Buscar

Want to know more about osteoporosis and osteopenia? We'll dive into these conditions and give you some handy tips on preventing future problems and taking care of your bones. What is Osteopenia? Osteopenia (low bone density) is the initial stage of bone mineral density loss, which can eventually progress to osteoporosis if steps are not taken to prevent it. What is Osteoporosis? Osteoporosis is a condition that weakens our bones. While it literally means “porous bone," it doesn’t mean that our bones are doomed to succumb to the changes that can happen to us silently over time. Our bones are living tissues that are constantly breaking down and remodeling themselves.  Osteoporosis and osteopenia are typically diagnosed by testing bone mineral density using scans that your primary care provider can easily order. This is important testing because it dictates your risk of breaking a bone in common areas like your hip, wrist or spine. It also helps set the stage for talking with your healthcare team to develop a treatment plan. Most people will reach their peak bone mass in their mid to late twenties. There are several factors that increase our risk of osteoporosis or osteopenia as we age, such as menopause, genetics and other lifestyle factors. However, there are several things you can do to mitigate this breakdown and assist your body in the constant remodeling it does to our bones. 3 Controllable Factors to Build Strong Bones 1. Talk to your primary care provider They can go over a plan and prescribe things such as vitamin D, calcium and medications that can help if you are at risk or have osteoporosis or osteopenia. 2. Maintain a healthy diet Talk to a dietician if you need further help as they can be an invaluable resource to develop a plan.  Eat foods rich in calcium, vitamin D and vitamin C. These assist with the rebuilding of bone. Examples include but aren’t limited to leafy greens, legumes, salmon and healthy dairy products.  Don’t smoke — it directly correlates with a decrease in bone mass. Smokers also take longer to heal from a fracture.  Limit alcohol to two to three beverages per week. Alcohol interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. 3. Exercise Talk to your primary care provider to get a referral to physical therapy if you need help with exercise.  Our bones adapt to the stresses we put them through. Therefore, exercise should be tailored to putting the right stress on our bones. There is good quality research that most exercise is safe when dealing with less bone mineral density.  The exercises should be progressively challenging and increase the load for resistance and weight training at least two to three days a week. Examples include squats, step-ups, chest presses and rows.  Exercises higher in velocity will lead to more power and bone adaptation. Examples include quicker push-ups, marching and quicker walks.  Exercises that are weight-bearing will lead bones to adapt to the stress placed on them. Movements such as mini stomps, step-ups, jumping, jogging and so forth may be used depending on how your body tolerates these things to really stimulate bone adaptation. There are aspects of aging and bone health we can’t control, but we can take steps to minimize the chances of bone loss and osteoporosis. Talk to your healthcare team to determine your risk and don’t forget to show your bones a little TLC – you’re going to need them.

Read More About A Therapist's Tips to Prevent and Manage Osteoporosis

© Arthon Meekodong via Canva.com Breast cancer screening has long been a cornerstone of women's healthcare. With 1 in 8 women diagnosed with breast cancer in their lifetime1, the United States Preventive Services Task Force (USPSTF) has developed screening recommendations to help detect early-stage cancer. Notably in 2023, the USPSTF revised the recommended age for biennial mammogram screenings for women with average risk to start at age 40 instead of 502, estimated to result in 19% more lives being saved3 by starting screening earlier. While initiating screening at an earlier age offers advantages to a wide demographic, concerns about the potential of over-screening prompted research into the feasibility of identifying women with lower breast cancer risk who could safely delay mammograms. While guidelines address high-risk individuals, a notable gap exists in providing recommendations tailored to those at lower risk. To gain insight into a patient's risk level, physicians are able to utilize genetic testing to understand an individual's genetic makeup, providing precise insights into their predisposition to various health conditions, including breast cancer. Armed with this genetic information, healthcare providers could craft tailored screening strategies that align with an individual’s specific risk profile. This genetic risk-based approach underscores the value of genetics in individualizing the onset of screening to help avoid over-screening and its associated costs. Surprisingly, genetic information is not currently being widely utilized to identify women at risk of breast cancer or other diseases in clinical practice, despite its potential to make a significant positive impact for patients. A recent retrospective analysis of 25,591 women from the Healthy Nevada Project4 sheds light on the potential benefits of this genetic risk-based approach. The study classified 2,338 (9.1%) of these women as having a low genetic risk for breast cancer. What's remarkable is that these women exhibited a significantly lower and later onset of breast cancer compared to their average or high-risk counterparts. This finding suggests that it might be safe for low-risk women to delay mammogram screening by 5 to 10 years without compromising their health.

Read More About Optimizing Mammogram Screenings: A Genetic Approach to a Personalized Screening Schedule

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.

Read More About 11 Tips Caregivers Need to Know

Hygiene in healthcare is an essential backbone to providing the safest, most optimal care to every patient. From everyday handwashing techniques and getting all necessary vaccinations to surveilling our health system before the onset of outbreaks, at Renown Health, creating and maintaining a low-infection environment is a group effort. From ensuring fundamental infection prevention practices are carried out to identifying process improvement opportunities, Renown’s Infection Prevention (IP) department is here to help care teams be successful in their role. This effort is led by members who are devoted in sharing evidence-based best practices to our patients, employees, healthcare organization partners and community. Making “Zero” A Reality Reducing healthcare-associated infections is possible when core infection prevention practices are incorporated into the daily care of our patients. These team members are dedicated to Renown’s commitment to creating a culture of Excellence, caring for our healthcare environment, and our care teams. “Often times, when asked what we do in our work it can be a challenge to answer because unpredictability is built into almost every day; and in that, we as a team must divide and conquer,” said Susanne James, Manager of Infection Prevention. Every day, each team member is assigned a day to perform required surveillance activities. Whether they are reviewing patients’ infections and isolation and evaluating lab orders for possible infectious processes or reporting communicable diseases to the local health authorities and the CDC, every Infection Preventionist participates in improvement projects and address issues as they arise. The Infection Prevention team plans, organizes, manages and evaluates the Infection Prevention Program and ensures IP policies reflect current best practice. They work closely with all departments at Renown in order to achieve high levels of standards that are implemented to reduce transmission of infection. “As a team, we perform ‘Infection Prevention Environment of Care Rounding’ on all units and departments to ensure our environment complies with regulatory requirements,” said Erika Clark, Operations Analyst at Renown Health. "We work together with Facilities and Site Practice Leaders to ensure a safe environment.” The pandemic challenged all Renown teams to find creative solutions for issues no one ever imagined. Our Infection Prevention department worked tirelessly alongside Renown's Hospital Incident Command Structure (HICS) and care teams in creating several lines of defense against COVID-19, including: Launching Renown's Alternate Care Site to meet the need for critical patients. Bringing on the new lab tests and specimen collection criteria. Managing demand for personal protective equipment (PPE). Bringing vaccines to staff and then to the community. Managing ill employees and our visitors. Keeping all locations informed on pandemic status and changes (which were occurring at breakneck speed). These initiatives enabled Renown's care teams to focus on providing the safest care possible to patients saving countless lives. This solidified the fact that together, the team can accomplish anything. “Infection Prevention is proud to be a valued and respected member of the care team,” said Susanne James. “We appreciate being a trusted resource and take this responsibility seriously as this enables us to provide staff the best possible tools to be successful.” Fight the Good Fight Against the Spread of Disease Educating patients and providers plays a huge part on the Infection Prevention stage. This team provides educational materials on a range of topics, some of the most important are, proper hand hygiene and the use of PPE. All these materials can be found throughout our health system and serve as an important reminder – infection prevention starts with all of us. “We partner with every aspect of the health system – environmental services, nutrition services, lab services, facilities, pharmacy, physical therapy and occupational therapy, respiratory care, patient access, security, nurses, providers and quality...just to name a few!” said Susanne James. Our Infection Prevention team also partners with Washoe County Health District and other public health agencies to report – and in turn, stop the spread of – diseases and exposures. These close partnerships poise our team to do what we do best: Fight the Good Fight. “I greatly appreciate everyone in the IP department for sharing their expertise as I learned a new position,” said Erika Clark. “I love working with my team and how closely we work with other departments to ensure excellence in all we do.” Our health system is ever-changing. But according to the experts in our Infection Prevention department, the three main ways to prevent illness and disease that remain the same time and time again are to: Clean your hands. Hand hygiene is the most effective way of preventing the spread of infections. The CDC recommends washing your hands with warm soap and water for 15-20 seconds or using an alcohol-based hand sanitizer. Clean your hands often and assist our patients to do the same. Learn expert hand-washing advice here. Get vaccinated. Immunizations are one of the top methods you can embrace the fight against preventable diseases, such as COVID-19, flu, measles, tetanus and more. Discover how you can get vaccinated with Renown. Keep germs from spreading. Practice good hygiene by covering your cough or sneeze or wearing a mask and sanitizing frequently touched spaces. Stay home if you feel ill to prevent the spread of illness and infection. Be sure to bring up any illness concerns with your primary care provider. “Every aspect of our health system has an infection prevention component, and we work daily to ensure our staff, patients and visitors are providing and receiving care free from potential harm or infections,” said Susanne James. “We are often the first call staff make when they have questions, concerns or just need someone to help improve process or outcomes.” Reveling with Renown Proudly defining themselves as a “small but mighty” team, the six-person Infection Prevention department moves mountains to ensure the safety of anyone who walks through Renown’s doors. The tight-knit nature of this team can be felt from miles away, and to them, being “small but mighty” is not a hindrance, as they have the support of the IP Champions and the entire health system.   “I originally came to Renown in 2018 as a nurse traveler, the facility and people I worked with immediately made an impact on me,” said Brian Stroud, Infection Preventionist at Renown Health. “My wife and I chose Renown and Reno due to the positive impact the people had on us. Everyone is welcoming, helpful and caring. Now, I am a full-time employee, and the team has made my transition into infection prevention trouble-free." Renown’s mission of providing a genuine difference for the health and wellbeing of the community is heightened and echoed by the Infection Prevention team. “I chose Renown because of the reputation Renown has earned in the community because of the excellent care and level of services provided,” said Shannon Oriola, Infection Preventionist at Renown Health. “I absolutely love this team and my Renown family!” “What brought me to Renown was the opportunity to acquire diverse skills which then motivated me to pursue my master’s degree,” added Paul DeLeon, Infection Preventionist at Renown Health. “What keeps me here is the people – Renown attracts hard working, ethical and caring people.” "My wife and I loved coming out to the Nevada mountains on vacations," added Russ Laarman, Infection Preventionist at Renown Health. "After being in Michigan for 47 years, we took the plunge and made NV our home. The experience has been great! I work with a great team that is very knowledgeable and works hard to ensure positive outcomes for our patients and colleagues at Renown.” Their pride shines through with their own individual accolades, both inside and outside of work. This past year: Shannon Oriola received a scholarship from the Association for Professionals in Infection Control and Epidemiology (APIC) for “improving outcomes through knowledge and practice,” which provided her with a $1,000 scholarship to attend the annual APIC conference in Indianapolis. Paul DeLeon earned his Certification in Infection Control and Prevention from APIC. Erika Clark completed Renown’s High Potential program, a six-month program that gives employees hands-on learning experience with several competencies, including emotional intelligence, effective communication, building successful relationships and organizational knowledge. Brian Stroud and his wife Charla became official Nevada residents. Russ Laarman scaled Mount Whitney. ...And the list keeps growing! Charged with the goal of keeping disease spread at bay, our Infection Prevention team remains vigilant and dedicated to their mission. Their commitment to Renown and to keeping our health system clean and healthy proves the age-old saying true: not all heroes wear capes. “I’m so very proud of the work Infection Prevention does every day, working with the vast teams throughout the health system to improve lives,” said Susanne James. “We would like to thank all of you for protecting the health and safety of your colleagues, our patients and the community.”

Read More About Department Spotlight: Infection Prevention

Do it for the patient. That’s the motto that each employee in the Customer Engagement Center (CEC) lives by every single day. This team spins all the existing stereotypical thoughts about call centers on their side by empowering and partnering with patients to achieve their best health. Being transferred around several times just isn’t in this team’s DNA – being a one-stop-shop for patient scheduling, referrals, insurance matters and more is how they proudly operate. Through elevating the customer engagement experience, the CEC closes care gaps to ensure patients get the right care at the right time. From employees who work from our home base in Reno, all the way to the southeastern corner of Florida, this primarily remote team stays firmly connected and collaborative to make patient care possible for all Renown Health patients and Hometown Health and Senior Care Plus members.  The “Make It Happen” Department  Back-to-back phone calls about a wide variety of patient needs? They make it happen. Referrals that need to go directly to the provider? They make it happen. Complex insurance questions that need to be resolved? They make it happen. The CEC is the keeper of all things customer service and all things patient satisfaction, leveraging technology to improve engagement and accessibility – and they wear that badge with pride.  “Patient care is our first priority,” said Cindy Arevalo, Supervisor of Customer Engagement. “Even though we aren’t face-to-face with them, we are always there to help them over the phone with whatever their needs are.”  The CEC has a lot of different sub-departments under its umbrella: scheduling, referrals, insurance, patient outreach, personal assistants, MyChart customer service and more. Each team handles calls for a different section of our health system, including the hospitals, imaging, primary care and specialty care. While their individual teams may be different, one aspect of their jobs remains the same: they care. Deeply.  “We advocate for the patient, especially when they can’t advocate for themselves,” said Amanda Ishii, Referral Specialist.  “We are the first people that patients speak to, and we all have empathy to listen to them, help them solve their problems and take as much time as they need to care for their needs,” added Susana Arroyo Garcia, Supervisor of Customer Engagement.  Customer loyalty is key to the CEC. Every CEC team member builds strong relationships with patients and members. Whether they manage patient outreach or manage back-to-back inbound calls, each employee feels a special connection to the helpful work they do to solve a variety of patient concerns.  “As Senior Care Plus Personal Assistants, for instance, we help guide our members through complex situations, and we eliminate the process of transferring them to different departments, becoming a ‘one-stop-shop' for them,” said Stephanie Perez Campbell, Senior Care Plus (SCP) Health Coordinator. “While every day is different, we are constantly learning new things and helping members navigate through the health system."  With the 4.5 million calls the CEC handles per year, the nature of their jobs is undoubtedly fast paced. However, this does not intimidate the CEC team members; instead, it inspires them to continue reaching new milestones, helping thousands of patients and members every year by handling all the scheduling and referral work on the backend so that they can receive the care needed.  “I never find myself sitting around asking, ‘what should I do next,’” said Gina Briles, Supervisor of Customer Engagement. “We always support each other to stay on top of it all in order to take care of our patients.”  By wearing a lot of hats and managing many different work queues all while staying engaged with each patient, the CEC is full of natural problem-solvers, helping our healthcare network run smoothly.  “The Engagement Center is the front door for the community; serving as the voice of the customer, we ensure patients do not fall through the cracks of the complex healthcare system and are able to easily access the right care at the right time through an exceptional experience,” said Candace Dietrich, Director of Customer Engagement.   Consistently Connected  With thousands of referrals to process and millions of calls to field, the ways the CEC stays connected to patients and members as well as each other can be related closely to magic. No concern goes unnoticed, and no problem is too complicated.  “The sheer volume of patients we engage with is incredible,” said Rene Jacinto, Manager of Customer Engagement. “We processed nearly 200,000 referrals and authorizations last year.”  “We expect a steady increase of calls year-over-year. My team processed 1,259 referrals in one day alone recently,” added Arielle Gomes, Referral Specialist.  A superpower that every CEC team member holds is the ability to listen. According to this department, active listening is key when problem-solving with every patient and member, as that skill helps them anticipate patient needs and resolve their issues quickly and efficiently.  “I’ll always listen,” said Alex Gomez, Customer Engagement Representative. “I want them to know that they are in good hands, especially when they are feeling scared or frustrated.”  Team members like Alex help carefully guide customers through the Hometown Health and Senior Care Plus enrollment process, increasing membership and engaging patients to find the perfect plan for them.  One of the largest challenges the CEC faces is the departures and arrivals of providers. The ebbs and flows of all hospital systems include provider departures and shifting provider availabilities. Despite this challenge, the CEC staff work hard to ensure communication with all patients regarding provider changes is consistent and that all patients are scheduled in a slot that works for both their schedule and the provider’s schedule.  “It’s important for us to be flexible, because things can change at a moment’s notice,” said Gina Briles. “This is more than just a job – we are here for our patients. What we are doing impacts everyone.”  Throughout all times of transition, the CEC builds robust relationships with both patients and providers within our organization and community, a skill that this team emphasizes as “fundamentally important.” For example, SCP Personal Assistants like Stephanie Perez Campbell will coordinate care with community resources and offices, giving members one less call to make and one less hurdle to cross in order to get the care they need.  On top of it all, even though this team has the ability to work from all 50 states (and many of them work outside of Nevada!), every employee feels connected to their colleagues and their work.  “This is the best group of people I’ve ever worked with,” said Riley Petro, Manager of Customer Engagement – Imaging. “I am super lucky for this job and am so thankful for these people.”  Proud and Powerful  The proof is in the pudding – or rather, the proof is in the numbers. Within the 4.5 million calls they successfully field every year, approximately 1.6 million of those calls route through the private branch exchange (PBX) team – the team that oversees the main operator lines – under the guidance of Jess Nater, Supervisor of Customer Engagement. The CEC is also on track to handle nearly 300,000 referrals this year alone. Additionally, the Hometown Health CEC team was recognized nationally this year with a five-star rating from Medicare.  “We all have the initiative to grow, and because of this, we are always learning something new,” said Cindy Arevalo. “Our leaders also support our growth, especially if we want to skill-build or advance in our careers.”  The CEC is frequently the first stop on the career ladder for many employees as they start their journey in healthcare, and CEC leadership is committed to the growth and development of their teams to reach their career goals at Renown.  The secret formula for all this success can be in part attributed to the pride each CEC employee has for their team, their work and Renown.  “We have a very supportive team,” said Holly Coffey, Supervisor of Customer Engagement. “I’ve seen our leaders support their teams tremendously.”  “We rely on each other,” added Ashleigh Carty, Customer Engagement Representative. "I love the relationships we create with one another.”  Employees in the CEC come from many walks of life, choosing to work at Renown and Hometown Health for a variety of different reasons, many related to the positive power our health system holds. Team members in this department hold a myriad of different career backgrounds, including pharmacy technicians, medical assistants, population health professionals, community health workers and more.  Some team members, like Nikki Clifford, Customer Engagement Representative Lead, heard wonderful things about Renown from her mother, who also works for Renown. According to Nikki, “seeing how happy my mom has been in her career made me want to join too. I’ve loved it here ever since.”   Katie Lunau, Supervisor of Customer Engagement, also grew up in a family involved in healthcare, and she wanted to follow in their footsteps. Choosing Renown as the place to follow her family path was a simple one, because “Renown stood out as the company that was actively involved in the community helping others.”  For other team members, like Susana Arroyo Garcia, Ashleigh Carty and Stephanie Perez Campbell, Renown and Hometown Health’s impact on the local healthcare landscape was their primary driver for choosing a career here and in the CEC specifically.  “Renown is very well-known in the area,” said Stephanie Perez Campbell. “I went to school in Reno for public health, so Renown came up all the time in my schooling. I knew Renown had a lot of different opportunities available for career growth, and with the friendly environment I always experienced here, it was an easy decision.”  “Once I went through the interview process and joined the team, I immediately realized that there are outstanding managers, support systems and communication skills here. People genuinely care,” added Ashleigh Carty.  Ashleigh is exactly right. As emphasized by every team member, employees in the CEC care. Their heightened levels of care and empathy set the bar high for all at Renown and Hometown Health, and their impact will be felt for years to come.

Read More About Department Spotlight: Customer Engagement Center

We plan for the birth of a child, weddings and retirement, but rarely do we discuss how we want to be cared for at the end of our lives. Getting through this challenging conversation and completing an Advance Directive can give you peace of mind that your loved ones will not have to make difficult choices on your behalf. The best time to complete an Advance Directive is now – don’t wait until a life-limiting illness or crisis occurs to discuss your views about end-of-life care and to learn what choices are available. By preparing in advance, you can help reduce the doubt and anxiety related to decision-making for your family if you cannot speak for yourself. What are Advance Directives? An Advance Directive is a document that states your choices about medical treatment and names another person to make medical decisions on your behalf if you are unable to. This document allows you to make legally valid decisions about future medical care.  “Completing your Advance Directive is a gift you give your family,” says Director of Palliative Care, Mary-Ann Brown RN, MSN. “The stress associated with these difficult decisions is decreased if everyone knows what is important to you and what you want at the end of life.”

Read More About Plan Early: Completing Your Advance Directive

Early detection is a significant piece of the breast cancer puzzle. Susan Cox, Renown Health Director of Cancer Operations, discusses what you need to watch for and how the latest technology can help detect potential cancer sooner. When should women start getting breast exams? It depends on risk factors: Average-risk women: Most medical organizations recommend the first mammogram between 40 and 44. Higher-risk women: Dependent on their high risk, which will dictate when they start screening, but generally around the age of 30 and not before 25 years old.

Read More About Ladies! Get Screened for Breast Cancer

August is National Make-a-Will month. We talked to Renown Health Foundation Planned Giving Officer, Abbey Stephenson, to learn more about wills, trusts, and estate plans and why you should feel motivated this month to get started. Did you know that 2/3 of Americans don't have a will or trust? If this is you, don’t worry, you’re not alone. Although there are laws in place to determine who inherits your assets if you die without a will or trust, having a will or trust ensures your assets go where you want them to go after you are gone. They can also help minimize disputes between family members and heirs about who gets what. In Nevada, the laws that govern who gets what if you die without a will or trust can be found in Chapter 134 of the Nevada Revised Statutes. There are other documents that people often prepare at the same time as their will or trust – like an advance health care directive and durable power of attorney for assets. These documents all together are called an estate plan. Although they have other purposes too (like nominating a guardian for a child, planning for disability or avoiding probate, which is a court process), wills and trusts are documents that say who will receive your assets after you are gone. The most common type of trust is often called a revocable living trust or a family trust. People who have a trust usually still have a will, although it is a shorter form of will called a pour-over will. It’s a good idea to talk to an estate planning attorney about whether or not a trust makes sense for your family or circumstances.  Now that you’re ready to get started, here are some mistakes to avoid: 1. Failing to plan Not setting aside the time to plan may be the biggest mistake. Failing to prioritize preparing or updating your estate plan means your last wishes and desires may not be fulfilled. The right documents memorialize what you would like to happen upon your disability and death so that other people can know and follow your wishes with respect to your care and your assets.  2. Failing to coordinate beneficiary designations Certain types of assets like life insurance and retirement accounts are not covered by your will or trust and need to be addressed separately. These types of assets are referred to as non-probate assets because they transfer under contract principles and don’t require court supervision or probate to be distributed to the named beneficiaries. By completing beneficiary designation forms provided by the retirement account custodian, insurance company or financial institution, you can direct your assets to one or more beneficiaries. 3. Failing to title your assets properly Asset titling refers to how you own your asset – such as in your individual name, jointly with someone else, or in a trust or entity. For example, assets titled for two people with a “right of survivorship” will automatically go to the surviving owner. Review your asset titling and make changes, if needed, to ensure your property and assets are passed down the way you intend. 4. Failing to include charities meaningful to you In addition to providing for family members and other important people in your life, you many also choose to give to charities meaningful to you in your estate plan. When you include a charity in your estate plan, that gift is called a planned gift and many charitable organizations, including Renown, recognize such donations through their legacy giving societies. As you prepare to make your own will or a more comprehensive estate plan, we recommend you consult with a lawyer. Here are some free resources that may be helpful too:  Renown Health Foundation is proud to sponsor the Family Estate Planning Series put on by PBS Reno and the Community Foundation of Northern Nevada. The free, 8-week course of 90-minute, in-depth workshops is a great place to learn much more and to help you get started in the planning process. The next course begins on September 7, 2022. More information can be found here. Renown Health offers periodic advance health care directive workshops where attendees can learn about, complete, and sign their directive. The next workshop is scheduled for September 14th. More information can be found here. The American College of Trust and Estate Counsel provides information on a number of commonly asked estate planning questions here. If you are interested in including a charitable gift to Renown in your estate plan, we would be happy to talk to you about how your gift will make a difference for our mission. Please contact Abbey Stephenson at abbey.stephenson@renown.org or visit renown.org/LegacyGiving to learn about Renown Health Foundation’s Legacy Giving Society and ways to give.

Read More About Estate Planning Mistakes to Avoid

Renown Health is proud to embrace the Reno-Sparks culture that makes our community stand out, which is why we sponsor the Reno Rodeo, an early summer staple with roots in the community as deep as our own. One of our many ties with the Reno Rodeo includes Renown Regional’s own emergency room nurse and Miss Rodeo Nevada 2022, Gabby Szachara. A Reno native, Gabby developed a love for the Reno Rodeo at a very young age. “I loved watching the girls on the Reno Rodeo Flag Team when I was little and knew I wanted to be part of the Reno Rodeo someday,” said Gabby. “As I got older, I started to make connections and build relationships with some people in the rodeo scene, and they generously lent me their horses so I could participate in the Reno Rodeo Flag Team.” Gabby was on the flag team for three years before being crowned Miss Rodeo Nevada 2022 last year.  Before joining the Reno Rodeo Flag Team, Gabby was a student at the University of Nevada, Reno, and a member of the women’s volleyball team. In December 2017, she graduated with a bachelor’s degree in public health. At first, Gabby was interested in a career in sports medicine – it made sense with her background in athletics. But, after working in the medical field as a certified nurse assistant and an emergency medical technician, she grew passionate about patient care and decided she wanted to become a nurse. “I’ve always loved teamwork and helping others,” said Gabby. “It’s important to me to be there for others, especially when it might be their worst day.”  In December 2021, Gabby graduated from Truckee Meadows Community College with a nursing degree and joined Renown Health this February. “I love Renown for various reasons. Everyone here is so nice and welcoming, and there is a great team dynamic,” said Gabby. “And I love that Renown’s main color is purple because that is my favorite!” When Gabby isn’t in her scrubs and caring for patients, she is in western wear and carrying out her duties as Miss Rodeo Nevada. “I do a lot of traveling across the country to attend other rodeos,” said Gabby. “I enjoy meeting so many wonderful people and experiencing the culture of different states.” Gabby’s main goals as Miss Rodeo Nevada are to promote the western way of life, agriculture, rodeo and community benefit. In addition, she visits local schools to talk with kids about how they can get involved in these areas and inspires them to turn their dreams into reality.  Gabby has a special place in her heart for the Reno Rodeo. “Reno is my home, and the Reno Rodeo is the heart and soul of summer in northern Nevada. Everyone comes together and dusts off their boots to have fun and also contribute money to important causes in our community,” said Gabby. “I love the comradery, the friendly and healthy competition and the great people.”  If you’re going to the Reno Rodeo this weekend, watch for Gabby and her horse, “Torque.”  And if you see Gabby in the halls at Renown Regional, give her a high-five for all her hard work as a nurse and Miss Rodeo Nevada!

Read More About Meet Gabby, Renown Regional ER Nurse and Miss Rodeo Nevada

You may recognize her from billboards around town or the cover of Renown's latest annual report, but what you might not know is the story behind the now-familiar face. Paola Espinoza-Patino is the oncology unit's associate nurse manager at Renown Regional, and she grounds her work in hope and determination daily. Meet Paola:

Read More About Paola’s Story: Bringing Hope and Determination to Patient Care

Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

Read More About Bone Fractures in Children Honest Expert Advice

National Healthcare Decision Day is forthcoming. Here’s an easy and free way to commemorate the occasion: openly discussing how we want to be cared for at the end of our lives. Join Renown Health’s experts at a workshop about making decisions about an advance directive. Among the random national holidays, this one has significance: April 16 is National Healthcare Decision Day. And experts agree that the best time to discuss your views about end-of-life care and to learn what choices are available is before a life-limiting illness or crisis occurs. By preparing in advance, you can help reduce the doubt and anxiety related to decision making for your family if you cannot speak for yourself. “Completing your advance directive is a gift you give your family,” says Mary-Ann Brown, RN, MSN, director of Palliative Care. “The stress associated with these difficult decisions is decreased if everyone knows what is important to you and what you want the end of life.” What Are Advance Directives? An advance directive is a document that states your choices about medical treatment and names another person to make medical decisions on your behalf if you are unable to. This document allows you to make legally valid decisions about future medical care. Find more information about advance directives and the form online. The Conversation The first step in completing an Advance Directive is to think about what’s important to you and talk to your loved ones. The Conversation Project provides helpful tools to guide you and your family through this challenging topic. Getting this information together will help you fill out and complete your advance directives. Some things to consider and discuss with your family include: When you think about the last phase of your life, what’s most important to you? Who do you want involved in your care? Who should make decisions on your behalf if you’re not able to? Where do you want or not want to receive care? Are there specific treatments you would or would not want? Complete Your Advance Directive Planning In order to complete an advance directive, you will need either two witnesses or a notary to sign the form. Be sure to note restrictions on the witness process. When an advance directive is complete, you should keep the original. Copies should be given to your agent named in the form, your family, your doctor(s) and the location that you receive care. Renown Health offers four advance directive workshops every month to cover the details of filling out this document. A healthcare team is available to answer questions and work through the process with you. A notary is also present to finalize the process, which means you can complete your advanced directives during this workshop. Find the workshop by calling 775-982-RSVP for more information. Advance Care Planning Workshop April 17, 1-2:30 p.m. | Free Join Renown Health’s experts for a workshop about making decisions regarding end-of-life care. You will learn how to fill out an advance directive, receive one-on-one assistance and have your documents signed by a notary. Workshops are typically held several times each month. To RSVP, call 775-982-7787

Read More About Here's How to Commemorate National Healthcare Decision Day