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For more information on Encompass Health, Click Here.Life happens fast sometimes this can result in you or a loved one facing a terminal illness or needing unexpected life-saving care. According to an AARP study, only about one-third of adults have a plan in place that expresses their wishes for end-of-life care.Advance care planning is a process that helps us plan for life's what if moments. This process gives individuals and their caregivers the opportunity to plan for future healthcare decisions should they be unable to make their own decisions or speak for themselves.Whether your'e facing an acute illness, terminal diagnosis or an unexpected accident, advance care planning can help alleviate the burden on you and your loved ones while also ensuring you receive care that is consistent with your beliefs, values, wishes and goals.What are the benefits of advance care planning?Advance care planning gives individuals and their loved ones peace of mind during moments of unforeseen illness or injury. Creating a plan ahead of time can help improve your quality of life during a healthcare crisis and also alleviates the worry of loved ones wondering if they did the right thing on your behalf.In addition to helping individuals and their families, advance care planning also ensures your healthcare teams knows your preferences and whether you would like to receive life-sustaining measures, such as cardiopulmonary resuscitation (CPR), ventilator use or comfort care.Advance care planning is an important part of disease self-management for many older Americans currently living with one or more chronic conditions. While many people living with a chronic disease are able to experience a high quality of life, these diseases are also typically accompanied by periods of gradual decline.Taking the time to talk through possible life-altering situations with your loved ones gives you the opportunity to express your wishes and ensure your voice is heard so that your healthcare preferences are honored when it matters most.What are advance directives?While its important to talk about your wishes, its even more important to document them. Research shows that people who document their preferences by using advance directives are more likely to get the care they prefer at the end of life than people who do not.Advance directives are a group of legal documents that express an individuals healthcare choices should they become unable to communicate their own decisions, and they can be updated at any time should their beliefs or viewpoints change. Examples of advance directives include a medical power of attorney, living will or directive to a physician. One of the most important elements of an advance directive is naming a trusted friend or family member as a medical power of attorney, giving them healthcare decision making rights. Choosing someone you trust as your healthcare proxyand whom you have had multiple discussions with regarding your beliefs, wants and goalsis one of the best ways to ensure your healthcare choices are honored in times of unforeseen medical crises.A living will is another important document that allows you to outline your healthcare preferences in specific situations. For some people, staying alive as long as medically possible is important to them, and therefore they might elect aggressive treatment should they be faced with a life-threatening situation. Others may choose to receive comfort care instead.When should I start advance care planning?Its common to ignore the possibility of serious disease, life-threatening trauma or death until a crisis occurs. However, these circumstances bring pain and trauma not only to the person afflicted, but to their loved ones as well.None of us know what tomorrow may bring, so its smart to start planning for the future now. Having a plan in place and beginning these discussions with your loved ones can help you prepare for a potential life-threatening event and greatly reduce the burden it may bring.

Falls are a scary thing. Its normal to feel scared of falling, especially if you have fallen before. Even those who dont fall can develop the fear if they have a friend whos fallen. Falls among adults 65 and older can be dangerous and costly. According to the Centers for Disease Control and Prevention, about $50 billion is spent each year on medical costs related to non-fatal falls. One out of five falls causes a serious injury such as a head injury or fracture. Even though we cannot always prevent a fall, it is possible to take measures to help reduce risk of injury related to a fall. There are also things that you can do to be less fearful of falling.Why do Falls Occur?Balance problems are very common in the elderly population. Fear may develop as people begin to lose control of their balance. Problems with balance and strength put you at risk for a fall. Some people tighten their muscles when they feel they are about to fall. However, this stiffening can limit the range of motion and make a fall more likely.Some contributing factors for a fall include:Problems with vision or the inner earLoss of sense of touch in the feet and anklesDizziness due to medical conditions such as orthostatic hypotension or diabetesWeak muscles, especially in the legsFoot problems and foot deformitiesMemory loss, confusion or difficulty with problem-solvingMedication-related fallsEnvironmental risks such as outside hazards like icy sidewalks and home hazards such as loose throw rugs and risky footwear like flip-flops or high heelsTips to Prevent a FallTalk to your doctor. Make sure to see your doctor regularly and inform them of any falls or changes to your health. Some of the medications that you use could lead to side effects such as dizziness and drowsiness that may lead to a fall. Common medications that can cause these side effects are blood pressure, pain, and sleep medications and antidepressants. Because the way your body reacts to medicines can change as you age, you should regularly review all your medications with your doctor. They will be able to make changes to them if needed.See your eye doctor and make sure your eyewear prescriptions are up-to-date. Poor vision and conditions such as glaucoma and cataracts increase the chances of falling.Remove hazards. There are several measures you can take in your home and outside of it to reduce the risk of a fall.Remove loose rugs and cords and keep pathways clear.Install grab bars as needed in the bathroom near the toilet and in the shower. Install railings as needed throughout the house.Add railings to stairs.Choose chairs with long arm rests. Using rails or arm rests improves safety with getting in and out of a chair. When sitting down, back up until you feel the chair against the back of both your legs. If you have a walker, back up with the walker. Next, reach back for the armrests and lean forward to sit down on the chair.If your couch is too low, making it hard to stand up, consider purchasing couch risers.Keep things within reach. Keep things you often use within reach, including water, remote control, books or tissues. Keep items in the same place to establish a familiar routine.Use walker trays with your walker to help carry items safely from room to room.Re-arrange furniture to open the area and remove unnecessary obstacles in your path. You can also keep the furniture in strategic locations in case you need to hold onto them as you walk.In your bedroom, consider repositioning your bed against the wall to make it more accessible. You can add bed rails that can be installed under the mattress to help get in and out of bed safely.Make sure to have proper fitting footwear.Consider purchasing adaptive equipment (reachers for hard to reach items, tub transfer bench to improve safety getting in and out of the tub, handheld shower, etc.)Begin strength and balance exercises. Exercise helps prevent falls by strengthening your muscles and improving balance. Regular exercise and staying active is one of the best ways to prevent falls. Balance, strength, endurance and flexibility all come from exercise. Good activities to improve balance include Tai chi, yoga, dance and stretching. Yoga and tai chi not only help with balance but also provide a time for recollection and quiet meditation. Cleansing your mind with these activities can help you focus on whats important in your lifeyour health and your family. Peer support has been shown to be very effective. Get out and exercise with a group; it will build up your confidence so that you can actively work on your balance. Also remember to use the heel-toe walking method. Focus on getting the heel down first with every step. When you are walking, be aware of your surroundings.How to Get up after a FallIt is important to be able to reach for help in the unfortunate event that you have fallen. Always keep a cell phone with you. Put it on a lanyard around your neck while you move around so that you have it with you constantly throughout the day. Keep a list of emergency numbers near your phone and in your cell phone. There are home monitoring devices also available. If you fall, you can press a button on the device around your neck or wrist. This alerts emergency responders to come and help you.Steps to Get Up if You have FallenIf you have fallen, the first thing you need to do is make sure you are not hurt.Stay calm. Do not get up suddenly; wait for a few minutes to make sure you are not injured or dizzy.Slowly move your hands, feet, arms and legs, and make sure you are not in pain.If you are in pain, wait for help to arrive before moving. Do not attempt to get off the floor if you are injured. It can make the injury worse.Call 911 and wait for help to arrive, and let them know what area of your body is hurting.If there is a pillow within reach, use it to place under your head.If you are not injured or in pain, it is very important that you know how to get up safely.Prepare, Rise and SitThere are three main steps to fall recovery: Prepare, rise and sit.Prepare: While you are on the ground, dont try to stand up on your own. Look around for a sturdy piece of furniture like the sofa or a sturdy chair. Now roll over to your side by first turning your head in the direction of the sturdy furniture, followed by your shoulders, arms, hip and your leg moving to the side.Rise: Push your upper body up and lift your head, and make sure you feel steady.Now get up on your hands and knees and crawl to the sturdy chair or furniture. Place your hands on the chair and slide one foot forward so that it is flat on the floor in preparation for kneeling.Sit: Keep the other leg bent with the knee on the floor. From this kneeling position, use your hands to slowly rise and turn your body to sit on the chair. Do not get up suddenly; let your body rest and sit for a few minutes before you do anything else.Know your body and know your limitations. Fall prevention is key. If you have fallen, feel unsteady or if you are afraid that you may fall, make sure to talk openly with your doctor. He may change your medications, prescribe physical or occupational therapy, and get you started on a fall prevention program.The content of this site is for informational purposes only and should not be taken as professional medical advice. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding any medical conditions or treatments.

The new year is about new beginnings, and for many of us that means New Years resolutions. If youre contemplating what yours should be this year, consider the following suggestions to stay healthy and active as you age.Learn Something NewStudies show that learning something new when you get older keeps your mind sharp and can even ward off dementia. Maybe you pick up a new hobby such as knitting or you enroll in a class at your local community college. Its never too late to learn something new. Not only will it help keep your mind sharp, but also, depending on the activity, it is an opportunity to meet new people.Staying social as you age is key to warding off loneliness and isolation. Joining a new club or program stimulates your mind and introduces you to new people at the same time. Check with your local senior center or parks and recreation department to see what options are out there. Libraries and churches also offer opportunities for learning and/or gathering.Get ActiveExercise is important at any age, and it offers many benefits as you get older. Make a commitment to add exercise into your daily routine, even if its just light exercise. The CDC recommends those 65 and older get at least 150 minutes of exercise per week, or about 30 minutes five days a week. The benefits of exercise for senior adults are endless, including:Improving bone density and preventing bone lossHelping decrease arthritis painAiding in the management of chronic health conditionsBoosting your moodImproving cognitive functionDont know where to start? Here are a few moderate exercise suggestions to help you stay active as you age.Drink More WaterAs you age, the importance of staying hydrated is even greater. In fact, studies show that seniors are more vulnerable to dehydration, which is a leading cause of hospitalizations in older adults. The average person needs six to eight cups of water each day, but as you age, you may need even more. While that may sound like a lot, you dont have to get all your daily intake from water alone. Incorporate foods with high water content, such as cucumbers and watermelon. Also, mix it up. Add fruit to your water or try a low sugar sports drink. Just be aware that not all liquid beverages count toward your water intake and beverages like alcohol, coffee and tea could even negate it. These are diuretics and could dehydrate you, especially if you consume too much of them.Get a Good Nights SleepIf you wake up each morning feeling tired and irritable, youre likely not getting enough sleep. The National Institute on Aging (NIA) recommends seniors over the age of 65 get seven to nine hours of sleep each night. However, for many older adults thats not as easy as it sounds. If that is the case for you, make a resolution to develop a healthy sleeping routine, and follow it every nighteven on weekends and when traveling.The NIA offers the following strategies to develop a healthy sleeping routine:Go to bed and get up at the same time each dayDont nap late in the afternoonExercise regularly, but not within three hours of bedtimeAvoid caffeine late in the dayUse your bedroom for sleeping only and keep it at a comfortable temperatureLimit screen time in the hours before bedEat More AntioxidantsTheres no cure for aging, but if you want to slow the process, a good start is adding antioxidants to your diet. Aging is the result of the accumulation of oxygen radicals over time. One way to delay or slow aging: include plenty of antioxidants in your diet. Antioxidants protect your cells from the damage caused by oxygen radicals.Some examples of antioxidants include vitamins A, C and E, as well as copper, selenium and zinc. Foods high in these antioxidants include sweet potatoes, fish, poultry, mushrooms, oysters, legumes and more.While you may not need as many calories as you once did when you were younger, your body still needs nutrients. The best way to do that is with fresh, whole foods, not pre-packaged ones. While supplements can provide needed nutrients, they are not meant to replace food and beverages. In fact, the Dietary Guidelines for Americans states that your nutritional needs should come primarily from food and beverages.

Americans today are living much longer than they did a century ago. According to the National Center for Health Statistics, individuals born in 1900 had a life expectancy of 46. In 2020, life expectancy for the US population at birth was 77. Studies suggest this increase in longevity may be due, in part, to the use of prescription medications, as well as healthier behaviors. While living longer is certainly desirable, quality of life is even more important.While it may not be possible to control every factor as you age, the following steps can help you remain healthy and active into your senior years.Eat HealthyFollowing a healthy diet doesnt have to be complicated. Opt for a variety of high-quality natural foods that are grown in the ground or foods that have health boosting qualities.Start by adding color to your diet. Eating the rainbow is a term used to describe a diet filled with a variety of colorful fruits and vegetables. Colorful foods are packed with vitamins, minerals, antioxidants and phytonutrients. By choosing colorful fruits and vegetables, you increase your chances of getting the nutrients you need.Choose lean proteins. Seafoods, eggs, lean meats, legumes, nuts and seeds are all great sources of protein. Proteins can curb hunger because they are more satisfying. They also aid in building muscle and strengthening bones. Healthy protein has been shown to lower blood pressure and increase metabolism.Be sure to add calcium-rich foods to your diet. Low-fat dairy products such as milk and yogurt are a great source of calcium along with nuts, soybeans and leafy green vegetables. Some foods are frequently fortified with added calcium, including orange juice and cereals.Limit fatty foods, sugary drinks and processed foods to an occasional treat rather than a daily staple. Chemically processed foods, such as pastries, packaged breads, candy, ice cream, pizza and frozen meals, typically have artificial flavoring and refined ingredients. They often contain empty calories with very little nutritional value.Hydrate. While staying hydrated is important at any age, older adults are at greater risk of dehydration due to reduced thirst levels, age-related changes, medical changes, and taking prescription medications including diuretics. Staying hydrated is essential for brain and heart health, preventing kidney stones and urinary tract infections, temperature regulation, and even reducing joint pain.Stay ActiveAside from maintaining your physical health, regular exercise provides mental health benefits, helps with weight maintenance, lowers the risk of high blood pressure and heart disease, improves sleep, relieves stress, reduces pain, improves balance and flexibility and lowers the risk of chronic health conditions. Look for ways to increase daily activity.Set a goal of 150 minutes of moderate activity per week. If you havent been active, start slowly and build. Aerobic exercises that raise your heart rate offer the most benefit. Think dancing, walking briskly, swimming or biking.Add strengthening exercises twice a week. Squats, lunges, stretch bands, wall pushups, step-ups or stair climbing and bicep curls with weights (or even cans of food) are all examples of muscle strengthening exercises. Building and maintaining muscle mass helps prevents falls, increases bone density and improves coordination and mobility.Focus on balance. Stand on one leg with arms outstretched (or hold onto a chair if you are unsteady). Walk in line as if you were on a tightrope. With each step, try to balance on one foot for two to three seconds. Core strengthening exercises also lead to better balance.Maintain Regular Doctor VisitsIt is easy to skip routine medical visits when you are feeling well, but visiting your doctor at regular intervals is a big part of staying healthy. Reasons to keep those appointments:Regular visits make it possible for your doctor to identify problems at the earliest stages when they are easiest to treat. Health screenings can provide valuable information about your overall health.Routine visits allow time for you to get to know your doctor and him to get to know you. Familiarity helps your doctor recognize changes in your health and better understand your needs.Annual lab tests (or lab tests at the interval your doctor determines is best for you) can reveal changes in organ function or other health issues. It can identify the need for more testing or closer monitoring.Cost reduction is another reason to keep those appointments. Treating health conditions before they worsen may help you avoid surgery or other more costly treatments.Closely monitoring chronic health conditions allows your doctor to adjust medications and treatment regimes to keep chronic conditions under control.Exercise Your MindMemory problems and cognitive decline are common in the elderly, but there are steps you can take to help keep your mind sharp.Continue to learn. Learn a new skill or try something that challenges your brain. Do crossword puzzles, jigsaw puzzles, Sudoku, join a book club, learn to play bridge or chess or take up a new hobby. Lifelong learning is a great way to keep your mind engaged and active.Exercise. An added benefit of physical activity is brain health. Look for ways to mix it up when exercising. Take a ballroom dancing class, join a bowling league, exercise outdoors or play a sport. Combining exercise with social interaction offers additional benefit.Find a purpose. Maybe youve always wanted to write a book or get your college degree. Its never too late to reach those goals that once seemed out-of-reach.Practice mindful meditation. Studies have shown that even 10 minutes of meditation can boost brain function and lower anxiety.Maintain Good Oral HealthOral health impacts overall health and wellbeing. Daily oral care not only reduces the risk of dental disease, but it can also improve your health. Reasons to practice good oral care:Approximately 68% of adults 65 or older have gum disease.Gum disease and infected teeth can lead to heart disease, dementia, respiratory infection and diabetes complications. Bacteria from the mouth doesnt just stay there, it travels through the bloodstream impacting other areas of the body.Oral health issues impact your ability to chew and swallow, which can affect your nutritional status and may prevent you from indulging in your favorite foods.Good oral hygiene can prevent problems with gums and teeth. Brush twice a day for two minutes each time. Use a soft bristled toothbrush and replace it every three to four months or when bristles are worn. Floss daily and visit your dentist regularly for check-ups and cleanings.Stop smoking. Smokers produce more plaque which can build-up on the teeth. It also causes staining, gum disease, tooth loss and, in some cases, oral cancer.The content of this site is for informational purposes only and should not be taken as professional medical advice. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding any medical conditions or treatments.

A Letter from Dr. Lisa Charbonneau, Encompass Health Chief Medical OfficerDr. Lisa CharbonneauHealthcare is complicated. At Encompass Health, we understand that and want to make it a little less complicated. In this guide we want to equip you with the information and tools you need to make the best decisions for your health as you or a loved one ages. Yes, healthcare can be complicated, and it tends to get more complicated as you age, but a little knowledge and some advanced planning can go a long way in navigating you or a loved ones care in your 60s and beyond.In This Post You You Will Learn:How to Better Talk to and Understand Your DoctorHow to Pick the Right Medicare Plan for YouWhat are Your Rights as a PatientWhat the Different Settings of Care AreCutting through the Medical Jargon: How to Talk to Your DoctorSometimes, interpreting a doctors medical jargon can feel like trying to understand a foreign language.Most patients and families, dont want to admit they dont understand when a doctor begins explaining a complicated illness or condition, and instead sit quietly nodding in affirmation.Jargon is pervasive in all professions, but it has its greatest impact when doctors try to communicate with patients. Peoples lives are at stake. Healthcare professionals have their own verbal shorthand that may be highly effective when they speak to each other but causes confusion when used with laymen.The use of jargon begins in medical school. A medical student can quickly rattle off that, Mrs. Jones had a syncopal episode last night without any evidence of arrhythmia. I dont think it was vagal but I ordered a 2D echo and holter. I still cant rule out a vertebrobasilar event. Everyone wearing a white coat understands this secret language, but as a patient lying in the bed, you may feel terrified and confused.Medical Jargon is EverywhereThe average American reads and speaks at an eighth- or ninth-grade level, yet doctors assume that their patients will understand their obscure communication.Multiple studies have looked at the use of jargon by doctors and the failure of patients to understand them. One study of 249 emergency room patients reportedthat 79% did not know that the word hemorrhage was the same as bleeding and 78% did not know that a fracture was a broken bone. In case you think these were illiterate, underprivileged people, 45% of the people in the study were college educated. We cannot assume that the lawyer or English professor has any more understanding than someone with less education.What Can You Do to Interpret the Medical Speak?There are some steps that you and your families can take so you dont fall into the same trap that so many do. One simple program is the Ask Me 3 program that provides you with three questions to ask your doctor.What is my main problem?What do I need to do?Why is it important for me to do this?Unfortunately, you may still get jargon-packed answers. So, here are a few more tips to make sure you walk away with a clear understanding of your problems.If you do not understand what your doctor is saying, immediately stop them and ask them to use simpler language. Dont pretend that you understand when you do not.Tell the doctor what you think they said to be certain that you understood them. This is called a teach back.If you feel you need more time, ask to schedule another visit in the near future. This may be a telehealth visit and you will have the opportunity to have others listen in and help you.If the doctor is busy, ask if there is a nurse or assistant who can answer your questions.Take a trusted friend with you for another set of ears and even to take notes.Ask who you can call if you still have questions when you get home.Back to TopUnderstanding MedicareIf you or a loved one are nearing the Medicare age but are unsure what this benefit provides or the plan that is best for you, we are here to help you understand your options. Medicare is the national insurance program for adults age 65 and older. Its also a benefit most working adults pay for throughout their lifetime.Throughout the years, Medicare has evolved and extended the amount of plans available. Understand your options now, so you can pick the best plan for you or your loved one when the time comes.What to Consider When Picking a PlanWhen it comes to deciding between a traditional Medicare plan and a Medicare Advantage plan, consider two things: your income and your freedom to choose your provider. As you add supplemental plans to traditional Medicare, it can cost more than Medicare Advantage plans. However, with traditional plans, you have the freedom to choose any Medicare-approved, certified provider anywhere. Most Medicare Advantage plans require you to see a provider within their network and may require prior approval or a referral for certain procedures or healthcare servicesIf youre still searching for answers on what the best plan is for you, Medicare offers these seven things to consider when selecting your Medicare coverage.How Do You Enroll?You are automatically signed up for Medicare at age 65. However, if you want to select a Medicare health or drug plan, you have a seven-month period around your 65th birthday to sign up for one. This is called the initial enrollment period, and it:Starts three months before you turn 65; if a plan is selected during this period, it will go into effect the first day of the month you turn 65.Includes the month you turn 65; if a plan is selected during this period, it will go into effect the first day of the month following your 65th birthday.Ends three months after you turn 65; if a plan is selected during this period, it will go into effect the first day of the month after you enroll.If you later decide to change your plan or join a plan after that seven-month period has closed, enrollment is open each year from Oct. 15 to Dec. 7. Changes or enrollment during this time period will go into effect the following January.What are the Different Plans?In general, there are two types of Medicare plans: traditional Medicare and Medicare Advantage.Traditional Medicare includes Parts A and B. Part A is automatic and includes hospital insurance, which covers hospital stays, as well as skilled nursing facilities and hospice. Part B is optional and is deducted from your Social Security should you enroll. It includes medical insurance, which covers outpatient services, as well as some physician visits and preventative care. Other supplemental plans can be added through private insurance companies; these are paid for out-of-pocket.Also referred to as Medicare Part C or MA plans, Medicare Advantage is an all-inclusive plan that includes both parts A and B, as well other coverage such as prescription drugs, dental and more, depending on the plan. These plans are offered through private Medicare-approved companies. If you join a Medicare Advantage plan, you will likely be required to choose healthcare providers that participate in your plans network.There are a variety of Medicare plans out there today, so as you near the Medicare age of 65, start researching your options to find the one that best meets your needs.Back to TopYou Have a Choice in Your CareKnow Your OptionsDuring a medical emergency, there might not be time to determine your options for care, but once that emergency is stabilized, your physician or case manager could recommend you transition to another care setting as part of your recovery. These settingsknown as post-acute careinclude home health, inpatient rehabilitation, skilled nursing homes and long-term acute care hospitals.Your care team could refer you to one of these settings based on your abilities and goals, but as a patient, you have a choice in selecting which facility you go to. In fact, it is your right as a patient. The Center for Medicare/Medicaid Services refers to this as patient choice.What is Patient ChoiceIn 2019, the Center for Medicare/Medicaid Services updated its discharge planning rules to require providers to inform you of your choices when it comes to your post-acute care options. Compare providers near you with this tool from Medicare.gov.Your referring clinicianstypically a physician and/or a case managerare required to inform you of the different care settings available in your area that are appropriate for the level of care you require. They also have to tell you if they or their organization have any financial ties to those listed and to share information from those providers, so you can make an educated choice.The information they share should be related to your recovery goals. Depending on the setting of care, some of that information could include data surrounding rehospitalization (the need to transfer back to the acute care hospital) and patient satisfaction scores, as well as return to community rates.While all this information can be empowering, it can also be overwhelming, especially if you are not familiar with the different settings of post-acute care.What are the Different Settings of Care and Which is Best for YouAn Encompass Health inpatient rehabilitation gymAs defined by the Medicare Payment Advisory Commission, post-acute care is rehabilitation or palliative care that a patient receives after a stay in an acute care hospital, or in some instances, in lieu of a hospital stay. That care can take place in the home or in a facility, depending on the patients needs. Medicare recognizes four primary types of post-acute care:Home health is care that is provided in the home to help you recover after an illness or injury. Your doctor or other provider can refer you to home health and work with you and the agency to determine how many visits you are eligible to receive each week. Home health is designed to meet you where you are. If youre recovering from a surgery or a recent hospital stay or managing a disease or injury, home health provides care in the comfort of home. Home health services include nursing, therapy, nursing aides and social workers.Inpatient rehabilitation hospitals provide a hospital level of care with intensive therapy to help you regain your independence and ultimately return to your community after an illness or injury. While at an inpatient rehabilitation hospital, you will receive three hours of therapy a day, five days week. You will also have frequent visits from a rehabilitation physician and other physicians, depending on your needs. Nursing careis provided around the clock, and a multi-disciplinary team that includes rehabilitation physicians, nurses, therapists, dietitians, pharmacists and case managers will design a unique care plan to fit your goals. Conditions commonly treated at rehabilitation hospitals include stroke, head or spinal cord injuries, neurological disorders such as Parkinsons and multiple sclerosis, amputation and hip fractures.At a skilled nursing facility, you will receive therapy and nursing care. However, unlike inpatient rehabilitation facilities, there are no legal requirements mandating the number of hours of care per day that must be provided. Physician visits are not as frequent, either.If you or your loved one has had a particularly extended and medically complex hospital stay, a long-term care hospital may be recommended. At a long-term care hospital, you will receive nursing and rehabilitation care for an extended period of time. Many patients referred for this level of care are not yet able to participate actively in rehabilitation and may require assistance breathing.Will Insurance Cover My Care?That depends on your insurance and your coverage. You do have to meet certain medical requirements for the different settings of care to receive Medicare coverage. Also, some Medicare plans, such as Medicare Advantage ones, limit you to providers within their network. Work with your care team or primary care physician to determine if you meet the requirements of a particular setting. Make sure to discuss your goals, so they can fully understand your long-term needs and the setting that will best help you meet them. In some circumstances, you can consult with your preferred provider to see if they can work with your insurance to help you receive coverage.Do Your ResearchYour care team is required to provide you and your loved one with data regarding the quality of care of providers in your area, but take time to do a little research yourself. Look at patient reviews on websites. Ask family and friends with similar conditions who have had good outcomes and experiences. Where and who you receive care from matters, so take time to look around and find the best provider to help you reach your recovery goals. Perhaps a family member can tour a facility you are considering or take a virtual tour online. By understanding the different settings of care now, you are already taking a step in the right direction.

When Darryl Williams arrived at Banner Health hospital on July 15, he thought he was getting a second chance at life.The 56-year-old veteran had been awaiting a double-lung transplant, and he was scheduled to have the procedure just in time.I have pulmonary fibrosis, he said. When I was reading up on it, it said there was a three- to five-year life expectancy. I was in the fifth year when everything got approved.However, before surgery could begin, he had to have a COVID-19 test. To his surprise, it was positive. His transplant would have to wait.Battling COVID-19Initially, Williams had attributed his difficulty breathing to his pulmonary fibrosis, a condition that is characterized by shortness of breath and a dry cough. However, after a few days in the hospital, it was clear thatCOVID-19was exacerbating his symptoms.After about eight days, I couldn't breathe, he said. They put me in a high-density oxygen unit. Probably a day after that, I needed to go on a respirator. I remember the doctor telling me most people don't come off them.That is one of the last conversations Williams remembers until he woke weeks later.Preparing for surgeryWhile Williams battled COVID-19, his care team continued to prep him for his double-lung transplant. He remembers at least one time, a group of clinicians helping him stand.That's the only thing I remember, he said. I had to be strong enough to stand on my feet to get a lung transplant.Though he only recalls standing up once or twice, his care team at Banner continuously helped him stand as he battled COVID-19.Miraculously, Williams did survive that battle, and on Sept. 17, he finally had the life-saving surgery he entered the hospital for many weeks ago.Recovering from COVID-19 and a transplantBattling COVID-19 alone left Williams extremely weak, but adding a double-lung transplant to that meant that he needed rehabilitation to get him back to his home and family.Williams entered Encompass Health Rehabilitation Hospital of Northwest Tucson on November 6. There, he received a combination of physical, occupational and speech therapy to help him regain his strength and abilities after being hospitalized for so long.It was two or three months that I was strapped down with IVs, Williams said. I was immobile for so many months. Id lost a lot of muscle mass. Simple things like walking were tough.He had also been on a feeding tube for many months, so in addition to learning to walk again, he was learning to swallow and eat solid food again.His therapy team started small, helping him build his strength and practice everyday tasks. Even though he spent months in the hospital, he was ready to return home after less than two weeks at Encompass Health Northwest Tucson.I see why the doctors sent me there, Williams said. I felt a lot stronger when I left and I was walking around the facility without a walker.Returning homeWilliams said he thought it was a miracle when he learned he would receive a double-lung transplant. After his battle with COVID-19, he got one more miracle when he was able to return home to his girlfriend and dog months after his initial trip to the hospital in July.On Thanksgiving, he sat down with his family for a full, solid meal something he couldn't have done just a couple weeks earlier.Written and Submitted by: Encompass Health- click for more information*For the original blog post click here*

The COVID-19 pandemic has changed our lives in many ways. While we continue to hope that some of those changes will eventually go away, there are some namely in the area of healthcare that are likely to stick around well after the pandemic.However, this isn't necessarily a bad thing. In fact, some of those changes could be quite good for both patients and healthcare workers alike. The following are just a few of the lasting impacts that the COVID-19 pandemic could have on the healthcare industry as a whole.Inpatient rehabilitation is the right setting for medically complex patientsPrior to the pandemic there was a common misconception that sicker patients could not tolerate three hours of therapy a day; therefore, the thought was, inpatient rehabilitation was not the proper setting of care for them. Those of us working in this setting know that assumption to be false, and the recovering COVID-19 patients we treated during this time drove that point home.These patients came to us from the acute care hospital extremely weak, often having been on a ventilator for weeks. Our multidisciplinary approach to therapy plus our hospital level of care allowed them to heal and regain their strength, resulting in roughly 80 percent of recovering COVID-19 patients in our care discharging back to their communities.We were able to meet these patients where they were in their recovery, designing therapy and care plans specific to their goals and needs, just as we do with all of our patients, such as those recovering from a severe stroke or brain or spinal cord injury.There will be a continued focus on mental health, and not just for patientsIf there was ever a time that tested the mental health of all of us, it has been the COVID-19 pandemic.The isolation and separation for patients has been extremely difficult, as have the pressures put on those working in healthcare during this time. While we've long screened for signs of depression and anxiety in our patients, we may have overlooked ourselves as well as those working alongside us.This is not new, but certainly something the pandemic has shined a spotlight on. Just as we take care of our patients mental health, we must also take care of ours and our colleagues in healthcare during and after this pandemic.Telehealth will continue to be an option for the right patients and circumstancesAs many sheltered at home, telehealth allowed patients and their physicians to stay connected.While a physical examination cant be replaced by a video call in certain instances and settings of care, telehealth has proved valuable for many patients and their physicians at this time. This is likely to increase in the future, but only for the right patients and the right circumstances.Communications among staff and patients is keyThis has always been the case, but again, the COVID-19 pandemic has emphasized this fact. Constant communications between clinicians and their patients and their caregivers has been especially crucial, but its also crucial among our disciplines and leadership.When the CDC declared COVID-19 a pandemic in March 2020, the news was changing daily. At Encompass Health, our COVID-19 task force was meeting multiple times a day, informing our hospitals of the changing guidance coming from the CDC and more. At our individual hospitals, leadership was alerting staff daily of any changes.Its those communications that allowed us to continue to operate efficiently amongst all the change and uncertainty.Pandemic or not, those frequent communications must continue to be a priority, so we can best serve both our patients and their caregivers, as well as our colleagues and staff.Written & Submitted By: Encompass Health, Sarasota- click here for more information*For Original Blog Link Click Here*

With two COVID-19 vaccines now being distributed, a sense of relief and anticipation is in the air. The first two vaccines have a 95% effectiveness rating. The fact that there are another three vaccines in phase 3 clinical trials certainly sweetens the deal.This long-awaited news is promising. However, that doesn't mean its time to let our guard down. We must remain vigilant in our now routine measures of infection control namely handwashing, social distancing and wearing masks.Because of the limited supply of the vaccine, it is being distributed in phases and vaccinating those at greatest risk and exposure first. That means it could be several months before the vaccine is available to the general public.As predicted, cases and hospitalizations have continued to rise since the holidays, and we can only expect that to continue in the first few weeks of the new year.We are all tired of this pandemic, but we also know that many lives can be saved in the next few months by reducing the spread of COVID-19 before the vaccine is widely distributed to the public.Until then, here are some reminders from the CDC on how to slow the spread of COVID-19 and keep you and your loved ones safe:Wear a mask in public. Make sure it covers both your nose and mouth.Keep your distance. Six feet or two arm lengths is still the recommended distance to keep from those outside your household.Stay out of poorly ventilated spaces.Avoid crowds.Wash your hands. Soap and water is preferred, but keep sanitizer readily available when that's not an option.If you feel sick, do not come to work! Seek medical care if appropriate.While we can finally see a light at the end of this long tunnel, we still are months away from being back to normal. In the meantime, following these simple guidelines could save lives.Submitted & Written By: Encompass Health- click here to learn more.

A Letter from Dr. Lisa Charbonneau, Encompass Health Chief Medical OfficerDr. Lisa CharbonneauHealthcare is complicated. At Encompass Health, we understand that and want to make it a little less complicated. In this guide we want to equip you with the information and tools you need to make the best decisions for your health as you or a loved one ages. While the title of this guide addresses those 60 and older, it is really designed for anyone who wants to take control of their healthcare.Yes, healthcare can be complicated, and it tends to get more complicated as you age, but a little knowledge and some advanced planning can go a long way in navigating you or a loved ones care in your 60s and beyond.Cutting through the Medical Jargon: How to Talk to Your DoctorSometimes, interpreting a doctors medical jargon can feel like trying to understand a foreign language.Most patients and families, dont want to admit they dont understand when a doctor begins explaining a complicated illness or condition, and instead sit quietly nodding in affirmation.Jargon is pervasive in all professions, but it has its greatest impact when doctors try to communicate with patients. Peoples lives are at stake. Healthcare professionals have their own verbal shorthand that may be highly effective when they speak to each other but causes confusion when used with laymen.The use of jargon begins in medical school. A medical student can quickly rattle off that, Mrs. Jones had a syncopal episode last night without any evidence of arrhythmia. I dont think it was vagal but I ordered a 2D echo and holter. I still cant rule out a vertebrobasilar event. Everyone wearing a white coat understands this secret language, but as a patient lying in the bed, you may feel terrified and confused.Medical Jargon is EverywhereThe average American reads and speaks at an eighth- or ninth-grade level, yet doctors assume that their patients will understand their obscure communication.Multiple studies have looked at the use of jargon by doctors and the failure of patients to understand them. One study of 249 emergency room patients reportedthat 79% did not know that the word hemorrhage was the same as bleeding and 78% did not know that a fracture was a broken bone. In case you think these were illiterate, underprivileged people, 45% of the people in the study were college educated. We cannot assume that the lawyer or English professor has any more understanding than someone with less education.What Can You Do to Interpret the Medical Speak?There are some steps that you and your families can take so you dont fall into the same trap that so many do. One simple program is the Ask Me 3 program that provides you with three questions to ask your doctor.What is my main problem?What do I need to do?Why is it important for me to do this?Unfortunately, you may still get jargon-packed answers. So, here are a few more tips to make sure you walk away with a clear understanding of your problems.If you do not understand what your doctor is saying, immediately stop them and ask them to use simpler language. Dont pretend that you understand when you do not.Tell the doctor what you think they said to be certain that you understood them. This is called a teach back.If you feel you need more time, ask to schedule another visit in the near future. This may be a telehealth visit and you will have the opportunity to have others listen in and help you.If the doctor is busy, ask if there is a nurse or assistant who can answer your questions.Take a trusted friend with you for another set of ears and even to take notes.Ask who you can call if you still have questions when you get home.Understanding MedicareIf you or a loved one are nearing the Medicare age but are unsure what this benefit provides or the plan that is best for you, we are here to help you understand your options. Medicare is the national insurance program for adults age 65 and older. Its also a benefit most working adults pay for throughout their lifetime.Throughout the years, Medicare has evolved and extended the amount of plans available. Understand your options now, so you can pick the best plan for you or your loved one when the time comes.What to Consider When Picking a PlanWhen it comes to deciding between a traditional Medicare plan and a Medicare Advantage plan, consider two things: your income and your freedom to choose your provider. As you add supplemental plans to traditional Medicare, it can cost more than Medicare Advantage plans. However, with traditional plans, you have the freedom to choose any Medicare-approved, certified provider anywhere. Most Medicare Advantage plans require you to see a provider within their network and may require prior approval or a referral for certain procedures or healthcare servicesIf youre still searching for answers on what the best plan is for you, Medicare offers these seven things to consider when selecting your Medicare coverage.How Do You Enroll?You are automatically signed up for Medicare at age 65. However, if you want to select a Medicare health or drug plan, you have a seven-month period around your 65th birthday to sign up for one. This is called the initial enrollment period, and it:Starts three months before you turn 65; if a plan is selected during this period, it will go into effect the first day of the month you turn 65.Includes the month you turn 65; if a plan is selected during this period, it will go into effect the first day of the month following your 65th birthday.Ends three months after you turn 65; if a plan is selected during this period, it will go into effect the first day of the month after you enroll.If you later decide to change your plan or join a plan after that seven-month period has closed, enrollment is open each year from Oct. 15 to Dec. 7. Changes or enrollment during this time period will go into effect the following January.What are the Different Plans?In general, there are two types of Medicare plans: traditional Medicare and Medicare Advantage.Traditional Medicare includes Parts A and B. Part A is automatic and includes hospital insurance, which covers hospital stays, as well as skilled nursing facilities and hospice. Part B is optional and is deducted from your Social Security should you enroll. It includes medical insurance, which covers outpatient services, as well as some physician visits and preventative care. Other supplemental plans can be added through private insurance companies; these are paid for out-of-pocket.Also referred to as Medicare Part C or MA plans, Medicare Advantage is an all-inclusive plan that includes both parts A and B, as well other coverage such as prescription drugs, dental and more, depending on the plan. These plans are offered through private Medicare-approved companies. If you join a Medicare Advantage plan, you will likely be required to choose healthcare providers that participate in your plans network.There are a variety of Medicare plans out there today, so as you near the Medicare age of 65, start researching your options to find the one that best meets your needs.You Have a Choice in Your CareKnow Your OptionsDuring a medical emergency, there might not be time to determine your options for care, but once that emergency is stabilized, your physician or case manager could recommend you transition to another care setting as part of your recovery. These settingsknown as post-acute careinclude home health, inpatient rehabilitation, skilled nursing homes and long-term acute care hospitals.Your care team could refer you to one of these settings based on your abilities and goals, but as a patient, you have a choice in selecting which facility you go to. In fact, it is your right as a patient. The Center for Medicare/Medicaid Services refers to this as patient choice.What is Patient ChoiceIn 2019, the Center for Medicare/Medicaid Services updated its discharge planning rules to require providers to inform you of your choices when it comes to your post-acute care options. Compare providers near you with this tool from Medicare.gov.Your referring clinicianstypically a physician and/or a case managerare required to inform you of the different care settings available in your area that are appropriate for the level of care you require. They also have to tell you if they or their organization have any financial ties to those listed and to share information from those providers, so you can make an educated choice.The information they share should be related to your recovery goals. Depending on the setting of care, some of that information could include data surrounding rehospitalization (the need to transfer back to the acute care hospital) and patient satisfaction scores, as well as return to community rates.While all this information can be empowering, it can also be overwhelming, especially if you are not familiar with the different settings of post-acute care.What are the Different Settings of Care and Which is Best for YouAn Encompass Health inpatient rehabilitation gymAs defined by the Medicare Payment Advisory Commission, post-acute care is rehabilitation or palliative care that a patient receives after a stay in an acute care hospital, or in some instances, in lieu of a hospital stay. That care can take place in the home or in a facility, depending on the patients needs. Medicare recognizes four primary types of post-acute care:Home health is care that is provided in the home to help you recover after an illness or injury. Your doctor or other provider can refer you to home health and work with you and the agency to determine how many visits you are eligible to receive each week. Home health is designed to meet you where you are. If youre recovering from a surgery or a recent hospital stay or managing a disease or injury, home health provides care in the comfort of home. Home health services include nursing, therapy, nursing aides and social workers.Inpatient rehabilitation hospitals provide a hospital level of care with intensive therapy to help you regain your independence and ultimately return to your community after an illness or injury. While at an inpatient rehabilitation hospital, you will receive three hours of therapy a day, five days week. You will also have frequent visits from a rehabilitation physician and other physicians, depending on your needs. Nursing careis provided around the clock, and a multi-disciplinary team that includes rehabilitation physicians, nurses, therapists, dietitians, pharmacists and case managers will design a unique care plan to fit your goals. Conditions commonly treated at rehabilitation hospitals include stroke, head or spinal cord injuries, neurological disorders such as Parkinsons and multiple sclerosis, amputation and hip fractures.At a skilled nursing facility, you will receive therapy and nursing care. However, unlike inpatient rehabilitation facilities, there are no legal requirements mandating the number of hours of care per day that must be provided. Physician visits are not as frequent, either.If you or your loved one has had a particularly extended and medically complex hospital stay, a long-term care hospital may be recommended. At a long-term care hospital, you will receive nursing and rehabilitation care for an extended period of time. Many patients referred for this level of care are not yet able to participate actively in rehabilitation and may require assistance breathing.Will Insurance Cover My Care?That depends on your insurance and your coverage. You do have to meet certain medical requirements for the different settings of care to receive Medicare coverage. Also, some Medicare plans, such as Medicare Advantage ones, limit you to providers within their network. Work with your care team or primary care physician to determine if you meet the requirements of a particular setting. Make sure to discuss your goals, so they can fully understand your long-term needs and the setting that will best help you meet them. In some circumstances, you can consult with your preferred provider to see if they can work with your insurance to help you receive coverage.Do Your ResearchYour care team is required to provide you and your loved one with data regarding the quality of care of providers in your area, but take time to do a little research yourself. Look at patient reviews on websites. Ask family and friends with similar conditions who have had good outcomes and experiences. Where and who you receive care from matters, so take time to look around and find the best provider to help you reach your recovery goals. Perhaps a family member can tour a facility you are considering or take a virtual tour online. By understanding the different settings of care now, you are already taking a step in the right direction.

For more information on the author, Encompass Health, CLICK HERE!Many of us believe that once our workplace is running smoothly, then we will have time to be happy but research actually shows the opposite to be true. When we embrace happiness first, in spite of our circumstances, we strengthen our ability to think creatively and solve problems more efficiently.At Encompass Health, we strive to focus on the positive as part of our five core values, known as The Encompass Health Way. Through this, we strive to have a positive spirit and find light even in the most difficult situations. We celebrate successes and inspire others to create meaningful impact every day.While there will always be external circumstances that make our work challenging, deciding to be happy is something we can control. Below are five science-supported activities that can help you focus on the positive which in turn can increase your resilience, problem-solving abilities and overall quality of life. Pick one of the activities below and try it out with your team.GratitudeResearch shows that expressing gratitude allows you to notice the good things that already exist.Action itemThere are many ways of expressing gratitude, but an easy way to start is writing down five things a week that you are truly grateful for. Focus on the why behind your feelings of gratitude and focus on that as you are writing about them. Make sure you truly feel grateful about them, not just writing what you think you should be grateful for.Take it to your teamShare this practice with your team and ask people to take turns at the beginning of team meetings highlighting what they are grateful for.Cultivate optimismNo matter how rough a day was, every day holds the opportunity for something really great to happen.Action itemSpend 15-30 minutes thinking about what you would like your team to look like six months from now. Write a description of what that goal looks like: describe the interactions that take place, your daily tasks and your teams outcomes. Hold onto your description, read it daily and think about how good it will feel to reach that goal. Plan small action steps to help you reach it.Take it to your teamHave your team do the same exercise on their own and ask them to bring in a picture of something that symbolizes their vision. Make a poster for your office or put the pictures on a bulletin board for everyone to see.Care for your mind and bodyWe've all heard it before, its important to take care of our minds and bodies. Its hard to make yourself the priority, but you cant take care of others if your vessel is empty.Action itemYour movement doesn't have to take place all at once. Make a point of parking a little further from the door than you normally would, stand up while youre on phone calls, or set a timer that reminds you to stretch every hour.Take it to your teamKeep some comfortable shoes in the office and turn your one-on-one meetings into walking meetings.Learn new coping skillsPeople who create meaning from their adversities are more resilient and are able to find new solutions to old challenges.Action itemMake a point to look for a lesson in each situation. Consider what skills your current situation is allowing you to develop and focus on mastering them.Take it to your teamEmpower your team to challenge every negative comment they hear with a positive or silver lining. You could even turn this into a game and give people points for every silver lining they find during the week.Avoid overthinkingOverthinking a difficult situation drains our mental resources. Controlling our thoughts, however, allows us to reclaim cognitive control of our lives.Action itemSchedule 30 minutes a day to allow yourself to worry or ruminate over difficult situations. When your mind starts to chatter outside of the scheduled time, gently remind yourself that you have some time set aside for that later, but to refocus on the task at hand.Take it to your teamChallenge your team to not sweat the small stuff. Encourage the team to make posters of the big stuff. This could include things like your teams mission or goals. When the team finds themselves spending time and energy on challenges, have them circle back and decide if this is time well spent or if they are overthinking the small things.

FacebookTwitterLinkedInEmailAs you get older, your body and mind changes. Your skin gets a little thinner and bruises more easily; your hair gets a little grayer. Remembering the names of old friends might be more difficult, and forgetting why you entered a room could be a frequent occurrence.These are normal parts of aging, but what about those signs and symptoms that arent so normal?While you should always consult with your doctor if there is a dramatic change in your health, here are four signs you shouldnt ignore that could be early indicators of a more serious health condition.Loss of SmellLoss of smell can be caused by several normal conditions, such as allergies and colds. After age 60, the decline in your sense of smell could be a normal part of the aging process. This gradual degeneration of smell is called presbyosmia and is normal in many older adults.A complete loss of smell, also known as anosmia, could be a sign of a more serious condition. A recent study by the National Institute on Aging revealed that loss of smell could put you at greater risk for mild cognitive decline and could be a sign of an underlying neurological condition. The study, which was conducted over a two-and-a-half-year period, also found that in many cases, a loss of smell was a pre-clinical sign of Alzheimers and other dementias.If you experience a sudden loss of smell unrelated to allergies or a cold, talk with your doctor to rule out any serious conditions.Swollen Feet or AnklesSwollen feet or ankles are normal, especially at the end of the day if youve been standing or walking for prolonged periods.If the swelling in your feet and ankles is prolonged and accompanied with pain, you should talk with your doctor. More serious conditions that cause swelling in one or both of the feet and ankles include congestive heart failure and blood clots.Congestive heart failure, or CHF, is a condition where the heart does not pump blood efficiently enough to meet the bodys need. Poor contraction of the heart muscle prevents the blood from being efficiently pumped out to other parts of the body causing fluids to build up in the body, particularly in the ankles, feet and lungs. In addition to swollen feet, other symptoms include shortness of breath, a fast or irregular heart beat and rapid weight gain.Blood clots, or deep vein thrombosis, can also cause swelling in the feet and legs. If the swelling is accompanied by pain, throbbing, redness or is hot to the touch, you should seek medical care.Unexplained Weight LossThe average persons weight can fluctuate anywhere from three to five pounds daily, so slight changes to your weight over time are normal.Rapid weight loss, though, could be a sign of something more serious. If you have lost 5% of your body weight or more than 10 pounds over a short period of time without trying, you should talk to your doctor to rule out any serious health issues.One common condition associated with rapid weight loss is diabetes. If you have type 2 diabetes, your body does not use insulin properly, which could trick your body into thinking you are starving, so it begins burning fat and muscle to compensate.Type 2 diabetes is a serious condition, but it is a manageable one with the proper diet and medication or insulin, if needed.Shortness of BreathAs you get older, shortness of breath occurs more frequently and even after tasks that are not that strenuous, but when shortness of breath starts interfering with your daily life, its time to talk to a doctor.COPD stands for chronic obstructive pulmonary disease and is used to describe a variety of progressive lung diseases, including emphysema and chronic bronchitis. One of the early signs of the disease is shortness of breath when you are not physically active. The most common cause of COPD is smoking or second-hand smoke, but there are other pollutants that could put you at risk for developing COPD.If shortness of breath, wheezing and coughing are preventing you from taking part in activities you used to enjoy, see your doctor. COPD is a chronic condition, but it can be managed with oxygen and/or medications.

To learn more about Encompass Health, CLICK HERE.Did you know that about 25% of people over age 65 have diabetes? Simply put, diabetes is too much sugar in your blood. Over a period of years, it can do serious damage to your nerves, blood vessels and organs and lead to devastating consequences if left untreated, including heart attacks, stroke, kidney disease and blindness. However, reversing type 2 diabetes could be possible.The increase in type 2 diabetes coincided with the obesity epidemic, starting back in the 1990s. Today, two-thirds of Americans are overweight or obese. We now know that obesity is the No. 1 modifiable risk factor for type 2 diabetes. We also know that type 2 diabetes is often due to insulin resistance, a condition in which your pancreas is secreting adequate insulin, yet your cells are not able to utilize it effectively. It is thought that insulin resistance is due primarily to excess fat accumulation in skeletal muscle.Can type 2 diabetes be reversed?You may have heard that type 2 diabetes may be prevented or even reversed. How is this possible? It may be true if you are obese and your diabetes is primarily due to insulin resistance. Lab tests can be done to confirm this. Obesity is measured by BMI (Body Mass Index), and a BMI of 30 or greater is obese.Obesity is often due to a combination of lifestyle factors: poor diet, excessive calorie intake and sedentary lifestyle. Our addiction to fast food, heavily laden with excess fat, sugar and supersize portions, along with our sedentary lifestyle, has led to an obesity and type 2 diabetes epidemic. But you can take control of your health, and possibly reverse your diabetes, by eating healthier, exercising and losing weight.The Diabetes Prevention Program, or DPP Study,showed a 58% chance of preventing type 2 diabetes or reversing it by losing weight, eating healthy and exercising. The program worked particularly well for adults age 60 or older, with the percentage increasing to 71%.Recommendations from this study included: losing a minimum of 7% of your body weight if you are overweight or obese, eating fewer calories and exercising a minimum of 150 minutes per week.How do you get started?Sometimes it all seems so overwhelming! I recommend making small changes that can be built upon over time. Remember the goal is to lead a healthier lifestyle, so the changes should be permanent. It has been well documented that fad diets don't work. Instead, choose two healthy lifestyle changes that you can realistically achieve. Once those have been incorporated into your daily routine, choose two more and so on.For example, you could set your goals to eat more vegetables and green salads, stop drinking soda and walk for 30 minutes every day.What does a healthy diet look like?Diet recommendations for diabetes are the same as for heart disease and other chronic diseases. All of the research supports plant-based diets such as the Mediterranean diet. Incorporate plenty of leafy greens, vegetables, fruit, beans, nuts, avocados and fish into your diet. Cut way back on red meats, fried foods, fast foods and sweets. The Healthy Eating Plate advises to fill half of your plate with leafy greens and vegetables, one quarter of your plate with lean protein, and one quarter of your plate with whole grains. Add some healthy fat such as olive oil, and a small serving of fruit for dessert.The health benefits you may expect to see once converting to a plant-based diet are numerous. They include weight loss, improved blood sugar control, improved blood pressure and cholesterol ratios, prevention of cancer and other chronic diseases, more energy and improved mood.Eating healthy can also be fun and delicious. Be creative with your meals, try new foods or buy a heart healthy cookbook. Consider purchasing a grill or an air fryer, and throw that deep fat fryer away! Below is an easy Heart Healthy Recipe that you may wish to try. Good luck and remember, you can achieve anything you set your mind to!SPINACH SALAD with MANGO, GOAT CHEESE, AND WALNUTS1 Bag baby spinach (6 oz)1 Sliced mango1/2 Cup walnut halves4 oz Goat cheese crumbles Cup organic balsamic vinaigrette dressing, mixed with 1 tablespoon extra-virgin olive oilToss all ingredients together and enjoy a powerhouse of flavor and nutrients!

Pamela Gillis was used to her mother playing the role of the caregiver. In addition to being a mother and wife, her mother Hautie Ezell started her nursing career in the late 1940s, and was also a hospice volunteer and Sunday school teacher.Caring for others was a large part of her life, Gillis said. She was very independent, so it was hard for her to give in and let someone else take care of her.Thats what Ezell had to do though, at the age of 91, when after a fall, her health began to quickly decline. She had also suffered several small strokes and had dementia. At that point, their roles reversed, and Gillis became her mothers caregiver. It was a difficult time for both of them, but thanks to the help of family and friends, as well as home health and hospice, Ezells final days were filled with love and respect.Ezell passed away in December 2020. Though Gillis knows what it is like to be a caregivershes an area manager for Encompass Health Home Health & Hospice and has worked in hospice for many yearsshe said its different when you are caring for a family member, especially a parent who used to be the one taking care of you.When its your family member, especially your mother, it is totally different, she said.Gillis offers the following advice for those who are faced with caring for a parent or other loved one.Get helpAfter her mothers first fall, she had home health begin visiting to help provide therapy and medical assistance. Gillis said her mother looked forward to the visits each day, and her Encompass Health Home Health team was there the day Ezell transitioned to hospice.When I made the call to my office letting them know that I wanted my mother transitioned, they were great, Gillis said. My second family kicked in. It was a quick and timely admission, and they began meeting her needs and mine immediately. They were there to support us both.Dont neglect your own needsGillis admits this is easier than it sounds when youre faced with caring for a parent or loved one. In addition to caring for her mother, she was working and has children of her own.She said her family was great in offering to relieve her, and her husband took on household chores.You just have to form your own little caregiver team, she said. I also had a great group of ladies that stayed with her when I couldnt. Again, it was a blessing when hospice came onto the scene. Thats one thing I tell families that I talk with now: Let our hospice team help you. We are here for the patient and the family.Dont wait until its too late to call hospiceHospice allowed Gillis and her family to spend quality time with Ezell and one another during her final days. As the hospice team tended to her medical needs and kept her comfortable, the family was able to be with her. It lets you be the child or family member you are, Gillis said of hospice care.

FacebookTwitterLinkedInEmailHave you noticed the foods you eat dont quite taste the same as they used to? Maybe your meal tastes bland or your favorite snack isnt as delicious as you remember. You might be experiencing a common part of the natural aging process. As we get older our sense of taste changes. So, why does this happen?Taste Buds and AgingSense of taste, also called the gustatory system, is largely controlled by taste buds tiny organs located on the tongue, roof of the mouth, in the esophagus and back of the throat. Each taste bud contains receptor cells that are responsible for reporting the sense of taste to the brain. Taste buds receive the signal from tiny molecules that are released when chewing, drinking or digesting. Its how we experience the five types of taste: bitter, salty, sour, sweet and umami (savory). Its estimated that we have about 10,000 taste buds at birth, but the number of buds decreases with time. Taste buds regenerate quickly when we are younger, but over time they dont reproduce as quickly, or at all. Remaining taste buds shrink as we get older too, resulting in diminished sense of taste. Typically, seniors notice this loss of taste with salty or sweet foods first.The Smell-Taste ConnectionLoss of taste isnt the only sense that can dull with age; smell can diminish as well. In fact, the two are closely related.Sense of smell is controlled by the olfactory system. Those same molecules that signal taste to the brain also signal the olfactory nerves. Olfactory nerves are responsible for what you smell and how you perceive foods texture, temperature, spiciness and flavor. Take the nasal congestion common with colds as an example. Your food might taste different when you have a cold because you cant smell it as well.Just like taste buds decrease with age, so do the olfactory fibers in the nose. The remaining fibers arent as strong, especially for seniors older than 60.Other CausesLoss of taste and smell is considered a normal part of aging, but there are other causes:Viral infections: The common cold, flu and COVID-19 can cause a temporary diminished sense of smell and taste.Medications: Certain medications, both prescription and over-the-counter medicines, can alter the senses, especially antibiotics and blood pressure medications. Speak with your doctor before stopping or changing your medications.Dental problems: Gum disease, a tooth abscess, thrush or dry mouth can affect sense of taste.Smoking: The toxic chemicals in cigarettes interact with your tongue in such a way that the taste buds lose their shape and become flatter.Head or facial injuries: Trauma to the head, neck or brain can damage the olfactory nerves that signal scents to your brain.Nasal polyps: These soft, noncancerous growths on the lining of your nasal passages or sinuses can impact your senses.Cancer treatment: Some types of cancer and cancer treatments can alter the signals between your nose, mouth and brain.Vitamin deficiencies: Loss of taste and smell could be a sign that your body is low on certain vitamins.The Effects of Losing Sense of TasteThe loss of taste can have a negative impact on quality of life and lead to other health complications.It makes it difficult for people to eat well and have an adequate diet, explained Madeline Kolpin, a registered dietitian at Encompass Health Rehabilitation Hospital of Jacksonville. Bitterness might be more apparent to those with impaired taste and sweet or salty flavors might be harder to detect. Many older adults show a preference for very sweet or salty foods because of dulled taste which can lead to an imbalanced eating pattern.You might lose your appetite and eat less, resulting in poor nutrition, vitamin deficiencies and weight loss. Changes to the sense of taste might also tempt you to add excess salt and sugar to foods to enhance flavor. Be mindful of salt/sugar being added to foods, warned Kolpin. Excess salt and sugar can lead to or worsen health conditions such as high blood pressureand diabetes.You might also not be able to detect if food or liquid is spoiled or if it contains ingredients youre allergic to.Is it Treatable?That depends. Unlike those gray hairs or wrinkles under your eyes, if changes to taste and smell are age-related, its not possible to reverse those changes.However, if your reduced senses are a result of other causes, it might be only temporary or treatable. For example, impaired senses caused by a cold can be improved with nasal spray while you wait for the cold to clear up. Or if medication is the culprit, your doctor might consider adjusting prescriptions. Speak with your doctor about changes to your sense of taste and smell to determine the root cause and explore possible treatment options.Coping with Loss of TasteIf your sense of taste has weakened, there are ways to make your food more palatable without reaching for the salt or sugar. Daria Zajac, a dietitian at Encompass Health Rehabilitation Institute of Libertyville, recommends these tips to her patients.Instead of reaching for the salt shaker, try reaching for Mrs. Dash or a variety of herbs and seasonings like sage, thyme, rosemary. Even adding a splash of lemon or lime juice can give food some pizzazz and moisture without overpowering a meal. Other herbs and spices you can add to bring out foods flavor include basil, oregano, rosemary, cilantro and tarragon. Feeling more adventurous? Add spices like black pepper, chili pepper, cinnamon, cumin, garlic powder and ginger to enhance flavor.When it comes to livening up your meals, it isnt just the food that matters. Lonely mealtimes can be daunting, Zajac said. If you can, make meals more social by cooking and eating with friends and family members.Temperature can also factor into taste. For example, you might find chilled or frozen foods to be more appetizing than hot foods or the other way around. Play around with temperature. You could incorporate foods like yogurt or frozen fruits, or warm up leftovers to room temperature instead of piping hot.

In October 1988, Sidney Holmes was unjustly arrested and charged with armed robbery. Despite being wrongly convicted and sentenced to 400 years in prison, Sidney never lost hope. Throughout his sentence, he earned his associates degree in theology and discovered his passion for customer service and personal growth while working in the prisons kitchen. In 2017, Sidney applied to the Innocence Project, where his case would be reviewed by their conviction unit. Nearly six years later, in February of 2023 Sidney's sentence was vacated and he was released just a month later.Since returning home, Sidney has joined the Encompass Health Rehabilitation Hospital of Sarasota cafeteria staff where he has shown unwavering dedication to patient satisfaction and teamwork. With the help of his director, Sidney applied and was selected to receive the prestigious DM&A CDM, CFPP Credential Grant through the Nutrition and Foodservice Education Foundation. This award, sponsored by DM&A, recognizes Sidney's outstanding achievements and his commitment to excellence in his service to others. Sidney's inspiring journey from wrongful conviction to second chances is a testament to the power of resilience and determination.For his attitude, positivity, and humility, his co-workers and superiors helped him apply for a grant to become a Certified Dietary Manager, Certified Food Protection Professional. On Wednesday, the 57-year-old was awarded the grant, and celebrated while working the line with his colleagues.Being angry would just destroy myself. I have to thank God for giving me my freedom, said Holmes.

After years of raising children and caring for the familys needs, your parents have finally reached a point where they need a little help themselves. While it is not an easy transition, now is the time for some tough conversations about aging.Most families find these talks difficult but with the right approach they can be productive and spare feelings. Start by identifying current health and medical needs, and research available options to address both immediate and future issues. Talking with your parents before a medical crisis occurs allows them to communicate their desires and frees family members from having to make rushed decisions during a stressful time.Remember to listen to your parents concerns and respect their wishes while working together to find satisfactory solutions.Advanced Directives and Living WillsWritten, legal instructions outlining your parents desires for medical care, should they become unable to make those decisions themselves, are an important part of life planning. Explain that preparing documents such as a living will and advanced directive helps ensure their wishes are carried out if the day comes when they are unable to communicate them.Advance directive: This document assigns medical power of attorney to an individual who will represent the wishes of your parents if their physical or mental health renders them incapable of making such decisions. It applies only to medical mattersnot financial. Usually only one person is designated, although alternates may be named if the appointed person is unable to perform his duty.Living will: This legal document outlines an individuals wishes concerning end-of-life treatment choices if they are unable to communicate those wishes. It covers a variety of medical decisions including cardiopulmonary resuscitation (CPR), breathing assistance, organ donation, dialysis, medications, tube feedings and palliative or comfort care.Wills and Estate PlanningEstate planning involves the gathering and preparation of specific documents to determine how your parents assets will be managed and distributed after their deaths or incapacitation. Estate planning isnt limited to the wealthy; even those of modest means should put in place a plan outlining how their properties and wealth are to be transferred. Your parents estate might include houses, cars, artwork, jewelry, investments, life insurance, businesses, bank accounts, possessions and debt. Some key components of estate planning include:Wills. This is a legal document used to transfer the estate to named beneficiaries. It addresses the distribution of assets and outstanding debt. It also names an executor to oversee and manage the process. If your parents dont have a will, suggest they talk to an attorney about establishing one. If they currently have a will, it is a good idea to review and update it.Trusts. This is a legal entity that allows another party (trustee) the right to hold title to and manage assets or property for the benefit of a third party, or beneficiary. There are many kinds of trusts, and they should be set up by a qualified attorney or trust company.Secure a power of attorney. Unlike a medical power of attorney which is limited to health and medical matters, a Power of Attorney (POA) gives you the power to act on your parents behalf in managing financial and legal matters. There are two types of POAs to consider. A General Power of Attorney ends the moment your parents become incapacitated while a Durable Power of Attorney (DPOA) allows you to continue to act on their behalf should they become incapacitated due to a serious accident, severe medical condition or mental illness.Healthcare directives. An advanced health directive is a legal document outlining your parents healthcare wishes should they become incapacitated or unable to verbalize their preferences. It covers topics such as in-home or hospital medical treatment, life-support measures, autopsy or organ donation.Beneficiary designations. Consider naming primary and secondary recipients for insurance, 401(k) or additional assets not covered in a will.Managing FinancesConversations concerning finances and money matters are often some of the most challenging because relinquishing control of money can make seniors feel vulnerable. Still, keeping up with monthly bill paying and budgeting can be overwhelming. Elderly adults are also easy targets for scams and financial fraud. Signs you may need to step in to assist include:Unopened mail or billsCareless spending or unusual purchasesPhysical or mental changesComplaints of not having enough moneyCalls from creditorsTalk openly with your parents about your concerns and offer to help. They might see this as a loss of control, so be gentle in your approach. Start slowly by working together to review documents and ask about areas where they might need help. The following steps will help in understanding and managing your parents finances.Gather important documents including a list of bank accounts, pensions, 401(k) information, annuities, savings bonds, brokerage accounts, stocks, property deeds, vehicle titles and any loans or outstanding debts.Start small by offering support with chores such as writing checks or organizing bills.Streamline financial tasks. Consider using direct deposit and online bill paying. This allows adult children who dont live close to parents to still be involved in managing finances.Keep your parents informed and involved along the way. Review bank statements with them and discuss any actions you take.Maintain separate accounts. It isnt a good idea to combine your parents finances with your own.Is It Time to Give Up the Car Keys?When it comes to driving, it is not one size fits all. Some elderly adults are still capable behind the wheel, but if you are seeing indications driving is a safety issue, it is time to act. This might be the toughest conversation of all because giving up driving has the strongest impact on independence. Signs your parents may need to hang up the car keys include multiple traffic violations, frequent scrapes and dents, delayed response times, getting lost in familiar surroundings, repeated close calls, difficulty navigating parking and steering (hitting the curb, veering over the line) and problems with concentration.Follow these tips for having the conversation:Be understanding and sympathetic. Stopping driving severely impacts lifestyle. It means a loss of freedom and can limit the time spent with others. Approach the topic respectfully and gently.Assess the problem. Is it necessary to give up driving completely? Maybe limiting driving to daytime hours or short distances is a good compromise. If not, calmly state the reasons for your concern and ask your parent if she has noticed changes in her own driving skills.Do your research. What transportation options are available? Do your parents live in an area where public transportation is easily accessible? If not, most areas have services such as Uber or Lyft. Talk with other family members and friends about helping. Could a neighbor pick up your dad for weekly grocery trips? Consider coordinating your schedules. Could you book simultaneous hair salon appointments for you and your mom? Look for senior transportation options in the community.Involve agencies and experts. If you feel your parent is not safe behind the wheel, yet they still resist giving up driving, consider an evaluation by an occupational therapist. Would vehicle modification such as hand pedals and safety mirrors address the problem? Ask your parents to consider a safe driving course for seniors (AAA and your local DMV may offer a class). Avoid forcing them into a decision if they are resistant. Instead, make suggestions and give them time to consider their options.Normal Memory Loss or Something More Concerning?Occasional forgetfulness is a normal part of aging, but severe memory loss is not. Understand the early signs of dementia. If your parents miss paying a bill one month, misplace their keys at times or take a little longer to recall names, you can chalk it up to normal aging. But severe memory loss is cause for concern. When memory problems interfere with daily living, it could indicate mild cognitive impairment or dementia.Mild cognitive impairment (MCI)Some seniors experience memory loss and thinking problems that go beyond what is considered normal for their age. MCI may be a sign of early dementia, but not all individuals who suffer from mild cognitive impairment go on to develop dementia. Signs of MCI include frequently forgetting names, events or appointments. Those with MCI may lose things, have difficulty focusing, struggle to complete routine tasks or find it hard to come up with the right words during conversation. Most people with MCI can function independently but may benefit from a set daily routine, memory tools and to-do lists. If you suspect your parent has MCI, it is important to have annual (or more frequent) medical checks to track changes in memory and mental function.DementiaThere are many kinds of dementia, but Alzheimers is the most common. If your parent is showing signs of dementia, schedule an appointment with their doctor. Early diagnosis allows you and your parents time to make future plans and address issues that may arise. The Alzheimers Association lists 10 early signs of Alzheimers including:Memory loss that interferes with daily lifeDifficulty planning or solving problemsChallenges in completing familiar tasksConfusion about time or placeVision problems or difficulty with spatial relationshipsDeveloping problems in speaking or writingMisplacing items and not being able to retrace actions or recallPoor judgement and issues with decision-makingWithdrawing socially and losing interest in hobbies and activitiesMood and personality changesDiscussing Living ArrangementsOne of the biggest decisions elderly adults face is whether to age in place or relocate to a senior living community. While aging in place is an appealing option, there are many factors to consider. An open honest conversation considering your parents needs and desires is the best way to approach the situation.Social opportunities. Staying in the home means your parents are surrounded by the familiar and likely keeps them close to family and friends. Moving to an assisted living facility or retirement community may require your parents to relocate further away from their circle of family and friends. On the other hand, living alone might mean fewer opportunities to socialize with others. Many retirement and assisted living communities offer activities and provide transportation to local businesses and events, keeping seniors active and engaged.Access to medical care. Many retirement communities offer a variety of living options. Seniors can live independently in a house, condo or apartment with the option of transitioning to a place where more care is provided should it become needed. Couples may also remain together even when one spouse requires a higher level of care. Staying in the home might eventually require in-home care and present transportation challenges.Safety. Home security systems and medical alert systems are good options for those who choose to remain in their homes, but if safety is a concern, a retirement community can offer more peace of mind. Many have gated security, personnel who perform frequent wellness checks and other provisions to keep your parents safe.Financial considerations: The advantage of community living is that it frees residents of the burden of home maintenance and provides onsite care. However, the cost of an assisted living facility rises with the level of care required. If your parents need only minimal assistance, remaining in the home may be a more cost-effective option. But if around-the-clock care is needed, the price of in-home care may be more than that of an assisted living facility. Before buying into a retirement community, do your homework. Some facilities require a substantial entrance fee. It is also important to note whether the facility is a for-profit or non-profit community. Both have their own financial risks, and it is vital that you read the fine print and understand the contract.Review the rules: Retirement communities and assisted living facilities offer less freedom than living at home. If your parent balks at following rules, the transition may be difficult. Are overnight guests allowed? What are the parking restrictions? Be sure to carefully review all requirements and restrictions before signing on the dotted line.Help with Medication ManagementAccording to the Centers for Disease Control and Prevention (CDC), 42 percent of adults aged 65 and older take five or more prescription drugs, and the Lown Institute reports nearly 20 percent of older adults take 10 or more medications. Managing multiple medications is a daunting task for elderly adults. It is understandable that your parents may need help keeping track of prescription and over-the-counter medications. Ways to help with medication management include:Review all medications with your parents, including which medicines they take and why, noting any specific instructions (take with food, take as needed, etc.).Make a list of medications and drug allergies and encourage your parents to carry the list in their wallet or handbag.Develop a system for taking medications. Purchase separate pill boxes for morning and evening meds and prefill them weekly.Encourage your parents to set an alarm to remind them when a medication is due, incorporate medications into a routine (take morning pills after brushing teeth, evening pills after dinner), or arrange for a family member to call with a reminder.Invest in a digital medication dispenser. Some come with a compatible phone app that sends a reminder to your parent or loved one if a medication is missed.Provide a notebook where as needed medications can be recorded so they can remember the time of their last dose.Stick with a single pharmacy so all medications can be easily tracked. This also allows the pharmacist to watch for medication interactions and other concerns.The content of this site is for informational purposes only and should not be taken as professional medical advice. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding any medical conditions or treatments.

As a parent or loved one gets older, they may find it a little more challenging to get around safely. Maybe a short walk leaves them winded or their balance isnt what it used to be. If thats the case for your loved one, an assistive walking device could be needed to help them stay mobile and prevent a fall. Falls are a leading cause of hospitalizations for older adults and often lead to a loss of independence.If your loved one is experiencing difficulty moving around their environment, maybe its time to consider the use of a walker, a cane or even a wheelchair.Signs Your Loved One Needs an Assistive Walking DeviceThe following are a few warning signs to look for when considering an assistive device:They hold onto walls and furniture when walking aroundThey had a recent fallThey have unexplainable bruising (likely from bumping into furniture)They have complained about numb feet, also known as neuropathyIf your loved one has these signs, they may benefit from a walking device to help them balance and stay mobile. It can give them confidence and increase their activity. It will also make them feel safe. In short, their quality of life will improve.Types of Assistive DevicesMany people may benefit from a straight cane or walking stick for balance, while others may benefit from a four-wheel walker with a seat and basket, also known as a rollator. The four-wheel walker will provide the walking support your family member may need while also providing a basket for carrying belongings, and it also has the bonus of a seat to sit on if they are fatigued.Another option is a standard rolling walker. This device is lightweight, has two front wheels and is more stable than a cane or rollator. The standard rolling walker is best for someone who has balance issues and is unable to safely use a rollator.The last option would be a wheelchair. A standard wheelchair would be for a family member who is unable to walk or can only walk short distances. Another choice is a transport wheelchair. The transport wheelchair is lightweight and does not have large wheels and hand rims, so an aide or family member must be available to transport the patient. A transport wheelchair can be ideal for pushing a family member outside and to doctors appointments, as well as at malls and even theme parks.Determining the Best DeviceWhen deciding on an appropriate device for your loved one, consider their environment, such as the width of doors and the types of indoor and outdoor surfaces in and around thier home. For example, a rollator walker has four wheels and will roll across carpets and sidewalks much easier than a standard walker, whereas a straight cane will be easier to use on cobblestone or uneven surfaces.Medicare typically provides coverage for an assistive device every five years. Talk with your family doctor and Medicare for more information regarding coverage. Once you have decided to get an assistive walking device, the height of the device must be setup appropriately. The user should stand up straight and relax their arms to their sides. The walker or cane should be at wrist level. When holding the device, the elbows should have a slight bend.Choosing the most appropriate device is situational. Many people choose to have a cane for the house and a rollator to walk outside. Other people have a rolling walker at home but have a transport wheelchair for long distances.Most importantly, if your family member is having balance problems, is falling or seems to walk around the house from dresser to chair to table to counter, consider getting them an assistive device for walking.If your family member is hesitant to use a walking device, ask them to consider the costs of not using one, and weigh the risks versus the benefits. If you have safety concerns about your loved one or yourself, talk with your doctor. A physical therapist can also assist with balance concerns and the selection of the most appropriate walking device.The content of this site is for informational purposes only and should not be taken as professional medical advice. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding any medical conditions or treatments.About the authorDr. Tim McCutcheon is a team lead physical therapist at Encompass Health Rehabilitation Hospital of Sunrise in Florida. His responsibilities include lead therapist of the amputee program, co-lead of The Joint Commission Disease-Specific hip fracture program and site coordinator of clinical education for student therapists. McCutcheon has been with Encompass Health Sunrise since fall of 2006, and started his career there with the brain injury program. He has specialized in stroke and spinal cord injury before being promoted to orthopedic senior PT. He is recognized by his peers for his strong mentoring and leadership. McCutcheon continually promotes challenging, fun physical therapy to a diverse population. During time away from work, he enjoys spending time with his beautiful wife and three wonderful young daughters.

For more information on Encompass Health, Click Here.For decades, the conventional wisdom surrounding grief has centered on Elisabeth Kbler-Rosss theory that mourners typically navigate through five distinct stages of grief following a significant loss:DenialAngerBargainingDepressionAcceptance.Now amidst the COVID-19 pandemic, we are finding that these stages don't do enough to capture the experiences felt by millions as they contend with illness and loss in a global crisis. Gone are the days when grief could be packaged into five straightforward stages. Death is now a much greater part of our national conversation and an experience we are all sharing.As a result, a number of scholars in clinical psychology are working on new, modern trajectories for grief that can help us understand how to comfort those in mourning and how to accept cultural grief that may stay with us for years to come. The new grief trajectoriesAs I write this article, over 259,000 people in America have passed away from COVID-19. The circumstances surrounding the diseases spread, and the isolation it demands, mean that some mourners are experiencing multiple grief trajectories at the same time.Some hospice patients and their families must navigate terminal illness alone, as the risk of the diseases spread forces us to socially distance. Our grief as mourners is compounded as we face our cultures economic loss, the loss of routine and our loss of community. The rituals we once used to cope and give us closure, such as funerals or memorials, have unfortunately become opportunities to spread the virus. Every path once foretold is now unwritten.Scholar George Bonanno is leading the way in clinical research regarding new grief trajectories and has coined four separate trajectories to map the post-COVID-19 landscape for mourners over time, rather than adhering to the idea of a single linear progression of grief for everyone. A significant finding from his recent studies is that some mourners will experience chronic grief and chronic depression.What is chronic grief and depression?According to Bonanno, a key factor of someone who experiences chronic grief or depression is that they see no purpose in life now or in the loss of the person they loved. However, some individuals may experience severe depression but then see improvement after many months. Bonanno describes this group as function improved. He attributes their long-term improvement to their outlook on life and their ability to see their greater purpose.Bonanno characterizes those who are able to overcome their chronic grief or depression as resilient. He describes them as independent, purposeful and caring individuals who may have lost the love of their lives, but whose independence carries them. As hospice professionals, we can see these trajectories in the mourners we care for every day, and the studies surrounding each trajectory can help us improve our grief support to be more personalized.Unchartered territoryGrief can feel magnified when familiar routines are gone and options to cope are scarce. The practices we used to use to comfort mourners are no longer considered safe, like going over to someone's house or taking them out to dinner. As a result, our own emotional bandwidth to offer support to mourners is greatly reduced. Grief is one of the select experiences in life that connects our humanity, but the COVID-19 pandemic has challenged our ability to connect and mourn together.One of the greatest lessons we've learned from the pandemic and Bonannos research is that the way we view the world matters when we lose someone. It may sound simple the notion that our perspectives on life will dictate our path forward in grief but it is a concept that few psychologists have ever emphasized in grief support. Instead, theories like Rosss five stages of grief have viewed people as two dimensional actors, with grief happening to them instead of alongside them.The pandemic has taught us that those who are underserved and dependent are at greater risk for chronic depression and chronic grief since the ability to be resilient is tied to ones independence and stability following loss. The pandemic has also highlighted how the circumstances surrounding a loved ones death can add to our own suffering. If we were unable to be with the person who passed away, our imagination is often worse than the reality. If we never got the chance to tell them goodbye or how we felt, those feelings of loss are compounded by the tragedy of their sudden passing.New ways to honor loved onesWhile the pandemic has impacted the ways we grieve, we have also seen a lot of new creative ways to memorialize and honor our loved ones and grieve their passing. Although we don't currently have the opportunity to physically gather together in memory of those we've lost, technology has offered thoughtful alternatives that allow us to still support those who are grieving.Webinar memorials allow families, friends and caregivers to connect, grieve and share memories of loved ones while adhering to social distancing guidelines. Webinar platforms have also been successfully used to host virtual support groups for people to navigate their grief together.Online card writing services are a great way for people to send a sincere, custom message without ever having to leave home. Meal train websites also allow friends and family to send meals from local restaurants or coordinate a meal train among one another. Each of these are safe, efficient and contactless gestures that show support to those who are grieving. While the pandemic is still relatively new, many of us have become more aware of the fragility of life and how the loss of connection impacts our ability to mourn. Although the pandemic has significantly impacted our lives, it has also allowed us to discover new perspectives on the way we grieve that will continue to evolve for many years to come.Nichol Westendorf is Encompass Health director of hospice support services.