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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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Chronic pain can be one of the most distressing feelings someone may encounter – and more likely than not, you know someone who is managing their pain as a part of their healthcare journey. In fact, according to the Centers for Disease Control and Prevention, about 1 in 5 U.S. adults have experienced chronic pain in recent years. One of the most common methods of treating pain is through prescription pain medications; however, with the rise of the opioid epidemic across the country, leveraging other interventions to help patients manage their chronic pain has become increasingly more important. What if there was a way to treat pain directly without the automatic need for pain medication? Luckily for patients in northern Nevada, our Special Procedures department at Renown Rehabilitation Hospital specializes in exactly that: interventional pain mitigation sans painkillers. With nearly 95% of their patients who come in with pain-related mobility issues being able to physically walk out of the hospital after their treatment, much-needed relief is clearly in store. Tight-knit and forever-caring, the Special Procedures team knows how to transform the purpose of pain management. A Penchant for Pain Alleviation Renown's Special Procedures team offers a wide variety of pain management solutions that are uniquely tailored to each individual patient’s needs. With the help of a team of 14 attentive nurses, interventional radiology technologists and a surgical technician – plus a dedicated patient access representative ensuring everything goes smoothly behind-the-scenes – these lifechanging interventions include: Epidurals (including steroid epidurals) Nerve blocks Ablations Tenotomies Spinal cord stimulator trials Peripheral nerve stimulator trials The nurses on this specialized team guide patients before, during and after their procedures, making sure they are at ease throughout the entire process. Each nurse emulates both expertise and empathy to help light the path towards healing.  “Before each procedure, we get the patient’s vitals, health history and work with the doctor to answer any questions they may have about what is going to happen in the procedure room,” said Michon Edgington, RN. “After they’re all done, they come back to me, and I make sure they are ready to go home by educating them on their discharge. Our goal is to get them back to their families very quickly.”  “In the actual procedure room, we perform safety checks, do charting, prepare the sterile tray for the doctor and give medication for conscious sedations, all while consistently monitoring the patient and helping the doctor out along the way to help the procedure go well,” added Shannon Boelow, RN.  This team’s dedicated imaging professionals harness expertise that goes beyond capturing images. Their skillful utilization of X-ray technology serves as a guide for doctors administering treatments for pain – and according to our own physicians, our imaging technologists are some of the best in the business.  “Our X-ray skills here are specialized,” said Julie Smith, Imaging Lead. “Visually, the doctor needs to see what’s going on inside the body so they can accurately place needles and steroids. We all work together collectively and work with each doctor to accommodate their preferences, helping the treatments go much faster and minimizing the patient’s exposure to radiation.”  Serving as the ideal representation of both precision and support, the surgical technician on this team is an important collaborator in the procedure room, helping to ensure the success of every interventional procedure with a meticulous eye for detail.  “As the Special Procedures surgical technician, I get the room ready with all the necessary instruments, including making sure everything is sterile,” said Carrie Crow, Surgical Technician. “I enjoy keeping the team organized.”  Overseeing it all are the physicians, who are eternally grateful for the team for the life-changing interventions they offer every day.  “Our physicians are so phenomenal,” said Brittney Summerfield, Manager of Nursing. “They are very supportive and collaborative, and they always do the right thing. They have total confidence in us.”  Seeing patients walk out of the hospital happy and healthy is a driving motivator for this team. Whether they had significant experience in pain management or were ready for a completely new challenge, each team member comes to work every day inspired to move mountains.  “I had worked in pain management in other facilities, and I was extremely excited to come here and solely focus on pain,” said Jodi Eldridge, Supervisor of Special Procedures. “I enjoy seeing the patients so happy when they leave no longer in pain. I feel immediate gratification, because you truly feel like you’re doing something big for the patient. It’s very rewarding.”  “I decided to come work here because I worked in the inpatient setting for a long time, and I was ready to see a different side of healthcare and provide a different type of care to our community; plus, my coworkers are the best,” added Lisa Dunnivant, RN.  There’s no question that the realm of pain management is a delicate one – and there is no team better suited to take on that challenge than Special Procedures, working harmoniously to bring relief and a renewed sense of livelihood for every patient they serve.  “Some people believe pain management is just all about pills, and that is simply not true,” said Carrie Crow. “Our procedures are yet another way to help them manage their pain and find relief.”

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Injuries happen to everyone. They are caused by participating in sports, recreational activities like hiking, and even by accidentally stepping off a curb wrong. If you experience a sprain or strain, the first few days are often the most painful. Renown Sports Medicine physicians Luis Palacio, MD and Brandon Hockenberry, MD walked us through what to do after an injury.  Listen to Your Body See a medical professional right away if: You know or suspect that a bone is broken You are having difficulties putting full weight on a joint of the leg Pain or swelling is severe There is a sign of an infection, such as redness and warmth in the joint  The First 24-72 Hours Joint sprains tend to swell more than muscle strains. You can use ice as needed for comfort and to relieve any pain, but do not use ice for more than 15-20 minutes at a time. Ice and NSAIDs (such as ibuprofen) can help prevent excessive swelling and mask the pain, but they do not speed recovery. Some research shows that overuse of ice actually delays recovery.    During the first 24-72 hours, your injury will go through an inflammation phase. Inflammation is your body’s natural way to dispose of dead tissue cells, build new healthy structures, and hopefully heal even stronger than before.

Read More About How to Treat a Sprain or Strain

Over the past couple of years, pickleball has become the fastest-growing sport among people of all ages.  It’s a combination of tennis, ping-pong and badminton that originated in 1965. This sport can be played indoors or outdoors on a pickleball court where two players (singles) or four (doubles) hit a perforated hollow plastic ball over a 36-inch-high net using solid-faced paddles. A pickleball court is the same size as a double’s badminton court and measures 20×44 feet.  Pickleball is a fun, low-impact game that keeps people healthy and active. Kaitlyn Jacobson, Physician Assistant at Renown Urgent Care – Ryland, plays pickleball herself and is a big fan of the sport. Here she shares the top five health benefits of playing pickleball.

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Tendonitis occurs when a tendon in your body is inflamed or irritated. This painful condition can impact your day-to-day activities, but can be managed and prevented. Luis Palacio, MD, shared some insights into how to manage tendonitis. Overuse and Repetitive Motion Tendons are complex tissues in our body that connect muscles to bones, allowing us to move. Unfortunately, sometimes these tendons become inflamed, worn down or injured, a condition called tendonitis. Symptoms of tendonitis include pain or dull ache, tenderness and mild swelling at the site. While tendonitis can be caused by a sudden injury, it is more commonly seen in frequent motions, including: Repetitive motions in exercise, work or other physical activities. Awkward positions in a movement, including poor posture. Forced movements that strain your body. Sudden increase in frequency of movement or level of difficulty, including little to no recover time between new activity. Shoes without proper support or hard surfaces, such as concrete floors. Evaluation is Key If you suspect that you have tendonitis and it does not resolve on its own after a few days, you should get it evaluated by a primary care or sports medicine doctor. They can make recommendations to aid your recovery and refer you to the right sub-specialist if needed. With some intentional actions, you can help reduce the risk of tendonitis with the following suggestions: Add variety: Mixing up the type of exercise you do will help prevent repetitive motions that can result in overuse. Stretch and condition: Make sure the keep up with proper stretching and muscle strengthening to support your physical activities. Do it right: Make sure that the way you are completing exercise or work-related physical activities is correct. Seek out a professional for lessons or guidance if you are unsure.

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Becoming a caregiver or playing a more active role in another’s healthcare is a big responsibility. At some point, almost all adults will support an aging parent or a loved one in need. Keeping track of their needs and wellbeing, while also prioritizing your own can become overwhelming. It’s important to know: you are not alone, and help is available. Read on for 11 tips to help you manage your time, your own wellbeing and your loved one’s care. Self-care comes first. When your main priority is the person in your life who needs care, it’s easy for your own needs to take the backseat. Give yourself time each day to focus on your personal wellbeing. It’s hard to give a loved one the care they need if your own needs are not met. Prioritize the Activities of Daily Living (ADL). Make a note of what ADLs your loved one can do alone, what they need help with and what activities require the most help. This will help you work through the day with them, as well as plan out how the day’s activities will go. Do a home safety audit. Do showers, bathtubs and steps have safety grab bars? Look around the house for additional tripping hazards, like rugs or electrical cords. If your loved one struggles with day-to-day navigation of the home, consider scheduling an occupational therapy appointment. This type of therapy helps a person develop or maintain the motions required to accomplish daily tasks. You might also qualify for a referral to in-home healthcare, such as Home Care. Have the hard conversation. The best time to discuss views about end of life care and to learn what choices are available is before a life-limiting illness or crisis occurs. With advance care planning, you can help reduce the doubt and anxiety related to decision making at the end of life. Completing an Advance Directive is a great tool to sort out all these decisions before they’re needed. Attend a free workshop to learn more and complete this important document. Identify when you need respite. Respite care involves receiving a short-term break from caregiving. Organizing in-home care for your loved one will allow you to step away and tend to your needs. By identifying what kind of respite care you are seeking, you can find the right person to provide you with that much-needed break. Don’t wait until you feel overwhelmed, plan ahead. Write down insurance contact information. Have a direct connection to the right insurance professional for support and advice. If your loved one is eligible Medicare, this is a good opportunity to review their current selections and if they would benefit from a Medicare Advantage Plan or Medicare Supplement Insurance. Seeking out expert advice or information on Medicare options is a great way to navigate this. Consider calling a broker, or attend a free educational seminar with Senior Care Plus. Gather legal and financial information. Make a list of all existing legal documents and financial accounts that your loved one has. These might include a will, advance directive, power of attorney, bank accounts or investment accounts. If you have questions about how to manage them, or need assistance in setting up additional framework, reach out to a lawyer, legal service, financial adviser or bank representative. Create an inventory of medical information. Identify where all of your loved one’s medical records are, as well as a list of providers or healthcare practices where they have received care. Consider if you should have your loved one give you Proxy Access in MyChart, which allows you to access all the features in MyChart on their behalf, including viewing upcoming appointments, viewing test results and emailing a doctor on their behalf. Make a list of what others can do. Think about all the little (and big) things that need to happen, and write down tasks that others could take care of you. When someone says “let me know what I can do” you’ll be ready with a pre-written list of items they may be able to assist with. Tasks could include tackling around-the-house repairs, scheduling lawn work, helping to walk the dog, taking a car for an oil change and cleaning. Find programs and events for social enjoyment. If and when possible, seek an activity outside of the home. Look for community centers that have programs for seniors, recreational activities or meals that you can patriciate in together. If leaving the home is not an option, arrange for visits or in-home activities, such as movie nights, card games or time to visit with family. Research long-term options. If you will be considering a nursing home or assisted living, make a list of amenities that you and the person you are caring for would like. Take this list with you when visiting potential locations to make sure you don’t forget to ask about each item.

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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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Do you know your blood pressure numbers? Dr. Michael Bloch explains how maintaining healthy numbers are important for good quality of life and increasing longevity. High blood pressure, or hypertension, affects 85 million Americans – that’s one in three people. Left untreated, it can lead to serious and sometimes life-threatening health concerns such as vision loss, kidney disease, heart failure, heart attack and stroke. But what is it, exactly, what makes it go up and why is that increase in pressure so dangerous? All About Blood Pressure In order to function properly, your body requires a continual supply of oxygen rich blood, which is goes to organs and tissues via blood vessels called arteries. Your beating heart produces the force (or pressure) your vessels require to move blood. This is your blood pressure. Your blood pressure numbers reflect two forces at work – the pressure created as blood is pumped throughout the body (systolic) and the pressure when your heart is at rest in between beats (diastolic). A normal, healthy reading shows a systolic level at 120 or below over a diastolic level of 80 or less: 120/80. An increase in pressure occurs slowly over time, straining the circulatory system and forcing the heart, blood vessels and tissues to work harder. This friction damages blood vessel walls and lets plaque buildup from LDL cholesterol, setting the stage for hardening of the arteries. As more and more plaque builds up, your blood vessels narrow, further raising blood pressure, damaging the circulatory system and increasing your risk of serious health conditions. The Silent Killer High blood pressure is known as a “silent killer,” as most people with it have no symptoms. In fact, one in six of those affected don’t even know they have the condition. That’s why it’s so important to know your numbers. The only way to find out if you have high blood pressure is to have it measured, either by a health professional or using a home monitor. If your numbers are high, there are things you can do to help lower it – it is treatable, but not curable. You can manage it with medications and lifestyle changes including: Adhering to the Mediterranean diet Decreasing sodium intake Avoiding excessive alcohol consumption Increasing exercise and activity levels Losing weight Prevention and Genetics Even better? High blood pressure doesn’t just happen. You can prevent the condition altogether. How? Know your numbers and know your risk. Look at your family medical history. Genetics certainly increases the risk of it, but those same lifestyle choices that can improve poor blood pressure can also prevent you from developing it. So if your numbers are good, keep them that way – eat well, move your body, maintain a healthy weight and drink alcohol in moderation.

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Renown Health is closely following the national outbreak of the monkeypox virus and urging healthcare providers to be alert for patients with illnesses associated with a rash. In working with the Washoe County Health District (WCHD), Renown is closely monitoring the spread of monkeypox in the community and looking to prevent and reduce the spread of monkeypox. To help to ease worries, we consulted with Paul De Leon, Infection Preventionist at Renown Health. What Exactly is Monkeypox? Monkeypox is a rare viral illness caused by the monkeypox virus — the same family of viruses that causes Smallpox. Although symptoms are similar to Smallpox, monkeypox symptoms are milder and rarely fatal. However, it's important to mention that this virus can be more severe for these susceptible groups: Immunocompromised Pregnant women A fetus or newborn baby Women who are breastfeeding Young children Those with severe skin diseases such as eczema How is Monkeypox Transmitted? The monkeypox virus is not easily transmitted but occurs through sustained person to person close contact with an infected individual. Monkeypox can also be transmitted through direct contact with infectious rash, scabs, or body fluids. Monkeypox can also be spread through prolonged intimate physical contact, such as kissing, cuddling or sex. Lastly, monkeypox can be spread through contaminated linens or bedding. Transmission through respiratory secretions is uncommon but has been reported after prolonged face-to-face contact with symptomatic individuals. In addition, pregnant women can spread the virus to their fetuses through the placenta. Monkeypox Testing If you think you have monkeypox, contact your primary care physician or other medical providers to obtain testing. Notify the provider ahead of time before entering the physical office. Signs & Symptoms This current outbreak of West African monkeypox does not have the typical presentation of classic monkeypox. Symptoms usually appear one to three weeks after infection and include: Pimple-like rash or blisters on the face, inside the mouth, and on other areas of the body, like the hands, feet, chest, genitals, or anus. The rash will go through serval stages, including scabs, before healing and may be painful or itchy. Other symptoms of monkeypox can include: Fever Headache Muscle aches and backache Swollen lymph nodes Chills Exhaustion Respiratory symptoms such as sore throat, nasal congestion, or cough Symptoms of monkeypox may occur before or after a rash with some individuals only report experience a rash. Individuals with monkeypox are infectious once symptoms begin and remain infectious until lesions form scabs, scabs fall off, and a fresh layer of skin forms. The illness typically lasts 2-4 weeks.

Read More About Monkeypox: A Renown Expert Weighs In

Renown Health has long supported northern Nevada’s LGBTQ+ community Pride events with sponsorship, and we’ve collaborated with local and regional LGBTQ+ organizations as an ally. Renown’s Pride Committee works to deepen and broaden our external and internal efforts around LGBTQ+ community engagement, advocacy, and healthcare issues related to sexual and gender minorities, which is part of the greater Diversity, Equity and Inclusion efforts Renown is undertaking. According to Harvard Chan School, data shows that nearly a sixth of LGBTQ+ adults feel they were discriminated against based on their sexual orientation and gender identity. As a result, this brings to light the important need for education within the healthcare setting. Renown Health is bridging the gap for our LGBTQ+ population, and we know more work needs to take place in order to become an inclusive organization. Below are a few ways we’re working on improving our response to LGBTQ+ needs, and celebrate, respect and honor our diversity by being inclusive. Diversity, Equity and Inclusion The Diversity, Equity and Inclusion subcommittee was formed to heighten the awareness and develop a plan on how to better serve all of our diverse populations, including our LGBTQ+ patients. As the largest healthcare provider in northern Nevada, we knew that we could do a better job. The subcommittee provides us a forum to discuss ideas and develop plans to provide better care to these populations. Updated Medical Records with Preferred Name and Pronouns Of course healthcare is personal. We meet patients at their most vulnerable states. And relating to every person by the correct pronoun shows we respect their gender identity. A new medical records update supports our doctors, nurses and care team in capturing this vital information. We are now able to capture every person’s preferred name, sex and sexual orientation to better care for them. Kathleen Zaski BSN, RN, Manager of Clinical Informatics and IT Applications at Renown explains why this is so important. “Your name and identity are core to who you are as a person, and here at Renown, we aim to take care of you as a whole person and to provide the highest level of quality care to our community – all while ensuring the experience is exceptional and tailored to the individual. In other words, having the patient’s preferred name and pronoun in the medical record is important to validate their identity, and show we care, in an already high stress environment. Specifically, giving our providers easy access to the patients preferred name and pronoun in the medical record, allows them to properly address their health concerns. This also helps the health care provider foster a closer relationship with the patient. Studies have found this actually increases the quality of care by creating a more open and comfortable environment.” Gender Neutral Restrooms Mitch Harper, Senior Program Development Manager at Renown, recognizes there’s still so much more to improve upon in becoming an inclusive organization. “At the end of the day, it’s about creating a safe and welcoming environment for our community and our employees. Access to basic human services shouldn’t be contingent on an individual’s skin color, ethnicity, sex, gender identity, sexual orientation, age, disability, or beliefs. Ensuring that private restrooms are equally available to everyone on our campus is just one way we can provide a more inclusive, caring space for the people we serve.” Updated restroom locations: Roseview Tower: 10 Sierra Tower: 14 Tahoe Tower: 14 Helping to Lead and Influence Change Sean Savoy, Manager of Spiritual Care at Renown "The foundation of spiritual care is compassion – being with people in need by caring, supporting, and showing empathy, and promoting a sense of well-being. Being a member of the LGBTQ+ community informs that deep sense of compassion and empathy in a very special and unique way. Our human value, social validity, the very reality of who and what we are, even our right to exist, love and just be, are often called into question. This, in turn, can cause many of us to question ourselves and wonder about our self-worth. This experience should engender compassion and empathy so that we can better recognize, listen to and meet others’ needs to help them achieve inner peace, explore coping strategies to overcome obstacles during illness or crisis, and even find new balance by re-conceptualizing themselves in the context of health and illness. I have found that the intersectionality of my gay and spiritual selves has been a blessing in my life." Matthew Maloy, Team Lead Applications Specialist at Renown “I am a Team Lead Epic analyst in the IT department that is responsible for clinical based workflows for ED, Trauma, and Critical Care and have worked at Renown for 15 years. Being a part of the LGBTQ+ community influences my daily work by ensuring the Electronic Health Record reflects best practices such as giving clinicians the ability to document a preferred name, and displaying that throughout the medical record for consistency. Having the ability to influence decisions that move our community toward human value for all of us is a priority in my daily work.” Our Mission Renown Health’s mission is to make a genuine difference in the health and well-being of the people and communities we serve, including the LGBTQ+ community. We continue to build relationships to improve care, fostering better health outcomes for ALL of our patients by creating a more inclusive health system.

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A wedding is a big day for the wedding couple, but it’s also special for loved ones. A patient at Renown, Ken, got to take part in his daughter’s special day as her wedding plans changed to accommodate his medical condition. Grab some tissues and read how Renown’s team of compassionate caregivers and chaplains planned a wedding in Fianna’s Healing Garden. Ken was hospitalized at Renown Regional Medical Center where he was battling a lung problem – which was unrelated to COVID-19 – and his condition worsened rapidly on Wednesday, Aug. 12. His family made the decision to transition him to palliative care, which helps patients near the end of their lives remain comfortable, while supporting their dignity and quality of life.  Ken’s medical condition altered wedding plans for his daughter, Chandra, and her fiancé, Tyler, who were planning to tie the knot later in 2020. Chandra wanted her father there, but knew he could not leave the hospital. That’s why Chandra’s sister, Heather, approached Ken’s care team with a request to have a small wedding ceremony at the hospital.  Planning the Wedding A member of Ken’s care team, Amy Heston, registered nurse (RN), began planning how the wedding could be held outdoors in Fianna's Healing Garden in the E. L. Wiegand Pavilion, which was donated by the E. L. Wiegand Foundation.   In 24 hours, Amy planned a wedding ceremony with the help of her colleague, Breyanna Aufiero, RN; the Renown Spiritual Care team; and nursing leaders on the coronary intensive care unit (ICU). Together, they decorated the aisle in the garden with flowers and battery-operated candles. They also made a sign for Ken’s hospital bed, which read, “Father of the Bride,” and crafted a bow tie for him to wear for the special occasion.  With visitor restrictions in place at the hospital due to coronavirus (COVID-19), having the wedding outside in the Healing Garden allowed for more members of Ken’s family to attend including his wife, Charlotte, and his dog, Bella.   Every step in planning the wedding required thoughtful and thorough care coordination so Ken could participate. His breathing was supported by oxygen and special arrangements were made to transport the oxygen tanks he needed to take part in his daughter’s wedding. Amy worked with respiratory technician, Kasey Benfield, and critical care technician, Ruben Duckworth, to ensure Ken’s oxygen needs were met using portable machines.  Celebrating Love and Life Together Ken’s team of caregivers bathed him and shaved his face so he could look and feel his best for the ceremony. They put on his bow tie, covered his bed in decorations and his favorite blue, flannel blanket, and wheeled his bed outside for the ceremony.  Renown associate chaplains Terri Domitrovich and Susan Palwick coordinated music and performed the ceremony for Chandra and Tyler on Thursday, Aug. 13, 2020. The bride and groom shared their first dance in the garden and Ken’s care team provided water and treats to give the family a full wedding experience.   Shortly after the ceremony, Ken passed away. This wedding provided Ken and his family meaningful memories for their big life-changing moments as they celebrated and said goodbye.  “Seeing Ken surrounded by family he never would have gotten to see again while in the hospital, watching him get to share a father-daughter dance with Chandra on her wedding day, and having him tell me that this day meant more to them than we would ever know were some of the most moving moments I’ve witnessed as a nurse,” Amy said. “I am so thankful for the team we have here. I know that this beautiful day wouldn’t have happened without the help of every single person who gave their time, money, creativity and passion to make it a day to remember.”

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Bicycling is a great way to get the whole family moving. We’ve reviewed some family-friendly bike trails that’ll get everyone outdoors for some good, old-fashioned fun on two wheels. During the ongoing COVID-19 (coronavirus) pandemic, it is important to practice physical distancing and wear a mask when it’s impossible to stay six feet away from others. 1. Damonte Ranch Wetland Loop in Reno Duration: 3.1 mile loop. Skill Level: Easy. This paved loop trail is easy to access and has ample wildlife viewing opportunities with plenty of birds and wildflowers in the wetland.  Parking and Trail Access: Start at Damonte Ranch Park and follow the paved trail around the wetland loop. 2. Tahoe East Shore Trail Duration: 5.2 miles out and back. Skill Level: Easy. The Tahoe East Shore Trail closely hugs the shore of Lake Tahoe. The paved trail has mild inclines that make it the perfect adventure for all ages and skill levels.  Parking and Trail Access: Park along State Route 28 in Incline Village near Ponderosa Ranch Road for direct access to the trail.  3. Caughlin Ranch Trails in Reno Duration: 3.5 miles out and back Skill Level: Easy.  This paved trail wanders through the Caughlin Ranch neighborhood and features creeks, wildlife and shade.  Parking and Trail Access: Park along Caughlin Ranch Parkway for easy trail access. 4. Sagehen Creek Trail in Truckee Duration: 6 miles out and back. Skill Level: Intermediate. This dirt loop trail is a short drive from Reno and ends at Stampede Reservoir.  Parking and Trail Access: Park at the marked trailhead off of North Highway 89. 5. Truckee River Trail in West Tahoe Duration: 7.5 miles one way. Skill Level: Intermediate. Looking for a longer trail? This point-to-point trail meanders along the Truckee River through the scenic Olympic Valley.  Parking and Trail Access: Park at the Squaw Valley Village or in Tahoe City. Coordinate with two cars to make the trip one way. What family-friendly bike routes does your family enjoy? We’d love to know!

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