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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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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.

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If you’re expecting a new baby, you may have been given the advice to hire a doula. You may have seen statistics of improved outcomes among those who’ve had a doula attend their birth. Perhaps you’ve heard that the etymology is from the Greek word meaning “to serve.” But how does a doula serve their clients? A doula is a non-medical birth professional who will guide you through labor, birth, postpartum and beyond. Your doula can discuss your options with you so you can make informed decisions, as well as provide emotional and physical support to ease your experience. While each doula offers their own style, there are certain services that most doulas will provide for their clients. Typically, a birth doula will provide at least one prenatal visit, one postpartum visit and continuous support during active labor. A postpartum doula usually provides support during the 12 weeks immediately following birth, sometimes referred to as the “fourth trimester,” but some will continue care after that as well. Simply put, a doula provides informational, physical and emotional support during the childbearing year(s). Let’s take a closer look at these three ways a doula can support you. The Basics If you don’t know your options, you don’t have any. This is a common phrase in the world of birth work. When you’re in labor, you’re exhausted, in pain and there’s often urgency inherent or implied in any choices you make. So, when an intervention is offered, many birthing people accept it without question. One method that can help the decision-making process is to check your BRAIN: Benefits: What are the benefits of the proposed intervention? Risks: What are the risks of the proposed intervention? Alternatives: What are the alternative options? Intuition: What does your intuition tell you? Nothing: What if we do nothing? What if we wait? When you’re in active labor, you might have difficulty remembering this acronym; that’s where your doula comes in. At your prenatal visits, you can ask your doula for guidance in preparing your birth plan, which can include contingencies for certain potential interventions. And as choices arise during labor, your doula can guide you through the benefits and risks and can provide you with alternative options you might not otherwise be aware of that are available to you. Your doula can remind you to check in with your intuition and can help you quiet your mind so you can listen to your instincts. The Body Although we tend to see depictions of people giving birth on their backs with their feet in stirrups, this is only one of many ways to give birth. Walking and dancing can speed up early labor. Side-lying or hands-and-knees can prevent tearing during the pushing stage. Sometimes labor stalls, and a change of position is often helpful to get things moving again. Your doula can suggest positions depending on your stage of labor. Some labor positions might require the support of another person – your doula could fill this role or assist your partner in doing so. Some doulas also provide massage or even acupressure, and most will do the “hip squeeze” that so many laboring people swear by. If your baby is presenting posterior, or “sunny side up,” your doula can apply counter pressure to alleviate back pain during labor. Some postpartum doulas will do light housework while you rest and bond with your newborn. Others might care for your baby through the night so you can catch up on sleep. Many doulas have also gone through additional training to offer breastfeeding support and may be able to assist you with latch issues and nursing positions. The Mind Pregnancy, birth and postpartum periods can be some of the most emotional times in a person’s life. A doula will hold space for you and help you process your emotions before and after birth. It’s normal to feel apprehensive, or even fearful, about labor and birth, and discussing these feelings is the first step. A doula can help you navigate your concerns in a safe space so you can be prepared emotionally for your upcoming labor. Many doulas will also guide you through writing your birth plan, which can lessen anxiety about the unknown. If you have a history of trauma, your doula can assist in communicating this, so you don’t have to relive the experience every time you meet a new medical provider. Most people will experience some form of what’s often called the Baby Blues in the immediate postpartum period. The third day after birth tends to hit hard, as hormones attempt to regulate, but the Baby Blues can continue for weeks for some new parents. A postpartum doula’s support can be incredibly valuable during this time. When the baby blues last longer than a few weeks, it could considered a mood disorder. Most doulas will recognize signs of postpartum mood disorders and will have resources available for additional support. Choosing the Best Doula for You With so many wonderful doulas in northern Nevada, you might wonder how you could ever choose just one to attend your birth. Some expectant parents are unfortunately restricted by cost. With so many expenses related to a new baby, it can be difficult to budget doula services as well. Thankfully, Nevada Medicaid now covers doula care, and some commercial insurances are following suit. Check with your insurance company to find out if they might cover part of the cost for hiring a doula. If your insurance doesn’t cover doula services, some doulas offer a sliding scale based on income. You may want to interview multiple doulas to find the right one for you. If you’re the kind of person who wants all the information you can get, a more detail-oriented doula might be the best choice. But if you tend to feel overwhelmed by too many options, you might prefer a doula who only offers additional information as the situation calls for it. If you want massage or acupressure during labor, you might want to hire a doula with those certifications. Or maybe informational and physical support are not as important to you as emotional support, in which case your best choice could be a doula who has experience with postpartum mood disorders or trauma support. Regardless of who you hire, be sure to clearly communicate your desires and expectations – not just for your birth, but also for your doula. The most important thing when choosing your doula is trusting your gut. You need to feel comfortable with your doula, as they’ll be tending to you at one of the most vulnerable times in your life. When you find a doula that you click with, who listens to you and supports your choices, you have found the best doula for you.

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A well-child checkup is a great opportunity to monitor your child’s growth and development, and it's also a chance to establish a trusting relationship with your child’s pediatrician and have your questions answered. What to Expect at Each Checkup At every checkup, a comprehensive physical examination will be conducted to assess your child's growth parameters, including height, weight and head circumference. A developmental assessment will evaluate the progress of your infant or young child in achieving age-appropriate milestones, encompassing language skills, motor development, problem-solving abilities and psycho-social skills. In addition, your pediatrician will address common concerns such as feeding, sleep patterns, oral health and general infant care. Unless there are specific needs or concerns for your baby, routine laboratory tests are typically unnecessary. Your pediatrician will provide guidance on immunization schedules, post-vaccination expectations and when to seek medical attention. Furthermore, during each visit, you will receive age-specific guidance to help you anticipate your child's expected growth and development, along with essential safety precautions and illness prevention measures. Your pediatrician will discuss various topics, such as placing your baby to sleep on their back, utilizing rear-facing infant car seats until around age two, maintaining home water thermostats below 120 degrees Fahrenheit, ensuring dangerous objects and poisonous substances are out of sight and reach, emphasizing dental health and promoting the use of bike helmets, among other things. Preparing for Your Visit It is recommended that, as a parent, you write down any questions beforehand, so you don’t forget them in the moment. Most importantly, feel comfortable asking your pediatrician about anything that might seem unusual, as you are the parent, and you know best! Before leaving the pediatrician’s office, be sure that you fully understand any instructions given to you and ask for clarification if needed. From your child’s birth through young adulthood, you will be visiting your pediatrician regularly. The American Academy of Pediatrics provides what a regular schedule might look like. Well-Child Checkup Schedule Two to three days after birth and at one month Two months Four months Six months Nine months One year 15 months 18 months 24 months 30 months Three years, and yearly after

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Taking a few minutes to prepare for your child's pediatrician visit helps ensure that all your child's medical needs are met. Knowing the right questions to ask your provider can help you get the most out of your visit and ensure you and your child feel comfortable and informed. It is essential to base your questions on your child's specific health needs, but the ten options below are a great place to start. How is my child's overall health and development progressing? Is my child meeting their developmental milestones, and are there any areas where they may need extra support? What vaccinations does my child need, and are they up to date on all required immunizations? Are there any nutritional recommendations or concerns for my child's age and stage of development? What are some strategies for promoting healthy habits and physical activity for my child? Are there any warning signs I should look out for regarding my child's health or behavior? What can I do to help prevent common childhood illnesses like colds, flu strains or ear infections? What should I do if my child gets sick, and when should I seek medical attention? Are there any changes to my child's medication or dosage that I should be aware of? Is there anything else I should know or be aware of regarding my child's health or development?

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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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Giving birth expends as much energy as running a marathon. And just like you would only run a marathon with training beforehand, there are exercises you can do to prepare for birth. But instead of a coach, you'll have your birth team. Your birth team exists to help you navigate pregnancy and labor and support your choices. Let's say you've never put together a birth team before and are wondering where to start. Today we'll go over the three main positions to fill for your birth team's starting lineup. Birthing Person The birthing person is the leader of the team. After all, you can't have a birth team without someone giving birth. This person could be the baby's mother, gestational surrogate, birth parent before adoption, a transgender father or a non-binary parent. If you are not the birthing person, don't presume to know what the ideal labor and birth circumstances should be. And if you are the birthing person, don't allow anyone else to tell you what you want. This is your body and your birth; you are the boss in the birth room. Doula No birth team is complete without a doula, and although doulas have increased in popularity lately, many people still don't know what a doula is. Simply put, a doula is a birth professional – not a medical provider – who offers emotional, physical and informational support during pregnancy, labor and beyond. Most doulas' services include at least one prenatal visit and one postpartum visit, as well as continuous care throughout active labor. Some doulas provide more than one prenatal/postpartum visit, so be sure to ask what is included in their fee. Even if you have a partner who will support you during labor, studies have shown that a doula can significantly increase your likelihood of a positive birth outcome. Even the most supportive partner needs to rest, and a doula can ensure that you still get the care you need while your partner gets a break. Midwife or Obstetrician Finally, you'll want to choose the medical professional who will attend your birth. Many folks choose to give birth with the OB/GYN who does their annual check-ups, but there are many reasons someone might choose a different provider for their birth. The first step to finding the best attending provider for your birth is to decide which model of care aligns closest to your values and goals: the Midwifery Model of Care or the Medical Model of Care. .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-qm8j{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-2rvk{background-color:#ffffff;color:#000000;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} Midwifery Model of Care Medical Model of Care Philosophy Birth is physiological. Birth is potentially pathological. Interventions Medical interventions can cause more complications, and therefore are only used as needed. Medical interventions should be used, even in non-emergency situations and sometimes as preventative measures. Decisions Birthing person is the key decision maker. Medical professional is the key decision maker. Provider’s Role Providers monitor labor and will intervene or transfer to hospital if needed. Providers assess and control the birthing process.

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On behalf of Renown’s more than 7,000 employees, we are thrilled to introduce our healthcare system’s next CEO and President, Brian Erling, MD, MBA. Dr. Erling joins Renown after working for more than 20 years in Colorado, most recently as the CEO and President of Penrose-St. Francis Health System in Colorado Springs for Centura Health. “I am so excited to join Renown Health at this important time. Healthcare and our economy are amid a major transformation, and Renown Health is very well positioned for the future,” Dr. Erling said. “Our ongoing success will hinge on our ability to establish positive and productive relationships, maintain high-quality patient clinical outcomes and experiences, reduce healthcare costs, encourage innovation and improve access and affordability for patients and members.” Q: Let’s start at the beginning. When did your interest in healthcare first begin? A: Believe it or not, I started my healthcare career during high school in Minnesota when I worked as a nursing assistant. I then worked as a monitor tech while pursuing my undergraduate degree in biology from Drake University in Des Moines, Iowa. Q: Where did you go to medical school, and what was your first job after training? A: After graduating from The John Hopkins University School of Medicine and spending three years at the University of Virginia for my residency, I spent more than a decade in the emergency department at a level 1 trauma center. Q: Does your experience as a physician impact your approach to healthcare leadership? A: Yes, absolutely. I have worked my fair share of nights, weekends and holidays, and I know the sacrifices healthcare workers – and their families – make to care for our communities. I will never take it for granted. I also understand how complex healthcare organizations are, and I have experienced these complexities from both the clinical and non-clinical sides. I have provided clinical leadership for a large, regional health system and understand that quality, safety and innovation come from the people doing the work, not from a corporate office. But you also need strong managers and leaders to facilitate and prioritize the work while providing support and coaching. Q: What is the key to a successful healthcare system? A: Teamwork. In fact, being part of a high-performing, mission-driven team is my number one motivation. It’s what gets me up in the morning and why I work in healthcare. I view our greatest resource to be our people, meaning Renown’s more than 7,000 employees. Modern technologies – such as fancy robots and imaging equipment – are essential and pretty cool, but they are not why our patients choose us. They come for trusted care in their hometown. Q: Renown Health is going through a lot of exciting changes right now. What is one thing that excites you about joining this healthcare system in a rapidly expanding area of the country? A: I am very excited about the new partnership with Renown and the University of Nevada, Reno School of Medicine. While still in its infancy, it provides the platform for us to be the center for training, research and tertiary care for the region and beyond. Q: What is something you have learned from working with CEOs at other healthcare systems? A: Healthcare leaders often have a short half-life, but that is not me. I believe it is difficult to create and move an organization toward a unified vision when your leader changes every few years. As my track record will support, this is not my style. I have been in Colorado for over twenty years and now look forward to making Reno and Renown my home for years to come. Q: As you know, Hometown Health is Renown’s health insurance arm. How does equitable access to insurance fit into a person’s and a community’s overall well-being? A: Most health systems would love to have their own health plan. The reality is that you cannot meaningfully improve the health of the population without managing value and risk. We are fortunate to have Hometown Health as part of Renown Health, and in our community, and I am excited to work with Bethany and the team to fulfill the mission of the organization. Q: What does working at a not-for-profit healthcare system mean to you? How does it differ from the for-profit sector? A: I have worked in for-profit and not-for-profit healthcare. Renown is unique as the only not-for-profit health system in the market. What that means is that we invest every penny earned back into caring for our community. We don’t send money to shareholders in California or Pennsylvania, we invest it right here in Nevada. Not only is a not-for-profit healthcare organization where I want to work for, but it is where my family and I want to go for care. Q: What do you like to do for fun? A: I love spending time with my wife and three adult children. I met my wife, Jessica, while attending medical school in Baltimore. She was working as a nurse in the surgical ICU, and I was smitten. I offered to help her with a 3 a.m. bed linen change and bath for our trauma patient, and the rest was history. I also love exploring the outdoors, especially snowboarding!

Read More About A Q&A with Dr. Brian Erling, CEO & President of Renown Health

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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Since the COVID-19 pandemic, more people are working from home than ever before, leading to a rise in digital screen time. Between spending eight or more hours staring at a computer screen, and some downtime hours spent looking at a smartphone or watching TV, it’s almost inevitable to feel some adverse effects at the end of a day. Blue Light Effects vs. Digital Eye Strain Blue light is all around us, and the most natural source comes primarily from sunlight. Other forms of blue light are artificial and emitted by digital screens including LED TVs, smartphones, tablets and computers. Surprisingly enough, research shows blue light can actually have health benefits such as promoting alertness, boosting memory and cognitive function, elevating mood and regulating circadian rhythm. However, studies indicate that an excess in blue light exposure can lead to depletion of melatonin production, a hormone that regulates our sleep cycles. In today’s eyewear industry, blue light glasses are one of the more popular items purchased by consumers. Companies who sell the glasses claim they help with reducing or eliminating digital eye strain, while also increasing natural melatonin secretion to get a good night’s sleep. Other than their slight yellow tint to filter out blue light, they mostly look like regular glasses and come in many different stylish frames. You can find blue light glasses through various eyewear retailers. Most adults have experienced digital eye strain. Common symptoms of digital eye strain include headaches, blurred vision, irritated eyes, and fatigue. Many believe that digital eye strain is caused by overexposure to blue light, but medical vision experts say that is not the case. “Digital eye strain is related to how we use our digital devices, not the blue light coming out of them,” says Mitchell Strominger, MD, a neuro and pediatric ophthalmologist with Renown Health. Do Blue Light Glasses Even Work? Since blue light glasses aren’t medically proven to help with digital eye strain, you’re probably wondering if they’re even worth using. “If you’re one to binge a TV show or scroll though social media before bedtime, the blue light from those digital screens can disrupt your circadian rhythm and cause you to lose sleep, which can ultimately lead to other adverse health effects,” says Dr. Strominger. “While more research is still needed, some studies have shown that blue light glasses may prevent melatonin suppression and increase quality of sleep. There is no harm in trying them out and seeing if they work for you.” As for preventing digital eye strain, Dr. Strominger shared several helpful tips: Try using the 20-20-20 rule, which entails looking away from your screen and looking at an object 20 feet away for at least 20 seconds. Sit at an arm’s length (about 25 inches) away from your screen. Adjust the brightness and contrast of your screen, especially before bedtime. There is a night mode setting on most smart phones you can use. Reduce your screen time whenever you can and give your eyes a break.

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Over the past year, the safety of healthcare providers has received more public attention than ever before. Throughout the COVID-19 pandemic – and particularly in the early days – the public learned about the vital role of personal protective equipment (PPE) and other important processes that keep healthcare workers safe and healthy. However, people may be surprised to learn that germs and viruses are just one of the many risks that healthcare professionals face every day. Many people are fortunate enough not to have to worry for their physical and mental well-being when they go to work. Unfortunately, this is not the case for countless healthcare workers across the nation, for whom workplace violence is a daily concern. According to the American Hospital Association, healthcare workers are four times more likely to experience serious workplace violence than people in other industries. This is particularly troubling knowing that healthcare workers have dedicated their careers to serving others, putting their communities first- day in and day out. What is Considered Workplace Violence? The World Health Organization (WHO) defines workplace violence as, “Incidents where staff are abused, threatened, or assaulted in circumstances related to their work, including commuting to and from work, involving an explicit or implicit challenge to their safety, well-being, or health.” WHO considers both physical and psychological harm, including attacks, verbal abuse, bullying, and both sexual and racial harassment, to be workplace violence. Responding to the Challenge of Workplace Violence At Renown Health, we have no tolerance for abuse against our employees. As an organization, we have several systems in place to support and protect our staff. During staff orientation, we provide classes to prepare employees to prevent and de-escalate verbal or physical abuse. We also offer ongoing education to train our staff to respond to violent situations. If an incident does occur, our Violence Prevention Task Force reviews incidents and ensures the impacted employees receive resources and counseling to help them process what has occurred. We are among the first in the nation to have instituted a Zero Tolerance policy on workplace violence. This policy is in place to let our employees know that we have their backs in preventing workforce violence and we will address it assertively if the environment becomes unsafe. As a leader, I am continually impressed by our team’s desire and ability to support one another. However, I know that it is my responsibility to protect our team. No one should have to face harassment or abuse – in any form – in his or her workplace. I believe so much in this cause that I volunteer as Chair of the American Hospital Association’s Hospitals Against Violence steering committee, which works to understand the causes behind violence against healthcare workers and develops tools and processes to prevent these incidents from occurring. Violence was already a concern facing health care organization leaders prior to the COVID-19 pandemic. Now, the ongoing health crisis has elevated tensions. Health care is an industry like no other, with our most precious resource being our employees. As a community, as patients and family members, we have an obligation to ensure that all healthcare workers are safe while they go about their work. This starts with understanding, communication and unequivocal support for the profession. This month we launched the Be Kind campaign across Renown, a reminder to all of the importance of values like patience, kindness and gratitude. If you would like to join us in recognizing a healthcare hero, please submit your thoughts here. Thank you for working with us, and all healthcare providers, to create and maintain places of health and healing for all – and for kindly caring for those who care for you.

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In Nevada, we are so fortunate to have a number of not-for-profits and philanthropists who are supporting our mission at Renown Health; we couldn’t do it without them. In the world of healthcare, we are doing well in driving community benefit programming through operations. However, the things our communities need investments in are so much broader than we might be able to afford on our own. That is why it is essential for us to be supported by the people who are so in love with this community and want to assure we get the kinds of services and care for those who can’t afford it or add new services that are contemporary and leading edge that have not been offered here before. Establishing Behavioral Health & Addiction Institute We are so excited to receive a very generous donation from Chuck and Stacie Mathewson for the Stacie Mathewson Behavioral Health & Addiction Institute. This institute is so sorely needed in northern Nevada. Renown Health has a very important role in being able to bring attention to this important problem of mental health and addiction challenges in northern Nevada. Keeping Pediatric Care Close to Home One of the most important areas where philanthropy comes in handy for us at Renown Health is by assuring that we have the foundational programs that we would not be able to afford with operations alone. For example, the William N. Pennington Foundation’s generous gift has allowed us to create 15 pediatric specialty areas here in northern Nevada so children who have an illness or injury no longer need to leave town. The William N. Pennington Foundation supported Renown Children’s Hospital in a way that we never would have been able to support on our own. We are eternally grateful, and their gift — that 100,000 children are assured access to contemporary health and healthcare services — is beyond comprehension.

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