Why can I speak about this issue? I worked as a pharmacy technician before working as a Registered Nurse (RN) and ultimately becoming a Nurse Practitioner (NP) in 2000. I have been employed in health care for 33 years, including over 20 of those years as a NP. At present, I work in a specialized emergency service, and am attending the University of Washington for a Doctor of Nursing Practice (DNP) degree. I am writing in hopes to affect change on this ubiquitous delivery of health care problem.
A personal story exemplifies this issue. My 90-year-old grandfather was discharged from an ER and resumed taking a long discontinued antihypertensive (blood pressure) medication from an old pill bottle. He took this in addition to his newly prescribed antihypertensive medication, both medications listed as active in his discharge instructions.
Fortunately, my grandfather was okay, and my mother caught this error and understandably had something to say about it. She drove back to the hospital to give them a piece of her mind, before recommending they come up with a better system. They agreed.
One recurring and nationwide theme are health care providers, and patients, becoming confused with the list of medications in their medical records in all phases of care, including at hospital admission and discharge. This medication list often includes medications that are listed as active and those they haven't taken at times since many years ago.
Sadly, this is not an exaggeration, and often leads to harmful medication errors which are a big problem during all phases of health care. Affected phases include outpatient ambulatory care clinics, during hospital admissions, during hospital stays and hospital discharge. Because of these gaps, medication errors are not surprisingly a leading cause of injury or death.
This is a serious issue that I believe can be solved with a concerted effort by an interdisciplinary team approach along with a streamlined electronic health record system. This is in addition to an emphasis on patient education throughout all stages of treatment which includes outpatient care, an urgent hospital visit or inpatient stay. Providers and ancillary services should always be involved in this process.
Better practice solutions:
1. For health care providers, at all phases of treatment, if it remains unclear if a patient is taking a medication, ask questions, and if medication reconciliation is not possible then list it as such. Increasing awareness of this problem in the advent of increasing use of Electronic Health Records (EHR) is key.
2. Incorporation of admission and discharge medication reconciliation as a continuous process by admitting and discharging RNs, the pharmacist and nurse practitioner and physicians.
As noted by J AM Med inform Association (2016) working towards a solution would include incorporating reconciliation modules that are interoperable with other Electronic Health Record components. This includes medication history, the computerized order set and discharge documentation. Some EHRs have some interoperability with external sources (hospitals, clinics, pharmacy) to import medication history and share updated medication list at discharge, although this is not fail safe and should not be relied on itself alone.
3. As health care consumers, don't be afraid to ask questions or clarification. Most health care providers want you to be involved in your own care. You reserve this right 100 percent and it is okay to ask questions and include your loved ones to advocate for you in your treatment plan.
In summary, medication confusion and errors are fear reaching. It is up to us as health care providers to be conscientious and provide essential emphasis on patient education and collaboration. Encouraging patients and their loved ones to actively participate in their care is vital. This includes asking questions and seeking clarification about medications along with interdisciplinary providers to help prevent confusion and potential medication errors. Involving patient's loved ones can contribute to healthy outcomes. Refining EHR is of the utmost importance.
I thank all health care providers for dedication to this important cause, and I wish success in your continued efforts to make a positive impact on health care practices while encouraging health consumers to be proactive in their care.
Angela Buxton, FNP-BC is a national Board-Certified (BC) Family Nurse Practitioner (FNP) since 2000 and who is originally from Massachusetts, obtaining her undergraduate and graduate degrees at UMASS, Amherst, and worked as both a Registered Nurse (RN) and FNP throughout her career. She is currently attending the University of Washington to expand her skills as a Doctor of Nursing Practice in Psychiatric Mental Health. She has now been working as a NP at Harborview Medical Center in Seattle, Washington for the last 20 years. She enjoys her role in assessing, diagnosing and developing client centered treatment plans, not limited to prescribing medications. Population includes those who are underserved and across the lifespan. She has membership in Snohomish County, WA Search and Rescue (SSAR), has participated in team endurance events with lessons learned that crossover into daily life. Other outside interests include photography, painting, skiing and hiking the Pacific Northwest.
Every year, thousands of people end up in an emergency department due to things happening when they’re shoveling snow
ROCKFORD - It’s that time of the year when winter can really show its teeth. For adults, snow – especially the heavy stuff – also means lots of shoveling, which can lead to an assortment of health-related problems if you’re not careful and properly prepared for the winter season.
Photo: Serkan Gönültaş/PEXELS
“Every year, thousands of people end up in an emergency department due to things happening when they’re shoveling snow," says Amy Henderson, a family practice physician assistant for OSF HealthCare. "These include falls, sometimes people experience heart attacks from extraneous activities, back injuries amongst other things. So it’s really important to take some caution when you are going to be shoveling snow, and the snow is coming.”
Among the people at the greatest risk of experiencing potential issues while shoveling are the elderly, people with a history of back problems as well as people who have suffered a heart attack or other serious illness. Henderson says to check with your doctor first if you have any concerns about your health.
“If a person develops any chest pain, sharp, radiating arm pain, jaw pain, those are all signs and symptoms of a possible heart attack," says Henderson. "If those symptoms do not improve with rest after a short amount of time, it’s concerning. My advice would be to seek immediate medical attention if you’re concerned at all about a cardiac event or a heart attack; in this case it’s always good to play it safe than sorry.”
Safety is key when it comes to snow and ice. Henderson offers a few basic tips before getting started with shoveling your sidewalk or driveway.
“One of the most important things to do is wear the appropriate clothing to stay warm and avoid frostbite," says Henderson. "Also, stretching prior to going out and doing this activity is important so I recommend stretching 5 to 10 minutes before you go out in the cold. I also recommend staying hydrated because you’re doing physical activity.”
Other important tips include:
Lift with your legs, not your back
Push (don’t) lift the snow
Stay low to the ground
Shovel more frequently
Take breaks if you feel winded
Be aware of ice
Go inside to warm up in order to avoid frostbite
The same suggestions apply when using a snow blower. Many people are injured every year by pushing their snow blower, twisting their body or reaching into the snow blower.
The bottom line when it comes to snow shoveling, Henderson says, is play it safe, take your time and be sure to let your loved ones and friends know what you’re up to in the event something does happen. And don’t be afraid to ask for help.
Key Takeaways:
Every year, thousands of people visit the emergency department due to snow-related injuries or events.
People at the greatest risk are the elderly, those with back issues or a history of heart problems.
Wear appropriate clothing to stay warm and avoid frostbite.
Other tips include lifting with your legs, push (don't) lift the snow, take breaks, and be aware of ice.
If you experience a medical emergency, call 911.
“If you really should not be shoveling snow, or you’re at higher risk, I recommend trying to find someone else who can do it for you, whether that’s a neighbor or a family member. I highly recommend that," adds Henderson. "It’s not worth the broken hip or the hospital follow up. Another thing for people who are at higher risk is to bring a cellphone. If you do fall, you’re able to call somebody.”
Before you bundle up and head outside to shovel your driveway, make sure you follow proper safety measures to avoid injury. If you or a loved one experiences severe injury, heart attack, or other medical emergencies while shoveling snow, call 911.
BPT - If you are one of the more than 35 million Americans who are estimated to have obstructive sleep apnea (OSA), you already know how disruptive it can be to your life. While OSA is one of the most common and serious sleep disorders, the condition is widely under-diagnosed, so the number of affected Americans may be far greater.
What is obstructive sleep apnea?
OSA occurs when the muscles in the throat relax during sleep, blocking normal breathing. This can lead to low levels of oxygen in your blood while you sleep and result in poor sleep, fatigue and sleepiness that can negatively impact quality of life for many. In the long term, OSA has also been shown to contribute to high blood pressure, diabetes, cardiovascular disease and stroke.
Most people diagnosed with OSA are prescribed positive air pressure therapy devices such as continuous positive airway pressure, or CPAP, which can work very well in helping people receive the oxygen they need while they are sleeping. However, because many have difficulty using or tolerating these devices, a significant percentage of the population with OSA remains untreated, undertreated and at risk.
A new option for treating obstructive sleep apnea
Apnimed is a pharmaceutical company working to change the way OSA is treated. The company recently completed a large Phase 2b clinical trial, called MARIPOSA, to study AD109 (an investigational medication which is a single pill taken at bedtime) as a possible treatment for obstructive sleep apnea.
AD109 has the potential to be the first oral medication that treats both the underlying cause of OSA - airway obstruction at night - and improve the daytime symptoms of OSA, such as fatigue. It is designed to treat people with OSA from mild to severe.
Many patients with OSA are unable to adequately treat their condition with existing options, and the team at Apnimed is driven to find new solutions for patients and their doctors to overcome these barriers to treatment. The success of this effort is largely dependent on the dedicated work done by patients and doctors in the community who take part in clinical research.
"MARIPOSA results showed that AD109 improved daytime fatigue, which is an often debilitating effect of poor sleep due to OSA," said Paula Schweitzer, Ph.D., an investigator in the MARIPOSA trial and director of research at St. Luke's Sleep Medicine and Research Center, Chesterfield, Missouri. "For those who cannot tolerate current treatments, AD109 has the potential to be a convenient oral pill that could improve people's quality of life at night and during the daytime as well."
Learn about enrolling in the clinical trial
With the promising results from the MARIPOSA study, a new study is now available for people with OSA.
If you or a loved one has obstructive sleep apnea and you are unable to successfully use or tolerate treatment with a CPAP machine, you could be eligible to enroll in a six-month clinical trial called SynAIRgy.
To learn more about the clinical trial and to enroll, visit: www.SynAIRgyStudy.com.
URBANA - With the new year starting this week, your mind may wander back to conflicting summer news about aspartame, an artificial sweetener found in things like diet soda, gum, ice cream, yogurt and other sugar-free foods. The World Health Organization (WHO) cited “limited evidence” of aspartame being “possibly carcinogenic to humans.”
Not so fast, responded the United States Food and Drug Administration (FDA).
“Aspartame is one of the most studied food additives in the human food supply,” the agency said. “FDA scientists do not have safety concerns when aspartame is used under the approved conditions.”
Carly Zimmer, a registered dietitian-nutritionist at OSF HealthCare, explains how we got here.
Zimmer says the agency within WHO that researches cancer has four levels of certainty that a substance can cause the disease. Group one is labeled “carcinogenic to humans.” Things like tobacco, alcohol and solar radiation are here. Group 2A is “probably carcinogenic to humans.” Group 2B is “possibly carcinogenic to humans.” And group three is “not classifiable as to its carcinogenicity to humans.” Coffee and mercury are in this group.
WHO put aspartame in group 2B along with aloe vera plant extract and traditional Asian pickled vegetables.
“That group B classification means there is a possible risk for that substance to cause cancer, not that it’s necessarily linked to cancer,” Zimmer says.
The other thing to consider: Zimmer says the FDA sets an acceptable daily intake for the six sweeteners it has approved. For aspartame, the limit is 50 milligrams per kilogram of body weight. For example, someone who is 60 kilograms (or 132 pounds) would have to consume 75 packets of aspartame (think of brand names like Equal, NutraSweet and Sugar Twin) in a day to reach the limit.
“It would be pretty hard to reach those numbers,” Zimmer says.
That’s not a license to add a lot of sweeteners to your drinks or drink soda with every meal. Sugary foods are bad for your heart, among other things, and should be consumed in moderation. But cancer risk from diet soda? It’s not something to lose sleep over.
“Artificial sweeteners definitely have a place [in diets], but we don’t want to consume them in excess,” Zimmer says. For example, sweeteners can add sweetness to foods without raising blood sugar. That’s helpful for people with diabetes or heart disease.
Want to cut aspartame out greatly or all together? Try fruit-infused water, which you can make at home or get at the store. But check the label. Zimmer says drink mixes like Crystal Light often have aspartame. Hint Water is a better choice, she says. Also, look for high levels of added sugar on the food label.
And in general, talk to your health care provider or a dietitian if you have questions about what you should eat and drink.
The financial and emotional toll of providing and paying for long-term care is wreaking havoc on the lives of millions of Americans.
by Reed Abelson, The New York Times Jordan Rau, KFF Health New
Kaiser Health News - Margaret Newcomb, 69, a retired French teacher, is desperately trying to protect her retirement savings by caring for her 82-year-old husband, who has severe dementia, at home in Seattle. She used to fear his disease-induced paranoia, but now he’s so frail and confused that he wanders away with no idea of how to find his way home. He gets lost so often that she attaches a tag to his shoelace with her phone number.
The financial and emotional toll of providing and paying for long-term care is wreaking havoc on the lives of millions of Americans. Read about how a few families are navigating the challenges, in their own words. (Read More)
Feylyn Lewis, 35, sacrificed a promising career as a research director in England to return home to Nashville after her mother had a debilitating stroke. They ran up $15,000 in medical and credit card debt while she took on the role of caretaker.
Sheila Littleton, 30, brought her grandfather with dementia to her family home in Houston, then spent months fruitlessly trying to place him in a nursing home with Medicaid coverage. She eventually abandoned him at a psychiatric hospital to force the system to act.
“That was terrible,” she said. “I had to do it.”
Millions of families are facing such daunting life choices — and potential financial ruin — as the escalating costs of in-home care, assisted living facilities, and nursing homes devour the savings and incomes of older Americans and their relatives.
“People are exposed to the possibility of depleting almost all their wealth,” said Richard Johnson, director of the program on retirement policy at the Urban Institute.
The prospect of dying broke looms as an imminent threat for the boomer generation, which vastly expanded the middle class and looked hopefully toward a comfortable retirement on the backbone of 401(k)s and pensions. Roughly 10,000 of them will turn 65 every day until 2030, expecting to live into their 80s and 90s as the price tag for long-term care explodes, outpacing inflation and reaching a half-trillion dollars a year, according to federal researchers.
By 2050, there will be more than 86 million Americans over the age of 65. The U.S. does not dedicate enough funds for long-term care of the aging population. For the most, the financial burden is left on the shoulders of the senior and their financial resources or that of the family.
Photo: Spolyakov/PEXELS
The challenges will only grow. By 2050, the population of Americans 65 and older is projected to increase by more than 50%, to 86 million, according to census estimates. The number of people 85 or older will nearly triple to 19 million.
The United States has no coherent system of long-term care, mostly a patchwork. The private market, where a minuscule portion of families buy long-term care insurance, has shriveled, reduced over years of giant rate hikes by insurers that had underestimated how much care people would actually use. Labor shortages have left families searching for workers willing to care for their elders in the home. And the cost of a spot in an assisted living facility has soared to an unaffordable level for most middle-class Americans. They have to run out of money to qualify for nursing home care paid for by the government.
For an examination of the crisis in long-term care, The New York Times and KFF Health News interviewed families across the nation as they struggled to obtain care; examined companies that provide it; and analyzed data from the federally funded Health and Retirement Study, the most authoritative national survey of older people about their long-term care needs and financial resources.
About 8 million people 65 and older reported that they had dementia or difficulty with basic daily tasks like bathing and feeding themselves — and nearly 3 million of them had no assistance at all, according to an analysis of the survey data. Most people relied on spouses, children, grandchildren, or friends.
The United States devotes a smaller share of its gross domestic product to long-term care than do most other wealthy countries, including Britain, France, Canada, Germany, Sweden, and Japan, according to the Organization for Economic Cooperation and Development. The United States lags its international peers in another way: It dedicates far less of its overall health spending toward long-term care.
“We just don’t value elders the way that other countries and other cultures do,” said Rachel Werner, executive director of the Leonard Davis Institute of Health Economics at the University of Pennsylvania. “We don’t have a financing and insurance system for long-term care,” she said. “There isn’t the political will to spend that much money.”
Most countries spend more than the United States on care, but middle-class and affluent people still bear a substantial portion of the costs. (Read More)
Despite medical advances that have added years to the average life span and allowed people to survive decades more after getting cancer or suffering from heart disease or strokes, federal long-term care for older people has not fundamentally changed in the decades since President Lyndon Johnson signed Medicare and Medicaid into law in 1965. From 1960 to 2021, the number of Americans age 85 and older increased at more than six times the rate of the general population, according to census records.
Medicare, the federal health insurance program for Americans 65 and older, covers the costs of medical care, but generally pays for a home aide or a stay in a nursing home only for a limited time during a recovery from a surgery or a fall or for short-term rehabilitation.
Medicaid, the federal-state program, covers long-term care, usually in a nursing home, but only for the poor. Middle-class people must exhaust their assets to qualify, forcing them to sell much of their property and to empty their bank accounts. If they go into a nursing home, they are permitted to keep a pittance of their retirement income: $50 or less a month in a majority of states. And spouses can hold onto only a modest amount of income and assets, often leaving their children and grandchildren to shoulder some of the financial burden.
At any given time, skilled nursing homes house roughly 630,000 older residents whose average age is about 77.
“You basically want people to destitute themselves and then you take everything else that they have,” said Gay Glenn, whose mother lived in a nursing home in Kansas until she died in October at age 96.
Her mother, Betty Mae Glenn, had to spend down her savings, paying the home more than $10,000 a month, until she qualified for Medicaid. Glenn, 61, relocated from Chicago to Topeka more than four years ago, moving into one of her mother’s two rental properties and overseeing her care and finances.
Under the state Medicaid program’s byzantine rules, she had to pay rent to her mother, and that income went toward her mother’s care. Glenn sold the family’s house just before her mother’s death in October. Her lawyer told her the estate had to pay Medicaid back about $20,000 from the proceeds.
A play she wrote about her relationship with her mother, titled “If You See Panic in My Eyes,” was read this year at a theater festival.
At any given time, skilled nursing homes house roughly 630,000 older residents whose average age is about 77, according to recent estimates. A long-term resident’s care can easily cost more than $100,000 a year without Medicaid coverage at these institutions, which are supposed to provide round-the-clock nursing coverage.
Nine in 10 people said it would be impossible or very difficult to pay that much, according to a KFF public opinion poll conducted during the pandemic.
Efforts to create a national long-term care system have repeatedly collapsed. Democrats have argued that the federal government needs to take a much stronger hand in subsidizing care. The Biden administration sought to improve wages and working conditions for paid caregivers. But a $150 billion proposal in the Build Back Better Act for in-home and community-based services under Medicaid was dropped to lower the price tag of the final legislation.
“This is an issue that’s coming to the front door of members of Congress,” said Sen. Bob Casey, a Pennsylvania Democrat and chair of the Senate Special Committee on Aging. “No matter where you’re representing — if you’re representing a blue state or red state — families are not going to settle for just having one option,” he said, referring to nursing homes funded under Medicaid. “The federal government has got to do its part, which it hasn’t.”
But leading Republicans in Congress say the federal government cannot be expected to step in more than it already does. Americans need to save for when they will inevitably need care, said Sen. Mike Braun of Indiana, the ranking Republican on the aging committee.
“So often people just think it’s just going to work out,” he said. “Too many people get to the point where they’re 65 and then say, ‘I don’t have that much there.’”
Private Companies’ Prices Have Skyrocketed
The boomer generation is jogging and cycling into retirement, equipped with hip and knee replacements that have slowed their aging. And they are loath to enter the institutional setting of a nursing home.
But they face major expenses for the in-between years: falling along a spectrum between good health and needing round-the-clock care in a nursing home.
That has led them to assisted living centers run by for-profit companies and private equity funds enjoying robust profits in this growing market. Some 850,000 people age 65 or older now live in these facilities that are largely ineligible for federal funds and run the gamut, with some providing only basics like help getting dressed and taking medication and others offering luxury amenities like day trips, gourmet meals, yoga, and spas.
The bills can be staggering.
As Americans live longer, the number who develop dementia, a condition of aging, has soared, as have their needs.
Half of the nation’s assisted living facilities cost at least $54,000 a year, according to Genworth, a long-term care insurer. That rises substantially in many metropolitan areas with lofty real estate prices. Specialized settings, like locked memory care units for those with dementia, can cost twice as much.
Home care is costly, too. Agencies charge about $27 an hour for a home health aide, according to Genworth. Hiring someone who spends six or seven hours a day cleaning and helping an older person get out of bed or take medications can add up to $60,000 a year.
As Americans live longer, the number who develop dementia, a condition of aging, has soared, as have their needs. Five million to 7 million Americans age 65 and up have dementia, and their ranks are projected to grow to nearly 12 million by 2040. The condition robs people of their memories, mars the ability to speak and understand, and can alter their personalities.
In Seattle, Margaret and Tim Newcomb sleep on separate floors of their two-story cottage, with Margaret ever mindful that her husband, who has dementia, can hallucinate and become aggressive if medication fails to tame his symptoms.
“The anger has diminished from the early days,” she said last year.
But earlier on, she had resorted to calling the police when he acted erratically.
“He was hating me and angry, and I didn’t feel safe,” she said.
She considered memory care units, but the least expensive option cost around $8,000 a month and some could reach nearly twice that amount. The couple’s monthly income, with his pension from Seattle City Light, the utility company, and their combined Social Security, is $6,000.
Placing her husband in such a place would have gutted the $500,000 they had saved before she retired from 35 years teaching art and French at a parochial school.
“I’ll let go of everything if I have to, but it’s a very unfair system,” she said. “If you didn’t see ahead or didn’t have the right type of job that provides for you, it’s tough luck.”
In the last year, medication has quelled Tim’s anger, but his health has declined so much that he no longer poses a physical threat. Margaret said she’s reconciled to caring for him as long as she can.
“When I see him sitting out on the porch and appreciating the sun coming on his face, it’s really sweet,” she said.
The financial threat posed by dementia also weighs heavily on adult children who have become guardians of aged parents and have watched their slow, expensive declines.
Claudia Morrell, 64, of Parkville, Maryland, estimated her mother, Regine Hayes, spent more than $1 million during the eight years she needed residential care for dementia. That was possible only because her mother had two pensions, one from her husband’s military service and another from his job at an insurance company, plus savings and Social Security.
Morrell paid legal fees required as her mother’s guardian, as well as $6,000 on a special bed so her mother wouldn’t fall out and on private aides after she suffered repeated small strokes. Her mother died last December at age 87.
“I will never have those kinds of resources,” Morrell, an education consultant, said. “My children will never have those kinds of resources. We didn’t inherit enough or aren’t going to earn enough to have the quality of care she got. You certainly can’t live that way on Social Security.”
Women Bear the Burden of Care
For seven years, Annie Reid abandoned her life in Colorado to sleep in her childhood bedroom in Maryland, living out of her suitcase and caring for her mother, Frances Sampogna, who had dementia. “No one else in my family was able to do this,” she said.
“It just dawned on me, I have to actually unpack and live here,” Reid, 61, remembered thinking. “And how long? There’s no timeline on it.”
After Sampogna died at the end of September 2022, her daughter returned to Colorado and started a furniture redesign business, a craft she taught herself in her mother’s basement. Reid recently had her knee replaced, something she could not do in Maryland because her insurance didn’t cover doctors there.
“It’s amazing how much time went by,” she said. “I’m so grateful to be back in my life again.”
Studies are now calculating the toll of caregiving on children, especially women. The median lost wages for women providing intensive care for their mothers is $24,500 over two years, according to a study led by Norma Coe, an associate professor at the Perelman School of Medicine at the University of Pennsylvania.
Lewis moved back from England to Nashville to care for her mother, a former nurse who had a stroke that put her in a wheelchair.
“I was thrust back into a caregiving role full time,” she said. She gave up a post as a research director for a nonprofit organization. She is also tending to her 87-year-old grandfather, ill with prostate cancer and kidney disease.
Making up for lost income seems daunting while she continues to support her mother.
But she is regaining hope: She was promoted to assistant dean for student affairs at Vanderbilt School of Nursing and was recently married. She and her husband plan to stay in the same apartment with her mother until they can save enough to move into a larger place.
Government Solutions Are Elusive
Over the years, lawmakers in Congress and government officials have sought to ease the financial burdens on individuals, but little has been achieved.
The CLASS Act, part of the Obamacare legislation of 2010, was supposed to give people the option of paying into a long-term insurance program. It was repealed two years later amid compelling evidence that it would never be economically viable.
Two years ago, another proposal, called the WISH Act, outlined a long-term care trust fund, but it never gained traction.
On the home care front, the scarcity of workers has led to a flurry of attempts to improve wages and working conditions for paid caregivers. A provision in the Build Back Better Act to provide more funding for home care under Medicaid was not included in the final Inflation Reduction Act, a less costly version of the original bill that Democrats sought to pass last year.
The labor shortages are largely attributed to low wages for difficult work. In the Medicaid program, demand has clearly outstripped supply, according to a recent analysis. While the number of home aides in the Medicaid program has increased to 1.4 million in 2019 from 840,000 in 2008, the number of aides per 100 people who qualify for home or community care has declined nearly 12%.
In April, President Joe Biden signed an executive order calling for changes to government programs that would improve conditions for workers and encourage initiatives that would relieve some of the burdens on families providing care.
Turning to Medicaid, a Shredded Safety Net
The only true safety net for many Americans is Medicaid, which represents, by far, the largest single source of funding for long-term care.
More than 4 in 5 middle-class people 65 or older who need long-term care for five years or more will eventually enroll, according to an analysis for the federal government by the Urban Institute. Almost half of upper-middle-class couples with lifetime earnings of more than $4.75 million will also end up on Medicaid.
But gaps in Medicaid coverage leave many people without care. Under federal law, the program is obliged to offer nursing home care in every state. In-home care, which is not guaranteed, is provided under state waivers, and the number of participants is limited. Many states have long waiting lists, and it can be extremely difficult to find aides willing to work at the low-paying Medicaid rate.
Qualifying for a slot in a nursing home paid by Medicaid can be formidable, with many families spending thousands of dollars on lawyers and consultants to navigate state rules. Homes may be sold or couples may contemplate divorce to become eligible.
And recipients and their spouses may still have to contribute significant sums. After Stan Markowitz, a former history professor in Baltimore with Parkinson’s disease, and his wife, Dottye Burt, 78, exhausted their savings on his two-year stay in an assisted living facility, he qualified for Medicaid and moved into a nursing home.
He was required to contribute $2,700 a month, which ate up 45% of the couple’s retirement income. Burt, who was a racial justice consultant for nonprofits, rented a modest apartment near the home, all she could afford on what was left of their income.
Markowitz died in September at age 86, easing the financial pressure on her. “I won’t be having to pay the nursing home,” she said.
Even finding a place willing to take someone can be a struggle. Harold Murray, Sheila Littleton’s grandfather, could no longer live safely in rural North Carolina because his worsening dementia led him to wander. She brought him to Houston in November 2020, then spent months trying to enroll him in the state’s Medicaid program so he could be in a locked unit at a nursing home.
She felt she was getting the runaround. Nursing home after nursing home told her there were no beds, or quibbled over when and how he would be eligible for a bed under Medicaid. In desperation, she left him at a psychiatric hospital so it would find him a spot.
“I had to refuse to take him back home,” she said. “They had no choice but to place him.”
He was finally approved for coverage in early 2022, at age 83.
A few months later, he died.
Reed Abelson is a health care reporter for The New York Times. The New York Times' Kirsten Noyes and graphics editor Albert Sun, KFF Health News data editor Holly K. Hacker, and JoNel Aleccia, formerly of KFF Health News, contributed to this report originally published .
US Health and Retirement Study Analysis
The New York Times-KFF Health News data analysis was based on the Health and Retirement Study, a nationally representative longitudinal survey of about 20,000 people age 50 and older. The analysis defined people age 65 and above as likely to need long-term care if they were assessed to have dementia, or if they reported having difficulty with two or more of six specified activities of daily living: bathing, dressing, eating, getting in and out of bed, walking across a room, and using the toilet. The Langa-Weir classification of cognitive function, a related data set, was used to identify respondents with dementia. The analysis’s definition of needing long-term care assistance is conservative and in line with the criteria most long-term care insurers use in determining whether they will pay for services.
People were described as recipients of long-term care help if they reported receiving assistance in the month before the interview for the study or if they lived in a nursing home. The analysis was developed in consultation with Norma Coe, an associate professor of medical ethics and health policy at the Perelman School of Medicine at the University of Pennsylvania.
The financial toll on middle-class and upper-income people needing long-term care was examined by reviewing data that the HRS collected from 2000 to 2021 on wealthy Americans, those whose net worth at age 65 was in the 50th to 95th percentile, totaling anywhere from $171,365 to $1,827,765 in inflation-adjusted 2020 dollars. This group excludes the super-wealthy. Each individual’s wealth at age 65 was compared with their wealth just before they died to calculate the percentage of affluent people who exhausted their financial resources and the likelihood that would occur among different groups.
To calculate how many people were likely to need long-term care, how many people needing long-term care services were receiving them, and who was providing care to people receiving help, we looked at people age 65 and older of all wealth levels in the 2020-21 survey, the most recent.
The U.S. Health and Retirement Study is conducted by the University of Michigan and funded by the National Institute on Aging and the Social Security Administration.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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StatePoint Media - 2023 was a landmark year for Alzheimer’s disease research, including advancements in treatment, risk factors and diagnosis. Here are five significant discoveries made this year:
There are three new approved treatments for Alzheimer’s, with a fourth on the way
In July, the U.S. Food and Drug Administration (FDA) granted traditional approval for Leqembi for mild cognitive impairment due to Alzheimer’s and mild Alzheimer’s dementia. This treatment slows cognitive decline and can help people with early Alzheimer’s maintain their independence.
In June 2021, the FDA granted accelerated approval to Aduhelm for the same purpose. At the Alzheimer’s Association International Conference (AAIC) in July 2023, Lilly reported positive results for a third similar treatment: donanemab. The company expects FDA action in early 2024.
In May, the FDA approved the first treatment for agitation in people with Alzheimer’s — brexpiprazole.
Hearing aids could slow cognitive decline for at-risk older adults
In the largest clinical trial to investigate whether a hearing loss treatment can reduce risk of cognitive decline, researchers found that older adults with hearing loss cut their cognitive decline in half by using hearing aids for three years.
The intervention included hearing aids, a hearing “toolkit,” and ongoing instruction and counseling. Though the positive results were in a subgroup of the total study population, they are encouraging and merit further investigation.
Blood tests for Alzheimer’s are coming soon.
Blood tests show promise for improving how Alzheimer’s is diagnosed. Advancements reported for the first time at AAIC 2023 demonstrate the simplicity and value to doctors of blood-based markers for Alzheimer’s.
Blood tests are already being implemented in Alzheimer’s drug trials. And they are incorporated into proposed new diagnostic criteria for the disease. Blood tests — once verified and approved by the FDA — would offer a noninvasive and cost-effective option for identifying the disease.
First-ever U.S. county-level Alzheimer’s prevalence estimates
The first-ever county-level estimates of the prevalence of Alzheimer’s dementia — in all 3,142 U.S. counties — were reported at AAIC 2023. For counties with a population of more than 10,000 people age 65 and older, the highest Alzheimer’s prevalence rates are in:
• Miami-Dade County, Fla. (16.6%)
• Baltimore City, Md. (16.6%)
• Bronx County, N.Y. (16.6%)
• Prince George’s County, Md. (16.1%)
• Hinds County, Miss. (15.5%)
Certain characteristics of these counties may explain the higher prevalence, including older age and a higher percentage of Black and Hispanic residents, which are communities disproportionately impacted by Alzheimer’s disease. According to the Alzheimer’s Association, these statistics can help officials determine the burden on the health care system, and pinpoint areas for culturally-sensitive caregiver training.
Chronic constipation is associated with poor cognitive function
Approximately 16% of the world’s population struggles with constipation. This year, researchers reported that less frequent bowel movements were associated with significantly worse cognitive function.
People in the study with bowel movements every three days or more had worse memory and thinking equal to three years of cognitive aging. These results stress the importance of clinicians discussing gut health with their older patients.
To learn more about Alzheimer’s and dementia research, plus available care and support — and to join the cause or make a donation — visit the Alzheimer’s Association at www.alz.org.
While there is still much to learn about Alzheimer’s, 2023 was a year of discovery, giving researchers and families impacted by the disease hope for the year ahead.
Holidays can be a wonderful time of year when families get together and catch up on each other’s busy lives. All too often is also the time that you may find that things aren’t quite the same with our aging family members.
Those twenty-minute calls once or twice a month made everything seem a okay with the parents or grandparents. But now, you have noticed the signs and symptoms of dementia are starting to show.
Although the COVID-19 pandemic turned the world upside down, the rapid development of multiple vaccines has spurred hope that treatments – or even potential cures – may be found for other devastating conditions. One such candidate is Alzheimer’s Disease.
BRANDPOINT - Did you know that the first 12 weeks after giving birth are known as the fourth trimester? While you may have just given birth, your body will continue to change just like it did during your three trimesters of pregnancy.
The fourth trimester can have many surprises for first-time mothers. They might experience many physical, mental and emotional changes as their bodies heal and adjust to motherhood. While they may expect certain changes like stretch marks, hair loss and weight fluctuations, many other postpartum adjustments aren't discussed as much.
First Response™ wants to bring awareness to the changes mothers should expect during the fourth trimester. By learning about these changes and how to manage them, women can embrace and accept them with self-compassion and feel empowered to ask for support during their postpartum journey.
1. Postpartum bleeding
If you're a first-time or soon-to-be first-time mom, you may not know you'll experience bleeding after birth. While it may seem scary, this is a very normal part of the postpartum healing process.
According to the Cleveland Clinic, this vaginal discharge is known as lochia and contains a mix of blood, mucus and uterine tissue. It's similar to menstrual blood and can last several weeks, though the heaviness of the discharge should subside over time.
During the first six weeks after giving birth, use sanitary maxi pads (not tampons) to deal with the bleeding. For the first week, expect to go through several pads throughout the day. Most importantly, remember to take it easy and give your body time to heal.
2. Breast engorgement
During the fourth trimester, you may experience breast engorgement until your milk supply regulates. Your breasts may feel swollen, tight and tender, and you may even leak breast milk until symptoms subside, usually within a few days as you begin to regularly breastfeed. Use a cold compress to relieve swelling and pain. If you choose to breastfeed, you can wear a well-fitting bra to provide support and reduce soreness, according to La Leche League International.
If you don't plan to breastfeed, it can take up to several weeks for breast engorgement to subside. During this time, do not pump so your body gets the signal that it doesn't need to produce milk. A cold compress, supportive bra and over-the-counter pain meds can help you manage pain and discomfort until you stop producing milk.
3. Poor sleep
Babies don't have the same sleep schedules as adults. According to the Sleep Foundation, while newborns sleep up to 18 hours a day, they don't sleep in one solid block of time like adults do. Until your baby begins to sleep through the night, you will likely be up several times a night to attend to your baby.
To combat sleep deprivation during the fourth trimester, nap during the day when your baby sleeps. If a partner or family member is helping you, trade off middle-of-the-night feedings. Also, ask friends and family for help with house chores or child care so you can get some well-deserved rest.
4. Postpartum depression
You may have heard of the baby blues when mothers feel overwhelmed, irritable and stressed the first couple of weeks after giving birth. This is your body's natural response to the drop in hormone levels postpartum. However, some women may feel these symptoms more intensely and for long periods, indicating a more serious form of depression.
According to the National Institutes of Health, one in seven women can develop postpartum depression (PPD) within the first six weeks of giving birth. Some symptoms of PPD include:
Depressed mood
Loss of interest or pleasure
Insomnia
Loss of energy or fatigue
Feelings of worthlessness or guilt
Because of the societal expectations of motherhood, it can be difficult for women to admit they need help. That's why it's incredibly important for new mothers to have a support system of friends, family and other mothers to help them overcome the stigma of PPD and get the care they need.
If you're experiencing PPD, reach out for help and contact your doctor. While PPD is serious, it is treatable.
Get connected
These are just four ways your life may change after giving birth. While these changes may sound overwhelming, you can manage them with a little help and understanding. That's why First Response has launched the Pregnancy Hub by First Response.
This online community aims to connect, inspire and provide resources to those navigating trying to conceive (TTC), pregnancy and motherhood. By joining, you'll have free access to resources and advice, the opportunity to engage in meaningful conversations with other members, share personal experiences, and more. To learn more and get connected, visit FirstResponsePregnancyHub.SocialMediaLink.com.
**The content provided on this health blog is intended for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.**
Our study findings raise a public health concern, especially since the deaths in younger age groups are on the rise ...
by American Heart Association
DALLAS - Death rates related to infective endocarditis declined in most adults across the U.S. within the last two decades, yet accelerated among young adults ages 25 to 44 years old, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.
Infective endocarditis, also called bacterial endocarditis, is an infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel. The disease is rare, however, people with previous valve surgeries, heart valve abnormalities, artificial valves, congenital heart defects or previous infective endocarditis have a greater risk of developing it. It can also be a complication of injecting illicit drugs.
“Our study findings raise a public health concern, especially since the deaths in younger age groups are on the rise,” said study lead author Sudarshan Balla, M.D., an associate professor of medicine at the West Virginia University Heart and Vascular Institute at J.W. Ruby Memorial Hospital in Morgantown, West Virginia. “We speculate that this acceleration was likely, in the most part, due to the opioid crisis that has engulfed several states and involved principally younger adults.”
Researchers examined death certificate data from the Centers for Disease Control and Prevention’s (CDC) Multiple Cause of Death dataset, which contains death rates and population counts for all U.S. counties. They looked for national trends in deaths caused by infective endocarditis, plus differences in deaths related to age, sex, race and geography among states from 1999-2020. Researchers also analyzed the association with substance use disorder, considering the emergence of the opioid epidemic during the study’s time frame.
The analysis found:
In the 21-year period analyzed, infective endocarditis death rates declined overall in the U.S.
Death rates increased significantly for young adults, at an average annual change of more than 5% for the 25-34 age group and more than 2% for the 35-44 age group.
In the 45-54 age category, death rates remained stagnant at 0.5%, and there was a significant decline among those aged 55 and older.
Substance use disorder associated with multiple causes of death increased drastically – between 2-fold and 7-fold among the 25-44 age group.
Kentucky, Tennessee and West Virginia showed an acceleration in deaths caused by infective endocarditis in contrast to other states with either a predominant decline or no change.
“We found that substance use was listed as a contributing cause that could explain the higher death rates in the younger age groups and also in the states in those who died due to endocarditis,” Balla said.
The study researchers call the rise of infective endocarditis as the underlying cause of death in adults 25-44 years old “alarming” and recommend more investigation to identify the reasons for these trends among young adults and in the three states noted. Researchers speculate the increase is connected to the opioid crisis that has engulfed several states and involves primarily younger adults.
“Comprehensive care plans for those treated for infective endocarditis should also include screening and treatment for substance use disorder,” Balla said.
To address intravenous drug use, some states have started harm reduction programs, which are public health efforts to reduce the harm from substance use and drug abuse, such as increased risk of infectious diseases like HIV, viral hepatitis, and bacterial and fungal infections. “Whether these programs make an impact is yet to be determined,” Balla said.
Researchers were limited in the medical details they could collect because of the use of death certificate data, which may contain inaccuracies, such as errors in diagnosis, data entry and cause of death. For similar reasons, researchers could not determine a direct cause-and-effect relationship between the rise in deaths caused by infective endocarditis in younger adults and substance use disorder.
Some research has shown that singing can boost immunity. Other research has found singing can help stave off moderate dementia. OSF doctor Alina Paul suggests it is possible to sing your way to better health.
Bernd Everding/Pixabay
by Tim Ditman OSF Healthcare
CHAMPAIGN - Alina Paul, MD, has been singing for as long as she can remember. She added guitar while in boarding school in India.
Alina Paul, MD
Fast forward to 2023, and the family medicine physician at OSF HealthCare finds herself singing for patients who request it to brighten their day.
“It has changed the way I treat patients,” Dr. Paul says with conviction. “Singing and playing guitar is medicine. It’s medicine for the soul.”
Hearing those tunes is not just a temporary respite for the person in for a checkup. Dr. Paul says research has shown singing can have long-term health benefits.
The benefits
· Pain levels, physical and mental, can decrease. For people suffering from anxiety and depression, singing can increase the level of endorphins, the “feel-good hormone,” as Dr. Paul puts it. This brings them out of a dreary mood.
· Some research has shown that singing can boost immunity by increasing the level of the antibody immunoglobulin A. This antibody helps fight respiratory and other infections, Dr. Paul says.
· It helps your lungs perform better.
“We’re using our lungs to sing. We take deep breaths. Certain movements of the chest wall help with lung function,” says Dr. Paul.
· Other research has found singing can help stave off moderate dementia, Dr. Paul says.
“That’s amazing,” she says.
“We see a lot of patients with dementia. When you incorporate singing or even sing to them, their memory seems to improve. They’re happier,” Dr. Paul adds.
· Dr. Paul says singing can increase oxytocin, the so-called “love hormone.” This can help with social bonding and a sense of belonging.
· Singing can also improve public speaking skills, especially if you sing in front of others. Simply put, the more you use your voice, the more comfortable you are with it.
Keep your well-being in mind
Dr. Paul says there are some obvious, but important health matters to keep in mind if you pick up singing.
· If singing causes your lungs or throat to hurt, take a break. If minor symptoms persist, go to an urgent care. For things like difficulty breathing, chest pain or loss of consciousness, call 9-1-1.
· If you are sick, don’t sing – or do much else – around others. When we say words, our mouth spews microparticles that can carry diseases. And when you’re sick, you should be resting and recovering.
· Be kind to your neighbors, like in an apartment building. Don’t sing loudly at all hours.
How do I start?
Don’t feel like you have to run out and join a choir, Dr. Paul says. And don’t worry if your vocal skills aren’t Grammy worthy.
“Don’t take it as an exercise. Don’t do it because you have to. Do it because you want to do it,” Dr. Paul advises.
Try singing while in the car or shower. Do karaoke with friends. You don’t even need music. Try belting out your favorite song acapella while cleaning the house. Dr. Paul says closing your eyes can help focus the activity.
“Anybody can sing. Make a point to sing. It’s like meditation. It’s very beneficial,” Dr. Paul says.
TOLONO - Tolono Family Dental is hosting a free dental day on December 15. Located at 101 N Watson in Tolono, the practice is offering x-rays, exams, and simple cleaning services for anyone who does not have a dental insurance plan or on limited/fixed budget.
"We are ready to give back to the community," they wrote on Facebook. "If you are on a limited income or don't have insurance please come by our office on December 15th from 2-4 pm!"
Walk-ins are welcomed at the event, but registration in advance is recommended. For more information call (217) 485-5760.
URBANA - A new lawsuit claims a caffeinated drink at Panera contributed to a man's death.
Legalities aside, the issue of what people - especially young people - put in their bodies is something to be aware of, says Michael Broman, PhD, MD, an OSF HealthCare cardiologist. In fact, it’s one he thinks about daily.
“My children are 8 and 10. I don’t allow them to have caffeine except under my supervision and only in very small doses,” Dr. Broman says sternly.
Caffeine basics
Dr. Broman says energy drinks, when consumed properly, can provide the desired energy boost. A college student studying for a test, for example.
But it’s caffeine consumption that you must be aware of.
Caffeine also causes dependence. As a person uses more and more over time, they start to miss it when they don’t have it. They can withdraw from caffeine. That’s one of the most worrisome side effects, especially in kids. If a child is using a lot of caffeine and they stop, they can have attention problems and headaches. It can affect their performance in school and athletics.
Dr. Michael Broman OSF HealthCare Cardiologist
“Caffeine has clearly been linked to adverse events and toxicity when given at a high enough dose,” Dr. Broman says.
The effects of caffeine will vary from person to person. Some will be more sensitive to caffeine due to genetics. Others may be able to break down caffeine more quickly, meaning less sensitivity.
Generally though, Dr. Broman says taking in too much caffeine could lead to your heart racing, nausea, vomiting, diarrhea, chest pain and high blood pressure. You may also feel hyper and not able to sit still.
“Caffeine also causes dependence,” Dr. Broman adds. “As a person uses more and more over time, they start to miss it when they don’t have it. They can withdraw from caffeine.
“That’s one of the most worrisome side effects, especially in kids. If a child is using a lot of caffeine and they stop, they can have attention problems and headaches. It can affect their performance in school and athletics.”
What to know
Here’s the formula to remember: Dr. Broman says for children and adolescents, limit daily caffeine consumption to 2.5 milligrams per kilogram of body weight. (You can easily find a pounds to kilograms converter online.)
For example, if a high school student weighs 120 pounds (or around 54 kilograms), they would want to stick to 135 milligrams of caffeine per day. One PRIME Energy drink has 200 milligrams of caffeine. A 20-ounce bottle of Coca Cola has 57 milligrams. Caffeine content in coffee can vary. So be vigilant about your health and seek out the numbers. Check the product label or look up the product online before you swing by the drive thru or go to the store.
Photo: Lisa Fotios/PEXELS
The formula, though, doesn’t mean two bottles of Coke or a half swig of PRIME per day will yield no consequences for a 120-pound teenager. Rather, Dr. Broman recommends people under 18 not ingest caffeine regularly at all. Parents, teachers and coaches should watch what young people are drinking. Make the energy drink or soda a once-in-a-while treat. Water flavored with fresh fruit can be an alternative or talk to a dietitian about what’s right for you.
“A lot of these caffeinated beverages are marketed and flavored to taste good for children,” Dr. Broman says. “The drinks may also be in the store displays right next to the non-caffeinated beverages. They can look almost the same. So, it’s often difficult for a young person to figure out, ‘Is this beverage caffeinated? Is this one non-caffeinated?’”
And remember, everyone reacts to caffeine differently. Like any other ailment, know your health history and how your body responds to things. If you have significant symptoms from a caffeine overdose, call 9-1-1 and take an ambulance to the emergency department.
“People with prior cardiac conditions are way more likely to have very dangerous side effects from the use of caffeine,” Dr. Broman says.
by Tim Ditman OSF Healthcare URBANA - You’re coming to the hospital to give birth. You’ve had a hip replacement and now will have a hospital stay to complete rehabilitation. There are a lot of things swirling through your mind, notably thoughts like “Am I going to be OK?” Questions like “Where is my toothbrush?” are probably on the backburner. That’s why it’s a good idea to make a “hospital essential items” checklist now.
Kurt Bloomstrand, MD, sees these scenarios plenty while providing care in the emergency department at OSF HealthCare. He says a hospital will provide basic toiletries, blankets, food and clothing like a gown and socks. But some people prefer their own toiletries, clothes and snacks.
Other things to do and bring:
• Write down your health information: health insurance, medications, medical history, name of your primary care provider, allergies and legal documents like power of attorney and a do not resuscitate order. Have an identification like a driver's license, too.
“Some people in the emergency department are not able to tell us their health information given what they’re presenting for. So, it’s so valuable to have basic health information written down,” Dr. Bloomstrand says. He adds that knowing your health information allows providers to care for you properly. You can also bring legal forms to your provider anytime to be added to your medical record.
• Bring other items essential to your well-being: eyeglasses, contacts, hearing aids, dentures and a continuous positive airway pressure machine (CPAP) for sleeping. Bring cases and batteries for these items, too.
• When choosing clothes, opt for loose-fitting and short-sleeved garments.
“If you have an IV, a short-sleeved shirt is much better to access it than a long-sleeved shirt,” Dr. Bloomstrand says. “You can bring a robe to cover up.”
• For moms giving birth, bring your birth plan in written form. Pack a few pairs of clothes for you and your baby.
“Babies notoriously spit up on their clothes,” Dr. Bloomstrand said.
• The hospital can provide diapers, wipes and a breast pump. But, you can bring your own if you prefer a certain type.
“Not only can you use your breast pump, the people at the hospital can teach you how to use it.
What babies don’t need at the hospital: rattles, books and toys. Save those memories for home.”
• Don’t overdo it with personal items and food. This can cause your room to get cluttered and create a trip hazard. Have someone who can take unneeded items home.
• Don’t bring valuable items.
Dr. Bloomstrand says a phone is OK to keep in touch with loved ones. But other electronics and jewelry should stay home.
Hospitals have security, but like any other place, there is a chance for theft.
ROCKFORD - The holidays are typically a time for joy and celebration with loved ones. But for some survivors of violent crime, the holidays can also be filled with stress, anxiety and memories of not-so happy times.
“For other folks it can be the holidays that triggers something because maybe you’ve lost a loved one to gun violence or you witnessed losing that person and you’re going into the holidays and yes, it happened 20 years ago; that doesn’t mean you’re not going to have the symptoms and side effects of that loss,” says Therasa Yehling, manager for the OSF Strive Trauma Recovery Center at OSF HealthCare Saint Anthony Medical Center in Rockford.
Therasa Yehling
Yehling says those side effects include anxiety, depression or post-traumatic stress disorder (PTSD) after a trauma such as gun violence, assaults, domestic violence, human trafficking and armed violence or robbery in which they are the victim or witness.
The events causing the trauma could have occurred two weeks ago or 10 years ago. There is no expiration date on the grief that happens as a result of violent crime, Yehling adds.
“When we talk to people we actually try to get a full picture of the trauma in their lifetime," says Yehling. "We’re finding that some people have had a lot of trauma starting in their childhood all the way up. Really then, a new traumatic event can stir up all the old stuff that maybe we’ve never dealt with and the symptoms of trauma have rendered that person almost catatonic and they can’t function.”
Yehling offers several basic tips for violent crime survivors during the holidays.
Trust your grief and your healing
Experience the grief and don’t run from it
Say no to things that make you uncomfortable and form healthy boundaries
Create new traditions
Make a list of things you’re grateful for this year
Do something kind for someone else
If none of those things seem to help or if these feelings are interrupting daily activities Yehling says it’s time to seek professional help as soon as possible. She does warn that seeking support will also mean doing a deep dive into what’s causing your feelings.
“I think people have to understand that if someone is going to talk about something very traumatic, such as sexual assault, domestic violence, human trafficking – it is important that they talk to someone who can help them through that process, therapeutically," says Yehling. "Otherwise you’re helping them to relive it and that’s about it.”
Yehling adds that our expectations of having the perfect time with family during the holiday season are often unrealistic. While that can be stressful enough, it becomes worse when you add the complexities of being a survivor of violent crime. Yehling encourages family and friends to go slowly and give their loved one the time and space they need to get through the holidays.
“I just think whether you have trauma or not everyone needs to be gentle and kind and supportive,” Yehling says.
For more information on help for survivors of violent crimes, visit OSF HealthCare.
Key Takeaways:
The holidays can trigger emotions for survivors of violent crime.
Violent crime includes gun violence, assaults, domestic violence or robbery.
Side effects include anxiety, depression or post-traumatic disorder.
Ways to cope include saying no to things that make you uncomfortable, create new traditions or do something nice for someone else.
If nothing else helps, seek professional help as soon as possible.
Eating before bed, especially foods like ice cream is a no-no for people who suffer from acid reflux.
Abhishek Hajare/Unsplash
by Tim Ditman OSF Healthcare
URBANA - No eating after 6 p.m.
The advice from Greg Ward, MD, is sure to raise some eyebrows.
But he’s serious. It’s one way to prevent reflux, an ailment that’s painful and annoying in mild cases and can necessitate surgery in advanced instances. And it's something to be aware of during holiday eating.
Terminology
Dr. Ward, an OSF HealthCare surgeon, says you may hear many terms in this area of medicine: reflux, acid reflux, heartburn, indigestion and gastroesophageal reflux disease (GERD). They all describe the same thing: acidic contents of your stomach coming up into your esophagus and burning it.
Key takeaways:
• Reflux is when acidic contents of your stomach come up into your esophagus and burn it.
• Prevention includes not eating late; avoiding junk food, nicotine and alcohol; exercising; and sleeping with your head above your body.
• Treatments include medicine and, for tricky cases, surgery where the stomach is wrapped a bit around the esophagus.
“People lose sleep over it. They wake up in the middle of the night coughing. They have other discomfort,” Dr. Ward says.
One outlier term: Barrett’s esophagus. That’s when your esophagus (also called the food pipe) is damaged from chronic reflux, and abnormal cells grow. It’s named for Australian-born surgeon Norman Rupert Barrett, according to the National Institutes of Health. Barrett’s esophagus comes with an increased risk of esophageal cancer, and Dr. Ward says typical reflux treatments won’t work to lower the cancer risk. Instead, a doctor can use heat energy to destroy the abnormal cells.
Reflux treatment and prevention
Dr. Ward says changing your lifestyle is the best way to prevent reflux. Here’s a checklist to know:
• Don’t eat after 6 p.m. This can upset your stomach.
• “People love to have things like ice cream right before bed. That’s a killer for reflux,” Dr. Ward says.
• Avoid excess fatty food, nicotine, caffeine and alcohol.
• Exercise regularly.
• Sleep on an incline with your head above the rest of your body. This keeps the stomach fluid in place, Dr. Ward says. Don’t just do this with pillows, he warns. That can actually pinch the stomach. Instead, put the head of your bed frame on six-inch blocks.
Advanced cases
Dr. Ward says if simple lifestyle changes aren’t helping, the next step is likely medication. Protonix, Prevacid and Tagamet are common ones.
But some people won’t respond well to medication, or they don’t want to take it for the rest of their life, perhaps due to side effects like bone weakening and increased pneumonia risk. Dr. Ward says those people are candidates for minimally invasive laparoscopic surgery.
The person will do some pre-surgery tests to see how well their esophagus is working. The muscle needs to be working well for surgery to be an option.
On surgery day: “We wrap the stomach a bit around the esophagus to keep food from going back up into the esophagus when it shouldn’t,” Dr. Ward explains.
Dr. Ward adds that the procedure is usually a one-night stay in the hospital, but people usually report feeling better quickly.
“Very satisfying,” he says.
Another eyebrow raiser, but important guideline post-reflux surgery: no more carbonated beverages like soda. For life.
“You’re unable to burp,” Dr. Ward says plainly.
“You’ll really get uncomfortable if you drink a carbonated beverage. And if you force yourself to burp, it loosens the work we’ve done in surgery. All of a sudden, you’re having heartburn again.”
A small price to pay for a lifetime of minimal or no reflux.
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PONTIAC - People everywhere are conquering their cabin fever and are enjoying the great outdoors after a long, bitter winter. But before you head out for that hike, health care experts remind you to take precautions to avoid tick bites. Read more . . .
by Angela Buxton
Infective endocarditis, also called bacterial endocarditis, is an infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel. The disease is rare, however, people with previous valve surgeries, heart valve abnormalities, artificial valves, congenital heart defects or previous infective endocarditis have a greater risk of developing it. It can also be a complication of injecting illicit drugs.
"We are ready to give back to the community," they wrote on Facebook. "If you are on a limited income or don't have insurance please come by our office on December 15th from 2-4 pm!"
Walk-ins are welcomed at the event, but registration in advance is recommended. For more information call (217) 485-5760.
