Monday, November 21, 2016

Let’s recognize caregivers and make it easier for all of us to do the right thing

I walked out of the doctor’s office, overwhelmed and paralyzed. My daughter had just been diagnosed with multiple food allergies from nearly all fruits, numerous vegetables, seafood, nuts, soy, wheat, and more. We headed straight to the grocery store to figure out what she could eat without wasting away from malnutrition, or so I thought.

Two hours later, we were still in the grocery store, reading every label.

You would think I would know what to do. After all, I am a doctor. But that day, I was simply a mom and a caregiver.

My problem was simple in the big scheme of things. Many years later, we figured out what my daughter can and can’t eat, how to go out to dinner, have friends over, and basically return to normal everyday life.

But for many of the more than 40 million caregivers in the USA today, it’s not so easy.

The costs of caregiving: health, time, and money

Fully 32% of family caregivers provide at least 21 hours of care per week with the average of 62.2 hours, according to a June 2015 AARP and National Alliance on Caregiving research report, Caregiving in the U.S. Those who provide caregiving 14 hours per week or for two or more years doubled the risk of developing cardiovascular disease and significantly increased the risk of developing high blood pressure and depression.

And it’s not just the time burden and health risks, but there’s also the expense.

A just-released AARP study, Caregiving and Out-of-Pocket Costs: 2016 Report, concludes that “family caregivers are spending roughly $7,000 in 2016 on caregiving expenses which amounts to, on average, 20% of their total income.” Some groups, including Hispanic/Latino, African American, and those caring for someone with dementia experience higher than average out-of-pocket expenses.

Many caregivers are forced to cut back on their own personal spending, reducing leisure spending or retirement savings, to accommodate caregiving costs.

When I think back to the day our family life changed, I am struck by how little doctors seem to know about the impact of our recommendations to our patients. My problem was minor — just changing grocery shopping habits and recipes.

But think about a new diagnosis of diabetes. It’s not just the recipes and grocery habits, but more trips to the pharmacy, tracking blood sugars, and follow-ups to doctors. According to a Harvard Medical School study, it takes two hours on average for one doctor visit for travel, waiting time, and visit. Even more time is spent if one needs public transportation or to arrange a ride.

Maybe it’s time to contemplate new measures for health care delivery

What if doctors and health systems were measured by how much they reduced the time, money, and the overall burden of care that patients, family, and caregivers need to follow recommended care? What if we told our patients, their families, and their caregivers not only what they “should do,” but “how to” with the least disruption to their everyday lives?

We need to make it easy to do the right thing.

Doctors care about having meaningful time with their patients. So, every time a new guidance or documentation rule is mandated, physicians understandably complain about the new time burden to incorporate the new tasks into the workflow of their practice.

Similarly, every time we give our patients and caregivers new recommendations to follow, we are disrupting the “workflow of their lives.” Is it any wonder that compliance is challenging for our patients? Do we address the daily changes that will be needed in everyday living? The Lasix prescription that means figuring out where all the nearest bathrooms will be when the fluid reduction pill takes effect. Or the cost of dressings, bandages, tape, and time to manage wound care at home? And the anxiety of not knowing if one just broke sterile technique at home? What a steep learning curve we expect from our patients following each visit!

A thank you from health care providers to caregivers

November is National Family Caregivers Month. Kudos to all family and friend caregivers, not only for “care taking” — ensuring your loved one is safe, taking the correct medications at the right time, preventing falls, making the right meals, and helping with bathing — but also for “care giving” – the giving of love, compassion, and care. You are spending your precious hours and your own money to do what you do best: sharing your love to your parent, your spouse, your children, or your friends. You are making a difference to our patients (your loved ones). It’s time we clinicians pay tribute, recognize, and thank you for being a caregiver, and not just a caretaker.

The post Let’s recognize caregivers and make it easier for all of us to do the right thing appeared first on Harvard Health Blog.



From: Charlotte S. Yeh, MD http://www.health.harvard.edu/blog/lets-recognize-caregivers-and-make-it-easier-for-all-of-us-to-do-the-right-thing-2016112110705

Dementia rate declines but aging America may halt the trend

New research finds further decline in dementia rates, but experts warn better ways are needed to keep brains healthy

From: http://www.cbsnews.com/news/dementia-rate-declines-but-aging-america-may-halt-the-trend/

ВОЗ: Международная классификация болезней



From: World Health Organization http://www.youtube.com/watch?v=PzQjxA1Fs3c

世卫组织:《国际疾病分类》



From: World Health Organization http://www.youtube.com/watch?v=7nbOQ0FS__k

منظمة الصحة العالمية: التصنيف الدولي للأمراض



From: World Health Organization http://www.youtube.com/watch?v=qAbppBLFjzc

OMS: Clasificación Internacional de Enfermedades



From: World Health Organization http://www.youtube.com/watch?v=oVG8C_kggf0

Solo Teen 'Choking Game' Points to Suicide Risks

Kids who tried this game alone were almost 5 times more likely to think of killing themselves, study finds



From: http://www.webmd.com/parenting/news/20161121/teen-choking-game-played-solo-points-to-suicide-risks?src=RSS_PUBLIC

Poor Sleep Linked to Worsening Kidney Disease

But more shut-eye associated with better kidney function in study



From: http://www.webmd.com/sleep-disorders/news/20161119/poor-sleep-linked-to-worsening-kidney-disease?src=RSS_PUBLIC

Sabra Hummus Products Recalled for Listeria Fears

Sabra Hummus Products Recalled for Listeria Fears



From: http://www.webmd.com/food-recipes/food-poisoning/news/20161121/sabra-hummus-recall?src=RSS_PUBLIC

Let’s recognize caregivers and make it easier for all of us to do the right thing

I walked out of the doctor’s office, overwhelmed and paralyzed. My daughter had just been diagnosed with multiple food allergies from nearly all fruits, numerous vegetables, seafood, nuts, soy, wheat, and more. We headed straight to the grocery store to figure out what she could eat without wasting away from malnutrition, or so I thought.

Two hours later, we were still in the grocery store, reading every label.

You would think I would know what to do. After all, I am a doctor. But that day, I was simply a mom and a caregiver.

My problem was simple in the big scheme of things. Many years later, we figured out what my daughter can and can’t eat, how to go out to dinner, have friends over, and basically return to normal everyday life.

But for many of the more than 40 million caregivers in the USA today, it’s not so easy.

The costs of caregiving: health, time, and money

Fully 32% of family caregivers provide at least 21 hours of care per week with the average of 62.2 hours, according to a June 2015 AARP and National Alliance on Caregiving research report, Caregiving in the U.S. Those who provide caregiving 14 hours per week or for two or more years doubled the risk of developing cardiovascular disease and significantly increased the risk of developing high blood pressure and depression.

And it’s not just the time burden and health risks, but there’s also the expense.

A just-released AARP study, Caregiving and Out-of-Pocket Costs: 2016 Report, concludes that “family caregivers are spending roughly $7,000 in 2016 on caregiving expenses which amounts to, on average, 20% of their total income.” Some groups, including Hispanic/Latino, African American, and those caring for someone with dementia experience higher than average out-of-pocket expenses.

Many caregivers are forced to cut back on their own personal spending, reducing leisure spending or retirement savings, to accommodate caregiving costs.

When I think back to the day our family life changed, I am struck by how little doctors seem to know about the impact of our recommendations to our patients. My problem was minor — just changing grocery shopping habits and recipes.

But think about a new diagnosis of diabetes. It’s not just the recipes and grocery habits, but more trips to the pharmacy, tracking blood sugars, and follow-ups to doctors. According to a Harvard Medical School study, it takes two hours on average for one doctor visit for travel, waiting time, and visit. Even more time is spent if one needs public transportation or to arrange a ride.

Maybe it’s time to contemplate new measures for health care delivery

What if doctors and health systems were measured by how much they reduced the time, money, and the overall burden of care that patients, family, and caregivers need to follow recommended care? What if we told our patients, their families, and their caregivers not only what they “should do,” but “how to” with the least disruption to their everyday lives?

We need to make it easy to do the right thing.

Doctors care about having meaningful time with their patients. So, every time a new guidance or documentation rule is mandated, physicians understandably complain about the new time burden to incorporate the new tasks into the workflow of their practice.

Similarly, every time we give our patients and caregivers new recommendations to follow, we are disrupting the “workflow of their lives.” Is it any wonder that compliance is challenging for our patients? Do we address the daily changes that will be needed in everyday living? The Lasix prescription that means figuring out where all the nearest bathrooms will be when the fluid reduction pill takes effect. Or the cost of dressings, bandages, tape, and time to manage wound care at home? And the anxiety of not knowing if one just broke sterile technique at home? What a steep learning curve we expect from our patients following each visit!

A thank you from health care providers to caregivers

November is National Family Caregivers Month. Kudos to all family and friend caregivers, not only for “care taking” — ensuring your loved one is safe, taking the correct medications at the right time, preventing falls, making the right meals, and helping with bathing — but also for “care giving” – the giving of love, compassion, and care. You are spending your precious hours and your own money to do what you do best: sharing your love to your parent, your spouse, your children, or your friends. You are making a difference to our patients (your loved ones). It’s time we clinicians pay tribute, recognize, and thank you for being a caregiver, and not just a caretaker.

The post Let’s recognize caregivers and make it easier for all of us to do the right thing appeared first on Harvard Health Blog.



From: Charlotte S. Yeh, MD http://www.health.harvard.edu/blog/lets-recognize-caregivers-and-make-it-easier-for-all-of-us-to-do-the-right-thing-2016112110705

TV Snack Ads Make Preschoolers Snack More

This happened even with kids who weren't hungry, researchers found



From: http://www.webmd.com/parenting/news/20161121/tv-snack-ads-make-preschoolers-snack-more-study?src=RSS_PUBLIC

Endocrine Update 2017: Quick Thyroid Cases



From: Mayo Clinic http://www.youtube.com/watch?v=n2lfhGs_Doc

Helping hands

More than 600 ADA 2016 attendees participated in the Alliance of the American Dental Association's 60-second service project, assembling personal hygiene supplies into kits that went to a Denver-based nonprofit organization that helps underserved populations

From: http://www.ada.org/en/publications/ada-news/2016-archive/november/helping-hands

Dental Care International launches fifth year of Sri Lankan program

From a girls home to a career as a dental surgery assistant, Udeni Rathnayaka has had a remarkable journey.

From: http://www.ada.org/en/publications/ada-news/2016-archive/november/dental-care-international-launches-fifth-year-of-sri-lankan-program

How to save a life

How to save a life: DKMS We Delete Blood Cancer, an international nonprofit that works with the world's largest network of bone marrow donor centers, registered 17 new donors during ADA 2016 – America's Dental Meeting in Denver.

From: http://www.ada.org/en/publications/ada-news/2016-archive/november/how-to-save-a-life

Just the Facts — November 21, 2016

Over three-fourths of U.S. adults report that they plan to go to the dentist within the next year. However, only 37 percent of adults report having gone to the dentist within the last year.

From: http://www.ada.org/en/publications/ada-news/2016-archive/november/just-the-facts-november-21-2016

USDA’s Five Tips for a Food Safe Thanksgiving

WASHINGTON, November 21, 2016 – This week millions of Americans will gather family and friends around the dinner table to give thanks. But for those preparing the meal, it can be a stressful time. Not to mention, for many it is the largest meal they have cooked all year, leaving plenty of room for mistakes that could cause foodborne illness.

From: http://www.usda.gov/wps/portal/usda/usdahome?contentid=2016/11/0247.xml&contentidonly=true

Spicy snow peas



From: http://www.mayoclinic.com/healthy-lifestyle/recipes/healthy-recipes/rcp-20049826

Baked apples with cherries and almonds

Serve these baked apples as a light dessert or alongside roasted pork or pork tenderloin. One serving has 179 calories and 4 grams of fat.

From: http://www.mayoclinic.com/healthy-lifestyle/recipes/baked-apples-with-cherries-and-almonds/rcp-20049603

Pork tenderloin with fennel sauce



From: http://www.mayoclinic.com/healthy-lifestyle/recipes/pork-tenderloin-with-fennel-sauce/rcp-20049810

世卫组织:“生命呼吸”—— 回家之路



From: World Health Organization http://www.youtube.com/watch?v=tBcAsQ1a6is

9th Global conference on health promotion: Global leaders agree to promote health in order to achieve Sustainable Development Goals

Leaders from governments and United Nations organizations, city chiefs, and health experts from around the world today made 2 landmark commitments to promote public health and eradicate poverty.

From: http://www.who.int/entity/mediacentre/news/releases/2016/conference-health-promotion/en/index.html

Eastern Aleppo without any hospitals for more than 250,000 residents

More than 250,000 men, women, and children living in Eastern Aleppo are now without access to hospital care following attacks on the remaining hospitals over the last week. According to reports to WHO from the Organization’s partners in Syria, there are currently no hospitals functioning in the besieged area of the city.

From: http://www.who.int/entity/mediacentre/news/statements/2016/aleppo-without-hospitals-syria/en/index.html

Spicy snow peas



From: http://www.mayoclinic.org/healthy-lifestyle/recipes/healthy-recipes/rcp-20049826

Portobello and blue cheese salad



From: http://www.mayoclinic.org/healthy-lifestyle/recipes/portobello-and-blue-cheese-salad/rcp-20049811

Marinated portobello mushrooms with provolone



From: http://www.mayoclinic.org/healthy-lifestyle/recipes/marinated-portobello-mushrooms-with-provolone/rcp-20049812

Asparagus with hazelnut gremolata



From: http://www.mayoclinic.org/healthy-lifestyle/recipes/asparagus-with-hazelnut-gremolata/rcp-20049602

Pork medallions with herbes de Provence



From: http://www.mayoclinic.org/healthy-lifestyle/recipes/pork-medallions-with-herbes-de-provence/rcp-20049808

Pork tenderloin with fennel sauce



From: http://www.mayoclinic.org/healthy-lifestyle/recipes/pork-tenderloin-with-fennel-sauce/rcp-20049810

Baked apples with cherries and almonds

Serve these baked apples as a light dessert or alongside roasted pork or pork tenderloin. One serving has 179 calories and 4 grams of fat.

From: http://www.mayoclinic.org/healthy-lifestyle/recipes/baked-apples-with-cherries-and-almonds/rcp-20049603

WHO: Emergency Operations Surge Training



From: World Health Organization http://www.youtube.com/watch?v=bdyWGm_Iv2Q

世卫组织:健康促进上海宣言



From: World Health Organization http://www.youtube.com/watch?v=hNh37VVChk4

第九届全球健康促进大会



From: World Health Organization http://www.youtube.com/watch?v=WuNrxRr47RM

WHO: 9th Global conference on health promotion



From: World Health Organization http://www.youtube.com/watch?v=SHwocF4A-w8

WHO: Shanghai Declaration on Health Promotion



From: World Health Organization http://www.youtube.com/watch?v=fxlKWPJlkHs

Avoid these common health perils of Thanksgiving

With Thanksgiving rapidly approaching, here are a few tips to help you avoid some common health hazards related to this holiday.

One of the more typical reasons for a trip to the emergency department on Thanksgiving Day (and most days, frankly) is accidental cuts to the hands. Be careful cutting up that turkey! Always use a carving fork, and although the household might be busy, try to avoid distractions when working with knives. Thankfully most such injuries can be repaired in the ED, but occasionally are bad enough to warrant being seen by a hand surgeon. For simple cuts to the hand, we generally place non-absorbable stitches that need to be removed in about 10 days. Most of the time, antibiotics are not needed — just a really good washout and cleaning prior to stitching.

Everyone “knows” about the dangers of cooking turkey, yet somehow nationwide, each year, the rate of residential fires more than doubles during this time frame. Never leave the house with the oven on, and check on the turkey frequently. If you choose to deep-fry a turkey, always do this outside, and always make sure the turkey has thawed first. Placing a frozen turkey into a deep fryer can cause explosions of hot oil, which can lead to third-degree burns and other serious injuries. If you’re frying a turkey, always wear good footwear, practice fire safety, and monitor children in the area.

Most birds carry bacteria, and the turkey is no exception. The most common pathogen is Salmonella. If cooked properly, this poses no harm. Under-cooked, the bacteria can cause diarrhea, vomiting, fever, and general illness that ranges from uncomfortable to life-threatening. The recommended temperature for a cooked turkey is at least 165° F, and should be checked by thermometer. Did you know that if you have any questions about cooking your turkey, you can call the Butterball hotline? Even on Thanksgiving Day! (800-BUTTERBALL/800-288-8372)

Delicious holiday foods are usually well seasoned …with salt. For most adults this does little more than make you thirsty, but for people with congestive heart failure or chronic edema (water retention), extra salt can place increased stress on the body. If you have these conditions, please be careful with what and how much you eat. Inevitably, we will see a few patients with episodes of worsening heart failure in the emergency department … usually the day after a holiday.

Last but not least, be careful about driving. It’s all too common to see drunk drivers during Thanksgiving time. It is historically the most dangerous time of the year for car accidents and subsequent fatalities. Monitor how much you drink, and remember that even if you are sober, unfortunately not everyone else out there is. Be extra attentive. Drive safe!

Have a happy and healthy holiday season!

The post Avoid these common health perils of Thanksgiving appeared first on Harvard Health Blog.



From: Jonathan Nadler, MD http://www.health.harvard.edu/blog/avoid-these-common-health-perils-of-thanksgiving-2016111810694