Donna, a community health nurse at HCR, and I met at a downtown high-rise apartment complex to ‘open’ a patient who’d been discharged from the hospital the day before.  Donna is an ‘opening’ nurse – a registered nurse with special assessment skills (which were apparent as I watched her carefully and patiently go through all the aspects of this case). However, once the patient was opened, he would be cared for by his regular HCR nurse.

The patient, Pedro, had an osteomyelitis of his foot (an inflammation and likely bacterial infection of the bone), and several other health issues including kidney transplantation, diabetes, hypertension, , and a host of other problems which led to his need for over a dozen medications, some taken two, three, or four times per day.  Pedro produced a large plastic bag with at least 30 bottles for Donna to go through.  I already knew that medication management was a key area for coordination between the physician, pharmacy, and home care, but this was eye-opening!  Donna put the medications Pedro would need for the week in a medication management box, and made sure the others were put away safely.  During this process, she discovered that although Pedro thought Vitamin D was to be taken once a month, it had been prescribed for once a week, requiring her to call the doctor’s office.  She also found that several of the medications were no longer needed.  This is a common problem, which fortunately can be addressed by the opening home care nurse, and reconciled with the physician.

The bandage Pedro had on his foot wound was nearly completely unraveled when we arrived.  The appropriate use of the bandage, and how it should be managed to avoid infection and contamination, was something Donna would clearly need to go over WITH WHO?.  She examined the foot wound closely to determine if a wound care specialist was needed, or if the care could be handled by his regular nurse.

Donna’s in-depth questioning of Pedro regarding his living situation and family support reminded me of how different the controlled environment of the hospital and uncontrolled environment of the home can be.  Pedro doesn’t cook for himself, and relies on his stepdaughter to help him shop and cook.  He takes insulin twice a day, and said that he, “checks his sugars daily, and takes more sugar when the sugars are low.”  It was unclear what happened when the sugars were high.  Donna told me a diabetic educator would be assigned to Pedro, but that the hurdles of overcoming cultural preferences and his past unwillingness to modify his diet may be a problem.  Nevertheless, transcultural nursing approaches would be used by HCR’s staff in an effort to negotiate and ‘repattern’ Pedro’s behavior.  After all, you can never tell whether this may be the time Pedro will respond, perhaps with the help of his stepdaughter.

Pedro had received home care from HCR before, and asked about his Spanish-speaking nurse, Christina, with whom he’d established a bond.  He told us he felt his hospital team was so complex - with so many doctors - that he couldn’t relate to any one of them, but that he could relate to “his” home care nurse.  It was clear that in his own home Pedro felt better able to understand what was going on.  He was very pleased to learn that Christina would once again be assigned as his nurse and case manager!

As a physician, I was glad to gain some understanding of the environment and situations in which my plans of care sometimes have to be delivered.  It will affect my thinking in the future about how to best work with the home care nurse to set goals.  Walking alongside Donna gave me a new appreciation of how physicians and home care nurses working closely together can improve patient outcomes.

Each year, to publicly honor these amazing individuals and their profession, HCR recognizes our nurse employees during National Nurses Week in May. This year, nursing staff and administration gathered to celebrate the 2nd Annual Patient Memorial Garden Planting at our offices in Henrietta. In addition, we honor the legacy of Lillian Wald, creator and champion of public health nursing, by maintaining her grave at Mt. Hope Cemetery and holding annual memorial ceremonies honoring her legacy. Nurses Week 2010 culminated with a recognition and awards dinner, celebrating the work we do and acknowledging nurse accomplishments over the past year. The highlight of the dinner was the announcement of the nurse selected as the recipient of the HCR Lillian Wald award.

Every day, nurses demonstrate their passion and strong commitment to the patients they serve. Let us follow their lead and show them our appreciation for the vital work they do to keep us all healthy!

At HCR Home Care, we value our employees, their families, and celebrate our collective cultural heritage.  This year, we are jazzing things up a bit and adding a cultural spin on our summer event in recognition of HCR’s Transcultural Care Programs. 

There will be a little something for everyone to enjoy!  You can totally tantalize your taste buds with a variety of ethnic foods – Latin, Soul, and Ukrainian!  Does tapping your toes and dancing sound fun?  Great sounds of a Salsa and Gospel band will fill our ears!  And, it wouldn’t be an HCR event without our very own choir – HCR Caring Voices will be stopping in to belt out a few tunes!  For those bringing little ones, they can have fun playing in the enclosed playground or some games setup just for them.

Summer Fun…We Can Do That!!

Being in Human Resources, I get to meet a lot of people interested in joining the HCR Home Care family.  HCR provides skilled nursing, rehabilitation, social work, and home health aide services to thousands of Rochester-area patients each year.  Because the nature of what we do is so important and requires such a high level of trust between us and our patients, HCR is careful to bring people onboard who have a passion for caring for others and who demonstrate a high level of respect toward the needs of our community members.

Careers in Nursing
As part of our selection process, nursing candidates have the opportunity to talk with our nurse management team to learn more about what we do… community health nursing.  The majority of our nurses come from acute care settings like hospitals, but the home health environment is a distinctly different and rewarding experience.  Nurses who excel at HCR enjoy the flexibility to set their own schedules, manage patient care over the course of treatment, and provide a high degree of education to patients and their families. 

We also ask potential new nurse candidates to travel with and observe or “shadow” one of our seasoned community health nurses prior to deciding to join HCR.  This valuable shadowing experience allows candidates to clearly understand a typical day for a home care nurse and their role in administering home care.

I recently had a great conversation with a hospital nurse who had just completed her shadowing experience.  She remarked that the home health care approach allowed the nurse to provide the dedicated focus and support to patients that many nurses in the hospital wish to provide, but find difficult to do in that environment.  It is that opportunity… to have a fundamental and individualized impact in the patients’ preferred environment that defines the true value of home health care.

We’d like to share more with you regarding the benefits of working at HCR Home Care and the joy of home health nursing. To learn more, call me at 585-272-1930, or apply on-line at www.HCRhealth.com via our Employment page. We look forward to hearing from you!

HCR recognizes the unique needs of our distinguished veterans, and has taken the steps necessary to create a veteran-friendly home care environment… one that provides vets with the best quality home care. Our skilled health care professionals offer expert home care to veterans with all types of health-related needs, including medical and surgical care, chronic disease care, and pain management. In addition, HCR provides a full complement of home health aide services. Working under the direction of our nurses and therapists, home health aides assist our veterans with activities of daily living such as bathing, dressing, meal preparation, laundry, coordinating appointments, running errands, and providing companionship.

In addition, the clinical care coordinators at HCR work in partnership with Veteran’s Administration personnel to maximize VA and Medicare benefits for veterans – ensuring they receive the full range of services to which they are entitled. The close relationship HCR has with the VA and regional VA health centers helps provide peace-of-mind for our veterans, and allows them to focus on improving their wellness.

Home care services are often recommended by VA discharge planners, physicians, or by a social workers at the hospital; these individuals will generally initiate referrals to HCR. However, veterans may contact HCR at any time at 585-272-1930 and ask for assistance in starting services.

1. Healthy Nutrition
A healthy diet includes a variety of fruits, vegetables, and whole grains every day. Foods and drinks which are high in calories, sugar, salt, fat, and alcohol should be consumed in moderation or avoided all together. Food pyramids outline various food groups and food choices that form the foundation of a healthy diet.

2. Regular activity
Recommendations for an active lifestyle include at least 2½ hours of activity each week. Activities that elevate your breathing and heart rates should be included. For moderate endurance exercise, simply walk a little further each time you exercise and gradually increase the pace of your walks as the weeks pass. A very simple trick to get a bit more exercise without even trying is to park your car further away from the entrance to stores, work, etc. rather than looking for the closest spot. As always, check with your physician first before increasing your activity level.

3. Healthy lifestyle
Use sunscreen with sun protective factor (SPF) 15 or higher and UVA/UVB protection. The sun’s UV rays can damage your skin in as little as 15 minutes, so place sunscreen before you go outside. Wash your hands to stop the spread of germs and avoid getting sick. It is best to wash your hands with soap and clean running water for 20 seconds.

4. Manage stress
Be sure to maintain a healthy balance between work, home, and recreation. If you encounter periods of stress, reach out to family and friends and ask for their support. Stay positive and take time to relax. Be sure to get seven to nine hours of sleep each night.

• Apply a sunscreen with a SPF of 15 or higher. Reapply often. For children, it’s recommended to use sunscreen with an SPF 30 or higher.
• Wear clothing that’s dark and tightly woven.
• Wear a wide-brimmed hat and sunglasses.
• Keep children six months old or less out of the sun completely.
• Stay in the shade whenever possible.

Remember, it’s never a good idea to use tanning beds.

HCR Home Care wants you to be careful this summer! Practice these simple rules for optimal skin health.

• Secure rugs with two-sided tape to avoid tripping.
• Install hand rails on both sides of a staircase.
• Install night lights in areas of the home where you walk regularly.
• Add reflective, non-skid tape on all non-carpeted steps.
• Install lever-type handles on all doors (these are great for arthritic hands).
• Place a bench or sturdy chair near all entryways into your home. This provides a safe place to rest upon returning home or is a place to place heavy packages.
• Consider use of lighted rocker light switches.
• Consider a raised toilet seat (19” is the standard height for a senior) with nearby grab bars.

An HCR Home Care occupational therapist is the perfect resource to evaluate your home to make it a safer place to be! Call us at 585-272-1930 to find out more.

• Propane and charcoal BBQ grills should only be used outdoors.
• The grill should be placed well away from the home, deck railings and out from under eaves and overhanging branches.
• Keep children and pets away from the grill area.
• Keep your grill clean by removing grease or fat buildup from the grills and in trays below the grill.
• Never leave your grill unattended.
• Keep a fire extinguisher accessible near your grill area when you begin.

Every year, hundreds of people in the United States suffer painful and sometimes life-threatening burns resulting from the careless use of outdoor grills.

HCR Home Care wants you to be careful this summer! Follow these simple rules for safe grilling and have fun!

There are many factors which contribute to the development of arthritis.  Some people are genetically predisposed, some have previous illness or injury which makes them susceptible, or some may have occupational hazards. Being overweight or obese can also cause arthritis, due to the added pressure on the joints while performing daily activities such as walking. 

There are many medical options to treat and manage arthritis.  These can include medications, injections, and joint replacement. The cornerstone for the management of arthritis is exercise – and more specifically, strengthening, stretching, and low impact aerobic activities. 

The physical therapists at HCR Home Care are trained professionals who can evaluate, treat, and improve your arthritis and arthritic symptoms.  During an initial evaluation, the physical therapist will work to determine the root cause of your arthritis and then develop a customized treatment plan. HCR has the ability to develop tailor-made exercise programs suited for your specific needs which can improve your strength, flexibility, range of motion, and pain. 

If you or someone you know suffer from arthritis and would like more information on how to get relief, call us at 585-272-1930 or visit us on-line at www.HCRhealth.com.]]> July 09, 2010 hcr-can-help-you-manage-your-arthritis http://www.hcrhealth.com/content/news/blog/process-improvement-teams-can-do-that
Teams of employees regularly participate in process improvement training and the practical application of ‘lean office’ tools. They document current processes, identify areas for improvement, and then test solutions. The approach encourages cross-functional representation and has helped to provide fresh perspective, generate enthusiasm and buy-in, and foster creativity in our search for new and better processes. We are pleased to report we are having great success!

Why is HCR’s dedication to continuous process improvement so important? Our efforts to create value and eliminate waste yield benefits for all our patients. The projects in progress serve as stepping stones in a larger effort to transform the way we think about and manage change. Ultimately, HCR’s ability to strategically plan for change in response to the shifting home health care environment will help us provide the best possible service and achieve highest levels of patient satisfaction.
]]> May 14, 2010 process-improvement-teams-can-do-that http://www.hcrhealth.com/content/news/blog/falling-is-not-a-normal-part-of-aging
HCR Home Care is passionate about reducing our patients’ risk of falls in order to maximize their strength and mobility to maintain independence and wellness. We have developed and implemented very successful fall prevention programs in assisted and independent living facilities in the Rochester area. These comprehensive, progressive 10-week exercise programs include staff and resident education to create a real culture of safety.

Residents who participated in recent HCR Home Care falls prevention programs began with pre-assessments which included documenting their current balance, fitness, and mobility levels. During the 10 weeks, the residents increased their challenge-level of the exercises. At the end of the program, they were re-tested and EVERYONE improved on their objective measures! Socially, the residents interacted more with their peers and participated in more activities. Most importantly, their confidence level increased and their fear of falling virtually disappeared!
]]> May 07, 2010 falling-is-not-a-normal-part-of-aging http://www.hcrhealth.com/content/news/blog/truly-supporting-transcultural-care
HCR employs specially-trained and culturally competent health care professionals, and engages in evidence-based health care practices. The transcultural team received cultural competency training and certification by the founder of transcultural nursing, Dr. Madeline Leininger and transcultural nursing experts Dr. Margaret Andrews and Dr. Marilyn McFarland.

Our goal is to meet needs in a culturally sensitive manner most appropriate to patients and their family members. HCR respects and supports family traditions, religious beliefs, and language requirements – bilingual staff provides the expert care patients expect and deserve. Educational materials and other printed directives are available in Spanish, Ukrainian, and Russian. HCR also understands and supports unique food traditions – our diabetic and heart-healthy meal plans have been thoughtfully developed according to cultural preferences.

While the number of transcultural patients at HCR Home Care may not be as large as other groups we serve, their significance is the same. It is our responsibility to do everything in our power to live up to our mission of quality care… regardless of cultural or language barriers. At HCR, it’s something we do every day.
]]> April 30, 2010 truly-supporting-transcultural-care http://www.hcrhealth.com/content/news/blog/responsibility-to-help-minorities-improve-health
I recently read African Americans are 30% more likely than Caucasians to die from heart disease. This statistic shows one of the many reasons we should all be willing to help minorities understand the importance of good eating habits and exercise to enhance their quality of life.

I am a Hispanic female – and I have been touched by diabetes in my family. Half of my father’s twelve brothers and sisters have fallen victims of this devastating disease. Through education, exercise, and healthy eating, most of my aunts and uncles have been able to control their diabetes and live normal, productive lives.

This is a perfect example of why I believe it is possible to reach others to help educate them and improve their health status. Many people think they are alone with their illness or disease, but this couldn’t be farther from the truth. Here at HCR, not only are we responsible for educating minorities, we are also responsible for saving their lives.
]]> April 23, 2010 responsibility-to-help-minorities-improve-health http://www.hcrhealth.com/content/news/blog/live-in-genesee-county?-now,-so-does-hcr!
Since 1978, HCR has cared for patients with a variety of illnesses or injuries. Over that time, we’ve identified the need for areas of specific expertise, and have developed focused programs in a number of areas such as wound care, post-joint replacement therapy, and more. We’re excited by the fact that we can now offer many of those same programs to Genesee County’s residents.

HCR employs nurses, therapists, social workers, aides, and office staff who live in the Genesee County community and who understand the care needs of its residents. We are all committed to making a difference in Genesee County!
]]> April 16, 2010 live-in-genesee-county?-now,-so-does-hcr! http://www.hcrhealth.com/content/news/blog/national-public-health-week:-april-5-11
The rich tradition of public health services shaped by progressive reformers such as Lillian Wald is demonstrated in the daily labors of public health workers. The staff at HCR is dedicated to promoting public health through education and involvement in community events and partner organizations. HCR is proud of the quality care our clinicians bring to the homes of each of our patients; it is our privilege to participate in the advancement of public health.

Every year, during National Public Health Week, the American Public Health Association showcases the efforts of public health workers such as Lillian Wald and the thousands of men and women who followed in her footsteps. But public health requires efforts from every member of our community, not only professional health care workers, to do their part to prevent diseases and promote healthy living. As you contemplate the positive impact public health workers have made on society, consider your role and what you can do to improve public health in your community.
]]> April 09, 2010 national-public-health-week:-april-5-11 http://www.hcrhealth.com/content/news/blog/april-is-occupational-therapy-month
Occupational Therapists (OT) and OT Assistants focus on patients ‘doing’ whatever activities are meaningful to them. It is our goal to get beyond a patient’s illness or injury and develop solutions which ensure they are living life to its fullest. These solutions may be adaptations for how to do a task, such as putting on socks without back pain… or making changes to a home, such as adding a shower chair, or helping patients alter their habits or routine because of failing vision.

OT is a practice deeply-rooted in science and is ‘evidence-based,’ meaning the plan designed for each individual is supported by data, experience, and best practices which have been developed and proven over time.

Occupational Therapy looks at the whole person, including the psychological, physical, emotional, and social, and environmental. OT promotes health and the prevention of injury, illness, or disability (or to help patients live better with their ailments). Occupational Therapy concentrates on what matters the most to the patient – maintaining or rebuilding independence, and allowing them to participate in daily activities which allow them to live life to its fullest!]]> April 01, 2010 april-is-occupational-therapy-month http://www.hcrhealth.com/content/news/blog/american-diabetes-alert-day
If left undiagnosed or untreated, diabetes can lead to serious complications. Because the disease affects the proper distribution of blood and sugars throughout the body, diabetics are more likely to experience nerve damage and reduced blood flow to their extremities – particularly their legs, feet, and toes. Less blood means less nourishment to these lower extremities. Sores and infections may develop which have a much harder time healing, and often results in amputation. More than half of all lower extremity amputations performed every year in the United States are due to diabetes and related complications – with African Americans suffering a higher percentage than other ethnic groups.

Although there is no cure for the disease, diabetics can live normal, healthy lives. By taking personal responsibility for their diabetes and managing their day-to-day care, diabetics can significantly reduce their risk of lower extremity amputation. In addition to eating healthy, being physically active, and monitoring blood glucose levels and other vitals, diabetics need to pay particular attention to their legs, feet, and toes. They should examine their feet daily and call a health care team right away if a cut, sore, blister, or bruise on the foot does not begin to heal after one day. Also, wear proper shoes and socks to keep the blood flowing to the feet and toes by starting a physician-approved exercise regimen.]]> March 26, 2010 american-diabetes-alert-day http://www.hcrhealth.com/content/news/blog/brain-awareness-week---march-15-21
Normal brain function is truly wonderful. Changes to this normal function could result from sudden events such as stroke or injury from an automobile accident… or slower processes such as the onset of dementia, a brain tumor, Parkinson’s disease, or multiple sclerosis. At times like these, we find ourselves depending on people who have spent a lot of time “thinking about the brain.” We turn to neurologists, physiatrists, nurses, physical and occupational therapists, and speech-language pathologists. These practitioners have studied the brain and how it affects daily life.

We are fortunate to live in a community with excellent health care providers who can diagnose and treat people who suffer from changes to their brain. So, we keep our fingers crossed that our brains stay in good working order, and know at any given moment there are many in our community who can lend a helping hand if things change. Happy “Brain Awareness” Week. May yours remain healthy!
]]> March 19, 2010 brain-awareness-week---march-15-21 http://www.hcrhealth.com/content/news/blog/sleep-awareness-week
Sleep is vital to our health and well being and sleeping problems that are recurring could make our daily life more stressful. Stress is considered by most sleep experts to be the No. 1 cause of short-term sleeping difficulties. Common triggers include school-or job-related pressures, a family or marriage problem, and a serious illness or death in the family. Usually the sleep problem disappears when the stressful situation passes.

Here are some tips for sleeping smart:

1. Establish a regular bed and wake time
2. Avoid nicotine altogether and avoid caffeine close to bedtime
3. Avoid alcohol
4. Exercise regularly (but complete the workout at least 3 hours before bedtime)
5. Establish a consistent relaxing “wind-down” bedtime routine
6. Create a sleep-conducive environment that is dark, quiet and comfortable
7. Discuss the appropriate way to take any sleep aid with a healthcare professional

If your sleeping problem recurs or persists for longer than one week, you should consult with a physician. You might be suffering from sleep apnea, which is defined as sleeping without breath. Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institute of Health. Some risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Fortunately, sleep apnea can be diagnosed and treated with the right help.

Continuous Positive Airway Pressure (CPAP) is considered the “gold standard” of treatment for patients with sleep apnea and is usually the first choice prescribed by sleep centers. During this treatment, the patient must wear a specially designed mask that uses pressure to send air flowing through the nasal passages. The influx of air keeps the throat from collapsing during sleep and allows the patient to breathe freely without worry of episodes of nonbreathing. The CPAP unit must be prescribed to you by a physician, and the company that the CPAP unit is ordered from will provide the initial introduction. The CPAP unit is usually covered by most insurance because sleep apnea has been linked to serious problems. Thus, it is in your insurance company’s best interest to cover this preventative therapy. For any on-going assistance with the CPAP unit, you could contact a local home care agency and they will send a nurse to assist you. For instance, many nurses from Home Care of Rochester provide follow-up teaching and education on using the device, and can answer any questions that you may have. ]]> March 15, 2010 sleep-awareness-week http://www.hcrhealth.com/content/news/blog/obesity Obesity is a disease that affects nearly one-third, approximately 60 million of the adult American population. It is the second leading cause of preventable death in the United States.

By teaching healthy behaviors at a young age, we can help decrease the chance of children having obesity as an adult, which becomes more difficult to manage with age. According to James O. Hill, Director of the Center for Human Nutrition at the University of Colorado, says that while weight loss requires significant lifestyle changes, taking away extra calories through small steps can help slow and prevent weight gain. Behaviors involving physical activity and nutrition are the cornerstone of preventing obesity in children and adolescents. Parents are the most important role models for children.

Here are some ways that parents can establish a lifetime of healthy habits for their family:

Create an Active Environment:
• Make time for the entire family to participate in regular physical activities, such as walking, bicycling or rollerblading that everyone enjoys.
• Join together with other families for group activities like touch-football, basketball, tag or hide-and-seek.
• Assign active chores to every family member such as vacuuming, washing the car or mowing the lawn.
• Limit the amount of TV watching.

Create a Healthy Eating Environment:
• Implement a healthy diet, which is rich in fruits, vegetables, and grains for your entire family.
• Replace drinking soda with water.
• Avoid rushing to finish meals. Eating too quickly does not allow enough time to digest and to feel a sense of fullness.
• Avoid serving portions that are too large.
• Limit the frequency of fast-food eating to no more than once per week.]]> March 05, 2010 obesity http://www.hcrhealth.com/content/news/blog/february-is-american-heart-month
Heart attacks can be sudden and intense, or start slowly, with mild pain or discomfort. Here are heart attack warning signs for men:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath with or without chest discomfort.
• Other signs may include breaking out in a cold sweat, nausea or lightheadedness.

Women experience the same heart attack symptoms as men, most commonly chest pain or discomfort, but women are more likely than men to experience the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

Here are signs that could indicate a potential stroke:

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause

HCR’s Heart Failure and Stroke specialty programs could be of great help to you or your loved one. Our Heart Failure team is led by experienced cardiac nurses, physical and occupational therapists, and registered dieticians. In addition to providing expert care and education, we utilize state of the art technology to keep a close eye on patients to identify changes in health condition before they can become more serious problems. Our Stroke team maintains a specialized certification in stroke care known as the “Neuro-Development Treatment” that leverages normal, spontaneous responses involved in voluntary movement to improve the speed and extent of rehabilitation. We also provide patient and family education to reduce the likelihood of another stroke.]]> February 26, 2010 february-is-american-heart-month http://www.hcrhealth.com/content/news/blog/drinking-a-glass-of-orange-juice
In addition to comfier joints, orange juice is a great source for Vitamin C. Vitamin C may include protection against immune system deficiencies, cardiovascular disease, prenatal health problems, eye disease, and even skin wrinkling. According to researcher Mark Moyad, MD, MPH, of the University of Michigan, higher blood levels of Vitamin C may be the ideal nutrition marker for overall health. Therefore, make sure you’re drinking lots of orange juice to keep your immune system strong especially during this winter.]]> February 15, 2010 drinking-a-glass-of-orange-juice http://www.hcrhealth.com/content/news/blog/happy-salt-awareness-week
Here are various ways in which salt can be cut back in your diet:

• In the kitchen - Stop adding salt to your cooking unless it is absolutely necessary. Halve the amounts that recipes suggest and keep halving. Add seasonings in place of salt.

• At the home table - Don’t reach for the salt shaker. When reducing, shake only once and gradually wean yourself off this habit.

• Eating out - Ask for the salt to be left off chips/fries and other fast foods. Avoid foods you know are salty. Order the salad or baked potato instead of the fries.

• Grocery shopping - Learn to read nutrition labels. In particular, look at the amount of sodium in what you eat.
]]> February 05, 2010 happy-salt-awareness-week http://www.hcrhealth.com/content/news/blog/staying-socially-engaged
There are many ways you can stay engaged. Normal, day-to-day activities such as attending lectures, volunteering, becoming active in political or other civic affairs, or working full or part-time at a job that offers you mental stimulation are all equally valid approaches. Losing executive function – the ability to focus on tasks and make sound judgments - is one of the major reasons people find themselves unable to maintain an independent household. Therefore, it’s very important that these cognitive skills be maintained on a day-to-day basis. As Dr. Michelle Carlson, leader of the study, says: “Our bodies are meant to move and our brains are built for novelty.”
]]> January 29, 2010 staying-socially-engaged http://www.hcrhealth.com/content/news/blog/hcr-blood-drive
We recently held our second drive on Martin Luther King Day, January 28, 2010. And once again, we filled the “beds” (conference tables), and added 8 more first-time donors to the group. As Dustin Hilton, our American Red Cross rep, said, “75 lives were saved that day”. They all are Heroes. We’re grateful to our leadership in allowing us to open our doors to this opportunity, and to the dozens of employees who take the time to give, and give again. Truly, HCR cares.
]]> January 22, 2010 hcr-blood-drive http://www.hcrhealth.com/content/news/blog/can-touching-your-toes-test-your-arteries
A key component to touching your toes is stretching, which keeps your muscles flexible and healthy to help prevent certain kinds of muscular degeneration. Stretching helps limber up muscles and keeps them in good working conditions. This will also help reduce the stiffness that may occur following the performance of some physical activities. Please do remember, though, that stretching should be done gently and correctly.
]]> January 15, 2010 can-touching-your-toes-test-your-arteries http://www.hcrhealth.com/content/news/blog/reinventing-older-adulthood Seeing Old Age as a Never-Ending Adventure.”

Who can resist this? “When Charles Smith, 89, a retired engineer from Delray Beach, FL, was heading for the South Pole a few years ago, a woman got off the plane at base camp and started bragging about being 80. She was quickly put in her place. One of the fellows in the group tapped her on the shoulder and said, ‘I don’t want to prick your balloon, but there are three in our group who are older.’ ” Or the tale of the 90 year-old woman on a three month hiking trip in South Africa? Or the 89 year-old man who now needs a bit more of a boost up onto the wing of the plane when wing-walking since suffering a stroke?

When HCR first introduced its Lifelongevity program – “home care so you won’t need home care” – it was designed with people just like those described in this story in mind. People who wanted to go canyoning with their grandchildren, skiing far into retirement with their friends, or golfing 18 holes as often as they wished without having to worry about whether their bodies would keep up. Achieving and maintaining this kind of health and fitness at an older age is generally no easy task, and requires a serious commitment to ongoing aerobic and strength exercise, attention to nutrition and maintenance of a healthy BMI, and personal advocacy for one’s own health.

So although I’m a week late in doing so, I’d like to raise a New Year’s toast to the people in today’s article, and to all older adults who are living their lives to the fullest each and every day.
]]> January 08, 2010 reinventing-older-adulthood http://www.hcrhealth.com/content/news/blog/how-safe-is-snow-shoveling
The bad news is that at least 75,000 heart attacks occur each year during or shortly after strenuous physical exertion. According to researchers, about 1 in every 3 of those heart attacks are deadly, and are among people over age 60 who have been shoveling snow. Snow shoveling may cause a quick increase in heart rate and blood pressure. Also, shoveling is more difficult in the winter because the cold air makes it harder to work and breathe, which adds some extra strain on the body.

So, you may wonder: is snow shoveling a good idea if you’re older than 60? If you exercise regularly, have a healthy diet, and have no signs of heart disease, high blood pressure, or diabetes, then it’s probably safe to snow shovel. Some helpful tips to consider are:

1. Avoid caffeine or nicotine for at least an hour before and after shoveling.
2. Eat lightly because eating draws blood into the stomach, which means that less blood is circulating to the rest of your body.
3. Stretching helps to open up blood vessels and improve circulation to the heart.
4. Dress in layers so that you don’t become overheated as you work.
5. Find the right tool for shoveling, because the lighter the load, the less strain you will have.

Snow shoveling may be a vigorous activity for some, so most importantly – listen to your body. Stop if you feel pain!
]]> January 04, 2010 how-safe-is-snow-shoveling http://www.hcrhealth.com/content/news/blog/cataracts_and_diabetes
A cataract clouds the lens of the eye, blocking light from passing through to the retina and causing vision to be impaired. Symptoms include blurred, glared, or double vision. The pupil of the eye may appear milky or yellowish. To a person suffering from cataracts, light entering the eye may seem dimmer than it should, but bright light may cause increased sensitivity. Wearing sunglasses and using eyeglasses with glare control lenses may be helpful for mild cataracts. When vision is significantly impaired, removal of the lens, with a transplant of a new lens, is often recommended.

Diabetics may also suffer from other eye complications, including retinopathy and glaucoma. These conditions tend to develop more rapidly following cataract surgery, so it is essential that diabetics reduce their risk of developing cataracts by controlling their blood glucose levels. For those who have difficulty managing their diabetes, a Certified Diabetes Educator may be helpful in developing a plan to better control blood glucose.

It is important for all diabetics to receive annual eye exams. These exams allow for early detection and timely intervention… the keys to preventing vision loss. To speak with a Certified Diabetes Educator, call HCR Home Care at 585-272-1930.
]]> August 27, 2010 cataracts_and_diabetes http://www.hcrhealth.com/content/news/blog/what_to_look_for_in_a_home_care_agency
Start by asking about accreditations, licenses, and certifications. Full-service, certified, and licensed home care agencies (like HCR Home Care) have been reviewed and approved by New York State, and must adhere to state and federal regulations designed to protect patient safety. Such agencies will provide careful supervision of all personnel, and perform pre-employment criminal background checks, drug screening, and reference checks on all staff.

Next, there are two primary factors to consider when selecting the best agency: the types of services you will need, and how you expect to pay for those services. Consider these points:

• If you or your family member’s needs are medical in nature, or will involve personal care, you need a home care agency, not a companion care provider.
• If you have a specific disease or illness, ask if the home care agency has developed specialty programs around a given medical need.
• If you have specific language requirements or cultural values that you wish the agency to understand, accommodate, and respect, make sure the home care agency you choose supports your need both through the office staff and nursing and aide staff.
• If you will need transportation to appointments or events, using either your vehicle or their own, be sure the home care provider you select is willing to provide this service.

• Health and Wellness
• Transportation
• Money and Employment
• Translation
• Food and Nutrition
• Cooking and Housekeeping
• Completing Forms and Applications
• Legal Concerns

• Danforth Towers
• Lake Tower
• Hudson Ridge Tower
• University
• Kennedy

• Glenwood Gardens
• Lexington Court
• Blackwell Estates
• Elmdorf Apts
• Parliament Arms
• Glide Court
• Lena Gantt
• Atlantic Avenue

• 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.

A significant area that OTs address in the home is fall prevention.

Allow me to share a “fall risk” success story...