Holistic Care for Seniors

As we age, maintaining optimal nutrition becomes increasingly important to support overall health and well-being. For seniors, a well-balanced diet can significantly impact physical health, cognitive function, and quality of life.Aging brings changes to our bodies that can affect nutritional needs. Metabolism slows down, and the body may become less efficient at absorbing nutrients. Additionally, the risk of chronic conditions like heart disease, diabetes, and osteoporosis increases with age. Proper nutrition can help manage these risks and support healthy aging. It is important to eat well, even in our later years, to try to stay healthy as long as possible, keeping you in your home or residence of choice. Some essential nutrients include protein, fiber, calcium, Vitamin D, healthy fats, and Vitamin B12. These promote muscle mass and strength, bone health, digestive health, nerve function, and cab even improve cognitive function! It's also critically important to stay hydrated and watch portion sizes. Including variety and eating a wide range of foods also ensures you get different nutrients in your diet. Incorporating healthy eating into your lifestyle can significantly impact your ability to stay home and maintain independence for longer. The cost of care for nursing homes, assisted living facilities, and even in-home care have skyrocketed, and continue to increase.  A well-balanced diet rich in essential nutrients supports overall health, strengthens the immune system, and helps manage chronic conditions, reducing the need for frequent medical interventions. By focusing on nutrition, you can enhance your physical strength, cognitive function, and energy levels, which contributes to a higher quality of life and greater longevity in your own home. Making smart dietary choices can delay or prevent the onset of health issues that might otherwise necessitate a move to assisted living or frequent hospital visits.

Naples, Fla. (Sept. 24, 2024) - Healthcare Network is in-network for Blue Cross/Blue Shields Florida Blue insurance plan, offering an option for care to residents who may be impacted by stalled negotiations between the insurer and NCH over insurance reimbursements. The lack of an agreement between NCH and the insurer by the end of September could cause patients to pay higher out-of-network prices for NCH services.Were concerned about the well-being of the community and want to make sure everyone is informed that there are places they can go for care, said Jamie Ulmer, CEO of Healthcare Network. Since 1977, we have worked to support the communitys primary care needs, striving for a community where every person has access to appropriate health care.Services offered at multiple locations in Collier County include primary care for all ages, behavioral health care, dental care, pharmacy and addiction treatment. Telehealth is also available to patients.Blue Cross/Blue Shield and most commercial health insurers are accepted by Healthcare Network. The nonprofit, Federally Qualified Healthcare Center also offers a sliding fee program based on income and family size. For information on services, locations and to make an appointment, visit healthcareswfl.org or call 239-658-3000.About Healthcare Network Since 1977, Healthcare Network has distinguished itself by providing primary health care to men, women and children of all ages, helping the disenfranchised, underinsured, and uninsured of our communities, as well as those with insurance and resources who recognize the quality and comprehensiveness of care available. The organization has grown from two small trailers in Immokalee to a network of providers located throughout Collier County. Primary health care services include family care, obstetrics and gynecology, pediatrics, senior care, dental care and pharmacy as well as integrated and traditional behavioral health for both adults and children. Additionally, the organizations community health workers bring health and social services directly to underserved families. For more information, visit HealthcareSWFL.org, or to schedule an appointment, please call 239-658-3000.

What We Dont Know We Dont Know in Health Care: September 24, 2024 -Oral Care, Monitored Meals, and Aspiration PneumoniaProper oral care is crucial for maintaining optimal health. Keeping the mouth clean not only helps maintain the protective properties of saliva but also reduces bacteria in the mouth which can be a source of infection in aspiration pneumonia. In addition, monitoring meals and assisting with feeding for those at high risk for aspiration is also a necessity. The process of swallowing involves dozens of muscles that start in the mouth and include the pharynx, larynx, and esophagus. These muscles can become weakened with age and from various, often age-related diseases.  The aging population is especially at risk for aspiration pneumonia due to comorbidities, frailty, and conditions that can impair swallowing.  As a result, aspiration pneumonia is one of the leading causes of death from infection in individuals over the age of 65. One study shows that 1 in 10 deaths from pneumonia in elderly nursing home residents may be prevented by improving oral hygiene (Sjogren et al., 2008). Unfortunately, proper oral care and monitoring of meals is often overlooked in the health care setting.  Perhaps the greatest reason for this is the challenge that almost every health facility faces today: adequate staffing. When I started working in acute care as an RN over 20 years ago, nursing assistants (these are the staff generally responsible for proving oral care in an acute care setting) were typically responsible for 5-7 patients. Nurses had 3-5 patients (this was on a step down cardiac unit). Between the nurse and the assistant, we were able to provide oral care at every meal and offer one-on-one assistance to any patient that was at risk for aspiration. This is no longer the case.  RNs oftentimes look after upwards of 8 patients, and there is generally either no nursing assistant on the floor or only 1 for a patient load that can exceed 20.  Consequently, proper oral care is neglected.  I have often seen patients that are aspirating during meals, but do not have adequate staffing on hand to provide them with the supervision and monitoring that they need. This presents a hazardous catch-22: the aging individual needs to eat to maintain nutritional needs yet he/she needs assistance with eating to prevent aspirating pneumonia.   How can this be remedied? If the family is present, they can provide oral care and meal monitoring. If meal monitoring is required for an at-risk individual, its recommended to touch base with the health care team to inquire as to what the specific aspiration precautions are (every individual may have a different need and/or recommendation). A care companion can also be hired to provide the needed care. I hired a companion for my father when he was in a skilled nursing facility. He was not getting his teeth brushed or flossed regularly, and I was seeing a decline in his dentition. Having this extra support provided him with much needed assistance and the care companion had the added benefit of encouraging him to eat more at every meal, something that was a bonus as he was not meeting his nutrient needs. Touching base with staff to request that oral care and meal monitoring be done can also be helpful. Having an advocate to ensure necessary care is getting done can also be very effective in the health care setting.  What is proper oral care and effective meal monitoring?  Proper oral care includes brushing the teeth for at least 1 minute after every meal. It also includes using a soft bristle brush, fluoride toothpaste, flossing daily. A final component of oral care that is often not discussed is denture care. Dentures should be cleaned at least once per day and removed at bedtime. Removing them prior to sleeping can greatly reduce the risk of pneumonia (Iinuma et al. 2014). Effective meal monitoring includes adequate supervision during mealtime for those at risk of aspiration. Such supervision includes ensuring the individual is properly positioned for a meal (head of bed as high as can be tolerated and supine position), takes small bites, eats slowly, swallows a couple times in between each bite, and intermittently takes a sip of liquid to clear the mouth of food particles. The use of straws is generally not recommended for an individual at risk for aspiration as it propels the food to the back of the throat and hence can increase risk. I recall when I was working as a Registered Nurse (RN) in acute care that I was constantly removing straws from the bedside of at risk individuals and often reminding them to eat slowly and swallow at least twice between each bite to ensure food clearance. Individuals at risk for aspiration often require a modified texture diet as it can further prevent the aspiration of food and liquids.   This is a brief summary of the attention to detail needed in addressing oral hygiene and meal monitoring amongst the aging population. Both measures can play a significant role in reducing aspiration pneumonia.  If you would like more information on understanding proper oral care or any other questions that you may have regarding aging life care, please feel free to reach out to me.    Sources:1.      Sjogren P, Nilsson E, Forsell M, Johansson O, Hoogstraate J. 2008. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc. 56:21242130. 2.      Iinuma T, Arai Y, Abe Y, Takayama M, Fukumoto M, Fukui Y, et al. 2014. Denture wearing during sleep doubles the risk of pneumonia in the very elderly. J Dent Res. doi: 10.1177/0022034514552493 3.      F Muller, 2015. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541086/#