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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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With the dangerous heat wave impacting our region, there are 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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When it comes to our heart, keeping this vital source of life in tip-top shape is of utmost importance. Echo technologists or echocardiographers, otherwise known as "echo-techs," are charged with that mission, providing critical information that leads to life-saving interventions to keep our hearts beating strong.  Adrianne Little, echocardiographer at Renown Health, breaks down the echo-tech's role in the health system, the educational path it takes to get there and the unique perks that come with the profession.  What does an echo tech do?  “Echo techs play a key role in the diagnosis and treatment of patients,” said Adrianne. “We are members of the cardiovascular imaging team that perform ‘heart ultrasounds’ or echocardiograms. Although we are most commonly known as echo techs, our official title is either ‘cardiac sonographer’ or ‘echocardiographer.’”  Echo techs use imaging technology and sophisticated ultrasound equipment to produce images of the heart. These images show how well the heart functions, as well as the valves, chambers and blood flow. Echocardiograms are used to diagnosis and treat a variety of heart conditions such as murmurs, arrhythmias and heart failure.   At the end of the day, the main goal of echo techs is to help our cardiovascular team provide the quickest and most accurate diagnoses to help with patient management and help them receive the highest standard of care.  “When it comes to looking at the heart, we are part of the front-line team," said Adrianne. “We provide real time critical information that leads to life saving interventions down the road.”

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Becoming a parent for the first time means lots of new unknowns – from learning to breastfeed and swaddle to buckling your newborn into the car seat for the first time. But when it comes to putting them to bed safely, it’s important to remember it really can mean life or death. It’s something we’re taught before our little one is even here: the correct way to put your baby to bed safely. Sadly though, the number of infant deaths continues to climb. The main culprit of sleep-related infant death continues to be all the items parents leave in the crib with their babies. According to the Center for Disease Control and Prevention, there are about 3,500 sleep-related deaths among babies each year. “The best advice is ‘bare is best.’ Keep your infant’s sleep space clutter free – no blankets, bumpers, toys or pillows,” said Karen Wagner, Pediatric Nurse Practitioner. Follow the ABCs for Safe Sleep Remembering the ABCs is an easy way to remember how to put your little one to bed safely. A: Alone No blankets, toys or pillows. “We do recommend using a sleep sack as a blanket alternative,” said Karen. “It prevents the risk of suffocation and keeps your baby warm.” Keep in mind, the greatest risk for suffocation happens when babies are under 1 year of age, so it’s best to save the toys, blankets and pillows for their “big kid bed,” or around 18 months old. B: Back The slogan “back is best” is another good reminder. Keeping your baby on their back until they’re old enough to rollover helps reduce the risk of Sudden Infant Death Syndrome (SIDS). C: Crib It is best to have your baby sleep alone in their crib. While co-sleeping may be enticing, especially after a late-night feed, it increases the risks of possible suffocation. However, “having your child in your room, in their own crib or bassinet, is protective for SIDS,” Karen said. “In fact, we think co-rooming reduces SIDS risk by almost 50 percent.” Co-rooming allows parents to keep new babies in close reach and helps parents oversee their baby’s sleep, just in case something happens.

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November is National Alzheimer’s Disease Awareness Month. At Renown Health, we know that Alzheimer's safety for your loved one is a priority, as the symptoms can sometimes lead to unsafe situations. We asked Dr. Jonathan Artz – a neurology physician with Renown Health and an assistant professor of clinical neurology at the University of Nevada, Reno School of Medicine – for tips on keeping loved ones safe and secure.  According to the Alzheimer’s Association, Alzheimer’s disease affects safety in various ways, specifically due to body and brain adjustments. These changes can include: Judgment, including forgetfulness  Sense of place – getting lost on the way home  Behavior – being suspicious or fearful  Body difficulty – losing balance Sensing ability – noticeable sensitivity in hearing, seeing or temperature  Dr. Artz gives us four major tips to ensure your loved one’s safety as you both navigate this disease together.  Watch for Wandering  Those experiencing Alzheimer’s disease tend to wander and get lost. Try the following tips to reduce the risk of wandering:  Get your loved one an ID bracelet and have them wear it at all times. You can also enroll your loved one in “Wandering Support.”  Install door chimes so you know when exterior doors are open.  Ask neighbors to call you if they see your loved one out alone. Go with your loved one when they insist on leaving the house. Don’t argue or yell. Instead, use distraction or gentle hints to get them to return home.  Discourage Driving  Driving can be unsafe for someone with this disease. With this in mind, ask a doctor whether it’s safe for your loved one to drive. For example, on a case-by-case basis, there are certain situations where doctors are required to report individuals with particular cognitive impairments, wherein a form of a driving assessment will be recommended.  Limit access to the car. Keep the keys with you or lock them away.  Ask an authority figure, such as an insurance agent or a doctor, to tell them not to drive.  Adult-Proof Your Abode  A simple living space is a safe living space. This means reducing clutter and removing any issues that may pose a safety concern. You may also want to get advice from an occupational therapist (home safety expert). Keep in mind that some changes may not be needed right away. Focus on major safety concerns first.  Try the following tips:  Add lighting (or glow-in-the-dark tape) to brighten dark areas, including stairways and halls.  Use color contrast or texture indicators for dials, knobs and appliance controls.  Remind your loved one not to carry items while walking to avoid a fall.  Remove sharp objects from drawers and countertops.  Avoid using small throw rugs or doormats, as they are easy to trip on.  Move frequently used items so that they are easy to reach.  Lock away alcohol and tobacco products, as they are not recommended for dementia patients.  Install handrails in the shower, tub and near the toilet. Bathroom falls are especially common.  Adjust the setting on your hot water heater so water does not scald. Those with Alzheimer’s can lose their sensitivity to temperature.  Move and lock up hazardous chemicals and cleaning supplies, such as bleach and insecticides.  Disable and remove guns or any weapons. Supervise any medication taken by your loved one.  Promote a Positive & Healthy Lifestyle  Continually emphasize the strengths of your loved one by promoting participation in meaningful activities, wellness visits and healthy habits to help them improve their well-being. Here are some ways to keep them physically and mentally active:   Maintain regular vision and hearing screenings and make necessary adaptations.  Establish a routine for daily activities.  Encourage participation in self-care and leisure activities.  Work with your loved one’s doctor to establish a healthy diet.  Ensure proper hydration. It may help to set reminders for your loved one to drink fluids.  Encourage regular exercise. Exercise delivers oxygen to the brain, improving brain health. Promote good sleep habits. Good quality sleep can increase overall brain health and has been associated with improving memory, attention and concentration.  Resources and support are available with the Renown Memory Disorders Program. Providers within this program are specifically dedicated to treating several different memory-related disorders. Memory Disorders Resources & Support.

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According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new sexually transmitted infection (STI) cases in the United States each year, with rates continuing to increase.  What you may not know is most STIs are preventable. We talked with Renown Adolescent Medicine Specialist, Caroline Barangan, MD to learn more about STIs.  How Can You Get an STI?  The CDC (Center for Disease Control) says that STIs are acquired through sexual contact. There are bacteria, viruses or parasites that can cause an STI which may pass from person to person in blood, semen, vaginal and other bodily fluids.  How Do You Know if You Have an STI?  STIs can have a range of signs and symptoms such as:  Warts, bumps or sores on or near the penis, vagina, mouth or anus Swelling, redness or severe itching near the penis or vagina Discharge from the penis Vaginal bleeding that’s not your period Painful or uncomfortable sex Vaginal discharge that has an unpleasant odor, causes irritation or is a different color or amount than usual  Weight loss, diarrhea or night sweats Aches, pains, fever and chills Jaundice (yellowing of the skin and whites of the eyes) Painful or frequent urination  Sore throat if you engage in oral sex It’s important to know that the majority of people who have an STI commonly have no symptoms at all, which is why it’s important to get regularly tested once you have had any sexual activity. Young people less than 25 years of age should be screened on a yearly basis at minimum.

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One of the best things about living in the Reno area is the beautiful mountain range that surrounds our city. Many families take advantage of the activities the mountains have to offer or travel over them to visit friends and family in neighboring areas. However, for parents of infants there is often angst over your baby’s ears and altitude changes and the associated potential for ear pain and/or “popping.” Fortunately, there are things you can do to protect your infant’s ears the next time you drive over the mountain or hop on a plane with your little one. Baby’s Ears and Altitude Changes: What Causes Them to “Pop” The simple answer is pressure. The problem originates in the middle ear where there is an air pocket that is vulnerable to changes in pressure. The Eustachian tube, which runs behind the nose to the middle ear, is constantly absorbing and resupplying air to this pocket to keep it balanced. When the pressure is not balanced, your ears feel “clogged” or like they need to “pop.” In some cases this sensation can cause significant ear pain and even temporary hearing loss. Rapid changes in elevation or altitude, like driving over a mountain, or ascending or descending on an airplane, can cause rapid changes in pressure. In order to avoid problems, the Eustachian tube needs to open widely and frequently to equalize those pressure changes. The problem often intensifies during descents as you go from an area of lower atmospheric pressure to an area of higher atmospheric pressure. This is why you hear babies screaming on planes during descent or why your infant is wailing in the car seat as you head down the mountain. What can you do to make it a more comfortable trip for your child? First, be prepared. Babies cannot intentionally “pop” their ears like adults can, but we can help them by encouraging them to swallow. Offer your baby a pacifier or bottle while making ascents and descents. If possible, it may be helpful to have an adult ride in the back seat with baby if you’re in the car to ensure this can happen. Don’t let your baby sleep during descent on a plane. Help your little traveler out by offering him or her a pacifier during this process, as descent is the most likely time for pain associated with altitude changes. If your baby is congested prior to travel involving altitude changes, seek the advice of your pediatrician since they may have other solutions, including medications such as decongestants. If you return from a trip and notice your infant is still fussy and uncomfortable, contact your child’s doctor for a thorough ear evaluation. Safe travels!

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The road through cancer treatment can test even the toughest of spirits. A local organization is handcrafting and donating beaded bracelets to the courageous women who have reached the finish line at Renown Infusion Services. After finishing her sixth and final cycle of chemotherapy at Renown Infusion Services, Joan Jackson told her nurse, Daun Russell, RN, she was tired. Russell returned with a box and opened it -- as she does for all cancer patients completing treatment -- and said, “pick one.” What Jackson was selecting was a beautiful, handmade bracelet crafted and donated by the local Soroptimist organization. Jackson picked a purple bracelet with a tag that read, "Congratulations on completing your treatment. Imagine what you can do now." “Picking the bracelet was such a special thing to mark my last day of chemo,” Jackson says. "Their gesture impacted me for the good after going through so much.”   The women behind the bracelets  Bev Perkins, a member of the Soroptimist International of Truckee Meadows, says the bracelet project began in 2009 as a way of celebrating those who completed cancer treatment. She wanted the project to be hands-on, so she involved the club members by organizing a small budget and asking others to donate jewelry. The group comes together each year to make the bracelets. Perkins disassembles the donated jewelry, adding newly purchased beads to make kits for the bracelets. The volunteers also add a metal tag inscribed with an inspiring word, like “believe,” “hope” or “love.” “It’s a labor of love for us,” says Kay Dumhan, group treasurer. “It’s to show empowerment and to help these women know there are people who are encouraged by them.” “When bracelets are donated there is usually quite a bit of feedback on how much it’s appreciated,” Dumhan says. “We never want to run out so we make sure we have a supply there. We’ve had cancer survivors as members and that makes it all the more personal.”

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