Spring has Sprung!

Springtime means warmer days, blooming flowers and some serious cases of cabin fever. No one wants to be stuck indoors on the pleasant first days of spring. Remember that homebound seniors crave the sunshine too! Here are a couple of hints to ensure that your springtime activities with seniors are safe and beneficial.

Make sure that your senior is safe to participate in the outdoor activity. Remember that most seniors don't function at the same high level that their children and grandchildren do.

If you are going on a walk, encourage them to use their walker, cane or assistive device. If they have any balance problems, gait irregularities or lack the strength to safely get around their home, they are likely candidates for Home Health Physical Therapy.

If you are taking a drive, be sure to bring enough oxygen, medication, etc to get through the drive and remember to wear your seat belt! A drive to a remote location may be picturesque, but it may also pose problems for seniors. Plan a drive that will have ample places to stop and use the restroom as needed.

Spring is great time to investigate the offerings of neighborhood senior centers. Salt Lake County has 18 Senior Centers that offer classes, provide social activities and a place to meet like minded people. Each center provides transportation and a full lunch for a $2.50 donation. For more information, contact Salt Lake County Ageing Services at 801.468.2764.


Remember, even short periods of activity can have a profound effect on health and happiness! If your loved one is too uncomfortable or unsafe to participate in activities outside of the home, they may be a great candidate for Home Health Services. If you have any questions, please visit Millcreekhomehealth.com and use our "Ask an Expert" feature.

What is Congestive Heart Failure?

Elizabeth Taylor, one of my favorite classic movie stars passed away last week due to Congestive Heart Failure (CHF). You probably hear about CHF all the time, but do you know what it is and what can be done to treat it? Here's the deal on CHF:

CHF isn't curable, but it is treatable and there is a lot that can be done to promote comfort and increase life expectancy.

CHF means that the heart can no longer pump enough blood to supply the body's needs, typically due to heart attack, congenital defect or heart disease. Because the heart cannot pump as it normally would, blood can build up in areas where it typically doesn't. This fluid build up on the lungs, liver, gastrointestinal tract, and the arms and legs translates to a lack of oxygen and nutrition to organs, which damages them and reduces their ability to work properly. It also can be quite uncomfortable, causing shortness of breath, chest pain, coughing and fluid overload in the arms and legs. 

Millcreek Home Health and Hospice cares for many, many seniors with CHF for both home health and hospice. For details on how we provide stellar care for CHF patients on Home Health check out our past post here.  If CHF progresses untreated, it can be a terminal disease and patients may require hospice care. Because hospice focuses on making people as comfortable as possible, Millcreek offers the following care protocol:

·        Frequent Nursing visits to monitor for increased pain, discomfort & any change in condition.

·    All medications related to heart failure and all medical equipment are provided free of charge.

·        Management of fluid overload to promote maximum comfort

·        Massage Therapy

·        Volunteer Services to provide companionship & respite for caregivers

If you have concerns about a family member with CHF or have any questions, feel free to call Millcreek Home Health and Hospice and a Nurse will help you.

Millcreek's Newest Quality Care Innitiative

Nurse Practitioner House Calls

Millcreek Home Health and Hospice offers hospice patients the services of our nurse practitioner, Laura Chamberlain, APRN. Under Utah’s Nursing Advanced Practice Act, a Nurse Practitioner may provide the following services:

• Maintenance and promotion of health and prevention of disease.
• Diagnosis, treatment, consultation, and referral for common health problems
• Prescription or administration of prescription drugs or devices.

In concert with the patient’s Physician, Nurse Chamberlain, APRN, can provide timely evaluation of any pain or condition change and can make on the spot medication adjustments to promote patient comfort.

What are the Benefits of a Nurse Practitioner in Hospice?

Quick response to patient needs Ÿ High Availability Ÿ Trained to deal with complicated family situations Ÿ Able to adjust medications on the spot Ÿ Able to change the hospice diagnosis Ÿ May attend death if needed

Introducing Laura Chamberlain, APRN

Millcreek Home Health and Hospice is pleased to welcome Nurse Practitioner Laura Chamberlain to our Hospice Leadership Team. In partnership with each patient’s hospice physician, Laura provides the highest quality end of life care with a focus on maintaining patient comfort and dignity.  With over 10 years experience in the health care field, her experience includes serving as the charge nurse in Intensive Care Units and working as a Nurse Case manager in hospice. These experiences offered unique and valuable perspectives on patient family dynamics, the issues inherent to hospice care settings and the ability to provide high quality medical care.

Laura graduated Cum Laude from the University of Utah, earning a Bachelors of Science in Nursing degree in 2005. She went on to earn a Masters of Science in Nursing from the University of Alabama at Birmingham in 2010, where she graduated at the top of her class with a 4.0 grade point average.

Laura seeks to improve care to seniors by:

·         Providing attentive, timely, high quality medical care.

·         Involving patients and their family members in the plan of care and attending to their physical, mental and spiritual needs.

·         Using therapeutic communication skills throughout the management of care to build trusting relationships with patients and their families.

·         Empowering patients, caregivers and family members through simple and clear education, through demonstrations, visual handouts, and written instructions.

Laura Chamberlain’s exceptional clinical skills and finely tuned understanding of patient’s needs make her a rich resource for Millcreek’s hospice leadership team. We look forward to working with her now and in the future to achieve excellence in hospice care.



What is Palliative Care and When is it Appropriate?

Patients who have an advanced progressive disease, but are not appropriate for hospice care may choose to receive palliative care while on home health. Patients undergoing palliative care may still pursue aggressive treatment, but receive care that focuses on pain and symptom management.

The American Academy of Hospice and Palliative Medicine produced this video to introduce people to what palliative care is and what a Palliative Care Physician can do.

Any Physician can provide palliative care & Millcreek Home Health and Hospice works with numerous physicians to provide palliative care in the home.

Continuum of Care

Millcreek maintains an integrated home health and hospice team, which means that if at any point a patient decides to elect hospice care, they keep the same care nurse, aide and social worker. If a hospice patient recovers, they can easily transition from hospice and begin a home health episode with the same care team.

Common Diagnoses for Palliative Care

Cancer Ÿ Congestive Heart Failure ŸChronic Obstructive Pulmonary Disease

Kidney Failure Ÿ Amyotrophic Lateral Sclerosis Ÿ Any Eligible Hospice Diagnosis

If you have any questions about palliative care, please contact Millcreek at 801.463.2478

The goal of palliative care is to support comfort and quality of life.

Elder Abuse and Adult Protective Services

There was an awful story in the Salt Lake Tribune last week about financial abuse of elders. According to the article, Utah seniors lose an average of $1 million to thieves. Sadder still, is the conclusion that these thieves are most often family members.

There are resources for seniors who experience abuse, financial and otherwise. Millcreek Home Health and Hospice is bound by law to report abuse to Adult Protective Services, which exists to protect seniors from abuse. Their purpose, as listed on their website is:

To assist vulnerable and elder adults in need of protection to prevent or discontinue abuse, neglect, or exploitation until that condition no longer requires intervention.

Millcreek Home Health and Hospice's team of Nurses, Physical Therapists, Aides and Medical Social Worker are trained to recognize situations that may escalate to be, or already are abusive. We work with families to remedy difficult situations and when needed, provide referrals to Adult Protective Services. If you have questions about a senior who may need help with medical care in their home, contact Millcreek Home Health and Hospice at (801) 463-2478.

A Very Special Thank You Note

Millcreek recently received the following thank you note from a very special patient. Millcreek usually cares for seniors, but we are also able to care for anyone on Medicare, which means that on occasion we get to work with younger patients with disabilities. This letter came from the father of one such patient. Nothing makes us happier than knowing we made someone's life better!

Millcreek Home Health and Hospice,

This note of appreciation is long past due; however, out appreciation for the outstanding services rendered to my daughter Jane* has not been diminished by time. In all honesty you folks were a life saver at what could have been a very troubling time. Each person made an appointment, came to see what could be done to to ease any problems and the just did their job. But that's the point-they did it so well, it was obvious they liked what they were doing, knew what they were doing and if there were difficult situations they would point them out and make recommendations. They took an honest interest. Besides, they could get Jane up in the morning and I couldn't. We loved them and they loved us. We looked forward to their coming and enjoyed their conversations. They are people persons, the kind that make a company successful. 

Specifically we would like to acknowledge: Paige, Rebecca, Adrienne and Sarah for the outstanding services that were given to us.

-The S. Family.

All of Millcreeks clinicians and staff aspire to deliver this same high level of care to all of our patients. If you have questions about how Millcreek Home Health and Hospice can be a benefit to someone in your life, go to http://www.millcreekhomehealth.com/ and submit your question using the "Ask an Expert" feature.

*Names were changed to protect patient privacy.

Love is a Healthy Heart

Heart failure is the leading cause of death among seniors, contributing to more than 300,000 deaths per year. Patients diagnosed with Heart Failure require specialized home care that takes into account the many risk factors that complicate and exacerbate their condition and co-morbidities. 

25% of Heart Failure Patients are re-admitted to the hospital within 30 days of discharge.

Thankfully, many of these hospitalizations are preventable with appropriate home health care. 55% of re-hospitalizations occur due to fluid overload. Angina, Heart Attack and Arrhythmia account for an additional 40%—compounding the need for close, on-going care and monitoring in the home after patients are discharged.

In response to a growing need among seniors, Millcreek uses a home care plan that anticipates risk factors and implements proactive care to prevent re-hospitalizations for heart failure patients. 

Millcreek's heart failure program is designed for patient success.

Each patient receives custom-tailored care, but until the patient stabilizes, Millcreek implements the following protocol to ensure patient success from the moment they are discharged from the hospital.

• All hospital discharge paperwork is sent to the patient’s Primary Care Physician and/or Cardiologist upon discharge.
• A Millcreek Case Manager facilitates a visit to a cardiologist or primary care physician within 2 weeks of discharge.
• Nursing orders are front loaded & include PRN visits, so that patients are seen frequently until they stabilize in the home environment.
• Daily vitals & weights are taken and reported if they are outside of Physician ordered parameters. If the patient does not have an accessible scale, Millcreek provides one at no cost.
• Physical & Occupational Therapy evaluations are ordered for home safety, energy conservation and home exercise plans.
• Standing orders for Medical Social Work are written when the patient lives alone or with an elderly caregiver.
• Patients receive a phone call on off visit days to check on them.
• Ongoing patient teaching about symptoms, emergency protocol, diet and exercise.

Our goal:

Reduce re-hospitalizations by providing quality care,

that allows patients recover safely in their homes.

For more information on Millcreek's Heart Failure program, contact us through our website www.millcreekhomehealth.com .

A Look at Salt Lake County Seniors' Future

At first glance, Salt Lake County is young and vibrant. But it is important to remember those children’s grandparents and be aware of their unique and important needs. Here are a few facts about Salt Lake County’s future seniors. By 2033: *

• The 60+ population will surpass the school-age population
• Those 85 or older will multiply twelve-fold to over 103,000 by 2050. 46.3 percent of them will live in Salt Lake County.
• The retirement age dependency ratio (the number of persons 65 or older per 100 working age persons) County is projected to reach 39.9%.

Why is this important? Because if you are reading this you are likely younger and in great health, but in 15 years, your parents, or possibly even you, will need to know about resources available to seniors. You've heard it a million times, but now is the time to plan for your future. Be aware of the issues that seniors face and work to understand the challenges of caring for an elderly parent. Think and prepare for it now.

Home Health and Hospice services offer solutions like direct, in-home care, but they also help coordinate the more complicated parts of growing old or caring for a loved one. Millcreek Home Health and Hospice routinely helps families connect to community resources, find senior living communities that provide higher levels of care, help with long term planning and advanced directives, and generally provide support during what can be a trying and difficult time. If you have any questions about how Home Health or Hospice can be beneficial to your loved one, go to www.millcreekhomehealth.com and try out our “Ask an Expert” feature.

*The stats above are from a study available on the Salt Lake County Aging Services website, which offers some great resources for caring for seniors.

Employee Profile: Nan Green, Executive Director

Nan Green, Physical Therapist

Nan Green founded Millcreek Home Health and Hospice six years ago, after working as a physical therapist in home health for over 25 years. Her dedication to the health and wellbeing of seniors in our community are evident in her active role as Millcreek’s Executive Director.  Nan oversees operations, quality assurance, and compliance to standards of care in all disciplines. She participates in care management through hands-on involvement from admission to discharge, including post-service patient contact. Her commitment to excellence is apparent in the extensive quality assurance processes with a strong focus on agency-wide education at Millcreek Home Health and Hospice. Nan’s many years of clinical experience ranging from orthopedic out-patient to in-home rehabilitation of neurological, orthopedic and cognitively impaired patients, mean that Millcreek’s patients receive the highest quality care available in Salt Lake County.

Why Do Seniors Fall?

One third of elderly people living in the community fall each year, making falls the most common cause of non-fatal injuries and hospital admissions for trauma in this population. Falls are the leading cause of accidental death and the 7^th leading cause of death in people over 65 in the United States.

Falls are predictable and can be preventable

The greatest predictors of falls are:

·                     Muscle weakness

·                     Unsteady gait & balance deficits

·                     Environmental hazards in the home

The following chart details the most common reasons that seniors fall & what home health can do to help. 

Functional Impairment	Home Health Solution
Blood Pressure Abnormalities	·         Skilled Nursing to monitor medication changes, vital signs and response to medications.
Executive Failure	·         Skilled Nursing to assess patient’s ability to adhere to plan of care.
Gait Irregularities	·         Physical Therapy for assessment, gait training, muscle strengthening, balance activities and home exercise instruction. ·         Occupational Therapy for home safety evaluation and teaching compensatory techniques for effective participation in ADLs.
Neuromotor Deficits	·         Skilled Nursing for neuro assessment and treatment. ·         Physical Therapy for strengthening and balance activities, and proprioception training. ·         Occupational Therapy for home safety evaluation and teaching compensatory techniques for effective participation in ADLs.
Postural Deviations	·         Physical Therapy for postural awareness activities.
Vestibular Dysfunction	·         Physical Therapy for balance training.
Vision	·         In conjunction with Skilled Nursing or Physical Therapy, Occupational Therapy visits for home safety evaluation and low vision training.

What if My Loved One Has a Fall?

The “slip and fall” is common this time of year and can cause serious health problems for seniors, especially if they live alone. Time and time again Millcreek’s nurses and therapists see patients who experience a fall that precipitates major health problems. There are several ways to prevent falls, including physical & occupational therapy, but it is also important to know what to do after a fall occurs.

If your loved one falls:

1.  Do not make them get up immediately. Help them calm down and reassure them that you will help them.

2.  If they cannot get up, call for help and provide first aid. Make sure that they are in a comfortable position and that they are warm enough. 

3.  If they can get up, proceed with care and gently help them to a seated position.

4.  Once they are up and seated somewhere safe and comfortable, check for injuries. Be especially mindful of potential hip injuries, bruising and cuts, which are common when a senior falls.

5.  Call their primary care physician and let them know about the fall and any injuries or discomfort.

A past fall is the highest indicator for future falls, so be sure to minimize risks to fall by clearing walkways of clutter, throw rugs and cords to trip over. Keep seniors homes well lit and be sure to shovel and de-ice walkways. Physical Therapy and Occupational Therapy can prevent falls and should be considered when a senior has a fall. Therapy will address the strength and balance issues that cause falls and will provide solutions, customized to meet individual needs.  

If a senior has a fall, there are many resources, often free of charge, to help promote their safety. Millcreek Home Health and Hospice is always available to answer questions and supply referrals to community resources.