What is your relationship with vegetables?

My good friends at the Visiting Nurse Service of New York alerted me to the fact that March is National Nutrition Month, which is great because it gives me a chance to blog about one of my favorite things: cooking. I really enjoy cooking, and I think learning how to cook can change your relationship with food.

It’s no secret that most people in this country don’t eat the right amount of vegetables. I can’t help but think that the shift to convenience foods that was made in the middle of the 20th century is responsible for this. When I was growing up, vegetables were usually steamed from frozen and served as side dishes. We rarely ate anything fresh, except for corn during the summer, and that too was steamed in the microwave. More often than not, we ate those mixtures of corn, peas and orange cubes that are supposed to be carrots.

Now that I’m all grown up, I hardly ever buy frozen vegetables. Instead, I buy fresh kale and slow-cook it with garlic and olive oil. I roast Brussels sprouts in the oven until the outer leaves get crispy. I brighten up just about any dish with red, yellow and orange bell peppers. We never had kale at home when I was a kid; now I crave it. Kale has a very high nutritional value as it contains beta carotene, vitamin K, vitamin C, lutein, zeaxanthin and calcium. It also contains sulforaphane  which is known to fight cancer. I get all these things on a regular basis, all because the way I view vegetables has changed.

So what’s your relationship with things that are green? And how do you help other people change the way they view food, so that that they learn not only to eat healthier but to enjoy it?

(Note: if you need some advice on how you, as a caregiver, can cook healthy meals for your caree, read these tips from VNSNY, 10 Cooking Tips for Caregivers).


Earlier today, …

Earlier today, our friends at Visiting Nurse Services of New York tweeted an interesting Wall Street Journal article about doctors’ disagreements over whether to prescribe statins for people who may have elevated cholesterol but who are otherwise healthy. The article presented arguments from two doctors, one who claimed that statins prevent heart disease, and another who said that there is no proof that they prevent heart disease, while they can cause diabetes and other problems.

This got me thinking, since I recently read another article about ACOs, in which many experts agreed that the ACO model can’t be successful unless patients take responsibility for their own health. While it’s true that people need to take care of themselves, after reading the WSJ article, I all I could think was, “how are people supposed to make informed decisions about their care when all the information they get is contradictory?” Asking patients to choose between disagreeing doctors is, for some, a tall order.

Maybe the WSJ is to blame in this instance for its presentation of the issue. It’s one thing to give people a list of pros and cons–that would be useful, in fact–but to present people with one doctor saying “Yes! Take these to prevent heart disease!” and another who says “No! You might get diabetes!” is to confuse most people. These are two diametrically opposed positions–choose one, or the other. What do we want patients to do, flip a coin?

If we want patients to step up and take more responsibility for their own health, maybe we need to do a better job of communicating with them, and give them better information. Imagine your doctor prescribed statins for you. You pick up your prescription on your way home from work, and on the radio, a different doctor is talking about the dangerous side effects of statins, and how they shouldn’t be prescribed to healthy people. Are you feeling anxious yet? Somehow, I don’t think making patients anxious about the medicine they take will motivate people to be more accountable for their health.

Let’s find better ways to inform people so that they can feel better about the choices that they’re making, and in turn, feel better about being responsible for their own well being.

They’re not old, they’re just sweaty

Evidently, elderly people are ignoring the excessive heat warnings because they don’t consider themselves to be old. So how can you make sure that your elderly home care clients take care of themselves during this heat wave?

Impress upon them that everyone needs to be cautious when it’s hot out. It’s not just an issue of heat–here in Minnesota it is positively tropical, with dew points in the 80s. This causes problems because the water-saturated air means you’ll sweat, but your sweat won’t evaporate. The evaporation of your sweat is what cools your body. So without the evaporation, your body can’t cool down, and this makes you vulnerable to heat related illnesses. Children and elderly are especially vulnerable, but everyone is vulnerable and everyone needs to take precautions. Even those of us who feel like we’re not a day over 18.

Make sure your patients drink plenty of water this week. Also, make sure you drink plenty of water. We all need to stay hydrated and stay cool.

July is UV Safety month!

It’s also UV-Rays-Are-Out-to-Get-You month. That is why it is important to remember to take precautions by putting on sunblock, wearing long sleeves and hats, and avoiding sun during its peak hours.

As providers of home health care, we must also make sure that our home care patients take these same precautions. We don’t want our home care patients suffering from nasty sunburns or skin cancers. Also, it is supposed to be very hot in the Twin Cities this weekend–above 90 all three days–so please make sure to check in on elderly patients, especially those who do not have air conditioning. Make sure they stay in the shade, drink plenty of water, and take cool showers if they get too hot.

And do the same for yourself! Remember, we can’t take care of others without first taking care of ourselves.

Stay cool!

It’s hot today! Here are some tips for keeping your home care clients safe from heat

It’s supposed to be above 90 degrees today in the Twin Cities, and we all know what that means: 0% chance of snow! It als means it is important to take precautions. While we enjoy the sunshine and warmth, it is important to remember that our elderly home care clients are particularly vulnerable to health issues in extreme heat conditions. As a patient advocate, home care workers can do much to avert issues.  Here are a few simple reminders we can provide to our clients to avoid heat-related issues:
  • Drink plenty of fluids to avoid dehydration – avoid caffeine and alcoholic beverages.
  • Dress in light, loose clothing
  • Use a fan or air conditioner to keep you home cool
  • Consider going to public pools or air-conditioned libraries, stores, and malls.
  • Close shades and drapes to prevent excessive heating from direct sun
  • Avoid exertion and strenuous activity
  • Avoid the midday heat. Complete errands during the cooler morning or evening hours
  • Cool down with a bath or shower.

OASIS-C tip of the week: one pressure ulcer or two?

Is winter ever going to end?!!! Sigh. Here’s your OASIS tip of the week.

Q: If you have two Stage IV pressure ulcers with intact skin in-between them and a tunnel that connects them underneath the wound surface, do you have one pressure ulcer or two?

A: CMS Response: If a patient develops two pressure ulcers that are separated by intact skin but have a tunnel which connects the two, they remain two pressure ulcers.

OASIS-C tip of the week: Influenza Vaccines

Q: Can I answer M1040, Influenza Vaccine, “1-Yes” if we gave the patient the influenza vaccine during this episode of care for the current flu season even if no day in the quality episode fell between 10/1 and 3/31? I understand it won’t be included in the process measure computation, but it would be easier for my staff if they could just answer yes or no, without needing to worry about determining if the episode is within the measure calculation time frame.

A: CMS Response: No. “NA” is the appropriate response for M1040, Influenza Vaccine, when no day in the quality episode fell between October 1 and March 31. This means at the Transfer or Discharge, you are only considering the time period from the SOC or ROC, whichever is most recent, to the Transfer or Discharge date. If no day in this period of time fell between October 1 and March 31, NA is the appropriate M1040 response, even if the influenza vaccine was given for the current flu season.