When it’s Time to Start the Conversation About Home Care

By Faith Protsman, MD, Regional Medical Director, VITAS HealthcareTwo recent studies highlight how sepsis impact often extends well beyond the acute event that led to a patients hospitalization. The studies emphasize two particular points that should inform physicians and clinicians as they consider referring these patients to specialized care: Medicare patient data gathered between 2012-2017 shows that sepsis patients face considerably poorer health outcomes following hospital discharge when compared to non-sepsis patients, including elevated risk for death and increased use of advanced healthcare services. Sepsis survivors exhibit strong indicators of persistent inflammation and immunosuppression for up to a year after hospital discharge, increasing their risk of readmission or death. Both studies indicate a significantly elevated risk of death among sepsis patients after they have been discharged and ostensibly cured. Of course, sepsis patientsparticularly those of the Medicare cohort, who are largely of advanced agerarely leave the hospital in better condition than they entered.The Yende study, in particular, shows that neuroendocrine and inflammatory responses to sepsis can continue long after the patient survives a septic episode. For patients with advanced or chronic diseasesas was the case with nearly 78% of participants in the studythese biomarkers are associated with decline.Post-sepsis Discharge: A Critical JunctureIn many cases, these individuals life expectancies upon discharge will be less than six months. This is a critical juncture: While comfort-focused hospice care could provide an ideal source of support for the eligible patient, their family, and their caregiver(s), most sepsis patients are simply sent home without even a discussion about palliative end-of-life care and its benefits.Frankly, such an oversight is a disservice to everyone involved. The sepsis patient is left with physical and/or cognitive dysfunction, often without significant options for symptom management. Their partner or family will either need to assume caregiving duties or turn to costly private services. And the physician and hospital staff will likely see the patient again following another acute event, a readmission that impacts performance scores, strains resources, and unnecessarily fills beds.By no means do I intend to lay the blame for these unfortunate circumstances on physicians. Timely hospice referrals require ongoing education about end-of-life care, and open, ongoing communication between hospice providers and referral sources.More Help: How to Talk About Hospice Care >Those of us in hospice are working hard to bridge the gap, but even as our healthcare system transitions to a value-based model, the mentality of fee-for-service still permeates our nations acute-care facilities, and many hospitalists see a discharge home as a success.Hospice: A New Way Of Judging SuccessIn hospice, we judge our successes on the patients quality of life and the fulfillment of their goals and wishes near lifes end. Usually, that means going home with 24/7 support from an interdisciplinary hospice team. Whether home is a traditional residence, an assisted living facility, or nursing home, the hospice team will assist caregivers (and/or facility staff) with direct clinical care and education, integrative services, bereavement support, and delivery of medication, equipment, and supplies.In other cases, improving quality of life means remaining in a general inpatient setting with hospice support, taking the burden off hospital staff until the patient is able to transition home or until the patient dies. Hospice offers complex modalities in any setting, so patients who would otherwise be confined to an ICU can usually return home to be among loved ones.With support from hospice, a sepsis patient and their family are more likely to report higher satisfaction of care and greater quality of life. The patients emotional and spiritual needs can be met alongside their physical needs, thanks to care from chaplains, social workers, music and massage therapists, and other integrative specialists. Finally, the patient is more likely to die at home, surrounded by loved ones, rather than in the hospital.Because sepsis is most common in patients with advanced or chronic diseases that indicate hospice eligibility, acute incidences of sepsis should always trigger a hospice eligibility assessment. We owe it to our patients, their loved ones, and our colleagues in healthcare, all of whom can benefit from the support that timely end-of-life care offers. 

Maintaining proper nutrition is a crucial aspect of healthy aging, especially for seniors who wish to continue living independently and enjoying their golden years. By stocking your pantry with the right combination of nutrient-dense foods, you can empower yourself to prepare wholesome, energizing meals that support your overall well-being. In this article, well explore the top pantry essentials that should be on every seniors radar.The Importance of a Well-Stocked PantryA thoughtfully curated pantry is the backbone of a balanced diet. When you have a variety of healthy ingredients on hand, it becomes significantly easier to whip up nutritious meals on the fly, without the need for multiple trips to the grocery store. This not only saves you time and money but also helps you avoid the temptation of less-than-ideal food choices that can compromise your health.Pantry Essentials for SeniorsNow, lets delve into the specific pantry items that should be on every seniors radar. These versatile and nutrient-dense foods will serve as the foundation for countless delicious and nourishing meals.Whole GrainsWhole grains, such as brown rice, quinoa, and whole-wheat pasta, are powerhouses of fiber, vitamins, and minerals. These complex carbohydrates provide sustained energy and can help regulate cholesterol levels and blood pressure, reducing the risk of chronic conditions. Oatmeal, a classic breakfast staple, is another excellent whole-grain option that can be easily customized with fresh fruit, nuts, and a touch of honey.Beans and LegumesBeans and legumes are true nutritional superstars, offering a potent combination of protein, fiber, and antioxidants. From kidney and black beans to chickpeas and lentils, these versatile ingredients can be incorporated into soups, stews, and even meatless chili, providing a satisfying and filling base for your meals.Nuts and SeedsNuts and seeds are nutrient-dense snacks that can also be used to enhance the flavor and texture of various dishes. Almonds, pistachios, walnuts, and pumpkin seeds are all excellent sources of healthy fats, protein, and essential minerals. Keep a variety of these on hand for quick and nourishing between-meal bites or to sprinkle on top of salads, oatmeal, and yogurt.Canned GoodsCanned goods, such as tuna, salmon, and a variety of fruits and vegetables, are convenient and cost-effective pantry staples. These items often have a long shelf life, making them ideal for seniors who may not have the time or energy to frequent the grocery store regularly. When selecting canned goods, opt for low-sodium or no-added-salt options to keep your sodium intake in check.Spices and HerbsElevating the flavor of your meals is not only enjoyable but can also encourage healthier eating habits. Spices and herbs, such as garlic, ginger, turmeric, and basil, are not only packed with antioxidants but can also help reduce the need for salt, sugar, and unhealthy fats in your cooking. Experiment with different flavor combinations to keep your taste buds engaged and your meals exciting.Healthy Fats and OilsIncorporating healthy fats into your diet is crucial for maintaining overall health. Olive oil, avocado oil, and coconut oil are excellent choices for cooking, dressings, and marinades. Additionally, consider keeping a bottle of apple cider vinegar on hand, as it can be used to add a tangy twist to a variety of dishes, from salads to stir-fries.Dried Fruits and NutsFor a quick and satisfying snack, keep a selection of dried fruits and nuts in your pantry. Raisins, apricots, and cranberries provide a natural sweetness, while nuts like almonds, walnuts, and cashews offer a crunchy texture and a boost of healthy fats and protein. These shelf-stable items can also be used to add texture and flavor to baked goods, oatmeal, and trail mixes.Honey and Maple SyrupWhen it comes to satisfying your sweet tooth, opt for natural sweeteners like honey and maple syrup. These alternatives to refined sugar can be used in baking, drizzled over yogurt or oatmeal, or even incorporated into marinades and dressings. Not only do they provide a touch of sweetness, but they also offer additional health benefits, such as antioxidants and anti-inflammatory properties.Whole-Wheat Flour and Baking EssentialsFor any of your baking needs, keep a supply of whole-wheat flour, baking soda, baking powder, and spices like cinnamon and nutmeg. These ingredients can be used to create healthier versions of your favorite baked goods, from muffins and breads to cookies and scones. Experiment with natural sweeteners like honey or maple syrup to reduce your intake of refined sugars.Putting It All TogetherBuilding a well-stocked pantry takes time and effort, but the benefits are well worth it. Start by gradually incorporating these essential items into your shopping routine, and dont be afraid to try new recipes and flavor combinations. Remember, healthy eating is a journey, and by embracing these nutrient-dense pantry staples, youre taking a significant step towards nourishing your body and supporting your overall well-being in the golden years!  

Diabetes is a chronic condition that affects millions of people worldwide, causing high levels of glucose (sugar) in the blood. Over time, this can lead to serious health complications, including heart disease, nerve damage, and kidney problems. While managing diabetes often requires medication, there are also natural ways to lower your blood sugar levels and improve your overall health. In this article, well explore the top strategies for regaining control over your blood sugar naturally. From dietary adjustments to lifestyle changes, well provide you with the knowledge and tools you need to take charge of your blood sugar and live a healthier, more vibrant life!Understanding the Importance of Blood Sugar ControlMaintaining healthy blood sugar levels is crucial for everyone, but especially those with diabetes or prediabetes. High blood sugar, also known as hyperglycemia, can cause a range of adverse effects on the body, including: Increased risk of heart disease and stroke Damage to blood vessels, leading to vision problems, nerve damage, and kidney issues Slower wound healing and increased susceptibility to infections Fatigue, increased thirst, and frequent urination By taking proactive steps to lower your blood sugar, you can significantly reduce the risk of these debilitating complications and improve your overall quality of life.Dietary Strategies for Blood Sugar ManagementOne of the most effective ways to control blood sugar is through the foods you consume. Here are some dietary strategies that can help:Focus on Fiber-Rich FoodsFiber is a crucial component in regulating blood sugar levels. Foods high in fiber, such as whole grains, vegetables, fruits, and legumes, slow the absorption of carbohydrates, preventing rapid spikes in blood sugar. Aim to incorporate a variety of fiber-rich foods into your meals and snacks.Prioritize Lean ProteinsProtein-rich foods like lean meats, poultry, fish, eggs, and tofu can help slow the digestion of carbohydrates, leading to a more gradual release of glucose into the bloodstream. Combining protein with carbohydrates at each meal can help maintain stable blood sugar levels.Choose Healthy FatsHealthy fats, such as those found in avocados, nuts, seeds, and olive oil, can also play a role in blood sugar management. These fats can help slow the absorption of carbohydrates and provide a sense of fullness, reducing the likelihood of overeating.Limit Added Sugars and Refined CarbohydratesFoods high in added sugars and refined carbohydrates, like white bread, pastries, and sweetened beverages, can cause rapid spikes in blood sugar. Limit your intake of these items and opt for complex carbohydrates, which are digested more slowly.Incorporate Chromium and Magnesium-Rich FoodsCertain minerals, such as chromium and magnesium, have been shown to help regulate blood sugar levels. Foods rich in these nutrients include leafy greens, nuts, seeds, and whole grains.Lifestyle Modifications for Blood Sugar ControlIn addition to dietary changes, adopting a healthy lifestyle can also contribute to better blood sugar management. Here are some key lifestyle modifications to consider:Regular ExerciseRegular physical activity can improve insulin sensitivity and help your body better utilize glucose. Aim for at least 30 minutes of moderate-intensity exercise, such as brisk walking, swimming, or cycling, most days of the week.Stress ManagementChronic stress can disrupt the bodys ability to regulate blood sugar levels. Practice stress-reducing techniques, such as meditation, yoga, or deep breathing exercises, to help keep your blood sugar in check.Adequate SleepLack of sleep can negatively impact blood sugar control. Aim for 7-9 hours of quality sleep each night to support your bodys natural blood sugar regulation.Maintaining a Healthy WeightExcess weight can contribute to insulin resistance and higher blood sugar levels. Achieving and maintaining a healthy weight through a balanced diet and regular exercise can have a significant impact on blood sugar management.Monitoring and Tracking Your ProgressEffective blood sugar control requires ongoing monitoring and tracking. Here are some strategies to help you stay on top of your progress:Regular Blood Glucose MonitoringUse a home blood glucose meter to check your levels regularly, especially before and after meals. This will help you identify patterns and trends in your blood sugar levels, allowing you to make informed dietary and lifestyle adjustments.Keeping a Food and Activity JournalDocumenting your food intake, physical activity, and blood sugar readings can provide valuable insights into how your body responds to different factors. This information can help you fine-tune your approach and identify any potential triggers for blood sugar spikes.Collaborating with Your Healthcare TeamWork closely with your healthcare provider, such as a registered dietitian or certified diabetes educator, to develop a personalized plan for managing your blood sugar. They can provide guidance, support, and recommendations based on your individual needs and health status. Regaining control over your blood sugar naturally is a journey, but its one that can have a profound impact on your overall health and well-being. By incorporating the strategies outlined in this guide, you can take proactive steps to manage your diabetes, reduce your risk of complications, and improve your quality of life. Remember, every small change you make can contribute to significant improvements in your blood sugar levels and overall health. Embrace the process, celebrate your successes, and dont hesitate to seek support from your healthcare team and loved ones along the way! Disclaimer: This article is for informational purposes only and does not provide medical advice. While we at Chefs for Seniors specialize in providing healthy, customizable meals, we are not medical professionals. Always consult with your healthcare provider for medical advice, diagnoses, and treatment plans to fit your specific needs.