax. You should also take the vaccine if you don’t remember having had chickenpox, as you may have had it as a very young child.

Side effects of Shingrix include mild soreness, redness, and swelling at the injection site. Some people also reported headaches or feeling tired and achy after receiving the shot.

The worst side effects lasted 2 or 3 days, and the CDC says that even if you experience those side effects, it’s still better than suffering through weeks of shingles and possible complications.

Celebrate Senior Citizens Tomorrow—And Every Day

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Senior citizens, it’s time to celebrate!

It’s 30 years since the first National Senior Citizens day was declared by President Ronald Reagan. Tomorrow, August 21, is the 30th annual observance of Senior Citizens day.

Senior citizens today are more active, financially secure, and healthy than ever before. With average life expectancy hovering around age 80, we’re lucky to have our seniors around for years—long enough to benefit from the wisdom and experience you can only gain by living to old age.

photo of elderly woman talking, with george burns quote: "by the time you're 80 you've learned everything. you only have to remember it."

Reaching advanced age comes with unique difficulties. Physical and mental decline, increased risk of accidents, and costly medical bills are just some of the challenges seniors face as they age.

On Senior Citizen’s day, let’s support, honor, and show appreciation to our seniors, and recognize their achievements.

Here are some ways you can celebrate the senior citizens in your life:

  • Send them flowers
  • Visit them at home or long-term care residence, and spend some time with them
  • Call to chat if you can’t visit
  • Take them out for dinner
  • Thank them for everything they’ve done for you over the years
  • Listen to their stories
  • Ask their advice
  • Buy a gift—even the new blanket they need or crossword book they’ve wanted

Don’t live near your elderly loved ones? You can still show them you care with a special phone call, letter, email, or video call. You can also volunteer with local seniors who may not have family nearby.

Studies show living alone is one of the highest risk factors for depression and other mental health issues among seniors. Living alone can also be a health and safety risk for declining seniors who don’t realize their own limits. Celebrate the senior citizens in your neighborhood by visiting regularly and making sure they’re okay. If it seems they can no longer live alone, don’t hesitate to alert their families or your local social services.

This Senior Citizens day, we invite friends and family of our residents to Regency Nursing. Come visit, participate in the programming, and show your senior loved ones how much they mean to you.

Tracheostomy Care Information

Posted on by Judah

When someone can’t breathe on their own, due to illness or injury, many times doctors will perform a tracheotomy. This is a medical procedure that temporarily or permanently opens a hole in the neck for a tube to pass through to the patient’s trachea, or windpipe.

The hole, called a tracheostomy or stoma, is located below the vocal cords. When the tube is inserted, air can enter the lungs and bypass the mouth, nose and throat.

Here’s what you need to know about the procedure:

When does a patient require a tracheostomy?

Doctors will create a stoma in any situation where breathing is impossible. This can be for patients after surgery or in intensive care, patients with chronic lung diseases or cancers, patients in a coma, or in other situations. People who need long-term respirator or ventilator support will also require a stoma.

Many times, the tracheostomy is temporary, and it will be repaired after you recover. Normally, all that’s left after recovery is a small scar where the stoma once was.

For long-term or permanent stomas, your loved one may need to learn how to speak around the tubing, and will need ongoing care. At Regency Nursing, we provide outstanding tracheostomy care to keep the incidence of complication low.

What are the risks of a tracheotomy?

Every medical procedure carries some risk. When the procedure involves breaking the skin, we have the twin risks of infection and hemorrhaging.

Tracheotomies also carry specific risks, including:

  • damage to the glands in the neck, particularly the thyroid.
  • lung puncture or collapse.
  • scar tissue in the windpipe.
  • erosion of the trachea is also a serious risk, but it’s extremely rare.

What does tracheostomy care entail?

The procedure to create the stoma shouldn’t take longer than 45 minutes. Your loved one may then stay in the hospital until they recover from the surgery. During this time, they won’t be able to eat normally, and may require a feeding tube. They may also need speech therapy to help learn how to talk around the tube.

If your loved one is going home after a tracheotomy, you will receive clear instructions on how to care for the stoma and tubing. You will need to suction the tube every day, clean the inner cannula if there is one, and change the dressing at the opening.

You will also need to check the surgical site daily for signs of infection or other complications.

If your loved one is at a skilled nursing facility, the nursing staff will take care of the stoma. At Regency Nursing in particular, your loved one will be in good hands. Our nurses are specially trained in tracheostomy care, and we go above and beyond in keeping your loved one’s stoma squeaky clean and clear.

To learn more, contact us at Regency Nursing and Rehabilitation.

Part Two: Original Medicare vs Medicare Advantage

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Welcome back to our two-part series about the costs and benefits of Original Medicare and Medicare Advantage. In our last post, we talked about how Original Medicare can leave you on the hook for thousands of dollars a year. One way to reduce that financial burden is to join a Medigap plan for as little as $60 a month. Today let’s discuss the other option: Medicare Advantage plans.

Medicare Advantage

Sometimes called Medicare Part C, Medicare Advantage (MA) plans must cover all services Original Medicare does, except hospice care. (When a patient gets admitted to hospice, their coverage automatically reverts to Original Medicare.) MA providers can also  offer other benefits—such as prescription drug coverage, dental care, and vision plans—in order to stay competitive.

As we explained last time, Medicare contracts with private insurance companies to offer Medicare Advantage plans. Medicare pays the private insurer a set amount per beneficiary per month, and they use the funds to cover your medical costs. Beneficiaries who choose MA plans are still part of Medicare, and still pay their Medicare Part B premiums. Some MA plans don’t charge above your Medicare premium, while other plans can cost as much as an extra $200 a month. The three most common types of plans are:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Private Fee-for-Service (PFFS)

Each type of plan has different rules, restrictions, and networks. Approximately 21 percent of New Jersey seniors enrolled in an Advantage plan in 2017. Let’s explore the pros and cons of Medicare Advantage:

The Plus Side of MA: Extra Coverage

The main draw of MA plans is that they usually provide benefits for some of Medicare’s non-covered services. Prescription drug coverage continues to be a problem for seniors under Medicare. Part D, Medicare’s optional prescription drug plan, has serious gaps in coverage that can cost thousands of dollars a year. By contrast, many MA plans offer broad drug coverage with much smaller co-payments. Plus, they often offer dental and vision coverage, unlike Original Medicare.

When it comes to care in a skilled nursing facility, some MA plans don’t require the  3-day qualifying inpatient stay Original Medicare demands.

Another benefit is that while the co-payments are often higher than Original Medicare’s, most MA plans have an out-of-pocket maximum. That means once you’ve paid a certain amount of co-payments, your insurer will pay your out-of-pocket expenses for the rest of the year. If you need a surgery, for example, you’ll probably reach your out-of-pocket maximum fairly quickly—leaving you with no out-of-pocket costs for the rest of year. In Original Medicare, you always have to pay the 20% copay, regardless of how much you’ve already paid.

The Downside of MA: Less Standardization

Since private insurers administer the MA plans, they can apply their own rules to the Medicare plan. While the basic coverage is the same, the plans have much more flexibility in how to apply your coverage. Here are some of the things you can expect from a private insurer:

  • Higher premiums, deductibles, and co-payment amounts. These plan details can change from year to year.
  • Stricter rules for coverage of certain services and products. You may be required to get a referral  from your primary doctor in order to see a specialist. You may also be required to stick to doctors or hospitals in the plan’s network. Tip: HMO plans are generally cheaper than PPO, but restrict you to a smaller network of medical providers.
  • No guaranteed plan renewal. Advantage plans have annual contracts with Medicare, so if your provider chooses not to renew their contract, you’ll have to find a new insurer.
  • No out-of-state coverage. Original Medicare offers you a nation-wide coverage. It’s the same in every state, so if you travel often, you can use your Medicare coverage anywhere you go. Medicare Advantage often only covers you regionally.

Which Plan is Right for Me?

Now that you know more about Original Medicare and Medicare Advantage, you are more equipped to make the decision based on your personal circumstances. If you have high prescription medication costs, you might prefer an Advantage plan, while if you split your time between two states, Original Medicare is probably the way to go. Because MA plans are not standardized, make sure to check the benefits of each one before you choose a plan. A licensed insurance agent can help you find the plan to best suit your needs.

Prevent Caregiver Burnout

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If you spend any amount of time caring for your elderly parents, you are at risk of burning out. What does burnout mean? How does it look and where does it come from?

The dictionary defines burnout as “physical or mental collapse caused by overwork or stress.” And both overwork and stress are common among caregivers to the elderly. Whether your parents live with you, live alone, or in a long-term care facility, the burden of their care sits heavily on you.

Causes of Caregiver Burnout

You’re in danger of burning out any time you start pushing your limits without stopping to care for yourself. This can include:

  • Working too hard and not accepting help
  • Not sleeping well
  • Not eating well
  • Stress from financial problems
  • Confusion from all the medical decisions
  • Guilt about those medical decisions

Being the primary caregiver of an elderly or disabled person is physically taxing. Some seniors need extensive help with dressing, toileting, and bathing. If you’re the one doing all that, you can get worn down very quickly. In addition, it’s difficult to juggle work responsibilities with caregiving. Your career may suffer, or you may find yourself skipping the things you used to enjoy because you simply have no time.

Besides the physical aspect of caring for your parents, you also have the crushing emotional burden of assuming a “parenting” role for your own parent. Unresolved resentments between elderly parents and their adult children, or between siblings, tend to come up during medical episodes and while making medical decisions. This all contributes to the load of mental and emotional stress caregivers carry.

All these factors and more play into caregiver burnout, and it’s important to recognize when you’re overdoing it.

How Burning Out Looks

After a time of neglecting yourself and focusing solely on your parent or loved one, you might start feeling depressed or anxious. You may lose weight, have changes in appetite and sleeping patterns, and feel irritable a lot. You could even find yourself dealing with a lingering cold that just won’t go away.

You might not even notice these red flags right away. Many times caregivers are so overwhelmed, they can’t stop to think about how they’re feeling. Others may pick up on the signs of burnout, and can let you know when you need to take a break.

How to Prevent Burnout

  • While it won’t completely eliminate your caregiving burden, consider placing your parent in a long-term care facility. Feelings of guilt and inadequacy may prevent you from taking that step, but it’s something to consider when you don’t have a lot of help and you’re getting run down from all your responsibilities. Many times, moving your loved one to a skilled nursing facility is the best option for everyone. In facilities like Regency Nursing‘s, residents get superior care and have a warm social atmosphere if they desire. You can still be as involved as you want to be in your loved one’s care, and often your relationship improves when you’re no longer the full-time caregiver.
  • Take care of yourself. Take breaks from caregiving to indulge in activities you enjoy. Accept help when others offer it, and learn how to delegate. Make sure to schedule—and attend—regular doctor appointments for yourself.
  • Practice stress relief. Even if you make no other change, just making a habit of reducing stress will work wonders on your mood, appetite, and long-term health. For some stress-reducing techniques, see our previous blog post, Take a Break From Stress.
  • Embrace your medical decisions—and their consequences. One of the hardest parts of being a caregiver is the responsibility of making medical decisions. Ideally, you have an advance directive signed by your parent, but what happens if you don’t, and you’re long past the point where Mom and Dad can communicate their wishes? You do your best to follow the doctor’s and facility’s recommendations, and then choose the option that seems best. Later, you may feel like you made a bad decision, and you may blame yourself for the results. Remember that you did the right thing at that time, and there’s no way to know how the other options would have turned out. Keeping that mindset will help you have more peace of mind during this challenging time.