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Deciding on hospice care for a loved one is a deeply personal and challenging decision, balancing their wishes and medical realities. Rebecca Edwards, DNP, from Renown Hospice Care, explains the signs indicating when it might be time for hospice and offers guidance on navigating this decision with compassion and clarity. Understanding Hospice Care  Before exploring the decision-making process, it’s crucial to have a clear understanding of what hospice means. Hospice care represents a shift in how we approach living with a terminal condition, emphasizing comfort, dignity, and quality of life above all else. When there is no longer a pathway to a cure, side effects of treatment outweigh the benefits, or someone is simply tired of frequent hospital visits, then it may be time for hospice. Hospice care is mainly done in the home, where most people wish to be. It's a compassionate, team approach to care that focuses on meeting the physical, emotional, and spiritual needs, supporting their families, and honoring individual preferences. 5 Critical Signs to Be Aware Of Decline in Overall Health: When a loved one's health continues to decline despite ongoing medical interventions, this may be a sign that these treatments are no longer effective.  Increasing Pain and Symptoms: When managing symptoms such as pain, nausea, fatigue or shortness of breath becomes increasingly challenging, hospice can offer specialized support and expertise in symptom management.  Frequent Hospitalizations: Repeated hospitalizations or emergency room visits can signify that the disease has progressed to a point where managing symptoms and providing comfort at home or in a hospice setting is a more appropriate approach.  Difficulty with Daily Activities: If your loved one is experiencing difficult with activity of daily living such as dressing, bathing, or mobility, it may be a sign that they require additional support and assistance. Prognosis of Six to 12 Months: Hospice Care is typically recommended for patients with a prognosis of about one year or less if the disease follows its normal course. However, it’s important to remember that every individual is unique and prognosis can vary.

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Summer is around the corner, bringing heightened risks of heatstroke, especially for children who cannot regulate their body temperature as efficiently as adults. Infants are particularly vulnerable and may not express discomfort, so never leave a child unattended in a vehicle. Top Tips for Preventing Heatstroke Reduce the number of deaths from heatstroke by remembering to ACT. Avoid heatstroke-related injury and death by never leaving a child alone in a car, not even for a minute. And make sure to keep your car locked when you’re not inside so kids don’t get in on their own. Create reminders. Keep a stuffed animal or other memento in your child’s car seat when it’s empty, and move it to the front seat as a visual reminder when your child is in the back seat. Or place and secure your phone, briefcase or purse in the backseat when traveling with your child. Take action. If you see a child alone in a car, call 911. Emergency personnel want you to call. They are trained to respond to these situations Keeping Your Baby Cool in the Back Seat In hot weather, it is crucial to keep your baby cool and hydrated by using a car seat cover or towel over them to reflect the sun's rays. Dress your baby in lightweight clothing that covers their arms and legs. Keep an eye on your baby's skin color. Move them to a cooler place if they look too red or flushed. Keep the temperature at a comfortable temperature for you, not for your child. Keep the windows cracked open for ventilation and ensure nothing is blocking the airflow from entering or exiting the vehicle. Dress your infant appropriately for their environment, including appropriate head and neck coverings, to keep them cool and protected from sunburns. Ensure you have enough fluids to last an hour before getting out of the car or use bottled water if possible. Never leave your child unattended in a car. Steps to Follow if You Suspect Heatstroke  Call 911 immediately.  Cool the victim – Get the person to a shady area, remove restrictive clothing and cover skin with sheets soaked in ice-water, and place ice packs in the arm pits and groin.  Have the victim drink cool fluids, preferably an electrolyte-containing sports drink.  Monitor body temperature with a thermometer but stop cooling efforts after temperature has dropped to 102 Fahrenheit. Baby Safe Classes These classes help prepare parents for emergencies that may occur in baby’s first year. Safe Kids Worldwide Did you know heatstroke is the leading cause of non-crash related fatalities in children? “On average, every 10 days a child dies from heatstroke in a vehicle. In more than half of these deaths, the caregiver forgot the child was in the car.”

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Flu shots don’t just protect those who get vaccinated; they protect everyone, including your family and the community. As we continue navigating the COVID-19 (coronavirus) pandemic, Renown Health infection prevention expert Whitney Robinson explains how getting your flu shot is vital for staying healthy. 5 Ways to Schedule Your Flu Shot Call Us! 775-982-5000 Urgent Care Appointments Renown Pharmacy Vaccinations Make an Appointment via MyChart Need a Doctor? Find One Now Reasons to get the flu shot Chills, body aches, fever, congestion; getting the flu isn’t fun. But in addition to protecting yourself with a flu shot, you’re helping reduce flu cases and hospitalizations, Whitney said. Flu shots are currently available at pharmacies throughout the Reno area. Whitney says the ideal time to get your flu shot is September through October, but remain relevant throughout the winter months as it only takes two weeks for the antibodies to develop in your body. This timing allows the vaccine to provide the strongest protection during the length of flu season. Who needs a flu shot? Almost everyone. The Centers for Disease Control and Prevention recommends the yearly flu shot for everyone six months of age and older. Equally, they consider it the first and most crucial step in protecting against the flu virus.

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Dr. Shipra Singh, a Pediatric Pulmonologist, outlines the challenges of diagnosing asthma in children due to symptoms resembling other respiratory issues. It's particularly difficult to identify in infants and young children, who may not clearly exhibit breathing difficulties. Asthma, often confused with bronchitis, croup, or allergies, is a significant chronic illness causing school absenteeism, as per the CDC. Risk factors include prenatal smoking and family history of allergies or asthma. Infants and toddlers are more susceptible due to smaller airways and respiratory viruses, which can exacerbate conditions like colds and bronchitis. How can I tell if my child has asthma? Unfortunately small children are unable to describe their symptoms, making asthma difficult to diagnose. Your child may even be active, playing and smiling, although they are experiencing chest tightness or labored breathing. Observe your child and let the child’s doctor know if: Your child’s breathing behavior has changed (coughing, wheezing, rapid breathing) Your child’s breathing pattern changes (day vs. night, with rest or activity, inside vs. outside) You have a family history of asthma or allergies Your child’s breathing is triggered by any foods or allergies With your help, your child’s doctor can make the best diagnosis to determine if your child has asthma. A pediatric pulmonologist (lung specialist) or pediatric allergist may also have to be consulted for special testing. Tests may include lung function testing, allergy tests, blood tests and X-rays for an accurate diagnosis. What is the treatment for infants and toddlers? Young children can use many of the same medications as older children and adults, although the way they take them and the dosage will differ. A nebulizer (or breathing machine) creating a medicated mist for your child to breathe through a mask may be used. An inhaler with a small spacer tube connected to a mask is also common to help your child breath medication into their lungs. Either of these options are effective. Asthma in children is treated with both fast-acting and long-term medicines to open up airways quickly for easy breathing and also to lessen asthma symptoms over time. Communicate with your child’s medical providers to create a personalized asthma management plan for them. How can I manage my child’s asthma? Recognize your child’s breathing habits and be aware of worsening symptoms. Consult with your child’s doctor on a daily asthma action plan to recognize worsening symptoms and track medications. Here’s an example of an asthma action plan provided by the U.S. Department of Health and Human Services’ National Institutes of Health). Be consistent with the plan and talk to your doctor before changing it. Have an emergency plan in case of a serious asthma attack. Know where the closest ER is and know who can take care of your other children. Also know what the medical treatment coverage is under your insurance plan. Dr. Singh explains, "Discussing asthma with your child may be difficult. Some kids find the subject frightening or confusing. Others, especially the older kids, may resent the treatment and may not be interested in doing it. Talk to your doctor about advice to build an open and trusting relationship regarding your child's asthma care."

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Car seat mistakes can have very serious consequences. Misuse of a car seat can injure your child, or fail to keep them safe in the event of a crash. A lot goes into finding the right car seat for your child. With so many factors to consider (including age, weight and height of the child, type and brand of a car seat, cost of the car seat, etc.) it can be easy to forget critical factors. Here are two common mistakes that certified technicians often find when speaking with parents. Mistake #1: Getting a used car seat without knowing its history Why: A used or secondhand car seat can pose several factors that can compromise its safety in a crash. First, car seats expire six to ten years after their date of manufacture, so refer to the car seat's manual for recommended car seat longevity. The safety mechanisms can be compromised if a car seat has been in a crash. So it's crucial to replace your car seat following a collision. Solution: Only use a car seat if you know its history. A new car seat is your best bet, as they are up to date on the latest safety guidelines, and safety mechanisms are up to standard. However, if you are considering a used car seat for your child, please ensure the following: The car seat has never been in a car crash. The car seat isn't expired or outside the manufacturer's recommended longevity. It comes with the car seat manual and has all safety labels, including manufacture date, model number, and use instructions and restrictions. The car seat or any of its parts have not been recalled. The overall state and integrity of the car seat and its parts are undamaged. The carseat or any of its parts have not been recalled and are present and in working order.

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Although the exact cause of Sudden Infant Death Syndrome is unknown, there are steps parents and caregivers can take to reduce the risk. Here's what every parent needs to know. SIDS is the leading cause of death in the country in infants in their first year of life. However, the exact cause of SIDS still remains a mystery, though it is often attributed to unsafe sleeping practices. Karen Wagner, a Pediatric Nurse Practitioner at Renown Health answers some of the most commonly asked SIDS questions. Protecting Babies from SIDS: Always place babies on their backs when putting them to sleep for naps and at night. Use a firm sleep surface, such as a mattress in a safety-approved crib, covered by a fitted sheet. Share your room – not your bed – with your baby. Your baby should not sleep in an adult bed, on a couch, or on a chair alone, with you, or with anyone else. Keep soft objects, such as pillows and loose bedding, out of your baby's sleep area. Do not smoke during pregnancy or around the baby; these are strong risk factors for SIDS. The risk of SIDS is even greater when a baby shares a bed with a smoker. To reduce risk, do not smoke during pregnancy, and do not smoke or allow smoking around your baby. Your SIDS Questions Answered:  Who's most at risk? Three out of five SIDS victims are boys. African American and Native American infants are twice as prone to the syndrome. Other groups at increased risk include preemies, low-birthweight babies, and infants exposed to cigarette smoke. Is putting my baby down on their back really that important? It's vital. Back-sleeping increases a baby's access to fresh air and makes her less likely to get overheated (another factor linked to SIDS). I put my child to sleep on their back at night, but can I let this rule slide for a short nap? It's not worth the risk. Babies who normally sleep on their back are 18 times more likely to die of SIDS when placed down on their tummy for a snooze. Is side-sleeping safe? No. Studies show that putting a baby down on her side rather than on her back doubles the SIDS risk. It's easier for an infant to roll onto her tummy from her side than from her back. I'm worried about my baby getting cold. Is it safe to cover them with a blanket? Wait until their first birthday. Blankets, pillows, comforters and stuffed toys can hinder your child's breathing; even soft or improperly fitting mattresses can be dangerous. If you're worried that your little one may get chilly, swaddle them in a receiving blanket or use a sleep sack.

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The kids are back in school and the holidays are all but a distant memory: Now what? Karen Wagner, APRN, offers specific tips about getting kids back to their routines in the post-holiday-hustle-and-bustle. Are you finding the kids struggling with bedtime routines? Having trouble getting them to tackle homework? There’s a simple reason: The holidays messed with their mojo! Here, we talk with Nurse Practitioner Karen Wagner about what to do to get them back on the straight and narrow.  Why Routines Are Important “Holidays are a fantastic time to get together with family and friends, so our routines are usually off — and this is understandable, “Wagner says. “While the holidays are exciting, they are chaotic and can put our kids out of the routines.” So how do you get kids back into those routines they crave?  “Consistency/routines are crucial for our kids,” she says. “Most people — kids and adults —  experience a let-down feeling after the holidays, and post-holiday adjustment takes time.” So what can we do, specifically? Wagner recommends the following:  Re-establish family routines, including before- and after-school programs or child care routines. Once kids are back on the regular schedule, they’ll find that sense of familiarity as the old routine returns. But keep in mind, this won’t happen overnight.  Encourage healthy eating, as the upheaval of their schedule can be offset by a balanced diet.  Make sleep time a priority: Keep in mind that it might take up to three nights of strict bedtime to get them back on track. But enforcing normal bedtime will get their bodies back on a normal schedule.  Return to usual chores and expectations. Nothing encourages a return to routine like reminding them of the basics.  Incorporate indoor and outdoor time. They likely spent lots of time outdoors during our unseasonably warm winter break — and they even had a snow day or two! So encouraging both indoor and outdoor time will help them return to a circadian rhythm and tire them out from exposure to fresh air.  “It is never too early to encourage a love for physical activity in kids by exposing them to fun fitness activities and sports,” Wagner says. “Physical activity improves bone health, cardiorespiratory and muscular fitness, decreases levels of body fat, reduces symptoms of depression, and improves cognitive skills and the ability to concentrate.”

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With more than 3 million cases in the United States each year, human papillomavirus (HPV) is a common sexually transmitted disease and can lead to the risk of several cancer diagnoses. Fortunately, a vaccine can prevent more than 90% of HPV cancers when given at the recommended ages. We talked to Renown Pediatrician Vanessa Slots, M.D., to learn more about HPV and the importance of getting your child fully vaccinated.   What is HPV?   Talking about sexually transmitted infections can be uncomfortable, but learning how HPV is spread is important for prevention. HPVs are spread via skin-to-skin contact. According to the National Cancer Institute, there are low/medium-risk HPVs that can cause warts and cervical dysplasia (abnormal cells on the cervix), and there are high-risk HPVs that can cause various cancers. HPV is perhaps most known for causing cervical cancer. Other cancers related to HPV are anal, vaginal, vulvar, penile and oropharyngeal cancers. In fact, men are four times more likely than women to suffer from HPV-associated oropharyngeal (mouth and throat) cancer. HPV is so common that nearly all sexually active people will be exposed at some point in their lifetime, with around half of infections being a high-risk virus.  Benefits of the HPV vaccine   Immunizations are safe and effective and have successfully reduced the transmission of many deadly diseases. The CDC (Centers for Disease Control and Prevention) states the HPV vaccine protects against infections that can lead to HPV related cancers and abnormal cells that can lead to cancer (precancers), as well as genital warts.   The recommended HPV vaccine schedule   The American Cancer Society states that the HPV vaccine is most effective when two doses are given to girls and boys between the ages of 9 to 12. There should be at least 6 months between the first and second dose. “You might be asking why your child needs to get the HPV vaccine at this young age when they are not sexually active,” says Dr. Slots. “Research shows that people have a better immune response to the vaccine when younger than in their late teens and early 20s.”   For teens and young adults ages 13 through 26 who have not been vaccinated, getting the HPV vaccine is still highly effective in preventing cancers and genital warts.   CDC recommended HPV vaccination suggestions:  2-dose schedule for people who get their first dose before their 15th birthday.  3-dose schedule for people who get their first dose on or after their 15th birthday.   “By following the recommended HPV vaccine schedule and getting your child the correct number of doses, this will ensure they have adequate protection against HPV associated diseases including cancer,” says Dr. Slots.

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Many millennials are fortunate to have good health, but it’s important to be prepared for your next doctor’s visit. Here are three things that millennials should stay on top of for tracking and maintaining their health. For many millennials, doctor visits and preventive healthcare fall by the wayside. Alison Lynch, MD, a family medicine provider with Renown Medical Group says there are a few key things you can do now to set yourself up for a healthy future. 1. Establish with a Primary Care Provider Millennials are more likely to go to urgent care or consult the internet when a healthcare issue arises. While these are helpful tools, here’s a better one: a primary care provider. The benefit of establishing with a primary care provider is that your medical records, history and a baseline for your health will be documented. That means that when a problem or question comes up, your doctor will already have helpful information on file and can help you navigate your needs. Having a primary care provider is often required for prescription refills and referrals to a specialist. By establishing now, you’ll be able to get what you need in the future much faster. Make an Appointment Today 2. Protect Yourself and Your Community There are a few vaccinations and screenings that Dr. Lynch recommends for millennials. Flu Shots: These are available every year and are recommended for protecting not only yourself against the flu but also others you may come into contact with. Flu shots are usually available from August through December through your healthcare provider, pharmacies and pop-up events. Tetanus or Tdap: Most people receive a tetanus shot as a child, but it’s recommended that everyone get a booster every 10 years. If you are overdue, talk to your primary care provider or pharmacist about getting updated. Pap smear: If you’re a woman, a pap smear is recommended every three years in your 20s and every five years in your 30s. HPV vaccine: This vaccine helps prevent the virus that causes cervical cancer as well as the majority of head and neck cancers and warts. The HPV vaccine is recommended for all genders up until age 45. STD screening: Consider an STI/STD screening if you’re sexually active.

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Renown Health has two retail pharmacy locations – one at Renown Regional on Pringle Way and another on Locust Street. And while many people think of a pharmacy as where we get prescriptions and pick up refills, it’s so much more. Adam Porath, vice president of pharmacy services at Renown, discusses five benefits of switching to a Renown Pharmacy.  1. Hospital Integration With the Meds-to-Beds Program, the Renown Health Pharmacy delivers prescriptions to patients on the floor when they leave the hospital. Another thing that is interesting about the pharmacy is its integration with providers. So, if there is a problem with your prescription, the Renown Pharmacy can get hold of your provider right away. We also can see your lab results and make sure that the dose you are prescribed is the right one. 2. On-Site Vaccinations The Renown Health Pharmacy has a private consultation area to administer vaccines on-site. Their team routinely stocks more than a dozen vaccines, and you can call either location (Regional: 775-982-7737 and Locust Street: 775-982-5280) to see if what you're looking for is in stock. Appointments are available in MyChart. 3. Compounding Services Only a fraction of pharmacies in the United States provides compounding services. In the Reno/Sparks area, there are just a few and Renown Pharmacy is one of them. Traditional retail pharmacies take drugs received from a drug manufacturer and put them into a smaller container in the individual amount that the doctor prescribed for a patient. A compounding pharmacy provides medications that are not available commercially. For example, a doctor has prescribed a dose that is smaller than what is commercially available. Compounding the medication will provide the dosage as prescribed. Another example could be a child who can’t take a tablet. The pharmacy may be able to use compounding to convert medications into something that is the child can take.

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Getting the COVID-19 booster is the best way to protect yourself from severe illness or death due to COVID-19, and both the CDC and the FDA have approved booster shots for people ages 18 and older. So, with the holidays right around the corner and infection rates on the rise both in Nevada and nationally, the best thing you can do to prevent the continued spread of this deadly virus is to get boosted today. The Basics: Who: It is recommended that everyone 18 years or older get a COVID-19 booster shot. When: At least 6 months after completing your primary COVID-19 vaccination series. What: Any of the COVID-19 vaccines authorized in the United States. The CDC allows for mix and match dosing for booster shots. How: To make an appointment for your COVID-19 vaccine booster, please visit vaccines.gov today. Appointment Reminders: Don’t forget to bring your CDC vaccination record card to your appointment. Refresh yourself on the potential side effects and remember that these are normal signs your body is building up protection. Commonly Asked Questions: Q: Does anything change if I received the Johnson & Johnson as my first COVID-19 vaccine? A: If you received the Johnson & Johnson COVID-19 vaccine, you are elidable for a booster two months after completing your primary vaccine. Q: Is the formula the same for the boosters as it was for the primary vaccine? A: COVID-19 booster shots are the same formulation as the current COVID-19 vaccines. However, in the case of the Moderna COVID-19 vaccine booster shot, it is half the dose of the vaccine people get for their primary series. Q: Am I still considered “fully vaccinated” if I don’t receive a COVID-19 booster shot. A: Yes, everyone is still considered fully vaccinated two weeks after their second dose in a two-shot series, such as the Pfizer-BioNTech or Moderna vaccines, or two weeks after a single-dose vaccine, such as the J&J/Janssen vaccine. All information courtesy of the Center for Disease Control and Prevention. All information courtesy of the Center for Disease Control and Prevention

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Feelings of grief can take on many forms and can occur in reaction to many situations, including the death of a loved one or a medical diagnosis for yourself or someone close to you. It is important to remember that this reaction is entirely natural, and many people who experience grief find outside help to be a valuable part of the healing process. Below is a list of both local and national grief and bereavement resources for all ages and specificities. If you or someone you know is experiencing grief, the trained professionals below are here to help. Solace Tree Support groups for children and teens (ages 3 to 18), young adults and their family members. For more information visits solacetree.org/grief-programs or call 775-324-7723. Healing Minds Counseling services for those coping with the loss of a loved one or major life change. For more information visit healingminds.com/grief-counseling-reno-nv or call 775-448-9760. Circle of Life Hospice Support groups open to the community held the first and third Tuesday of every month. Fore more information visits colhospice.com/bereavement-and-spiritual-care or call 775-827-2298. Summit View Hospice Grief and bereavement support open to the community-groups, memorials and by mail. For more information visit summitviewhospice.com or call 775-636-9598. The Compassionate Friends Monthly support group on the second Monday of each month for families after a child dies. Fore more information visit facebook.com/TheCompassionateFriendsofReno, compassionatefriends.org or call 775-750-7005. Healing for Survivors of Suicide Links and resources for those who have lost a loved one to suicide. For more information visit survivingsuicide.com GriefShare Grief recovery support groups meeting weekly both in-person and online with options in Reno/Sparks, Carson City and rural cities. For more information www.griefshare.org National Alliance for Grieving Children Resources for parents and caregivers to help children navigate the challenges of bereavement and grow into healthy adults. For more information visit nacg.org/resources-and-support/ Mourning Hope Grief Center Grief support groups, counseling, resources and COVID-19 support for children, adults and families before and after a death loss. For more information visit mourninghope.org Crisis Support Services of Nevada 24/7, free, confidential and caring support to people in crisis across Nevada and the U.S. For more information visit cssnv.org, call 775-784-8090 or text CARE to 839863 National Alliance on Mental Illness-Warmline A stigma-free, non-crisis phone service you can call or text that is staffed by trained peers in recovery. For more information visit namiwesternnevada.org/resources/ or call 775-241-4212. Vitas Healthcare Grief and bereavement resources and support groups both virtual and phone-in. For more information visit vitas.com/family-and-caregiver-support or call 866-489-0583. St. Mary’s - Hospice We Promise Resources on grief for all groups including children to adults, trauma, caregivers and more. For more information visit hospicewepromise.com/topics/grief or call 775-525-6700. Mountain View Mortuary Grief support and tools available to assist you in your healing journey including “365 Days of Healing” email list for daily support and comfort. For more information visit mountainviewmortuary.net/resources/grief-support or call 775-788-2199 Sesame Street – Helping Kids Grieve Discover games, videos and more on topics important to you and your child. For more information visit sesamestreetincommunities.org/topics/grie Trauma Intervention Program-Northern NV A national non-profit organization of volunteers dedicated to ensuring those emotionally traumatized receive assistance. For more information visit tipnnv.org/about-tip/resources Pregnancy & Infant Loss Support Organization A non-profit organization dedicated to the support of families who have lost a baby through miscarriage, stillbirth or neonatal death. For more information visit pilsos.org Caring Info A program of the National Hospice & Palliative Care Organization providing free resources to help people make decisions about end-of-life. For more information visit nhpco.org/patients-and-caregivers/

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