posted on February 16, 2012
Rina Schnaufer, RN and Joetta DeVeronica, RN
Telemonitoring systems, such as Cardiocom®, can help home health care providers address a large percentage of our patient population such as those with Hypertension, Heart Failure, COPD, Asthma, CAD, and/or Diabetes, amongst other possibilities.
The Cardiocom® systems are installed in the patient’s home for remote monitoring. Information is sent through a telephone or internet line and then we are able to monitor vital signs along with the symptoms of the disease. Reminders can also be sent to patients and calls made to help to improve overall patient compliance with treatment care plans. The goal is to identify symptomatic patients and intervene early to prevent unnecessary hospitalizations, as well as to support health outcomes, interdisciplinary communication, and optimize care.
Below is an example of how Telehealth monitoring can connect patients, home care clinicians, and their physicians to their daily status.
This patient was refe
rred to our Telehealth Team for a diagnosis of heart failure. After several days of monitoring, we noticed a trend of elevated blood pressures in the morning. The blood pressures would range from 200's/100's in the morning to normal readings in the afternoon (per HCR standard parameter guidelines, normal BP readings are 160/80). The patient and physician were unaware this was happening. After contacting the physician and providing the Telehealth reports, the physician was able to make the necessary medication changes and the patient's blood pressures are now stable.
Telehealth provides your patients with the opportunity to be connected to their medical team daily. This gives patients and families a sense of security, confidence, and independence. Telehealth also provides for clinicians a regularly scheduled report to support your clinical assessments. Telehealth monitoring is an important part of a patient's home health care plan and provides valuable information to the entire healthcare team and the patient on a daily basis.
Many more HCR patients could benefit from Telehealth; the above is only one example of many. There have been numerous times when Telehealth has been an important and helpful tool providing daily monitoring and can help to truly provide thorough quality care. To learn more information about HCR’s Telehealth Program or to inquire directly, click here.
posted on February 9, 2012
Chris Chimenti, MSPT - Director of Therapeutic Services
It’s amazing how much Home health practice has changed over just a few years. When I began my career as a home health Physical Therapist in 1999, a stack of new referrals, a variety of paper documentation forms, a pen, and a pager were standard issue for home care field clinicians.
The pager was my lifeline to the home office. When the office needed to contact me, I would get a page containing the office phone number. (The phone number followed by the numbers “911” was code for an urgent patient care need.) While in transit between patients without a cell phone, I would find the nearest pay phone to reply to the page. By the time a phone booth was successfully located, the person who generated the page would likely have left their desk to attend to another matter somewhere else in the office and this communication cycle would start again.
Paper documentation was completed to log the details of patient care. Photocopies of these notes were produced to build a “travel folder” to serve as a portable record. Unless I spoke directly with the nurse or social worker involved in the case or stopped by the medical records department to review the patient’s chart, there was no means of gleaning valuable clinical information about my patient without the physical documents in hand.
A new era of home health care has dawned, and at HCR technology is at the heart of operations becoming an irreplaceable necessity. Today we have touch screen tablets connected to a wireless network available 24/7. Clinicians maintain a full medical record on the device through our cutting edge, industry-leading software.
Through the tip of a finger swipe, the clinician can access the patient’s referral, physician orders, diagnosis list, medications, and visit notes completed by each member of the interdisciplinary care team. Internet access can be utilized to retrieve valuable community resources or health-related information for the patient.
Email alerts are readily apparent on the device, so each clinician can easily monitor and process information arriving from the office or fellow colleagues. Cell phones replace the old phone booths for field clinicians, allowing instantaneous communications on behalf of their patients. Now communication with the office from the field is easy, efficient, and effective.
The road to becoming an industry-leading provider has been paved with cutting-edge technology and skillfully navigated by the expertise and dedication of HCR employees. It is hard to imagine the barriers to quality care that once existed. Looking back, the good old days of home care weren’t actually that good after all.
posted on February 7, 2012
Carmen Camacho, RN, BSN
As we settle into February, which is Black History month, it is easy to reflect on many individuals from the past. In addition to our own ancestors, there are
others who stand out in our minds and have certain significance in our lives. For me, one such person is Mary Eliza Mahoney.
Mary was born in Massachusetts to Charles and Mary Jane. Early on Mary expressed an interest in nursing. At the New England Hospital for Women and Children Mary began her career in caring. Finally, in 1878, when Mary was thirty-three, she was admitted to the hospital’s nursing program.
Of the forty-two students admitted to the program, only four made it to graduation. One of the four, Mary received her certification on August 1, 1879, thereby taking her place in history as the first African American professional nurse in this country! Mary’s career spanned forty years and her patients had nothing but praise for the care she gave. Mary was one of the original members of the Nurses Associated Alumnae of the United States and Canada (later known as the American Nurses Association or ANA).
Mary died on January 4, 1926 after a three year battle with breast cancer. She is buried in Woodlawn Cemetery, in Everett Massachusetts. The National African American Nursing Sorority,
Chi Eta Phi , restored and maintains her gravesite. In 1973 they erected a monument to honor her life and accomplishments.
posted on February 3, 2012
Sue Bourne, RN, MSN - Directory of Specialty Programs
Today we are excited to announce the start of a new image-sharing process that we are piloting with three nurses (and hope to roll out to the rest of our nurses soon).
Formerly, the image-sharing process involved taking a digital camera to the client’s home (of which we only had four or five to share amongst all our field clinicians). Our nurses would then have to return the camera to the office so that a clinical support staff member could upload the pictures than either print or attempt to email to our wound care nurses or physician offices. What a hassle!
While in the field, nurses can use their Android device (that they use for documentation), to take pictures and then they can automatically send the picture on their device through HCR secured email to the wound care nurse team – essentially in one step! Now, our clinicians will be able take and share these images in real time. We have developed a protocol to provide guidance to you to ensure HIPAA compliance.
The WOCNs then attach the wound picture to the patient record and can print the picture as needed. We can also forward these images on to the client’s physicians just as securely and easily. Amazing! Physicians will get faster and more accurate updates on their patients and overall quality of care can be provided.
We are very thrilled to be able to use the latest technology to move our quality care and superior service to the next level of home care services. We look forward to what new advances still await us!
posted on January 25, 2012
Approximately 25% of people 75 years or older suffer from a condition known as low vision. Low vision can be caused by age-related eye changes such as reduced contrast sensitivity or an increased sensitivity to glare. The most common cause of low vision is the presence of age-related eye diseases such as macular degeneration, glaucoma, or diabetic retinopathy. Although vision loss may be permanent in many circumstances, skilled professionals such as Occupational Therapists can teach individuals with vision loss strategies to compensate for low vision, thus maximizing participation and independence in their daily tasks.
Most people desire to live independently in their own home as they age. Family members may have concerns about their loved one’s ability to live alone when he or she experiences vision loss. An Occupational Therapist can help by evaluating the home and making simple changes in an environment to assist the individual with low vision better manage daily tasks. Simple adaptations and strategies that an Occupation Therapist may use for people living at home with vision loss include: correct use of lighting, contrast, and augmenting lost vision with alternative sensory input.
Lighting is one of the most effective changes one can make to their homes and it is simple. Occupational Therapists ensure that available lighting is optimal for task performance. Lighting should evenly illuminate the environment or tasks being completed. The Occupational Therapist checks for shadows caused by light, as this can be visually confusing for a person with vision loss. When adding additional lighting, the Occupational Therapist ensures that the modification does not increase the presence of glare (e.g. light reflecting off of a shiny surface).
Occupational Therapists may use contrast as another simple, yet effective, modification to the home, allowing the individual to easily locate objects. When enhancing contrast, the Occupational Therapist places dark objects against lighter backgrounds, or vice versa. Examples of using contrast within the home would include the placement of bathing items in contrasting colored containers or the use of a dark place mat under light-colored plates to improve visibility.
People with low vision may instinctively rely on information that is received through hands and feet as their vision decreases. Occupational Therapists can help train those with vision loss how to enhance to attention this information and place tactile cues to promote safety and independence. One technique utilized by HCR Home Care Occupational Therapist, Jen Thompson, is the placement of velcro at the top and bottom of the stair rail, allowing those with vision loss to feel when they have reached the last step. This simple strategy may prevent an injury related to a fall within the home.
Making a home safer for those with vision loss does not need to be complicated or costly. Occupational Therapists have many useful adaptations and recommendations that can increase independence for those living with low vision. For more information, please call HCR Home Care and ask about our Low Vision program or submit a request for information here.
posted on December 28, 2011
Aging and independence seem to fight against each other; as age increases, independence seems to decrease. For many seniors, the concept of a nursing home represents the end of independence and many fear asking for assistance if this is the answer.
This situation often results in a common dilemma – both for the individuals seeking help and for caregivers who feel they cannot provide the complete care needed for their loved one. While placement in a nursing home may seem like the most obvious and perhaps easiest choice, consider a home care agency as an alternative option.
The expanse of care available at nursing homes is also available through home care agencies. These agencies carry extensive geriatric expertise with nurses; physical, occupational, and speech therapist; social workers and geriatric care managers; dieticians; home health aides; and companion providers all available directly to your home.Geriatric care managers and social workers are on hand to ensure patients and careivers know about all the resource
s that are available and ensure all your needs are met.Companions offer a unique type of service to those needing occasional assistance. Whether you need help running errands, taking care of your pets, or help with housekeeping, companions provide the little extra help you need. Additionally, these providers can help keep your social life active. Companions are there to play card or board games and accompany you to social events.
Eligibility for home care is not restricted to specific needs or care levels. Home care services are available to individuals needing assistance due to dementia or Alzheimer’s as well as individuals with physical limitations. Therapists can teach clients exercises to regain or enhance balance. Occupational Therapists can offer patients advice on how to remedy tripping hazards in your home or provide tools to for daily living to patients with Parkinson’s or after a stroke.
Clients with dementia can remain at home with home care assistance. Home health aides and companions can provide in-home servi
ces for activities of daily living (ADLs), instrumental ADLs (IADLs), and cueing. Companion or Home Health Aide services are tailored to your needs and often at a cost less than assisted living or a higher level of care.
Many Independent living communities offer the independence clients need with assistance available as you need it. Shared aide programs – using home health aides from agencies in an independent living community – provide morning, evening, and night checks as well as medication reminders. The services offered by home care agencies can be provided for through insurance and are available through private pay if your needs are not covered. Companion or Home Health Aide services are tailored to your needs and often at a cost less than assisted living or a higher level of care.
If you’d like more information regarding services available through HCR Home Care, please call us at 585-272-1930 and ask to speak to a Home Care Specialist.
posted on 1 November 2011
By Chris Chimenti, MSPT, Director of Therapeutic Services
On October 26, 2011 we honored the work, compassion, and dedication of HCR’s great team of therapists at the 11th Annual Therapeutic Services Appreciation Event. While we honored our Therapeutic Services Team as a whole, we also had an opportunity to recognize a select few for their outstanding accomplishments.
- Vincent Sanza, PT – Therapist of the Year Award. Granted to a therapist, nominated by their peers, who exhibits the following characteristics: Team Work, Professionalism, Dedication to Excellence, and Focus on HCR’s Mission and Vision.
- Jason Berl, PT – Emerging Leader Award. Granted to a therapist who demonstrates extraordinary commitment to professional development and life-long learning.
- Kerri Watkins, PT – Best Practice Award. Granted to a therapist who demonstrates consistent adherence to best practice standards and excellence in home health service.
- Katie DuRei, PT; Melissa Triantafilou, OT; and Kevin Birkemeier, PT – ESOP Customer Service Award. Granted to a therapist who demonstrates commitment to the customer, promotion of HCR’s services and focus on the growth of the business.
Take a moment to congratulate all the award recipients from this year’s event. And be sure to thank all of the therapists at HCR for their commitment and dedication to home health care service.
posted on March 21, 2011
by Adam Fabrizi, Community Outreach Coordinator
HCR Home Care has partnered with the Rochester Housing Authority to provide service coordination and facilitation for all senior and disabled residents. Staff from HCR is able to assist residents with questions, problems or other needs regarding the following:
- Health and Wellness
- Transportation
- Money and Employment
- Translation
- Food and Nutrition
- Cooking and Housekeeping
- Completing Forms and Applications
- Legal Concerns
HCR staff has offices in the following buildings:
- Danforth Towers
- Lake Tower
- Hudson Ridge Tower
- University
- Kennedy
HCR staff also assists residents at the following sites:
- Glenwood Gardens
- Lexington Court
- Blackwell Estates
- Elmdorf Apts
- Parliament Arms
- Glide Court
- Lena Gantt
- Atlantic Avenue
The service facilitators representing HCR are Dornetia Dorn, Wanda Pacheco, Rosa Arroyo, Viviana Soto and Lumarie Ramirez. Robert Jean-Jacques and Karyn Spetz, two of HCR’s Medical Social Workers, are also available to consult with residents. Bilingual (Spanish) staff is available for all buildings. HCR’s involvement with RHA is overseen by Sarah Miner, R.N. She is able to assess residents’ medical needs and discuss any health-related concerns they may have.
HCR is hosting monthly programs and presentations in the buildings. Watch for information about upcoming dates and times!
For additional information, contact Adam Fabrizi, Community Outreach Coordinator, at
[email protected] or (585) 295-6496.
posted on November 26, 2010
By Dave Carro, Marketing Manager
For millions of Americans, a nap following Thanksgiving dinner is almost as traditional as serving turkey and watching the Macy’s Thanksgiving Day Parade. With a full belly, a warm house, and an empty recliner, how can anyone say no? Well, you may not be able to say no, even if you wanted to, thanks to an amazing amino acid in turkey called tryptophan.
Every year, we hear about tryptophan, especially around the holidays. It is a favorite subject among journalists looking for a topic to share with their readers other than the craziness around Black Friday shopping. But I wanted to know more about this amino acid so I did a little digging. According to HowStuffWorks.com, tryptophan is an ‘essential’ amino acid. Not knowing what that meant, I poked around enotes.com and found out that there are 20 different amino acids (organic compounds) which make up all proteins in the human body. These amino acids replenish tissue, red blood cells, enzymes, and other substances. Of these 20 amino acids, about half can be manufactured by the body. They are called ‘nonessential’ amino acids because they don’t have to be obtained from the diet. The remaining half, called the ‘essential’ amino acids, cannot be produced by the body and must be obtained from the diet.
So, tryptophan is an essential amino acid. This little guy helps the body produce the B-vitamin niacin, which, in turn, helps the body produce serotonin, a remarkable chemical that acts as a calming agent in the brain and plays a key role in sleep. So you might think if you eat a lot of turkey, your body would produce more serotonin and you would feel calm and want a nap. But nutritionists and other experts say the tryptophan in turkey probably won’t trigger the body to produce more serotonin because tryptophan works best on an empty stomach. The problem is, we don't have empty stomachs after Thanksgiving dinner! The tryptophan in a Thanksgiving turkey has to compete with all the other amino acids the body is trying to use. So only part of the tryptophan makes it to the brain to help produce serotonin to trigger sleepiness.
So, if this is the case, why do so many of us make a beeline to the Laz-y-Boy recliner or couch to grab some Zs following a big Thanksgiving turkey dinner? It’s simple... just take a look at the mess in the kitchen. Sleep is a much better alternative than cleaning the bottom of the turkey roaster.
Acknowledgments
- ‘Is there something in turkey that makes you sleepy?’ 07 November 2007. HowStuffWorks.com. 26 November 2010.
- ‘Food And Nutrition - What Is The Difference Between Essential And Nonessential Amino Acids?.’ Science Fact Finder. Ed. Phillis Engelbert. UXL-Gale, 1998. eNotes.com. 2006. 26 Nov, 2010
posted on November 19, 2010
By Colleen Gladstone, RN, CDE – Diabetes Specialist
November is American Diabetes Month. This is a great time to raise awareness about the symptoms and risk factors for diabetes, and also to recognize where we may have control in managing this complex disease. As a health care worker at HCR Home Care, I interact with diabetic patients on a daily basis. As the incidence of Type 2 diabetes has risen dramatically in recent years, it has likely touched each of our lives in a personal way, either through diagnosis of a friend or family member, or possibly through our own diagnosis of diabetes. Sadly, many diabetics are not aware they have the disease until they develop one or more of its complications, such as blindness, kidney disease, heart disease and stroke, nerve damage, or infections. Early detection and intervention are the keys to preventing long-term complications.
Recognizing the symptoms of diabetes, such as excessive thirst, extreme hunger, frequent urination, unexplained weight loss, blurred vision, unusual fatigue, numbness or tingling in the hands or feet, dry itchy skin, cuts or bruises which heal slowly, and frequent infections is critical to detect the disease in its early stage. If these symptoms occur, it is important to see a doctor right away.
Because symptoms often go unrecognized, knowing common risk factors for diabetes is helpful in identifying people who should be tested. This includes people younger than 45 who are overweight and have one of the following risk factors: have a family member with diabetes; are African-American, Hispanic/Latino, Native American, Asian-American, or Pacific Islander; gave birth to a baby weighing more than nine pounds; diagnosed with gestational diabetes; and are physically inactive. All people aged 45 or older should be tested.
While none of us can control risk factors such as age and ethnicity, focusing on those risk factors we can control, such as obesity, may delay or prevent the onset of diabetes. Controlling blood glucose, blood pressure, and cholesterol levels through healthy eating, physical activity, monitoring, and use of medication as prescribed, will help to reduce the risk of diabetic complications. People with diabetes can enjoy a healthy and active lifestyle!
For more information, contact HCR Home Care at 585-272-1930. Don’t forget to check out our Facebook Fan Page and be a fan! www.facebook.com/HCRHomeCare.
