@ FALLS BY THE NUMBERS
Every 13 seconds an older adult is treated in an emergency department for a fall.
700,000
The number of people hospitalized each year because of a fall.
1 No.
Falls are the most common cause of traumatic brain injuries.
SUMMER 2016
Steady as you go STAY UPRIGHT WITH OUR BALANCE PROGRAM A grandfather can once more make it to his grandson’s baseball games because he’s steady on his feet. Another senior is no longer stranded at home because she can manage the steps on city buses. And yet another woman can safely walk sandy beaches again on vacations with her family. All three are moving with
confidence now, thanks to Nazareth Hospital’s Balance Program. Since its start in 2013, the program has helped over 300 area adults regain lost balance and protect themselves from dangerous falls. How dangerous? One in five falls causes a serious injury, and —Continued on page 2
IN THIS ISSUE
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FROM START TO FINISH Extensivists ensure patients are taken care of once home
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CARE AFTER STROKE How to be a caregiver to someone
GET YOUR RX You need a prescription to participate in the Balance Program. Ask your doctor if it’s right for you.
Steady as you go
•• You take multiple medicines •• You have health issues that increase your risk of falling, such as Parkinson’s disease
— Continued from page 1
Finding your footing falls are the top cause of death from injury in older adults. “That’s why it’s so important to tell your doctor if you feel dizzy or unsteady,” says Heather Wilkinson, DPT, Physical Therapist with the program. “Don’t wait for a fall to happen.” Speaking up is especially important if: •• You’re older than 65 •• Your vision or hearing is getting worse
If your doctor refers you to the Balance Program, here’s what you can expect: You’ll undergo computerized balance testing on our NeuroCom Balance Master. NASA developed it to test the balance of astronauts after their return from space. Next, our therapists will use these and other test results to design an exercise and education program just for you. “A big part of our job is to uncover
what’s contributing to your balance problem,” Wilkinson says. “Is it your posture? How you position your feet? Muscle weakness? Once we have the answers, we tailor the treatment.” Typically, the program lasts for 8 to 12 weeks. Most participants see a dramatic improvement in their ability to stay steady and safe. “This program works,” Wilkinson says. “And it changes lives.”
If you need a primary physician, call 1.866.NAZARETH (1.866.629.2738).
ONCOLOGY REHAB
Live better after cancer Cancer treatments can give you back your life. But they can also take a toll on your body. Chemotherapy can sap your energy. Surgery might leave you with some pain. Or scar tissue from radiation therapy might make it hard to fully move your limbs. A new oncology rehabilitation program—offered through Mercy Cancer Care—can help ease these and other cancer treatment side effects. The goal of the program, launched in late January, is to help cancer patients thrive during and after treatment. “Cancer treatment is very exhausting for the body,” says Michele Zappile-Lucis, DPT, OCS, Physical Therapist and Administrative Director of Oncology (cancer care) at Mercy. “And rehab can do wonders for patients who want to get back their energy, lessen pain and do the
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things they used to be able to do.” Through exercise and other therapies, oncology rehab can help improve: • Fatigue • Swelling in the arms • Loss of motion • Muscle or joint pain • Walking and balance • Burning or tingling in the hands and feet
LEARN MORE The rehab program is one more way Mercy cares for patients with cancer from diagnosis to survival. Call 215.335.3954 to learn more about the program. Or ask your doctor for a referral.
A NEW SERVICE HELPS PATIENTS STAY OUT OF THE HOSPITAL
The EXTENSIVIST will see you now Where would you rather be—at home or in the hospital? We’re pretty sure we know the answer to that question, which is why if you’re ever a patient at Nazareth Hospital, you may meet Genevieve Skalak, DO, FACOI. She’s a hospital extensivist—a new kind of doctor here at Nazareth who could play a key role in keeping you well even after you head home.
A bridge to better care Dr. Skalak’s job, in short, is to help people who have been hospitalized avoid repeat visits. That means making sure those who are at high risk for readmission—because of their illness or personal circumstances— get the care they need once they leave the hospital.
“As an extensivist, I provide a bridge between inpatient hospital care and the outpatient care that someone may still need,” Dr. Skalak explains. “It’s an additional service for patients who may need help during that vulnerable time when they’re transitioning from the hospital to home. We want to make sure patients have the support and care necessary to make that transition smoothly and safely.” The process of figuring out who might benefit from Dr. Skalak’s help begins as soon as someone is admitted to the hospital. A nurse records the detailed health history of each patient. That history helps determine if the person is at high risk of being hospitalized again soon. A number of things can put
someone at risk for readmission. For instance, they may have conditions such as chronic obstructive pulmonary disease (COPD), diabetes or unstable heart disease that are hard to manage. They may have recently visited the Emergency Department or had a lengthy stay in the hospital. Or they may lack important support services, such as reliable transportation to medical appointments. —Continued on page 4
DID YOU KNOW? Nazareth Hospital is accredited by The Joint Commission for hip and knee replacement. Learn more by calling 1.866.NAZARETH (1.866.629.2738). mercyhealth.org
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PATIENTS STAY OUT OF THE HOSPITAL
—Continued from page 3
Nice to meet you! Patients first meet Dr. Skalak when they’re in the hospital. “I introduce myself and talk about my role as a Mercy physician,” she says. “I tell them I’m not here to be their primary care physician or their physician while they’re in the hospital. But I could help them once they’re discharged.” Dr. Skalak has an office right across the street from Nazareth Hospital. Patients who agree to a follow-up visit see her within three days after leaving the hospital. That visit may include: •• A medical assessment and exam to make sure the person is doing OK since being discharged. “I want to know how someone is feeling,” Dr. Skalak says. “Are there any new symptoms, or symptoms that haven’t gotten better since their hospital stay?” •• Education about the person’s illness. “Sometimes patients have a new diagnosis and education is crucial because this is an entirely new problem for them,” Dr. Skalak says. •• A chance to talk about what might be getting in the person’s way of staying well, such as not using medicines correctly, not eating a healthy diet or not seeing their primary care doctor on a regular basis. •• A discussion about what to do if symptoms get worse—when the person needs to call their doctor right away and when to call 911. “The point of a visit with me is to make sure that someone is stable immediately after leaving the hospital,” Dr. Skalak says. “And to help them overcome any obstacles they may have to being well. It’s a safety net on top of their other great care.”
It takes a team HELPING NURSING HOME RESIDENTS STAY OUT OF THE HOSPITAL
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Putting competition aside and working together for the good of patients. That’s the mission of the NorthEast Cross Continuum Team (NECCT), a special group dedicated to helping nursing home residents avoid repeat stays in the hospital. Why these patients in particular? Many count on Nazareth Hospital for care. They often arrive with multiple health problems. That puts them at high risk for a return visit.
Genevieve Skalak, DO, FACOI, works closely with a patient’s doctor during and after a hospital stay. And she can also help patients find a primary care doctor if they don’t have one.
A patients-first approach Once a month, the NECCT brings together representatives from Nazareth Hospital and nine nearby nursing homes. Home health agencies and community groups also participate. Everyone shares their strategies for reducing readmission rates. That itself is a breakthrough. “Typically, nursing homes compete,” says Elaina Kim Watts, MHA, BSN, RN, CMM, Director of Care Coordination at Nazareth Hospital. “So it’s unheard
Staying well HOW TO AVOID A RETURN TRIP TO THE HOSPITAL By some estimates, nearly one in four patients nationwide who are admitted to a hospital with certain common medical problems are readmitted just weeks after discharge. At Nazareth Hospital, we’re deeply committed to keeping our patients healthy and avoiding readmissions. But we need your help to make that happen. Before you leave the hospital, be sure to ask your doctor or nurse who you should call if you have problems once you’re home—and get a phone number. Also find out about your: Medications
You may have been prescribed new ones in the hospital. If so, learn why you need to take them, how much you need to take and how often you need to take them. Also, see if you should keep taking your regular medicines.
Activities
See if you should hold off on driving, climbing stairs or lifting things—and if so, for how long.
Medical appointments
Follow-up tests or doctor appointments may be scheduled before you leave the hospital. Let us know if you need help with transportation.
Speak up, too, if you’ll need help with tasks like bathing, getting dressed or cooking. We can help arrange any extra assistance you need. Together, we can reduce your risk of another hospital stay—and help you stay well.
of, really, that people from so many homes are in the same room and talk so candidly about challenges they face and how to overcome them.” Residents who return to nursing homes after a hospital stay also share their insights on improving readmission rates. “We want to know: Is there anything we can do better to help you stay well?” Watts says. This feedback has spurred the hospital to put important practices into place. An example: Ensuring
a quick exchange of crucial information about a patient’s medical history between the hospital and nursing home. The result: Our readmission rates for nursing home residents are falling. The NECCT, which was launched in 2013, was Watts’ idea. She’s heartened by how much the NECCT is already helping patients. “Every avoidable readmission we prevent means that a patient’s life improved,” she stresses.
Read more about how Nazareth strives to keep seniors healthy. Go to mercyhealth.org/ naz/senior-services.
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shower and a raised toilet seat in the bathroom. If your home has stairs, install handrails going up and down the stairs. Telephone and call devices should be easy to reach too. • Make sure your loved one wears nonskid shoes. “These are just some of the things you can do,” Hillerman says. “A Mercy Home Health Occupational Therapist can assess your home and offer more ideas on how to make it safer.”
Make eating easier
After a stroke CARING FOR A LOVED ONE AT HOME Your loved one has survived a stroke. You may feel relieved that the worst has passed and the healing has begun. But the road ahead can still hold challenges—particularly at home. Safely managing life at home is an important part of a stroke survivor’s recovery. “As a caregiver, you play a vital role in helping your loved one recover,” says Mindy Hillerman, Physical Therapist at Mercy Home Health. “However, you don’t have to take on that role alone. The
therapists at Mercy Home Health can help.”
Prevent falls Many stroke survivors lose some physical abilities after they have a stroke, which may increase their risk of falling. To reduce the risk of your loved one falling at home: • Clear a path to the kitchen and toilet by moving furniture and any clutter from the floor. • Move electrical cords so they aren’t a tripping hazard. • Remove or secure any loose rugs. • Turn on night-lights so your loved one can safely see the way to the toilet in the dark. • Install grab bars in the tub or
Know the signs of stroke Anyone who’s survived a stroke is at risk for having another one. That’s why you should learn the warning signs of stroke and be ready to react quickly in case your help is needed. Stroke symptoms come on suddenly. The word FAST can help you remember them:
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FACE: Ask the person to smile. Does one side of the face droop?
ARM: Have the person raise both arms. Does one drift downward?
Some stroke survivors have a hard time swallowing and can easily choke. If your loved one has problems swallowing, you can try: • Cutting food up into smaller pieces. • Pureeing food. • Offering thick liquids to drink. They are easier to swallow than thin liquids like water. Also, make sure your loved one sits up straight when he or she eats or drinks. Encourage your loved one to take small bites of foods and small sips of drinks. “Caregiving is a big job,” Hillerman says. “Mercy Home Health can make that job easier.”
FIND OUT MORE Experience the high quality care that the Mercy Home Health team provides. To learn more, call 1.888.690.2551 or visit mercyhomehealth.org.
SPEECH: Have the person repeat a sentence, like “What’s your name?” Is the speech slurred?
TIME: It’s time to call 911 if you notice any of these signs of a stroke.
LYMPHEDEMA
How to cope with swelling Breast cancer treatment can be a lifesaver for women. But like all treatments, it sometimes causes side effects. One of them is a condition known as lymphedema—a buildup of fluid in the arm or other areas of the body, such as the chest, breast or hand. It can happen after treatment with surgery or radiation therapy. Lymphedema can’t be cured, but it can be controlled. “There are often ways to reduce the swelling and help keep it from getting worse,” says Catherine J. Friel, RN, Mercy Home Health Clinical Nurse Specialist. Here are some tips from Friel that can help if you have lymphedema:
Keep using your arm. Everyday activities, such as brushing your hair or bathing, can help drain the fluid from your arm. Rest sometimes. If your arm aches, lie down and raise it on a pillow above the level of your heart. Wear a compression garment. These are carefully fitted sleeves worn over the arm to help push fluid out. Protect your arm. Do your best not to get an infection or a burn. And avoid things that put pressure on your chest or arm. They could make the swelling worse. For instance: •• Ask to have blood pressure checked, blood drawn or shots given in the unaffected arm.
•• Clean and protect any cuts or
range. Follow his or her advice about your diet, exercise and medicine. •• Don’t go barefoot, even indoors. You might step on something and hurt your feet. •• Check your feet every day. Look for sores, blisters, red spots and swelling. Tell your doctor right away if you see any of these changes, even if they’re not painful.
If an ulcer does develop, then your doctor may clean out any infected and dead tissue. The wound will also need to be cleaned every day, using a wound dressing or bandage. Mercy Home Health nurses can come to your house to help take care of your wound. Learn more about this and other Home Health services at mercyhomehealth.org. Or call 1.888.690.2551.
scratches that could let in germs.
•• Be extra careful if you shave your underarms. •• Use an oven mitt that covers your lower arm. •• Put on protective gloves when doing chores such as cleaning or gardening. •• Wear sunscreen and insect repellent when you spend time outdoors.
FIND OUT MORE How can Mercy Home Health help you or a loved one? Learn about our services. Call 1.888.690.2551.
Living with diabetes PAY SPECIAL ATTENTION TO YOUR FEET Your feet need a lot of TLC when you have diabetes. That extra care is crucial because diabetes raises your risk of developing deep sores—or ulcers— on your feet. Here’s why: “Over time, high blood sugar can damage your nerves and make it hard to feel a blister or sore on your feet,” says Mindy Hillerman, Physical Therapist at Mercy Home Health. If you don’t notice that sore, it can grow deeper and even become infected. Sometimes an infection can even lead to the loss of a limb. But proper care can help keep your feet healthy, Hillerman says. Be sure to: •• Work closely with our doctor to keep your blood sugar in a healthy
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20 minutes could save your life.
Nonprofit Org. U.S. Postage PAID Harrisburg, PA Permit No. 66
Mercy Health System of Southeastern Pennsylvania 1 W. Elm St., Suite 100 Conshohocken, PA 19428-4108
That’s the amount of time it takes for a mammogram— including only a few seconds of compression. To make your appointment, call 215.335.6400. NAZ
Find more @ mercyhealth.org What can I do to keep my bones strong? Answer Estrogen played a big role in making your bones strong. Now that you have less estrogen, you’re at risk for osteoporosis. This is a disease in which bones become weak and can break more easily. But there are several ways you can help protect them. First, take vitamin D and a calcium supplement. Secondly, be sure to exercise regularly and make strength training part of your routine. can I lower my risk for Q How heart disease? Answer Say goodbye to any unhealthy habits like smoking or overeating. Replace high-fat and high-sodium foods with more fruits and vegetables. Reduce the toll that stress can take on your body by exercising and getting enough sleep. Check in with your doctor regularly so that he or she can monitor your blood pressure, blood sugar and cholesterol levels. And be sure to take time to celebrate your successes!
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For women: A change for the better Has it been at least a year since your last menstrual period? Then you’re officially postmenopausal. It’s a time that comes with new health issues, many of which are related to your body’s lower levels of the hormone estrogen. Joan Addley, DO, Family Medicine Physician at Mercy Primary Care, offers advice on how to stay as healthy and vibrant as you can.
Name: Joan Addley, DO Specialty: Family medicine (board certified) Graduated: Philadelphia College of Osteopathic Medicine Internship and residency: St. Joseph’s Hospital in Philadelphia Office locations: Mercy Primary Care–Rhawn Street; Mercy Primary Care–Gloria Dei Personal: Married (to a Mercy Health System cardiologist) and raising three teen boys
Is weight gain inevitable? Answer Not at all! See my advice above. Exercise and a healthy diet can help you keep a healthy heart and waistline. Plus, these habits can help lower your risk for both high blood pressure and diabetes.
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PRIMARY CARE CLOSE TO HOME Mercy Primary Care has locations at Holme Avenue, Roosevelt Boulevard (formerly Frankford Avenue) and Rhawn Street. To find a physician you can partner with for life, call 1.866.NAZARETH (1.866.629.2738).
MORE @ MERCY is published as a community service for the friends and patrons of Mercy Health System. Information in MORE @ MERCY comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your healthcare provider. Models may be used in photos and illustrations. If you would like to stop receiving this publication, please email IAtMercy@mercyhealth.org. 2016 © Coffey Communications, Inc. All rights reserved.