Journal Issue 9
Flu Shots Reduce Heart Events
Pathways Grief IssueSupport 8
The latest addition to Pathways extraordinary array of grief services is a support group for Chinese speakers to be held on Tuesday evenings in Redwood City. From September through June, Pathways provides many specialized support groups for loss of a parent, loss of a child, loss of a spouse or partner, and drop-in groups.
Yet another reason to get flu shots: it appears they reduce the risk of heart problems. And residents at highest risk of coronary disease problems benefit the most. Researcher Jacob Udell, MD, of the University of Toronto and his colleagues pooled the results of five randomized trials and found in follow-up that 2.9% of people who had the flu vaccine went on to have a coronary event; but 4.7% of those who didn’t get the shot had had coronary events. “We may have identified that the flu vaccine may also be a vaccine against heart attacks,” said Udell. They included five published trials and one unpublished trial that included a total of 6,735 patients, average age 67. More than a third of the patients (36.2%) had a history of heart disease. The authors calculated that for every 58 people vaccinated, one cardiac event could be prevented. For people who have had a recent heart attack, a flu shot could cut their risk of another heart attack or stroke by 55%. How does this work? Udell says one theory is that inflammation caused by the flu “may turn a stable plaque into an unstable plaque and cause a cardiac event.” Plaques results from the buildup of continued on page 3 Flu Shots
Many Kinds of Support
Pathways counts summer workshops, newsletters and memorial events among its comprehensive bereavement services. Groups examine common grief issues such as coping skills, loneliness, anger, “normal” grief and lifestyle changes. When group counseling is not appropriate, 1-to-1 counseling is available. Pathways opens bereavement support groups to anyone in the communities we serve, whether they had hospice or not. And there is no fee for these services thanks to generous contributions to Pathways Hospice Foundation. Support groups are held throughout the Bay Area (e.g. Los Gatos, Fremont, Sunnyvale, Redwood City). For information about grief support services or to request a speaker, call Chris Taich, Director of Bereavement Services at our main number: 1.888.755.7855.
Pathways Residential Care Journal
Sense of Touch
Second Year for Award
Changes with Age
Pathways Home Health has done it again! We received the HomeCare Elite award for topperforming home health care agencies for the second year in a row.
Many studies have shown that with aging, older people may have reduced or changed sensations of pain, cold, heat, pressure, and touch. For instance, older people may have trouble telling the difference between cool and cold, or between warm and hot, putting them at risk of burns or frostbite.
The award is sponsored jointly by the National Research Corporation, the leading provider of home health metrics and analytics, and DecisionHealth, publisher of the most respected independent home health newsletter, Home Health Line. The honor is recognition of the top-performing Medicare-certified home health agencies in the US. Nearly 10,000 agencies were considered. With quality weighted most heavily, the designation is bestowed based on:
Quality Best Practice Quality Improvement and Consistency Implementation Patient Experience Financial Performance “The 2013 HomeCare Elite winners demonstrate a commitment to providing patient-centered care and serving as leaders in the home health community,” said Mary Oakes, senior vice president of post-acute at National Research. “We congratulate Pathways Home Health & Hospice on being recognized as a top home care agency.”
Visit us online at www.pathwayshealth.org
Some of the normal changes of aging may be caused by decreased blood flow to the touch receptors, to the brain, or to the spinal cord. Minor dietary deficiencies, such as decreased thiamine levels, may also be a cause of changes. It is hard to tell whether these changes are related to aging itself or to the disorders that occur more often in the elderly. Medications, brain surgery, problems in the brain, confusion, and nerve damage from trauma or chronic diseases such as diabetes can change this interpretation without changing awareness of the sensation. After age 50, many people have reduced sensitivity to pain, or they may feel and recognize pain, but it does not bother them. Skin, muscles, tendons, joints, and internal organs all have receptors that detect touch, temperature, or pain. Some of the receptors in these areas give the brain information about the position and condition of internal organs. Even though a person may not be consciously aware of this information, it alerts us to problems (e.g., the pain of appendicitis). Reduced ability to detect touch and pressure increases the risk of injuries, including pressure ulcers. Fine touch may also decrease, however, some people develop an increased sensitivity to light touch because of thinner skin (especially people older than 70). To maximize safety, older people should make allowances for these changes, such as: • Looking at the thermometer or weather report to decide how to dress rather than waiting until they feel overheated or chilled. • Inspecting the skin (especially on the feet) for injuries, and treating injuries they find. People should not assume that just because an area is not painful, the injury is not significant. This information is from the National Institutes of Health.
Caring with Kindness and Dignity
ANTIBIOTICS When to Take Them Using antibiotics when they are not needed is causing a major problem. Over-prescribing or prescribing stronger antibiotics than are needed is leading to “super bugs,” bacteria that are resistant to antibiotics. Antibiotics don’t work against viruses like those that cause a cold or the flu. Here are some guidelines. ANTIBIOTICS ARE FOR BACTERIAL INFECTIONS
Severe sinus infections or those that last longer than 10 days Some ear infections Strep throat Certain wound and skin infections, such as staph infections Bladder infections
continued from page 1 Flu Shots
cholesterol, calcium and the clotting substance fibrin in the lining of the arteries. Another possibility is that the side effects of the flu, such as low oxygen levels, low blood pressure, coughing, rapid heart rate and sometimes pneumonia may strain the heart, leading to a cardiac event. The authors of the study described the flu vaccine as “low-cost, annual, safe, easily administered, and well-tolerated therapy to reduce cardiovascular risk beyond current therapies”. The study was reported in the Oct. 23/30 issue of the Journal of the American Medical Association.
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Viral Infections Most bronchitis Colds Flu Most coughs Most ear infections Most sore throats Gastroenteritis
Norovirus Resists Alcohol Gel Soap and Water Best Most of the time hand sanitizing gel does a good job of killing germs on our hands. The exception is the dreaded norovirus—the bug that can spread like wildfire among residents, causing diarrhea and vomiting and sending older people to the emergency room every winter. The alcohol in the gel breaks through the outer membrane of most viruses, but the norovirus has a capsule that resists alcohol. The Centers for Disease Control say that alcohol gel should only be used “in addition” to hand washing, but not as a substitute. Housekeeping should use a 10% bleach solution to wipe down surfaces frequently during outbreaks of norovirus.
Pathways Home Health & Hospice 585 North Mary Avenue Sunnyvale, CA 94085-2905 1.888.755.7855 / www.pathwayshealth.org
NONPROFIT ORG U.S. POSTAGE PAI D SUNNYVALE, CA PERMIT NO. 172
Serving San Francisco, San Mateo, Santa Clara, Alameda & Western Contra Costa Counties from offices in Oakland, South San Francisco and Sunnyvale.
Fall Prevention Program Pathways Hospice has an
excellent safety record for preventing falls.
We do a Fall Risk Assessment
on every patient.
Our fall prevention program
focuses on reducing the risk of falls by assessing medications, gait, balance, home environment, and the use of assistive devices.
**Peers are other hospices nationwide with a daily census of 100+ patients. National refers to all hospices. Information is from OCS Quality Assurance Performance Improvement Snapshot, the home health industry standard for benchmarking.