Tuesday, October 20, 2020

A home care check-in for Check Your Meds Day

A home care check-in for Check Your Meds Day

By Fatima Shell-Sanchez, Registered Nurse, Visiting Nurse Service of New York

Wednesday, October 21st is National Check Your Meds Day, and that is an excellent reminder for older New Yorkers and their family caregivers to spend a few minutes thinking about the medications they are taking, and make time to review them with your doctor or pharmacist.

Picture your elderly father living alone and seeing a doctor for several chronic conditions, and his latest checkup has you troubled. His high blood pressure has been creeping up again, chronic pain seems unmanageable and, concerned about keeping diabetes under control. The doctor has prescribed new medications. When you stop by for a visit with your dad, you encounter unopened prescriptions and over-the-counter medications, half-empty containers of outdated drugs and an assortment of loose pills you cannot even begin to decipher.

For many, caring for an older loved one with several chronic conditions, this scenario might be heart-breaking and familiar. With more than 83 percent of people over the age of 65 taking prescription medications, the possibility of mismanagement—including overdose or under dose—is a growing concern for family caregivers. Although balancing several medications can prove difficult for anyone, risks for the elderly can be complicated by memory loss as well as vision and hearing impairments.

The average senior takes more than five different pills daily, not including over-the-counter drugs or supplements, which can leave them more vulnerable to adverse reactions. In fact, researchers at the Centers for Disease Control and Prevention found that senior citizens are twice as likely to visit the emergency room because of adverse drug reactions as their younger counterparts.

My colleagues and I at the Visiting Nurse Service of New York work closely with those in our care and their family caregivers to reconcile all medications after a doctor’s appointment or trip to a specialist. You can help your loved one manage medications safely, too. Here are a few guidelines to help navigate medication adherence with family members and their doctors or pharmacist:

1. Make a list. 

Keep a personal record of all the meds your loved one is taking, including the name of the medication, the dosage instructions, the reason it was prescribed and the name and number of the doctor who prescribed it. Don’t forget to include over-the-counter meds and herbal supplements, too. 

If your loved one’s medication regimen is too complex to keep track of, ask your doctor if a service such as MedMinder, which sends caregiver alerts when a dosage is missed, might be something to try.

2. Take all medications to all of your doctors. 

An estimated 100,000 older Americans are hospitalized for adverse drug reactions yearly, and three of the most commonly prescribed drugs— insulin, the blood thinner warfarin (aka Coumadin) and the heart drug digoxin—are most often the cause, according to a study by researchers at the CDC published in the New England Journal of Medicine. If you or your loved one is unsure about any prescriptions, put everything in a bag and take them to your doctor. 

Ask for help figuring out what you are taking and why, to avoid taking medications incorrectly. Being knowledgeable about your meds is the first step in preventing medication errors. Most importantly, don’t leave the doctor’s office without an updated list of all your meds. The doctor might have changed or discontinued a prescription, and it is easy to forget such changes by the time you get home. For added assurance, share the list with your pharmacist, who can help keep track of and adjust medications, too.

3. Ask questions. 

Don’t be afraid to speak up. Every time a new med is recommended or prescribed, ask the physician and pharmacist these key questions: Why has this drug been prescribed? How does it work? How can I tell if the drug is working? What are the possible side effects? Is this drug safe to take with other prescriptions and over-the-counter drugs? I also recommend asking about the risk of taking medications with different foods and drinks. Something that seems innocent may cause an adverse reaction. Grapefruit juice, licorice, chocolate, alcohol and other food and beverages are known to increase side-effect risks with certain medications.

4. Change dosage. Overwhelmed? 

Ask your prescribing physicians about possibly lowering the number of different pills taken throughout the day. Studies show that the more pills a person takes, the less likely they are to adhere to the schedule and dosage.

5. Store smart. 

Don’t keep your meds in the bathroom or the kitchen. Many people are unaware that moisture and heat in these areas can affect medication potency. Knowing how to properly take and store your medications not only helps them work more effectively but also could save your life.

And remember, It’s OK to ask for help! According to the Family Caregiver Alliance, family caregivers spend an average of more than 24 hours per week solely providing care! It’s not a sign of weakness to ask for help. 

Speak with your doctor if managing medications is becoming a problem. In addition to the solutions mentioned here, you may be eligible for assistance from a licensed home care provider such as VNSNY or Partners in Care. Even a home health aide who comes once a week can provide helpful reminders for forgetful loved ones—and that can bring everyone peace of mind.

Saturday, October 17, 2020

We Can Work to End HIV/AIDS in the Bronx Latinx Community

Reduce the fear - Talk about sex, ways to curb HIV

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By Cariane Morales Matos, MD, Assistant Professor of Medicine, Albert Einstein School of Medicine and Attending Physician, Infectious Diseases, Moses Division

Many people feel sex is a taboo topic and hesitate to discuss it with their healthcare providers. Starting a conversation about HIV can feel just as nerve-wracking, if not worse! While you might feel nervous, the real danger is not discussing HIV prevention. Today we have medicines that can protect you before and after a possible exposure.

From 2009 to 2018, there was a 43% decrease in new cases of HIV in New York State. Despite these great strides in the mission to end the AIDS epidemic, new infections still happen daily. The most recent available statistics from December 2018 show more than 108,000 New Yorkers were living with HIV. More than half of those newly diagnosed (64%) were in people under 40, with Black and Hispanic people diagnosed at a disproportionately higher rate.

On October 15 each year, the CDC recognizes National Latinx AIDS Awareness Day to raise public awareness of the HIV epidemic in Hispanic/Latinx communities in the USA. In the Bronx, approximately 4 out of every 10 people living with HIV are Hispanic. While it may seem hidden, HIV/AIDS effects our community – our brothers, sisters, aunts and uncles. Awareness and new forms of prevention and education can help us stop AIDS.

Although there is currently no cure for HIV, we now know from several studies (HPTN 052, PARTNER), that if an HIV infected person is diagnosed and receives treatment promptly, the virus can be controlled and won’t be transmitted another person. In addition, the progression of the infection can be stopped to prevent AIDS, helping many with HIV live long, healthy lives.

If you are sexually active, using condoms consistently is your first step in protecting yourself against HIV. HIV testing is the second most important tool. Knowing your results will empower you to make informed choices for you and your partners’ health.

New medications like PrEP (pre exposure prophylaxis) can prevent you from getting future HIV infection and PEP (post exposure prophylaxis) can help if you think you have been exposed to HIV.  In some cases, you can take one pill a day to stay healthy and live a full, productive life.

Start a conversation with your doctor to help keep yourself and your community healthy this October.

You can visit the Montefiore Oval Center for sexual health services including HIV testing as well as medicines for before or after an HIV exposure. Call 718-882-5482 for more information and to set up an appointment. 

Wednesday, October 7, 2020

Organ/Tissue Donor Enrollment Day

Organ/Tissue Donor Enrollment Day
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By Leo Trevino, MPA, MDiv Manager, Organ/Tissue Donation Montefiore Medical Center

October 8th is national Organ/Tissue Donor Enrollment Day. Montefiore Medical Center will again be participating in this annual event with one goal: to register – in a single day - as many New Yorkers as possible to be organ, eye and tissue donors. 

The initiative is committed to bringing hope to the nearly 9,500 New Yorkers currently waiting for a lifesaving organ transplant.  

In the Bronx, there is a great need for organ and tissue donation. People suffering from organ failure, and those who have an organ that has been damaged by disease or injury, come from near and far to Montefiore to receive lifesaving care.

In addition, as of September 2020, there were over 100,000 people in the United State on the organ registry list waiting to receive the gift of life - and on average, nearly 20 people across the United States die every day from causes that are treatable with organ transplant. 

By taking simple steps to register, each Bronx resident can join the more than 5.6 million people who have enrolled in the New York State Donate Life Registry. Doing so can help potentially save up to eight lives through organ donation and enhancing many more through tissue donation.  

If you are interested in registering to be an organ and tissue donor, note these important and easy to follow steps:

  • Let your family members and doctors know that you want to be an organ and tissue donor.

  • Designate yourself as an organ and tissue donor when you get or renew your driver’s license.

*Enroll online through: donatelife.ny.gov/ref/LiveOnNYDD177

The choice to donate is the ultimate gift – please consider enrolling on October 8th (or any day). 

Tuesday, October 6, 2020

One step at a time: A physical therapist’s guidelines for better “PT”

Guidelines for Better Physical Therapy

Guidelines for Better Physical Therapy

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By Sonia Rapaport, Physical Therapist and Rehabilitation Instructor, Partners in Care

When recovering from a crippling injury, a stroke, a major surgery, or a debilitating condition, help is necessary to regain strength, coordination, and balance.

As a Physical Therapist and Rehabilitation Instructor at Partners in Care, the home care organization where I work, and its affiliate, The Visiting Nurse Service of New York (VNSNY), my colleagues and I work closely with our clients to combine the latest medical knowledge and the most up-to-date technologies with hands-on care. We also develop goals for recovery and create a plan of care that helps our clients develop the skills and confidence they need to regain independence.

In recognition of National Physical Therapy Month, here are a few pointers about the many ways physical therapy can be of benefit, and how your physical therapist can work with you to provide optimal rehabilitation at home.

Assess Safety 

First and foremost, your physical therapist will assess the safety of your home environment. This means ensuring that the space of your home is clear of obstruction and screened for falls risks–a safe recovery or rehab cannot be made in a danger zone!

Do You Need a Mobility Device? 

Your physical therapist will then determine if a mobility device, such as a walker or cane, is needed to assist your recovery and provide you with additional support when necessary. Mobility devices can prevent falls and further injury, and can also be helpful in regaining strength, coordination, and independence.

Develop a Care Plan 

A care plan based on your physical therapist’s recommendations and your personal goals will be developed to make certain that a clear line of communication is open, priorities are aligned, and rehabilitation is optimized.

Instruct Proper Body Movement and Positioning 

Excessive strain on joints and muscles while rehabilitating can initiate further damage and stunt the recovery process. Through physical therapy, you will be instructed on gait, learn how to conserve your energy, and avoid putting pressure on certain parts of your body which are not equipped to endure any weight.

Encourage Physical Activity 

A body in motion stays in motion! Keeping active is an essential part to recovery, and one of the most significant challenges that your physical therapist will help you overcome safely. Your physical therapist will develop exercise programs to target trouble areas, enhance balance and coordination, build up strength and stamina, and maintain muscle mass.

Educate on Proper Care 

Your physical therapist will instruct you and your caregiver on proper around-the-clock rehabilitation, which may include introduction of an exercise schedule, a list of things to avoid, and what to do if additional assistance is needed. Mental knowledge can be just as vital as physical strength when it comes to healing. 

Observe Progress

With each session, your physical therapist will track your progress and assess whether your care plan needs to be rearranged or accelerated. Close observation is key to proper care and full recovery. When undergoing physical therapy, it’s natural to feel discouraged by challenge, or lack of independence, but observing your progress will show you how far you’ve come–one step at a time.

Sonia Rapaport is a physical therapist and rehabilitation instructor with the Visiting Nurse Service of New York and its private pay affiliate Partners in Care. For more information please visit www.PartnersinCareNY.org or www.VNSNY.org, or call 1 (800) 675-0391.