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Home Health FALL 2012


Clinical Pathways An window into the history of Electronic Medical Records

Power over Breast Cancer What every woman should know about Breast Cancer

Nationally recognized, award winning care Interoperable electronic health records Selected as first post acute care provider by LAHIE OCS reports Medistar’s low readmission rates Strong, ethical leadership

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CONTENTS Home Health Fight The Flu


Learn how to avoid the flu & pneumonia this season

10 Conversations Medistar Home Health Chief Operating Officer, Gina Creel, discusses Clinical Pathways in an EMR World

11 Breast Cancer Awareness

Cover Story:

Inspiring stories from people women who have beat the disease & information about early detection

Staying Healthy for the Holidays



Home Health FALL 2012

VOL. 1 NO. 3


Beth R. Denton


Gina Creel


Quentin R. Graham James Shackelford Roseann Wentworth Lauren McMillan


Jeannie Stratton


Christi Bellizzi




Debbie Johnson, Rosalie Moscoe, Jennifer FitzPatrick, Gina Greel, & James F. Holland SomaComm, Inc. 3114 Swiss Avenue Dallas, TX 75204 214.296.4480



OUR MISSION Medistar Home Health's mission is to make a positive dierence in the lives of our patients, our healthcare partners and our valued employees as we provide superior quality and compassionate care, while adhering to the highest standards of excellence.


No part of this publication may be reproduced without written permission from the publisher.

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This publication is intended to provide accurate, authoritative, and detailed information in regard to the subject matter covered. All written materials are disseminated with the understanding that the publisher is not engaged in rendering legal or medical advice. Under no circumstance should the information contained herein be relied upon as legal or medical advice as it is designed to be a source of information only. Home Health strongly encourages the use of qualified attorneys or physicians with regard to the subject matter covered. Home Health does not guarantee the accuracy of the information and is not liable for any damages, losses, or other detriment that may result from the use of these materials.

I love autumn in Louisiana and all that it brings - cooler temperatures, pumpkins, fall foliage, football, and the beginning of the holiday season, starting with Halloween. Growing up in Shreveport, I loved being on the field on Friday nights as "Admiral" of Captain Shreve High School's Pep Squad. And it's just hard to top football in LSU's Tiger Stadium! Do I hear a "Who Dat?" But, fall also brings the beginning of flu season and the time to get your annual flu vaccine. While getting a shot is not at the top of my most favorite things to do in the fall, I much prefer a moment of minor discomfort to the weeks of misery when the flu strikes, and therefore I've already gotten my flu shot this year. Medistar Home Health kicked off our "Fight the Flu" Campaign on October 1st and is actively encouraging all of our patients to get a flu shot. For information on the flu and who should get the annual flu shot, a brief video on our website is well worth a few minutes:

In addition to finding out important information concerning the flu, if you drop by our website on a regular basis you’ll find additional educational opportunities concerning various health matters. Our Patient Education Center provides access to more than 4,000 topics relating to health and medication and is available to patients, families, and professionals. It’s packed with information about symptoms, diseases, tips and information on medications. Also, spend a few moments and tune in to some of our videos, or read some of the interesting and timely articles in our Blog Section. I invite you to check out our website,, and to experience how Medistar Home Health is Making a Difference in Home Health throughout the state of Louisiana.

Beth Denton, Medistar Home Health Owner and Chief Executive Officer Follow Beth on Twitter:



Healthy Holidays

Tips to De-Stress Through The Holiday Season

By Rosalie Moscoe


he holidays are upon us. Many people get nervous about the work involved - shopping, preparing, cooking, entertaining and gift buying. Family gatherings with relatives with whom you may not feel comfortable can also be a problem. Also, eating many sweets, cookies and cakes can increase stress and anxiety levels as can being a perfectionist! A good stress-relief strategy starts with making a plan then taking action! 1) Practice efficient time management. Each week finalize your “to do list” and allocate time accordingly. You’ll feel better once tasks are down on paper instead of having them whirl around in your head. Be sure to include your daily and/or weekly medications and check them off along with any other tasks. 2) Get physical for your health and well-being. Check with your



doctor before starting any new exercise routine. Taking a walk or swim at least three times a week is a great way to stay calm during holiday preparations. Exercise burns off pent-up stress. You will bring oxygen into your muscles and brain. Start slowly; build gradually – even stretching is beneficial. Are you doing these things already? Continue! It’s okay to take time for you. 3) Refrain from bringing cookies, cake or candies into your home in advance of the holidays. They’ll only get eaten (by you) and can increase blood glucose. This will make you cranky, tired and cause fluctuations of blood sugar (spikes and dips) - hypoglycemia, a forerunner of diabetes. If you are diabetic, don’t think that the medication you’re on will protect you. Keeping your blood sugar under control is the best thing you can do.

Rosalie Moscoe, Registered Nutritional Consultant Practitioner and motivational speaker, is an established author and former teacher of college-level courses in stress management. As a Registered Holistic Nutritionist, she also provides one-to-one nutritional consulting and avidly promotes stress-relief and boosted nutrition for optimum well-being. Rosalie is the author of the Amazon bestselling book, Frazzled Hurried Woman. To learn more visit:

Cut down on the amount of starchy carbohydrates you eat such as extra bread, muffins and potatoes. Instead, increase the amount of leafy greens and other green vegetables like asparagus, broccoli and Brussels sprouts – which are also great cancer fighters. Use olive oil as dressing for your salad plus wine vinegar or lemon juice. Toss out commercial dressings with added chemicals and fillers. Eat 2 to 3 servings of fruit per day. Treat yourself to a few squares (not a half a bar) of 70% or higher cocoa content, dark chocolate that contains disease-fighting antioxidants. Eat protein (such as fish, chicken, beef, eggs, cheese) at meals to give you a brain boost. The amino acids in proteins will fuel neurotransmitters in your brain. You’ll notice more energy and coping abilities. 4) Check with your physician first before starting any new vitamins and supplements. Taking a multivitamin, mineral tablet each day has been shown to improve mood and increase nutrients your body needs to fight disease and stress. An omega 3 fatty acid supplement (fish oil) is also frequently recommended for heart and brain health. Consider getting tested for vitamin D deficiency. Many people become deficient in vitamin D during the winter when there’s less opportunity to be in the natural sunlight. A supplement can help prevent many diseases, keep your bones strong and alleviate depression. A good probiotic such as acidophilus, (the friendly bacteria found in yogurt) can help you stay regular and clear out toxins from your body. Your physician can recommend the supplements most appropriate for you. 5) Keep to a good sleep routine. The holidays may disrupt your regular schedules, become hectic, and bring periods of chaos. You’ll need 7 – 9 hours of sleep per night to cope with added stresses. For quality sleep, limit nicotine and alcohol consumption especially after 6:00 p.m. Alcohol may help you get to sleep, but often will awaken you in the middle of the night. Listen to relaxation CDs or soothing, mellow music. Ensure that you sleep in a dark room to boost the brain’s melatonin production (which is known to enhance sleep). For relaxation, soak in a warm bath of Epsom salts, which increases uptake of magnesium. 6) Feeling overwhelmed? To unwind, take some gentle belly breaths. Inhale a gentle breath through the nose to the count of 4. Hold to the count of 4; breathe out through your mouth to the count of 5. Repeat when you feel anxious, rushed or stressed. Taking care of your health and stress through the holiday season will serve you well. You may even decide to continue these health-giving activities after the New Year!

Plan your Healthy Holiday Menu Here are several ideas to delight the palate and keep the body singing with health: Focus on fresh as much as possible, as in using raw or fresh veggies and fruits and "hiding your vegetables" by adding them to pasta meals or even replacing pasta with julienne vegetables like zucchini, onions, and peppers. Use the same sauce and grated hard cheese, such as fresh Parmesan or Peccorino Romano. For those in a time crunch, here's a way to prepare healthful meals: Start with base of organic field greens, from a package. Add grilled meat or fish from a local deli. Use fresh olive oil, lemon and salt to make a simple, satisfying dressing. You may indulge in lots of treats at holiday gatherings, so you can balance that out with other meals by cutting out starch and sugar during the holiday season. Try tossing bite-sized pieces of apple in a jar with cinnamon for a sweet treat, along with roasted nuts and/or seeds. These snacks will leave you very satisfied.. Keep eating healthy fats because your nervous system always needs them.



Family First

A Caregivers Guide to Managing the Holiday Season By Jennifer FitzPatrick

T he holiday season can be a trying time for families,

especially those who serve as caregivers for loved ones. However, a little preparation can prevent stress and make the holidays enjoyable for everyone. Encourage your loved one to get plenty of sleep, exercise and try to eat as healthfully as possible while still enjoying their favorite holiday treats. Don't over schedule. Make sure you have plenty of time to get from place to place if you are traveling or visiting multiple family members. Consider the homebound loved one’s illnesses and conditions when planning for the holidays. For example, travel can be very challenging with some chronic conditions such as COPD. When we add the stress of holiday traffic and delays, it can exacerbate issues for some seniors. Maybe the trip to visit the grandkids could be the week after the holiday to avoid airport rushes and gridlock.

If a loved one has Alzheimer’s disease, remember that some of the traditional decorations and sounds may agitate them. For example, Christmas tree lights, menorahs and other decorations may be distressing if they are having hallucinations and delusions related to the condition. Often those with Alzheimer's disease or dementia become agitated at large parties or big family dinners. Smaller groups tend to be better. Consider celebrating with that loved one in a smaller setting and maybe go to the bigger events with the rest of the family. Focus on the strengths the older loved one still has. For example, if someone is wheelchair-bound but can still wrap gifts, include them in that. The most important thing is to be flexible when caring for an older loved one during the holiday season. If someone has physical or cognitive

impairment or both, families want to be sure they can easily change plans if their loved one is having a “bad day.” Caregivers should also remember that they do not necessarily have to include the older loved one in every holiday plan they make. Be open to new ways of celebrating the holidays. It may even turn out to be more fun than that to which you are accustomed.

Jennifer FitzPatrick, MSW, LCSW-C is an author and educator. Founder of Jenerations Health Education, Inc., she has more than 20 years' experience in healthcare. and is an Adjunct Instructor at Johns Hopkins University. Her new book, "Your 24/7 Older Parent" answers the prayers of those dealing with the care of an elderly parent.



HEALTHYLiving Fight the Flu

Get Vaccinated to Protect Yourself From Influenza


s you age, what used to be simply the inconvenience of coughing and sneezing could become life threatening. Your immune system weakens, which makes it harder for your body to fight off viral infections. In the United States every yea year, the flu claims the lives of anywhere from 3,000 to 49,000 people and hospitalizes an average of 226,000. About 6 out of every 10 hospitalizations and 9 of every 10 deaths occur in people age 65 and olde older. Over 10,000 people die from pneumococcal infections. A weak immune system also leaves you susceptible to the worsening of preexisting conditions such as asthma or diabetes, and the development of bacterial pneumonia.

Influenza and pneumococcal disease are the most common causes of death in the United States from diseases that can be prevented by vaccination. The CDC recommends that everyone 6 months of age and older, and particularly those at high risk, such as those who are 65 and over or those with chronic diseases, receive an annual flu vaccination. People with Medicare coverage can get the flu shot at no cost, there is no coinsurance or co-payment, and the deductible does not apply. One of the common apprehensions about the flu shot is that it will make you sick. That is a myth. The flu shot helps prevent the flu; it does not give you the flu.

In fact, getting a flu shot is the best thing you can do to keep you from getting sick this flu season. Also, by protecting yourself, you’re protecting those around you. The vaccination can prevent you from spreading the virus to children or other love ones. This article is was also featured on Medistar Home Health’s blog. Medistar strives to be a resource on health & industry information for both patients and health care professionals. Learn more mo about the flu and a host of other health topics by visiting

Golden Chalice Pesto Un-Pasta Ingredients: One medium organic Spaghetti Squash ½ cup thinly sliced organic Red Onion ½ cup julienne (cut in thin strips) organic Red Bell Pepper 2 Tblsps. of Unsalted Ghee or virgin Coconut Oil 1 cup Organic Zucchini slices, julienne (cut lengthwise in thin strips) Organic Classic Pesto Sauce (recipe follows this one) 3 tablespoons O 1. Cut Spaghetti Squash in half and clean out seeds. (If you don’t have a sharp enough knife to do this, simply bake whole and clean out seeds after baking. 2. Drizzle one tablespoon of Unsalted Ghee on each half (or pure virgin Coconut Oil, if Vegan) cover and bake at 350 degrees for 30 minutes or more, depending on whether or not you like your un-pasta "al dente" -- a little more chewy. Scoop out two cups of squash, which should now look somewhat like spaghetti. It’s easier to keep in strands using fork to take out. 3. Sautee Onion and Pepper in Grapeseed Oil or organic Unsalted Ghee: 4. Add Zucchini to above and continue to sauté. 5. Add Spaghetti Squash and Pesto Sauce and Blend in well:

Debbie Johnson, Chef and author of Fun with Gluten-Free, Low-Glycemic Food Cookbook: Delicious, rich, and satisfying gluten-free, allergy-friendly, low-glycemic-index recipes for vegan to meat-eaters. HOME HEALTH | FALL 2012


HEALTH Conversations

From Folk Medicine to Clinical Pathways in an EMR World By Gina Creel

It was not until the early 1900s that licensing laws containing standardized nursing care were developed. Many world events have had important impacts on the evolution of nursing and standardized care. Throughout the course of history events, such as the Civil War, World War I, the Great Depression, World War II, Vietnam War, and the introduction of Medicare in the 1960s, have helped shape the nursing profession. It has progressed from the use of home remedies and folk medicine to a profession utilizing standardized practices of caring for the ill. The use of clinical pathways did not originate in the healthcare industry, but rather were used in the 1950s in the aviation and construction industry. Critical Path Methods were used to control and manage complex processes. It was not until the 1980s, that critical pathways were introduced to healthcare management plans and then later into the clinical pathways of toda today. Wikipedia defines clinical pathways, also known as care pathways, critical pathways, integrated care pathways, or care maps, as one of the main tools used to manage the quality in healthcare concerning the standardization of care processes. It has been proven that their implementation reduces the variability in clinical practice and improves outcomes. Clinical o pathways promote organized and efficient patient care based on evidence-based practice. Use of clinical pathways optimizes


outcomes in the acute care and homecare settings. With the introduction of Medistar’s state of the art Electronic Medical Records “EMR” system in 2007, we moved from a paper system, with nurses relying solely on their clinical training and experience while developing Plans of Care, to a more sophisticated methodology using clinical pathways. Such pathways, built into our EMR system, provide a comprehensive checklist for each home health visit and may be easily modified to accommodate physicians’ preferences and orders. The EMR is a more organized, systematic, efficient approach, which uses clinical pathways for specific disease processes to guarantee that recognized Best Practices are used in order to achieve optimal outcomes for the patient. The EMR provides our experienced, knowledgeable clinicians with current patient information at the tap of the finger and improves the care transition and communication process when a patient leaves a hospital or after a doctor’s appointment. Physicians have access to patient information using secure, encrypted, password protected internet access, just a awa An effective EMR system with few clicks away. built-in clinical pathways, like that used for years by Medistar Home Health, is the key to efficient, effective, coordination of care among all healthcare providers on the patient’s road to better health.

Gina Creel is the Chief Operating Officer at Medistar Home Health.


Finding Power over Breast Cancer What Every Woman Should Know By James F. Holland MD


very woman must think of breast cancer as a risk that can be managed better by attention than by negligence. Starting at age 50 ( and many think at age 40) mammograms are of great value in early diagnosis. Other supplementary diagnostic methods include sonography and magnetic resonance imaging. Self examination can help; professional examination is much better. Early diagnosis markedly improves curability. Although there are some known genetic predispositions, they account for less than one in ten breast cancers, and thus no woman is exempt. Although breast cancer occurs in men, the great preponderance in women establishes that estrogen is a critical component of its development. Post-menopausal

hormonal replacement increases risk. Exercise is one preventive, and is free. Drugs that diminish estrogen’s effect on breast tissue, such as tamoxifen or raloxifen, are valuable in women at high risk. We do not yet have a universal preventive, however. The possibility that a breast cancer virus may cause some of the problem as it does in mice is still under intensive investigation, which could open new avenues of prevention. For early detected breast cancers, removal of the entire breast is rarely needed. Preservation of the breast is psychologicallyadvantageous. After surgery, andsometimes even before, hormone therapy, radiation therapy, chemotherapy and

immunotherapy may all have roles to play in specific instances. Cure is possible most of the time, and even in the minority who are not cured, there are usually major benefits of treatment . The day will come when we know how to prevent many if not most breast cancers without seriously compromising normal life ( as has been true for lung cancer by tobacco avoidance, for skin cancer by sunshine avoidance, and for penile cancer by circumcision) Until then, alert attention, not fear , is the best path for today's woman. Dr. James F. Holland MD is a Distinguished Professor of Neoplastic Diseases Mount Sinai

For more information on breast cancer and treatments visit the Medistar Home Health Patient Education Center at HOME HEALTH | FALL 2012


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Home Health Fall 2012  

Home Health Magazine Fall 2012