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Kidney Health Awareness Month

Did you know that March is National Kidney Health Awareness month? Each March helps raise awareness about promoting good kidney health and highlights how home health and hospice care can help support those with kidney disease.

Sadly, kidney disease is often referred to as a silent disease that can manifest without the presence of many symptoms in its early stages. Often, individuals diagnosed with Chronic Kidney Disease (CKD) are unaware of their condition until it has advanced to later stages.

person holding kidney diagram

Role of Kidneys in the Body

Before you can understand ways to protect your kidneys, it’s vital to understand the critical function of kidneys in the body. Kidneys help regulate the body’s fluid levels, filtering out waste and toxins from the bloodstream. In addition, your kidneys release an essential hormone in blood pressure regulation. Kidneys also serve many secondary purposes, such as activating Vitamin D to maintain healthy bones and keeping blood minerals like potassium and sodium in the correct balance.

With all these vital functions in mind, it’s clear that protecting your body’s kidneys is crucial to good health.

Protecting Your Kidneys

Promoting good kidney health starts with protecting your kidneys. First and foremost, drinking enough fluids daily keeps your kidneys functioning effectively. Adults who do not have a diagnosed kidney condition should drink about 9 to 13 cups of fluid daily, according to the National Kidney Foundation.

Your diet and lifestyle are also quite important to maintaining good kidney health. By eating a well-rounded diet and maintaining a healthy body weight, you’ll help protect your kidneys from many factors that contribute to kidney damage. Aim to get at least 30 minutes of physical activity every day. It may take time, but developing a regular exercise routine can go a long way in helping support your overall health, as well as your kidney health.


Drinking too much alcohol can also wreak havoc on your kidneys and put them at risk for kidney disease. Consume alcohol in moderation. In addition, smokers are at an increased risk for kidney disease.

Home Health and Hospice Services

If you or a loved one has received a kidney disease health diagnosis, there is help. Our team offers supportive in-home services for individuals in need. We review services for individuals on dialysis on a case-by-case basis. Some individuals can continue dialysis treatments while also receiving supportive home health or hospice services. To learn more about how home health and hospice services can help you or a loved one, speak to a representative to discuss your unique situation.

Learn More About Dialysis and Hospice Care

Interested in learning more about the home health or hospice services available to individuals receiving dialysis? Contact us today.

Patient Safety Week 2023

Each year, Patient Safety Awareness Week (PSAW) is recognized to remind healthcare staff of the importance of promoting patient safety practices. Whether you’re a Nurse, Certified Nursing Assistant, or another type of healthcare professional, the steps you take daily can go a long way in keeping your patients safe.

5 Tips to Keep Your Patient Safe in Any Setting

From preventing choking hazards to simple fire prevention techniques, check out these five preventative measures you can implement to keep your patients safer.

patient safety

1. Fall Prevention by Ensuring Adequate Lighting

Elderly patients or patients in hospice are at an increased risk of falls, which can be caused by age-related loss of muscle mass, balance problems, cluttered environments, and so much more. While you’re likely already familiar with general fall risk precautions, one easy tip that is often forgotten is to ensure that a patient’s living area is adequately lit. According to the Centers for Disease Control (CDC), falls are usually caused by a combination of risk factors. The fewer risk factors a person has, the less their risk for falls is. As a healthcare professional, consider these ways to help encourage fall prevention for your patients:

2. Fire Prevention and Oxygen Safety

Another vital part of keeping your patients safe is understanding oxygen safety and fire prevention techniques. Remind your patients on oxygen that oxygen is extremely flammable. Therefore, provide patient education and remind patients of the dangers of smoking near an oxygen tank. Furthermore, all patients who smoke should be made aware of the designated smoking areas around your healthcare facility.

For home care patients, healthcare professionals can also help support fire prevention by helping their patients perform regular smoke detector tests or replace batteries.

3. Reducing Chocking Hazards

Another easy way to keep your patient safe is to follow proper eating protocols to prevent choking. Bed-ridden patients may wish to eat lying down. However, this poses a serious choking hazard. Before feeding a patient or giving them a meal, ensure they sit upright. After eating, patients should remain upright for at least 30 minutes to prevent aspiration. Any patient that has difficulty swallowing should take small bites with sips of liquids in between.


4. Preventing Bed Sores

Most healthcare professionals already know that frequent repositioning is an important step to prevent bed sores. However, adequate nutrition is another essential component to help reduce the risk of bed sores. Research studies suggest a clear correlation between nutritional deficiencies and an increased risk for pressure ulcers. Healthcare professionals and dietary department workers should pay close attention to their patients’ diets, helping to ensure they have a well-rounded diet with nutrient-dense foods. For patients with poor appetite, supplemental nutrition may be needed to help obtain proper nutrition and prevent bed sores.

5. Don’t Forget Footwear

When it comes time to transport a patient, healthcare professionals have many things to remember. Especially for patients who need help to ambulate several times throughout the day, it can be easy for healthcare professionals to forget the most important safety precautions for safe ambulation. As you prepare a patient for transport, ensure that they have the proper footwear to prevent falls. Standard socks are not proper footwear. Instead, patients should have non-slip shoes or socks on. Taking an extra moment to ensure your patient has adequate footwear is a simple and effective way to ensure they are safely transported.

Supporting Patient Safety

Patient safety is our utmost priority. To support this year’s Patient Safety Week, try implementing these five simple ways to keep your patients safe. Whether you see patients in a home setting or an assisted living facility, these tips can help reduce fall risk, prevent bed sores, eliminate choking hazards, and reduce fire hazards.

The Last Breath Brings a New Reality

Even when you know someone is dying, watching a loved one take their last breath is surreal.

If they are on life support, once they are removed from it, their breathing may change pretty quickly, and then it stops. Natural death can be different. For several minutes, you watch their breathing change. It becomes shallower, intermittent, until with great finality, they take their very last breath. Then, nothing but silence.


Physical Response to Grief

The emptiness of that moment feels like it would suck you into it if it could. You cry, with a depth of pain that feels like it is tearing right through you. You want to get away form the pain, but there is nowhere to run to. Part of their legacy is tied to you, sewn into the very fabric of your life. In losing others, one can feel like they have lost part of themselves.

Maybe that is why anxiety and feeling unsettled is so common after losing a loved one.

The Heart’s Response

In the acute phase of grief, there is physical and neurological consequence. One’s heart can actually change. Takotsubo cardiomyopathy (AKA broken heart syndrome) causes the heart’s main blood-pumping chamber (the left ventricle) to change shape and get larger. This weakens the heart muscle, and it doesn’t pump blood as well as it should. The symptoms usually last a few weeks, and one’s heart can return to normal function.

The word ‘takotsubo’ comes from the name of a pot used by Japanese fishermen to trap octopuses. When the left ventricle of the heart changes shape, it develops a narrow neck and a round bottom, making it look somewhat like an octopus trap.

The Brain’s Response

Then, there is the brain’s response to grief and loss. One can experience changes in memory, behavior, and sleep. Cognitive effects can also happen. One common one is known as brain fog. These neurological changes are a protective mechanism in order to help us survive.

Perhaps that protective mechanism helps younger folks survive, but the risk in elderly survivors can also increase. The depression, anxiety, and physical changes reduce one’s motivation to get up and move Non-adherence to one’s medical regimen can be compromised, increasing hospitalization risk.

supporting grieving loved one

Bereavement Support

I’m not sure the last breath is an event one can prepare for. The emotional toll can last months or years.

Which is why our hospice bereavement is so important. We provide bereavement support for over a year to those who must move forward but feel like they can’t. Children – both young and old – and other family receive care while the world moves on around them.

Thank A Social Worker

Social workers can be found in several settings, like hospitals, mental health clinics, home health services, hospice facilities, private practices, nonprofits, government agencies, and more. Social work might just be one of the most diverse professions out there.

Today, we want to thank social workers for all that they do in our society and highlight a few social workers who have left their mark on the world.

patient greeting social worker at the door

Ida Maude Cannon (1877–1960)

Social workers can commonly be found in hospitals and other healthcare settings thanks to social work pioneer Ida Cannon. Ida began her career as a nurse in 1898 and, after hearing a lecture by the “mother of social work,” Jane Addams, learned about the connection between living in poverty and health (Social Welfare History Project, 2012). After working as a visiting nurse in Minnesota for several years, Ida enrolled in the School for Social Workers in Boston, Massachusetts (Social Welfare History Project). Ida went on to work at Massachusetts General Hospital with patients from underserved populations and eventually became Chair of Social Services (Social Welfare History Project). She is considered one of the foremothers of medical social work to this day.

Whitney M. Young (1921–1971)

Today, social workers can also be found in the halls of government. One notable social worker in this field is Whitney Young, known widely as the co-author of President Lyndon B. Johnson’s War on Poverty (NASW). Whitney finished his Master of Social Work degree at the University of Minnesota in 1947 and began working for the Urban League of Nebraska in 1950 (NASW). He dedicated his career to addressing systemic inequalities like poverty and racism, becoming the director of the National Urban League in 1962 (NASW). Whitney also served as president of the National Association of Social Workers from 1969 to 1971, a time marked by unrest surrounding the civil rights of Black Americans, the war in Vietnam, and addressing the impact of poverty in the United States (NASW).

Dr. Phyllis Black (1936–present)

Dr. Black is well-known for her contributions to social work education and research over the past 50 years (CSWE, 2017). She received her BA and MSW from McGill University in Canada and received a doctorate from the National Catholic School for Social Services (CSWE). Dr. Black is a leader in the social work field for her role in molding the next generation of social workers. Her research has spanned a variety of topics, from healthcare and hospice work to ethics and practice evaluation. Notably, Dr. Black’s work with the Council on Social Work Education marked a shift from a content-based evaluation of social work learning to a competency-based model (2017). Not only did this change how social work students were taught, but it also changed how they practiced.

These three outstanding social workers are only a few representatives of the vast diversity within their field. They are each known for their willingness to blaze a new trail for the betterment of our society—a value intrinsic to social workers.

Today and every day, we want to acknowledge the social workers who step up to the plate and keep our world running. Thank you for all that you do.


Social Welfare History Project (2012). Ida Cannon (1877-1960) – Social worker, nurse, author and founder of medical social work. Social Welfare History Project. Retrieved 27 January, 2023 from https://socialwelfare.library.vcu.edu/people/cannon-ida-maude/.

National Association of Social Workers . (2017, October 10). Whitney M. Young, Jr. National Association of Social Workers (NASW). Retrieved January 28, 2023, from https://www.socialworkers.org/LinkClick.aspx?fileticket=8MP84GYP8i8%3D&portalid=0.

Council on Social Work Education (CSWE). (2017). Dr. Phyllis Black. Council on Social Work Education (CSWE). Retrieved January 28, 2023, from https://www.cswe.org/about-cswe/awards/2017-awardees/dr-phyllis-black/.

Frailty Assessments: 7 Keys to Improve Outcomes, Quality of Life

“Frailty is everyone’s business, and recognizing it improves outcomes and helps people live well longer,” said William Mills, MD, BrightSpring Health Services’ senior vice president of medical services, during Frailty: Why It Is Important, How to Identify It, and Programs to Help, a 2023 Clinical Impact Symposium webinar.

Addressing frailty is essential on many fronts. As Mills said, “Evidence shows that age, frailty, chronic disease load, and ADL dependency are predictive of mortality, hospitalization, and total cost.” At the same time, severe frailty is associated a five-fold higher risk of death at one year.

Frailty not only needs to be on your radar; you need a methodical, team-based, person-centered system to address this. The following are 7 elements your efforts should include:

1. A commonly used and accepted definition.

Mills noted that frailty generally is “a clinically recognizable state in which the ability of older people to cope with everyday or acute stressors is compromised by an increased vulnerability brought by age- associated declines in physiological reserve and function across multiple organ systems.” He added that the most commonly used definition is the “frailty phenotype,” which consists of five physical components: weight loss, weakness, exhaustion, slowness, and low physical activity level.

2. An understanding of how people express growing frailty and/or difficulty handling ADLs and IALDs.

Individuals aren’t likely to report that they are getting frail or weak. Instead, they may say things like: “The stairs are getting so hard to climb;” “Since my wife died, I just open a can of soup for dinner;” “I’ve lived here 40 years, and no other place will seem like home;” “I’m having more trouble getting around;” and “I’ve had a couple of falls – not too bad, though.” Family and team members need to be alert for signs that a patient is experiencing increasing frailty or frailty-related issues.

3. Consistent use of a proven assessment tool.

Mills said, “A clinical frailty tool should be quick, inexpensive, reliable, and easy to use in clinical settings because the identification of frail older people at risk is an important initial step potentially leading to appropriate preventive or treatment interventions and ultimately to higher quality care for this vulnerable population.” He noted that FRAIL scale is a simple questionnaire consisting of five yes or no questions addressing fatigue, resistance (inability to climb stairs), ambulation (inability to walk a certain distance), Illnesses (more than five comorbidities) and weight loss.

This scale, he said, has been shown to be able to predict mortality and incident ADL and IADL disabilities among community-dwelling older people in recent meta-analysis studies.” Other potentially useful instruments include the Clinical Frailty Scale, Edmonton Frail Scale, INTER-FRAIL Prisma-7, Sherbrooke Postal Questionnaire, Short Physical Performance Battery, and Study of Osteoporotic Fractures Index.

elderly man with cane at bottom of steps

4. Promote individualized, person-centered care.

Mills said, “An exciting project we have worked on involves a claims-based assessment to detect frailty. This is a unique opportunity to identify patients who may need specific interventions and provide them with those services.”

5. Include an exercise prescription to reverse frailty.

This should include resistance training, aerobic exercise training, balance training, and flexibility training. Mills and Renee Lach-Sharon, PT, MS, CPHQ, manager of therapy clinical and quality services at Rehab Without Walls NeuroSolutions, who also spoke at the webinar, talked about a new BrightSpring exercise program adapted from a program at the University of Otago in New Zealand. “The Otago program initially focused on falls prevention and found it useful in this regard. It has shown that even in higher risk populations, it was able to reduce falls by 35%, and it improved things like mobility and hand grip strength. We are looking at using it with very old adults who have multiple risk factors such as arthritis and deconditioning,” said Lach-Sharon.

This involves an individually tailored, home-based balance and strength falls prevention program delivered by a physical therapists and available via home health. Lach-Sharon stressed that intensity is key to the success of this program. This means sessions three days a week for each category of exercise, with a rest day between exercising in the same category. “We are looking to roll this out in the home health environment. Each visit would be about 45-60 minutes, then we would conduct follow-up calls to check in. This is key to the success of the program, as we are trying to make this a lifestyle change,” said Mills, adding, “One goal is to get these individuals into community-based exercise programs for socialization. This makes a tremendous difference in compliance.”

6. Have a way to measure outcomes.

This should include the use of your frailty assessment tool as well as measurements of gait speed, 30-second chair rise, and balance (4-stage balance test: stand with feet side by side, place instep of one foot so it is touching the big toe of the other foot, place one foot in front of the other – heel touching toe, and stand on one foot). Mills noted that, according to research, “The inability to stand on one leg for 10 seconds in mid to later life is linked to a near doubling in the risk of death from any cause within the next 10 years.”

7. Maximize your reach with technology and staff involvement.

Ideally, a good frailty program should be led by a trained physical therapist. BrightSpring is rolling out a national program currently. After starting the program led by physical therapy, leveraging technology, including efforts such as exercise videos and remote therapeutic monitoring can be useful as well. Make effective use of non- skilled staff and caregivers. For instance, consider using a standardized assessment tool to enable caregivers to address social determinants of health. “It is important to provide structure, clinical assessments and support between visits to assess frailty, falls risk, etc.,” Mills said, adding, “Make sure you provide a system for patients to get access to medications and maximize compliance with medication regimens.”

By assessing and addressing frailty, providers can manage patient proactively, instead of reactively. “We think an exercise prescription will be an innovative and exciting way to positively impact frail elders,” Mills said.

February is American Heart Month!

Fact #1:

Heart disease kills more than 600,000 Americans every year.

Heart disease continues to be the leading cause of death for Americans. Thankfully, heart disease is often preventable and can be treated by making healthier lifestyle choices.

Fact #2:

Chest discomfort or a heart attack is the first sign of heart disease.

Heart attack symptoms often include discomfort in the center of the chest that may last for a few minutes or comes and goes. It can feel like squeezing, uncomfortable pressure, fullness, or pain. Shortness of breath, breaking out in a cold sweat, lightheadedness, and nausea are also heart attack symptoms.

Fact #3:

Some people are born with heart disease.

A congenital heart defect starts at birth. Doctors are still puzzled as to why a baby might have a congenital heart defect, though it tends to be hereditary. Most of these heart disease issues include leaky valves or structural issues like holes in the heart.

Fact #4:

Unhealthy habits contribute to heart disease.

Not getting enough exercise, unhealthy eating, and smoking increase your chance of developing heart

disease. Additionally, high blood pressure, diabetes, and high cholesterol are other factors that can increase your risk. Speak with your doctor about prevention measures.

Fact #5:

Time is of the essence when someone is having a heart attack.

Heart attack victims can have sudden loss of responsiveness or may be unable to breathe normally. Loss of oxygen to the brain and heart can cause permanent damage, so calling 9-1-1 immediately is critical. EMS staff can start treatment upon arrival, often up to an hour sooner than if you drove yourself to the hospital.

Fact #6:

Women have the less typical heart attack signs.

According to Mayo Clinic, women are somewhat more likely than men to experience less common symptoms and signs, like neck or jaw pain prior to having a heart attack.

Fact #7:

The most common heart disease is coronary artery disease.

This disease develops when your major blood vessels that supply the heart with blood, nutrients, and

oxygen become diseased or damaged. Plaque build-up in your arteries, which causes inflammation, often leads to coronary artery disease. This build-up happens over a number of years and most people don’t notice a problem until they have a heart attack or large blockage in the arteries that requires surgery.

7 Heart Health Facts to Share during American Heart Month. https://info.totalwellnesshealth.com/blog/7-heart-health-facts-to-share-during-american-heart-month.

Black History Month and the Medical Advances We Have Today Thanks to People of Color

Have you ever touted the wonders of laser eye surgery to remove cataracts, blood transfusions, or pacemakers? We might not be promoting these and other advancements today if it were not for the ingenuity of African American scientists, practitioners, and other innovative people of color.

Black History Month highlights the significant contributions that African Americans have made to crucial medical advancements. Many of these people still need to receive the historical accolades they deserve. Nevertheless, if not for them, we wouldn’t have the life-saving medical innovations we take for granted today.

Black History Month graphic

The Importance of Black History Month

This observance originates in the founding of the Association for the Study of Negro Life and History in 1915, which author and historian Dr. Carter G. Woodson spearheaded. In 1986, Congress passed legislation that designated February National Black (Afro-American) History Month. Black History Month raises awareness of African Americans’ significant contributions, despite the prejudice, discrimination, and bias they have and continue to face.

Many pioneering African Americans have applied their skills and knowledge to solve medical problems, contributing to advancements in public health and healthcare delivery, despite the adversity and health inequities they encountered.

African American Trailblazers in Medicine

Open-heart surgery, blood transfusions, and pacemakers are some modern innovations for which we can thank African American trailblazers in medicine and healthcare. The following individuals are some of the pioneers who overcame cultural barriers to facilitate medical developments that have saved millions of lives.

James McCune Smith, M.D. In 1837, American-born Dr. Smith earned his medical degree from the University of Glasgow in Scotland, where he did not face as much bigotry and discrimination as he would have in his home country. He later moved to New York, where he became the first Black man to practice medicine in the United States.

Patricia Bath, M.D. Dr. Bath is a research scientist and educator with a medical degree from Howard University. She developed a method of laser eye surgery to remove cataracts. Patients worldwide have benefited from this widely used procedure.

Leonidas Harris Berry, M.D. In the 1950s, gastroenterologist Dr. Berry worked to encourage the inclusion of more black physicians in hospitals. His leadership in Chicago also led to more healthcare facilities being opened in underserved sections of the city.

Otis Boykin. Boykin, an electronics pioneer, is perhaps best known for improving the pacemaker, a small device that detects when the heart is beating too slowly or irregularly. Also, he patented almost 30 other electronic devices.

Charles Richard Drew, M.D. Dr. Drew is often hailed as the “father of blood banking.” He provided leadership in developing methods for preserving blood for donations and transfusions. Dr. Drew also led the first blood bank of the American Red Cross, also creating mobile stations that have since evolved into bloodmobiles.

Marilyn Hughes Gaston, M.D. Dr. Gaston is mainly responsible for advancing our knowledge and understanding of sickle cell disease, which leads to pain and complications for millions of people. Her research led to the development of sickle cell screening methods for newborns that are now widespread.

William Augustus Hinton, M.D. A graduate of Harvard Medical School in 1912, Dr. Hinton was the first African American to publish a textbook, which was titled, Syphilis and Its Treatment. He developed the “Hinton test,” a water-based chemical process for detecting syphilis in patients.

Mae C. Jemison, MD
Mae C. Jemison, M.D., the first African American astronaut in NASA history.

Mae C. Jemison, M.D. Dr. Jemison became the first African American astronaut in NASA history in 1992. She collaborated with the Centers for Disease Control and Prevention (CDC) to research many types of vaccines and conducted many experiments aboard the Shuttle Endeavor.

Daniel Hale Williams, M.D. Many people depend on open-heart surgery to save their lives. Dr. Williams was the first African American cardiologist to perform this surgery successfully. In addition to serving as the first Black member of the American College of Surgeons, he opened the first Black-owned and non-segregated hospital in the United States in 1891.

Kizzmekia Corbett, Ph.D. A researcher in immunology and infectious diseases, Dr. Corbett has worked on novel coronavirus vaccines since 2014. Her work has been influential in the development of the COVID-19 vaccine, which helped slow the spread of the virus.

Many of the medical advancements we take for granted today are largely due to the contributions of many African American researchers and physicians. Despite the cultural obstacles they have faced, their contributions to medicine and healthcare have improved our life expectancy and quality of life.

For most, the holidays are a time of joyous celebrations with family, friends, and delicious food. When you are living with a loved one or know a close someone with a terminal illness, the traditional holiday times don’t always carry the same cheer. Hospice is one service that can significantly alleviate some of the burden that lies on you as family members and friends to provide care to your loved one. Having a dedicated and caring medical team to help provide care during the holidays can protect the cherished time you have together.

The decision for a loved one to go on hospice is a challenging one. During the holidays, this decision can feel even harder. Oftentimes, families choose to push the decision until after the holidays, thinking it will alleviate stress to deal with it at a later time. In truth, hospice care can often make this transition period easier for you and your family, especially during the holidays. 

When you choose hospice care, you are met with a team of medical professionals, therapists, spiritual counselors, and a number of other individuals that will cater to the needs of your loved one. Your hospice team will take on the responsibility of making sure the medical needs of your loved one are met so that you, along with family and friends, can focus on spending quality time with your loved one during a time when it matters so much. Depending on where hospice care will be provided, consider bringing the holidays to your loved one. Traveling is often not an option for those on hospice care. Modifying traditions to fit the environment of your loved one, whether care is being provided at home, a long-term care facility, or the hospital, can help to maintain the holiday feel. Holiday decorations, cards from friends and families, and home-baked treats can inspire the holiday cheer and can help make your loved one feel at home, no matter where they are. 

While hospice has the ability to reduce stress and provide excellent care to your loved one, it does not guarantee that your holidays will feel the same as they always have. Try to keep in mind that traditions may have to be modified or left out this year and that it is completely okay to allow yourself to feel sadness during this time. Ask for help from family and friends to make this time of year manageable. Don’t forget to rest and set aside some time to take care of yourself as well. Given that some of the holiday celebrations may cause overwhelm, always check with your loved one to see what they are up for. This holiday season could be a time of many changes, so go easy on yourself if not every day feels easy to get through.    

If you are in a position where you could benefit from hospice care for a loved one this holiday season, schedule an appointment to discuss your options with your loved one’s medical team. Terminal illness can have the power to make the holidays feel isolating and void of cheer. Hospice has the power to restore the joy in your holidays with your loved one.   


Image 1 – Go Ahead And Put Up Your Christmas Tree (catcountry1073.com)

Image 2 – Family With Grandparents Enjoying Christmas Meal At Table | Fort Sanders Regional Medical Center, a member of Covenant Health (fsregional.com)

Medcure – Hospice And The Holidays – MedCure

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