Author Flannery OConnor writes, Fiction operates through the sensesthe first and most obvious characteristic of fiction is that it deals with reality through what can be seen, heard, smelt, tasted, and touched.As much as writers struggle to incorporate the five senses into their work, humans struggle more in reality. We move around our day without taking a moment to admire how the watery orange of a spring sunrise gives us hope and the tinge of tangerine in the wintertime causes wistfulness. Or how the fluffy bedspread comforts us as we sleep. The way in which we do this is through gratitude being thankful for noticing and for the stimulation provided. For celebrating our well-being and the beauty in this world.How does this concept apply to caregiving?Story-Centered CareIf we use Flannery OConnors quote to examine our everyday lives, we can enhance the stories we share about our loved ones through the senses. In the past, Ive written narratives about my mother, sister and father, in each of their care settings. These stories enhance our care for one another through compassion and through evoking the senses. For my father, I wrote how hed come home from work at the shoe store with the earthy smell of leather carried home on shirts. When writing stories about my mother, I wrote of the crisp cracking of Italian cookies called pizzelles. These stories help us take notice of who that person is. We can weave those stories into our care, along with our senses, to spark memories.There is such a strong connection between the sense of smell and memory. When it rains in springtime, Im taken back to my days spent in Oregon. Ill say, Its an Oregon morning, and my family knows what that means and understands where my mind is. Sometimes, I crave the rain to take me back to those memories. Our sense of smell travels straight to the temporal lobe, the smarter part of our tissues. In a way, its a direct line to who we are.Think of your loved ones as readers of this story you are in together in which specific characters, events and experiences influence each other to form a meaningful narrative. How can you enhance that? Using our senses.How Language Evokes the SensesWhen we communicate with loved ones, there are several ways to incorporate the senses into our time together, other than the simple conversations we resort to. For starters, think about reading poetry to them. When I put a book with William Wordsworths Daffodils in front of my mother, she read the poem with the correct intonation. Repetition is reliable. In her dementia, she wanted to know what came next, even if cognitively shed forget in the next moment. For me, I will forever associate the brilliance of a daffodil with that moment when she read it to me. Poetry is a healing language, and so is music. Both are filled with sensory references and oftentimes convey what ordinary humans cannot.Touch as Self-CareOur hands are constantly moving through the day. How often do we stop to consider what they are really feeling? I dont mean whether your muscles ache, or you have a cracked fingernail that throbs. But finding something you can touch to make you feel. It could be as simple as Playdough or fidget spinners. My mother felt her way in the world through baking and cooking. The Montessori method is based on this principle. There is something to be gained from whatever we hold in our hands. Our hands not only shape our environment, but they help us to create one too. When my mother moved into her first care home, a caregiver on staff brought her a doll. Mom carried that doll everywhere. If the doll was lost, my mother was too. This scene repeated itself with other residents, especially for females who had experienced motherhood. Dolls were given names, or they were caressed in the same way a woman caressed a newborn. The holding on grounded those residents.Taste as TourTo get to know her mother-in-law, Grethen Rubin, author of Life in Five Senses, took her on a taste tour of the lower East side of Manhattan, where her mother-in-law once lived. The prospect was so enticing, her daughters joined as well. I wish I would have taken my father to an Italian salumeria, where the smells of rich, fat cured meats might mingle with juniper or anise or saffron. Each might have evoked his travels to Italy, my mothers cooking in the kitchen, or our family dinners. Or even later, when he was a guest at his daughters table, and I plated the cheeses and salami, and he no longer did.Environment as Five SensesWhen you think about your loved ones environment, take in all the senses you can. Try making a list of the five senses and write a few items within each category that might be important to your loved one items you can focus on or add to their environment. Do they love flowers? Would they appreciate the sight and smell of them? Is removal of clutter important to them? My mother loved running her dry hands up and down my arms. I rubbed lotion on my arms before our visits to ensure they were smoother during our time. In the end, I doubt she noticed, but touching my arms made her feel known and loved. And grounded me too.Annette Januzzi WickAnnette Januzzi Wick is a ProMedica blogger and speaker. Wick is also author of two memoirs on love and loss,  Ill Be in the Car and Ill Have Some of Yours. Visit annettejwick.com to learn more.

You know that eating extra sugar can lead to weight gain, Type 2 Diabetes, heart disease, and a whole host of health problems. Yet here you are reaching for the candy jar on your desk or accepting yet another homemade dessert from a co-worker. Before you go beating yourself up about lack of willpower, know that we are born with an innate preference for sweets. Although our preference for nutrient dense foods led to our survival as a species, nowadays our easy access to tasty, energy dense foods have led to an obesity epidemic.So what can you do to change your behavior? Begin by taking some time to analyze why you are eating sweets and strategize a change.Rethink your mealsSkipping meals, like breakfast, leaves you vulnerable to getting overly hungry and increases the likelihood of grabbing a sweet pick-me-up. Start planning ahead. Factor in enough time in your day to eat meals. After all, food is fuel and to function optimally you need to fuel-up. If time is a factor, plan some easy meals like Greek yogurt, fruit, and a handful of nuts or a slice of whole grain avocado toast, a hardboiled egg, and a fruit.Your meal choice can also affect your desire for sweets. When you eat a bowl of cereal, which is highly refined, it spikes your blood sugar and drops it an hour or two later. Then, youre hungry and reaching for another sugar fix. Time to rethink your breakfast selection. Plan a more balanced breakfast, including three different food groups, one of them being a good protein source and another a good source of fiber. The protein and fiber will provide more staying power, so youll be less likely to search for a snack midmorning.You should plan your snacks, too. If theres a long time between meals and you have nothing to snack on but the candy jar on your desk or the vending machine down the hall, thats what youll be eating. Get rid of the candy jar out of sight out of mind! Start bringing in healthier snacks. Plan snacks that have staying power such as a handful of nuts, fresh fruit, a sandwich bag of fresh vegetables, Greek yogurt, or a hardboiled egg.Brush up on your sugar knowledgeIf you have a hard time cutting back on the sweets, another thing to sharpen up is your nutrition IQ and the sugar content in foods. Over the years, food manufactures have added more and more sugar to our food supply. Just to be clear, I am not talking about the sugar that occurs naturally in fruit, milk, sweet potatoes, and carrots. The sugar in these foods are paired with vitamins, minerals, and often fiber; healthy nutrients that we need. These unprocessed foods take longer to digest, have a more blunted rise to our blood sugars, and are more likely to make us feel full.Obviously, there is a lot of added sugar in pop, candy, and cookies, but when you look at food labels youll notice the added sugar in other items, such as spaghetti sauce, granola bars, salad dressings, yogurt, and prepared meals. The newly revised food labels not only tell us how much sugar is in that food, but how much of that sugar is added as opposed to occurring naturally. It may be helpful to visualize that four grams of sugar equals one teaspoon of sugar. Seeing that a bottle of sweet tea has 48 grams of sugar or 12 teaspoons of sugar may inspire you to quit sugar sweetened drinks cold turkey. The American Heart Association advises women and children to limit added sugar to 6 teaspoons or 25 grams of sugar a day, whereas men should limit their sugar intake to 9 teaspoons or 36 grams of sugar per day.Give yourself some time as you start to reduce sugar in your diet; change doesnt happen overnight. You will find that you are more successful working on one aspect of your eating pattern at a time, like eating healthier snacks rather than trying to change everything overnight. As you grow accustomed to eating less processed foods, you will probably find those sugary foods lose their appeal.Deborah Karl, LD, RD, CDE, is the program coordinator at the ProMedica Diabetes Care Center.

Identity theft is not a new crime. For centuries, people have misrepresented themselves for a variety of reasons, usually to skirt the law or gain financially. There are all kinds of identity theft, including social security, credit card, and even medical services. We most often hear about financial identity theft, and since that involves your personal bank accounts, it is the most dangerous.According to the Federal Trade Commission, 16.6 million people were victims of identity theft in 2012, and the number continues to rise. Its important to be aware of the risks and protect yourself before it happens. That begins with knowing how to prevent it from happening at all.Not all identity theft starts with computers. Thieves can find information from discarded mail, prescription bottles, stolen wallets, and even eavesdropping when using your credit card or writing a check. According to the FBI, identity thieves start with names, Social Security numbers and dates of birth. They also use Medicare numbers, bank account or credit card numbers, birth certificates, death certificates, passport numbers, telephone numbers, passwords that use maiden or middle names, and even fingerprints. The most common ways thieves get this information are through burglaries that involve the loss of checkbooks, drivers license, registration, credit cards, etc., email and phishing scams, and computer hacking.Even though just about anyone can become the victim of identity theft, it doesnt have to happen. There are a number of things you can do to protect yourself from these crafty thieves.According to the Department of Commerce, there are four main things you can do to protect yourself.1.Keep and dispose of your personal information, especially your social security number, securely. Keep your financial documents and records in a safe place that can be locked and only carry identification and other cards you will need for that specific errand. Shred documents that are no longer needed, destroy or remove labels from empty prescription bottles, and take outgoing mail to a US Postal Service mail box or post office.2.Take all the appropriate security measures for your cellular telephone, computer and other electronic devices. Make sure you are using a secure wireless network before you send any information. Use passwords, locks and antivirus software. And make sure you permanently delete all information from computers, phones and other mobile devices before you dispose of them.3.Ask questions before you share your personal information. Ask why they need the information, how the information is to be used, what their security measures are for protecting the information, and what would happen if you choose not to share the information.4.Never give information to someone you dont know. This includes phishing emails that should never be opened and the links or downloads contained in these emails. By opening an email from a stranger, you could be exposing your computer or device to a virus or spyware that can give thieves access to your information. Never give out your personal information to someone via the telephone, internet or mail unless you initiated the contact.IF YOU THINK YOU ARE A VICTIM OF IDENTITY THEFT, TAKE ACTION IMMEDIATELY.1.Call the fraud departments of the company or companies where the fraud occurred and tell them you are a victim of identity theft.2.Put a fraud alert on your credit and get a credit report from one of the three credit bureaus. When one credit bureaus gets a fraud alert, they will automatically contact the others. This is free and allows you to review your credit history for new accounts or purchases that you did not initiate.3.Report any fraudulent transactions to the Federal Trade Commission. The FTC has an online complaint form or you can call them at 1-877-438-4338. They will issue you an Identity Theft Affidavit which you should print and keep.4.File a report with the police department in your community. Take a copy of your Identity Theft Affidavit from the FTC, a photo ID, proof of your address, and any proof you have of the theft.These steps will start your recovery from the theft, and begin to restore your credit. Unfortunately, the investigation and follow-up on identity theft can take months or even years. But your quick action can limit the financial loss and damage.Submitted and Written By: HCR Manorcare - click here for more information

For More Information on ManorCare Nursing & Rehabilitation Center of Naples, CLICK HERE!So, youve heard the term reverse mortgage and you want to know what it is. Do you qualify? Is it right for you and your situation? Reverse mortgages are complicated. For some people, it is a good option in order to supplement income, or pay for health care expenses. For others, its not a good option, especially when considering your estate and heirs.To understand a reverse mortgage, you must first understand the term equity. Equity is the difference between the value of the asset/interest and the cost of liabilities of something owned. For example, if you own a house worth $150,000, but owe $100,000, you would have $50,000 of equity in your home.With a reverse mortgage, you borrow against the equity in your home (get a loan for part of the equity), allowing you to receive a cash loan without having to sell your home or pay any additional monthly bills. In other words, reverse mortgages take the equity in your home and turn it into a loan/payment for you. The money is usually tax-free and doesn't have to be repaid for as long as you live in your home. In the event of the death or relocation of the borrower(s), the reverse mortgage must be repaid by the borrower, a spouse or the borrowers estate.There are considerations to think about before shopping for a reverse mortgage.You have to meet certain qualifications to be able to get a reverse mortgage. You must be at least 62 years of age and have equity in your home.There are fees and costs associated with reverse mortgages. These can include closing costs, origination fees, mortgage insurance premiums and service fees throughout the life of the loan. Be sure to ask the lender to explain the Total Annual Loan Cost (TALC).Many reverse mortgages have variable rates. This means that the interest rate will change over time, often increasing. There are fixed rate reverse mortgages, but they are not as common. Fixed rate reverse mortgages often limit the amount you can borrow and may require you to take a lump sum instead of payments.Interest is not tax deductible ,until the loan is paid off.Interest is added to the balance each month. This means you owe more over time, increasing the total balance, as you are not required to make monthly payments towards the loan.You are still responsible for other home-related expenses. Property taxes, maintenance, insurance and utilities are still paid by the homeowners.Reverse mortgages use up the equity in your home .In the event of relocation or death, you, a spouse or the estate is responsible for repayment of the loan. If you or your heirs would like to keep the home, you or they can repay the loan and interest. If they choose to purchase the property, they should never have to pay more than the appraised value of the home, even with accumulated interest added throughout the life of the loan (non-recourse clause).There are situations that would require you to repay the reverse mortgage. Be sure that you understand all instances that may require you to repay the loan, for example, relocation.Reverse mortgages and rates are different from lender to lender. Be sure to shop around for rates and compare associated costs before selecting a lender.Reverse mortgages lessen your estate. Because you are borrowing against the equity, your estate is responsible for repaying the loan in the event of your death, thus lessening the amount of assets you leave to your heirs.Types of Reverse MortgagesThere are three types of reverse mortgages, each with different costs, fees and terms. The amount of money you are able to borrow, as well as the type of reverse mortgage you qualify for, is based on factors such as: age, home value, current interest rates and financial assessment. Below are the types of reverse mortgages, with brief descriptions of each.SINGLE PURPOSE REVERSE MORTGAGESSingle purpose reverse mortgages are offered by some state and local government agencies, as well as non-profit organizations. They are the least expensive option, but not available everywhere. Single purpose reverse mortgages can be used for one purpose, which the lender specifies, i.e. home repairs, property taxes, etc. In some cases meeting with a financial counselor is required.PROPRIETARY REVERSE MORTGAGESProprietary reverse mortgages are loans from private lenders. Depending on the home value and equity, you may qualify for a larger amount with a proprietary reverse mortgage. These loans can have higher costs associated. In most cases, these loans can be used for any purpose.HOME EQUITY CONVERSION MORTGAGEHome equity conversion mortgages (HECM) are federally insured and backed by the U.S. Department of Housing and Urban Development (HUD). The upfront costs of HECMs can be high, however the money can be used for any purpose. Meeting with a financial counselor is required to ensure that all costs, fees and terms are understood. HECMs allow the borrower to choose from several payment options including a single disbursement, fixed monthly payments, a line of credit or a combination of these options. HECMs also allow for the borrower to live in a nursing home or other medical facility for up to 12 consecutive months before the loan must be repaid.As with many loans, reverse mortgages allow you up to three days to cancel without penalty in most cases. Most reverse mortgages can be repaid early, and without penalty. Be sure to understand the terms and conditions as well as all associated costs when considering the reverse mortgage option. Shopping around before signing papers is also a good idea in order to be sure that you are making the best choice for your situation and your heirs. When making major financial decisions, it is a good idea to meet with a financial planner who has knowledge of your specific situation

For more information on Arden Courts of Lely Palms, Click Here.As a writer, I am fascinated by studies which evaluate writing content and styles and point us toward information we might not know about ourselves. Its like looking into the Magic 8-Ball to predict our future, only the ball is a piece of paper.I wrote the first draft of this article by hand with a few caveats. In ninth grade, I adopted a calligraphy-like writing style for a history project. My penmanship was altered again as a computer science major in college by using graph paper. Nowadays, anyone reading my writing will notices a mix of looping cursive and boxy print. When writing by hand, I mostly correct my spelling errors. Using a computer, I rarely stop to correct grammar knowing the software will redline it for me to fix later.What would any of this tell experts about my prospects for developing dementia as I aged?The Nun StudyAt the age of 14, Sister Mary (alias) entered the School Sisters of Notre Dame in Baltimore, and by 19, she had taken her vows. She taught English to middle-school students and took classes toward receiving her high school diploma. Sister Mary taught full-time until age 77 and retired at 84.In her later years, the University of Kentucky approached Sister Mary and other nuns about a study related to Alzheimer's and the importance of donating their brains to neurological science. Nuns were an ideal control group because they shared the same environment, health and fitness regimen. As part of the study, Sister Mary had been constantly tested on eight focal areas to assess memory, concentration, language, visuospatial ability, and orientation to time and place. She consistently scored well within normal ranges.As part of the broader study, researcher David Snowden reviewed personal essays each nun had written upon acceptance. One wrote, Now I am wandering about in Doves Lane waiting, yet only three more weeks, to follow in the footprints of my Spouse, bound to Him by the Holy Vows of Poverty, Chastity and Obedience. Another was a lister who wrote, I prefer teaching music to any other profession. Those whose writing styles portrayed a richer sense of grammar, imagination and emotion, such as the first writer, were less impacted by dementia than those who wrote in a more simplistic style.Did the higher cognitive functioning come first, and therefore dictate what kind of writing style one might have proffered? And can one postpone the effects of memory loss through the continual development, even at that age, of writing styles? These are the questions scientists continue to ask.Writing and Reading as We AgeWe are often amazed by writers who author books into their old age. Margaret Atwood is still productive at age 81. Agatha Christie died at 86 but wrote until her end. At 97, Herman Wouk wrote The Lawgiver, and Toni Morrison published God Help the Child at age 84.In Changing Minds, a book that examines the correlation between language and aging, Roger Kreuz and Richard Roberts found seniors in a living community used an average vocabulary of 21,000 words, while an average college student might only utilize 16,000 words, proving language mastery is a lifelong journey and learning does'nt necessarily end with school.Other studies show we can prolong our lives and cognitive functioning by keeping a journal and reading fiction as a noted by the Yale University School of Public Health. People who read books for at least 30 minutes a day lived, on average, nearly two years longer than nonreaders. And at present, the National Institutes of Health (NIH) is conducting a study into whether foreign language learning, which utilizes higher cognitive functioning, can also contribute to an increase in lifespan.It turns out, age is not the sole factor in determining our reading abilities, writing capabilities and learning. Yet, our reading, writing and learning can help extend our age.More about HandwritingAccording to results published in The Lancet Journal for Clinical Medicine, a group of 80 men and women in their 70s, all cognitively normal, took part in a Framington Heart Study where they were administered a writing test before any had developed Alzheimer's.Subjects described a drawing of a boy standing on an unsteady stool and reaching for a cookie jar on a high shelf while a woman, her back to him, is oblivious to an overflowing sink.Their language was analyzed by artificial intelligence to predict who would be more likely to develop Alzheimer's or dementia. Those that utilized repetitive words, made more grammatical or spelling errors where a subject, article, or verb was missing were categorized in a group where eight years later, they were impacted by Alzheimer's disease. Based on the writings, the program had predicted with 75% accuracy who would develop cognitive impairment.Aging and MeMy fathers chicken scratch was well-documented in our household. However, he was the storyteller and remembered details of long-forgotten events before succumbing to Parkinson's. My mothers handwriting was precise and was told she held her pen too tight. She was also a list maker, yet despite her dementia, she still read the headlines from magazine or newspapers I brought her. Whatever remained intact was a result of her reading and my reciting poetry aloud to her. The experts might have had difficulty predicting the outcomes of my parents.As for me, my first draft of this article contained multiple spelling errors. With the luxury of knowing I would correct that, I tried simply to evoke a thought.Every day, I push myself little more. Books from the library multiply like rabbits in my study. At age 55, after writing two memoirs, generating several volumes of poetry hidden in my files, and writing countless essays and articles, Im attempting to craft a second work of fiction. After reading conclusions of researchers, I fully expect this volume to keep my mind sharp.

Article Submitted By: ProMedica Skilled Nursing and Rehabilitation at Lely PalmsIn the final video recording I filmed of my parents together, Frank Sinatra croons on an old record player. In their senior living community residence, the music tingles my mother, Jeans ear. She asks my father, Hey Ette, lets dance. She sways to notes which have played inside her mind and body for decades. My father, tentative at first, laughs, while I record this intimate act.Fast forward to when my mother, alone without my father, takes the dance floor at a senior prom hosted by her care center. She locks arms with my husband, her son-in-law, and the two of them float along while envious residents and guests look on.We always danced in our family home. My mother always danced, prompted by music that filled a space in her heart, swinging her arms, propelling hips and feet forward. In her final months, dancing was her communication with me, with staff, and her younger self.Gordon Hempton, an acoustic ecologist and writer, ask, When I'm listening to music, do I want to dance? And when its over, has it affected me? Am I now living out those dance steps in the way I interact with people or carry myself down the path? These and many other questions are now being asked by researchers to learn about how dance lives within each one of us.Dance Movement TherapyAt a recent presentation on dementia, an older couple approached my table set up inside a senior center where the event was hosted. The husband attended a writing class there and the wife liked to dance. I have a friend who lives in a nearby senior living center, the woman shared. We visited her during one of their dances. The folks with dementia got up to dance. The others sat in the corners. We agreed those who experience cognitive loss often also lose the filter which causes embarrassment. They become present in the moment and the dance becomes muscle memory and therapy.Dance or movement therapy, according to the American Dance Therapy Association, is the psychotherapeutic use of movement to further the emotional, cognitive, physical, social, and spiritual integration of the individual.In my mothers care home, not only did they host senior proms, but the physical therapist and activities director joined residents for Friday dance parties. Tall and lithe, the therapist enticed the residents to rise from their seats and rock to the rhythms, if it was permissible. Whenever my mother recovered from her many hospitalizations, her body always wanted to join in the flow.When caring for loved ones who experience cognitive losses, we forget how dancing is a form of communication when other actions fail. It can trigger memories of happy times past, such as a wedding, a junior prom, or a quiet moment with a loved one. The loosening of the physical body opens it up to feel additional sensations. And the dancers are engaged with others in their surroundings, reducing the sense of isolation they might feel.Connecting Kids to Aging Adults through DanceWhen my son was younger, he was exposed to a program called Kindermusik. For over forty years, Kindermusik has been bringing the unparalleled benefits of music education to children and families around the world. Their curricula were designed for non-music teachers to integrate music into the programming of schools, churches, homes, ensuring every child received similar developmental benefits.Today, Kindermusik has extended its knowledgebase by developing a program called Bridges to work with seniors. Bridges is a multigenerational music and movement program brought to senior living facilities, community centers, and other organizations to connect generations. In the program, the seniors act as teachers and role models for the children by singing and dancing. The older adults are given a sense of purpose. The children gain through their interactions. And joy directors act as go-betweens between the seniors and children, encouraging the connections.As part of the National Institutes of Health (NIH), the National Library of Medicine undertook a systemic review of twelve studies on dance as it related to individuals with Alzheimer's. While their results confirm a positive effect on the participants well-being, future research focused on these patients should use a more exhaustive methodology and make a more detailed description of these kind of interventions.Despite the lack of clinical evidence, we recognize joy in the movement of our bodies. And there was never more bliss on my mothers face than when my teenaged son or my little niece arrived to take their grandmothers hand and lead her to the dance floor. Inside her spirit, her body was nimble, her connection to the present intact.Annette Januzzi Wick is a writer, speaker, and author of Ill Have Some of Yours, a journey of cookies and caregiving(Three Arch Press)and is a recipient of a 2020 NSNC award. A frequent contributor toCincinnati.com, her work has appeared in Cincinnati Magazine, nextavenue.com, Shanti Arts, 3rd Act Magazine, and others. Visit annettejwick.com to learn more.

While it may be common knowledge that diabetes is a serious health condition, there is often confusion about which type poses the greater risk. Both Type 1 and Type 2 diabetes can lead to health complications and increase your risk of dying prematurely. However, they are caused by different factors and must be treated and managed differently.Two major types of diabetes  one major health concernType 1A chronic condition in which the pancreas produces little or no insulin.Type 2A chronic condition that affects the way the body processes blood sugar (glucose).Although type 1 and type 2 diabetes are separate conditions, they have the same long-term complications, such as problems with:EyesVisual impairment or blindnessHeart and vascular systemIncluding blood clots, heart disease and strokeKidneysKidney damage or failureNervesNerve damage that causes pain or numbness  A woman may also have gestational diabetes, which is high blood sugar during pregnancy. Gestational diabetes typically resolves after pregnancy, but some women may continue to have symptoms of Type 2 diabetes and need continued treatment.Preventing Type 2 diabetesSince lack of exercise and eating foods with high sugar content contribute directly to Type 2 diabetes, there are ways to safeguard yourself and your loved ones:Avoid foods high in sugar content:Eat healthy foods, including fruits, vegetables, whole grains and lean meatsExercise 30 minutes each dayLose weight and keep it offSee your doctor for regular checkups Diabetes TreatmentType 1Most people with Type 1 diabetes are diagnosed as children or young adults and will need insulin injections throughout their lifetime to manage the disease.Type 2For those with Type 2 diabetes, diet and exercise alone can have a significant impact in reducing the amount of glucose (sugar) in your blood. In more stubborn cases, oral blood glucose lowering drugs or treatment with insulin may also be needed to avoid dangerous side-effects of the disease. LEARN MOREBalance, HCR ManorCare's comprehensive health and wellness blog, supplies readers with healthy ideas throughout the year. The blog is designed to serve as a resource, not only for patients, residents and families, but for anyone who strives to live a healthy, "balanced" life. For more information and help making healthy choices, go to balance.hcr-manorcare.com. If you need help making a health care decision, visit our CareFinder and live chat. 

Each day, the average person takes about 16 or so breaths every minute. That equates to roughly 700,000,000 breaths in a lifetime. If we are lucky enough to breathe fresh air, each one of those breaths will contain 78% nitrogen, 21% oxygen and a small percent of argon, carbon dioxide and other non-toxic gases. Even though oxygen accounts for only 1/5 of the air we breathe in, it is the only component of air that we actually use. In fact, oxygen is the single most important substance that we take into our body. Oxygen is the one necessary component in every chemical reaction important to human physiology. The cells of the body need oxygen to generate energy and without that energy the body would quite simply shut down.Oxygen provides cells with the energy needed to metabolize carbohydrates, transport nutrients, break down waste products and toxins, regulate the pH of body chemistry, drive the desire to breathe, and fight hostile organisms. A large part of our nutrition and energy comes from oxygen itself and it is even more important than food or water. Clinical studies show that a human being can live for days without water, and weeks without food but without oxygen biological death begins to occur within three minutes.Since oxygen is literally the breath of life, then it is understandable why getting oxygen from outside in the atmosphere to the tissues inside our body where it performs its life-sustaining duties as efficiently as possible is one of if not the most important health challenges one faces. In order to fully appreciate what an important process oxygen delivery is one must understand how oxygen travels to and through our body.In order to understand this flow of oxygen, lets break down the oxygen flow into seven basic and critically important - steps: Step 1: Oxygen Delivery The first step that needs to occur for oxygen delivery is oxygen access. Oxygen needs to gain access into the body. Step 1 is Oxygen Delivery when oxygen gains access to the body through the nose, mouth or in cases where an individual requires a tracheal airway a trach. When we take a deep breath, those atoms and molecules that make up the fresh air and the particulates that may pollute that same air gain access into our bodies. Step 2: Oxygen Passageway Once the air containing oxygen gains access to our throat, it is purified and then is inhaled into our lungs. The lungs are the main part of our Oxygen Passageway, which is step 2. In an attempt to purify the air that travels into the passageway, our nose hairs and mucous in the nasal passages and the bronchial tubes try to block particles that we breath in. However, if the particles are too small, they get by these defenses and may cause disease. When the lungs are damaged by disease, the passageway could be compromised. Diseases like emphysema, Chronic Obstructive Pulmonary Disease (COPD), blood clots (Pulmonary Embolisms), cancer, pneumonia, or Congestive Heart Failure (CHF) may compromise the oxygen passageway with restrictions, obstructions, disruptions or infiltrations. Because breathing is something all of us do all the time, we scarcely notice were doing it. So when our respiratory function gradually declines, we are unaware of the danger for far too long -- as when smokers fail to notice their shortness of breath, or believe it comes from eating too much. Step 3: Preload Once the oxygen reaches the platform or the alveoli, it then requires a means of transportation from the lungs through the body. This transportation which comes in form of blood flow is called preload. Preload is step 3 of oxygen delivery. The preload, or venous blood flow, circulates from the right side of the heart picking up oxygen from the lungs before flowing to the left side of the heart where it is pumped out as afterload .If the body is too dry volume depleted or dehydrated the volume flow in to pick up oxygen may be too low for adequate oxygen transport.Step 4: Oxygen Carrying Capacity When blood flows successfully from the right side of the heart into the lungs it carries with it hemoglobin. Hemoglobin, also known as the bloods Oxygen Carrying Capacity is step 4. Oxygen attaches to hemoglobin so that the blood can carry it through the circulation. If you are anemic or have a low hemoglobin blood count, your capacity to carry oxygen may be compromised.Step 5: Pump Once the oxygen has attached to the hemoglobin, it then needs to be pumped forward through the body. The Pump is step 5 of oxygen delivery. When the heart contracts, it will push the blood which is carrying oxygen out to the body. An efficiently pumping heart is important in order to assure adequate delivery of oxygen to the tissues.Diseases like Coronary Artery Disease (CAD), hypertension, and diabetes all may contribute to a weakened pump. A rapid or chronically elevated heart rate may be an indication that your pump is not working as efficiently as it should.Step 6: Afterload Once the heart pumps, the oxygen is then propelled into the circulatory system. This blood flowing through the circulatory network of arteries that stems from the left side of the heart makes up the afterload. The Afterload is step 6 of oxygen delivery. The afterload serves as the mechanism by which oxygen is carried through the circulation to the tissues.If the pressures of the blood flowing through the circulatory system i.e. blood pressure, is not optimal or if the circulation is compromised by plaque formation or narrowing, the work to deliver oxygen to the tissue will be increased.Step 7: Tissue Delivery It is the circulatory system that allows the afterload to bring oxygen to its ultimate destination which is the tissues where it is used for cellular respiration and metabolism. Step 7 is Tissue Delivery. Oxygen diffuses into the tissues by osmosis. Osmosis is most efficient when the concentration of oxygen in the blood is optimal, the body core temperature is normal, and the blood glucose levels are normal.Cellular metabolism and utilization of oxygen by the cell is compromised when the patient shifts from normal blood sugar and temperature measurements.As we take the journey with oxygen through these seven steps, it is easy to appreciate that most of us are suffering from some lack of oxygen. Whether from pollution, lung disease, fluid deficits, anemia, inefficient pump, vascular disease or metabolic abnormalities, our cells are being deprived of this vital element and thus weakening our immune system. Unhealthy or weak cells due to improper metabolism lose their natural immunity and are thus susceptible to viruses and lead the way to all kinds of serious health problems. So what can we do? We can start by looking to the seven steps.We need to1. Improve our access to oxygen2. Open up our pulmonary tree3. Maintain a healthy fluid balance4. Build up our blood5. Increase our heart pump6. Lower our pressure7. Feed our cellsStep 1: Improve Access to OxygenWe need to minimize exposure to environments where oxygen levels may be impaired. Secondhand smoke, outdoor air pollution, chemicals in the home and workplace, and radon all can compromise the oxygen concentration. Initiatives to improve your environment should include: make your home and car smoke free; do your part to decrease pollution; test your home for radon; try to avoid prolonged outside activities on bad air days; And talk to your health care provider if you are worried that something in your home, school or work may be making you sick.You also may want to have your oxygen saturation level checked. If your oxygen saturation is less than 98% you should follow up with your health care provider.Step 2: Open up the Pulmonary TreeDeep breathing exercises and avoiding behaviors which lead to lung disease are the fundamentals of good lung health. The most important rule to open up the pulmonary tree is: Dont smoke! Cigarette smoking is the major cause of lung cancer and Chronic Obstructive Pulmonary Disease (COPD), which includes chronic bronchitis and emphysema. Cigarette smoke can narrow the air passages and make breathing more difficult. It causes chronic inflammation, or swelling in the lungs, which can lead to chronic bronchitis. Over time cigarette smoke destroys lung tissue, and may trigger changes that grow into cancer. If you smoke, its never too late to benefit from quitting. Your health care provider and the American Lung Association can help whenever you are ready.Aerobic exercise and breathing exercise have been shown to help improve lung capacity.Step 3: Maintain A Healthy Fluid BalanceMaintaining an appropriate level of hydration is an important part of good health. Abrupt shifts in our fluid volumes may be an indicator of advancing disease. A 2-3 pound weight gain in 24 hours or a 5 pound weight gain in a week period should be reported to your health care provider for follow up.There isn't much guidance on the recommended amount of water that is needed daily. A general point, our thirst mechanism is what regulates hydration in the body and most people get an adequate amount of water just by paying attention to that mechanism. It is suggested that the average person loses about 10 cups of water every day, which should be replaced. This could be water consumed through what we drink or through foods that have high water content. Staying well hydrated and drinking even before you are thirsty is essential because thirst is a sign of a fluid deficit.Step 4: Build Up the BloodAnemia is a condition characterized by a deficiency of red blood cells, or of hemoglobin, in the blood. Hemoglobin is a protein located in red blood cells, which allows red blood cells to carry oxygen from the lungs to the rest of the human body. Anemia diminishes the capacity of the blood to carry oxygen. The element iron is needed to manufacture hemoglobin. Anemia can be temporary or long term, and it can range from mild to severe. The main causes of anemia are bleeding, hemolysis (excessive destruction of red blood cells), underproduction of red blood cells, and underproduction of normal hemoglobin.Iron deficiency anemia is the most common type of anemia. It can result from inadequate iron intake, decreased iron absorption, increased iron demand, or increased iron loss. Symptoms of iron deficiency anemia may include fatigue, shortness of breath, chest pain, dizziness, headache, and pica (unusual cravings for substances with no nutritional value such as ice, dirt, or starch).Blood tests such as a complete blood count (CBC) and serum ferritin level are useful for the diagnosis of iron deficiency anemia. A CBC can help determine red blood cell size, hematocrit (percentage of blood volume made up by red blood cells), and hemoglobin. Ferritin reflects iron stores and is the most accurate test to diagnose iron deficiency anemia. All of these blood tests would be decreased in iron deficiency anemia. Iron deficiency anemia is treated with iron supplementation.Step 5: Pump It UpHeart failure means that the heart isn't pumping as well as it should be. Your body depends on the hearts pumping action to deliver oxygen- and nutrient-rich blood to the bodys cells. When the cells are nourished properly, the body can function normally. With heart failure, the weakened heart cant supply the cells with enough blood. This results in fatigue and shortness of breath and some people have coughing. Everyday activities such as walking, climbing stairs or carrying groceries can become very difficult.Heart failure can be managed with heart failure medications and healthy lifestyle changes.Step 6: Lower the PressureHigh blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease. You can have high blood pressure (hypertension) for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.High blood pressure generally develops over many years, and it affects nearly everyone eventually. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.Step 7: Feed the CellsOur cells are happier when they are free of infection and metabolic fluctuations. Preventing infection and maintaining healthy blood glucose levels are some basic ways to keep the cells happy. A cold or other respiratory infection can sometimes become very serious. Good health begins where we live, learn, work and play and its important to ensure that safeguards are in place to protect us and prevent disease.HOW HCR MANORCARE CAN HELPHCR ManorCare is focused on caring for patients requiring skilled nursing and rehabilitation services. Services focused on caring for lung health include:Patients have their oxygen saturation measured at least as frequently as the other core vital signs. This means a minimum of every shift for 72 hours on admission and daily thereafter while on the short stay units or when they require closer monitoring.The clinical team monitors respiratory rates and lung sounds at a minimum daily on all short stay patients and with changes in condition. Cough and deep breathing maneuvers, incentive spirometry, chest physical therapy, suctioning and respiratory medications may be part of the individual prevention or treatment plan.Patients weights are monitored as frequently as daily in high risk patients and a minimum of once a week for short stay patients.Nutritional support and supplements are part of the ongoing care plan. When a patient requires blood replacement, the clinical team works closely with community partners to provide timely and appropriate interventions.Heart rates are monitored closely. Since heart rates greater than 80 may serve as herald that either the heart is not working as efficiently as it should or the demand for oxygen has increased, our clinical team works closely with health care providers in evaluating our patients for treatment interventions.Blood pressures are monitored at least daily on all short stay patients. Since elevated blood pressures may increase the risk of heart attack or stroke, blood pressures that exceed 140/90 are addressed by the clinical team in consultation with the patients health care provider.Clinicians and medical practitioners assess patients ability to deliver oxygen to the tissues through the Go with the FLO2W program whether you are recovering from a surgery or illness, or seeking a comprehensive review of palliative care or looking for palliative care.Submitted and Written BY: HCR Manorcare - click here for more information

For More Information on ManorCare Nursing & Rehab of Naples, CLICK HERE!According to the American Lung Association, the average adult takes 15 to 20 breaths a minute or in a given day over 20,000 breaths. The important respiratory system is made up of our nose, throat, trachea and lungs.We may take our lungs for granted until we have an acute episode like a cold or allergy that impairs our ability to breathe and perform routine day to day activities. The respiratory system can also be compromised due to chronic conditions such as Chronic Obstructive Pulmonary Disease (COPD) or acute, severe conditions like pneumonia.With COPD, one of the common symptoms is shortness of breath during activities due to the restriction of air flow during inhaling or exhaling. Therefore, many individuals with COPD have what can appear to be an intolerance to exercise.There are many reasons for an individual with COPD to engage in exercise and activities that are physically challenging. Exercise or physical activities help improve the efficiency of oxygen use and overall endurance. Exercise can also enhance muscle strength, balance and overall flexibility. As exercise improves the ability to perform activities, the symptom of shortness of breath lessens.Always consult your health care professional before engaging in new exercises or starting an exercise program in general. Anyone with lung disease needs to consider the type, amount, and frequency of exercise. Additionally, stretching, cardiovascular and strengthening exercises should be incorporated into the regime. Lastly, make sure the activities you chose are interesting, pleasurable and provide personal gratification.A warm-up type of exercise is important to prepare the heart and lungs for the conditioning phase of exercise. Warmup exercises can include stretching, range of motion exercises and low intensity exercises. This portion of an exercise routine slowly increases the breathing demands and circulation levels (heart rate).The aerobic conditioning(or cardiovascular) portion of an exercise program can include riding a recumbent or upright stationary bicycle and using a treadmill or walking on a level. During this phase of the exercise, it is important to measure your intensity of activity through measuring heart rate or exertion levels using the Rate of Perceived Exertion Scale (RPE). The RPE Scale is an easy to use tool for personal use to assess the intensity of your workout or any activity. It is a 0 to 10 scale with 0 being (Nothing at all) to 10 being (very, very heavy work). For people with lung conditions, exercising at this phase at a 3 to 4 level is often determined safe and effective.Strengthening exercises especially upper body exercises can be very helpful for people with COPD. A good measure of strength and endurance of the upper and lower body can be accomplished by performing a 30 second arm curl test and a 30 second chair stand test. These tests can be performed by an exercise professional or rehabilitation professional. Each test provides a baseline for strength and endurance and provides normative data for ages 60 to 94 (male and female). Strengthening exercise equipment can be accessed at a local fitness center or can be acquired at a sporting goods store (hand weights, cuff/ankle weights or exercise bands).Cooling down after exercise is just as important as warming up prior to conditioning or strengthening. Slowly decreasing the intensity of the exercises and engaging in range of motion or stretching exercises will allow your heart rate, respiration rate and blood pressure to return to resting (pre-exercise) levels.A few additional considerations for exercising for greater lung health include the frequency and duration of exercise. An initial exercise program can be started every other day and the exercise session should last for at least 20 to 30 minutes. The activity level can then gradually increase. One other important factor is to find an exercise activity that is pleasurable. Consider your personal characteristics: Is socialization important? Do you enjoy structure or self-led activities? Do you like sports or physically demanding leisure activities?Your pattern of breathing is also important to consider during exercise. Pursed lip breathing techniques can be used during exercise and other activities of daily living and mobility activities. Pursed-lip breathing technique is when one breathes through the nose with mouth closed then slowly breathes out through pursed partially opened lips. The inhalation phase takes approximately2 seconds and the exhalation phase is a bit longer about 4 seconds. Exercising while using the pursed-lip breathing technique helps to reduce symptoms of shortness of breath.Exercise to maintain and improve lung health can help an individual with COPD or other lung conditions live a productive and active life. As with any exercise program, consult your physician for guidance on the type and amount of exercise. You can request that your physician refer you to an exercise or rehabilitation professional familiar with pulmonary conditions. Pulmonary rehabilitation programs may be available at your local hospital.