Sepsis Awareness Month: Why Our Program Actually Works

By: Portia Wofford

Home health clinicians play an essential role in caring for patients who are:

  1. At risk of developing sepsis
  2. Recovering from sepsis or septic shock

Home health providers are vital in preventing hospital admissions and readmission among sepsis patients. According to the CDC, sepsis is the body’s extreme response to an infection. It is a potentially life-threatening medical emergency.

Many patients receiving home healthcare services have chronic medical conditions and comorbidities that put them at risk for infection, including COVID-19 and sepsis. According to the Global Sepsis Alliance, COVID-19 can cause sepsis. Research suggests that COVID-19 may lead to sepsis due to several reasons, including:

  • Direct viral invasion
  • Presence of a bacterial or viral co-co-infection
  • Age of the patient

According to Homecare Magazine, approximately 80% of people with COVID-19 will have a mild course and recover without hospitalization. The remaining 20% of patients with COVID-19 may develop sepsis and be admitted. Patients with severe illness will need home health care.

A study published in Medical Care by the National Institutes of Health (NIH) suggests that when strategically implemented, home health care can play an essential role in reducing hospital readmissions for patients recovering from sepsis. According to Home Health Care News, the study points out that sepsis survivors who were less likely to return to the hospital if they:

  1. Received a home health visit within 48 hours of hospital discharge
  2. Had at least one additional visit and
  3. Had physician visit within their first week of discharge

According to the findings, these interventions reduced 30-day all-cause readmissions by seven percentage points.

Home health clinicians are trained to monitor patients and identify signs and symptoms of sepsis. Additionally, they can teach patients and their caregivers how to prevent and recognize sepsis. According to research and estimates, rapid diagnosis and treatment could prevent 80% of sepsis deaths.

Home health care can contribute to early detection of sepsis

Early detection is critical. For each hour treatment initiation is delayed after diagnosis, the mortality rate increases 8%. Home health nurses can monitor and educate patients and their caregivers on signs and symptoms to report to include. Additionally, home healthcare agencies can provide screening tools that fill the gaps in identifying at-risk patients during transitions from inpatient to outpatient settings.

Home health provides case management for chronic comorbidities

  1. Some comorbidities like Type 2 Diabetes, chronic heart disease, and dementia were associated with sepsis risk in almost all infection types. Those with other chronic illnesses, cancer, and an impaired immune system are also at increased risk. Monitoring can help reduce risks.
  2. Post-discharge and follow-up visits, including telehealth visits, may provide positive intervention for post sepsis patients.
  3. Nurses can review and coordinate care to adjust medications, evaluate treatments and interventions, and refer for appropriate treatment.

When it comes to serious complications, our sepsis program effectively:

  • Prevents infections that can lead to sepsis
  • Recognizes sepsis symptoms before they become severe
  • Rapidly responds if sepsis symptoms occur by initiating appropriate treatments and referrals
  • Follows-up with care to ensure continued recovery

Oasis’s sepsis program promotes quality of care and improves outcomes for those at risk for developing or recovering from sepsis.

September is Healthy Again Month

During Healthy Aging Month, we focus on celebrating the many positive aspects of aging. Here are some tips to incorporate in your daily routine that can lead to a healthier lifestyle, allowing you to live your life to the fullest.

  1. Exercise – Get moving and active on a daily basis!
  2. Socialize – Stay in touch and find safe ways to connect with friends and loved ones!
  3. Stay balanced – Try new methods such as yoga to reduce stress and improve your overall balance!
  4. Rest – It’s important to make sure you are getting a good, quality rest each night.

These are important tips to keep in mind for all ages and stages of life. Not only this month, but from now on, remember to take care of yourself and those who surround you. Healthy aging starts with you and your health decisions.

Supporting Assisted Living Facilities During COVID-19

Happy National Assisted Living Week!

As the COVID-19 pandemic continues to change our daily lives, assisted living facilities continue to take the necessary precautions to ensure the safety of their residents and employees. While keeping your loved ones safe might mean you cannot connect in person, here are some ways to support facility residents and employees from a safe distance.

  • Get artsy. Spending the afternoon drawing pictures, painting windows, or snapping some fun photos are all great ways to get creative and share uplifting moments with residents. This can be a great way to engage children of all ages or to turn your talent into the highlight of someone’s day.
  • Become a Pen Pal. Since residents are socializing less due to the pandemic, starting a pen pal friendship with someone in an assisted living facility is a great way to communicate and share stories while practicing social distancing. This is the next best thing to in-person conversations!
  • Send a special delivery. You can never go wrong with sending a surprise package to support both staff and residents! Any sort of delivery – snacks, flowers, games, care packages, etc. – will brighten the day of anyone in an assisted living facility.
  • Coordinate a window visit. Sit outside, have a conversation, and share your smile with your loved one in a facility. You can play an instrument for them, talk on the phone, or even play a game – just to name a few!
  • Shoot a video. Creating a fun video of loved ones saying ‘hello,’ sharing words of encouragement, or acting out a skit are all directions you could take when shooting a video to share with those in assisted living facilities.

Whether it’s a photo of your playful dog, writing a letter sharing an uplifting story, or sending a bouquet of flowers for the front desk to display, it may be just the boost of happiness someone in an assisted living facility needs during this time. As we celebrate National Assisted Living Week, we encourage you to reach out to both residents and staff members with acts of kindness, reminding them of your support and love during these times.

How COVID-19 Affects Diabetes

By: Portia Wofford

Physicians, scientists, and researchers are still learning about COVID-19 and its effects on the body. As they study the impact coronavirus has on different illnesses and disease processes, diabetes is getting attention. The CDC notes that having Type 1 or Type 2 Diabetes increases your risk of severe illness from COVID-19. Because people with diabetes are at an increased risk for developing infections, they should take precautions to protect themselves against COVID-19.

Complications from diabetes related to COVID-19

Currently, there isn’t enough research or evidence to prove that diabetics are at an increased risk for COVID-19. However, if your diabetes isn’t well-controlled, you could have worse complications if you contract coronavirus. According to the American Diabetes Association (ADA), when diabetics don’t manage their diabetes and blood sugars, they are at risk for diabetes- related complications. Additionally, other conditions —such as heart or lung disease — and diabetes worsens the chance of you getting sick from COVID-19 because your body’s immune system is compromised. A recent study showed patients with COVID-19 and diabetes who had high blood sugars were more likely to have longer hospital stays.

If you do get COVID-19, the virus could put you at higher risk for sepsis  and diabetic ketoacidosis (DKA). Sepsis is a complication of COVID-19, which causes widespread inflammation throughout your body and can shut down organs. DKA happens when high levels of acid (ketones) are in your blood.

  • It’s hard to manage your fluid and electrolytes level in DKA.
  • DKA makes it difficult to maintain your fluid and electrolyte levels.
  • This makes treating sepsis hard because DKA causes you to lose electrolytes.

In addition to diabetes-related complications, diabetics also have a risk of developing other complications of COVID-19, such as pneumonia, organ failure, and kidney injury.

Type 1 and Type 2 diabetes and Coronavirus

According to the CDC, people at any age with Type 2 diabetes have an increased risk of severe illness from COVID-19. Based on the CDC, the ADA warns that people with Type 1 or gestational diabetes might also be at an increased risk. The ADA states it’s important for any person with either type of diabetes to manage their diabetes. Those who already have diabetes-related health problems are likely to have worse outcomes if they contract COVID-19 than diabetics who are otherwise healthy.

Tips to avoid infection

  1. Stay home as much as possible
  2. Monitor your blood sugar regularly. Maintaining optimal blood glucose, as determined by your healthcare team, is important in preventing severe complications to COVID-19.
  3. Wash your hands
  4. Avoid sick people
  5. Wear a mask
  6. Check-in with your doctors, via telehealth. Most providers schedule telehealth visits—rather than in-person visits. Ask your provider if he or she offers this service.
  7. Exercise. Try exercising at home. Walk around your neighborhood, but be sure to social distance. Right now, there are exercises and workout plans online where you can follow along.
  8. Wash your hands. Wash your hand with soap and warm water for at least 20 seconds. Keep alcohol-based hand sanitizer with you as well.
  9. Wear a mask and social distance. CDC recommends at least 6 feet apart.
  10. Eat a healthy diet:
  • Eat foods low in sugar
  • Limit foods high in sugar, carbohydrates, and fat
  • Try lean proteins instead of fried foods
  • Don’t forget your green, leafy vegetables

If your glucose readings change because of changes in your diet and activity level, speak with your healthcare team before making any adjustments to your insulin or other medications.

Your COVID-19 diabetes plan

Because of social distancing and shelter-in-place rules, it may be harder for you to get your supplies.

Stock up on enough supplies to last you for a couple of weeks, in case you get quarantined:

  • Healthy food
  • Simple carbs like honey, fruit juice, or hard candies in case your blood sugar dips
  • Make sure you have a 30 day supply of insulin and other medicine
  • Extra strips and batteries for your glucometer
  • Extra glucagon and ketone strips
  • Diabetes alert bracelet or necklace

Keep your home health team updated on your plans, and if you notice any COVID-19 symptoms be sure to alert your home health nurse.

What to do if you get sick

Be sure you know the signs and symptoms of COVID-19:

  • Cough, shortness of breath, or difficulty breathing
  • New loss of taste or smell
  • Fever or chills
  • Vomiting or diarrhea
  • Muscle or body aches

Notify your Oasis Healthcare nurse , with your most recent blood glucose readings, if you have any of these symptoms. Symptoms can range from mild to severe illness, and appear 2-14 days after exposure to COVID-19.

Portia Wofford is an award-winning nurse, writer, and digital marketer. After dedicating her nursing career to creating content and solutions for employers that affected patient outcomes, these days Portia empowers health related businesses to grow their communities through engaging content that connects and converts. Follow her on Instagram and Twitter for her latest.

Common Hospice Qualifiers

For many people, the decision to receive hospice care is made following the diagnosis of a life-limiting illness. Even so, some families still question this decision. Here are some common Hospice qualifiers to help determine when it might be time to elect the hospice benefit. 

  • Falls
  • Frequent physician, ET and/or Hospital visits
  • Weight loss and or BMI < 22
  • Decline aggressive therapy or is not a candidate
  • Wounds
  • EF < 20%
  • NYHA Class IV symptoms at rest
  • Little or no response to Bronchodilators
  • Serum < 2.5
  • Dysphagia and/or aspiration pneumonia
  • Shortness of breath and/or o2 sat of 88% or less
  • Frequent injections
  • Edema
  • UTIs
  • Upper respiratory infections, bronchitis or pneumonia

If you or a loved one are experiencing any of these symptoms and have questions about our services at Oasis Hospice, please contact one of our office locations near you to speak with a staff member about these Hospice qualifiers.

Music Therapy Benefits in Hospice Care

A Music Therapy Case Study | Joshua Gilbert, MT-BC

Throughout life, song can positively affect us both physically and emotionally. It influences bodily functions that we believe are beyond our control, such as heart rate, blood pressure and release of the body’s natural pain relief chemicals. Music therapy offers significant benefits for patients, caregivers and families. We offer it as part of our hospice services.

In a case study conducted (by Joshua Gilbert) on the impact of music therapy over a four-month period, with an older adult in hospice care, results exhibited significant signs of improvement in the following categories:

  • Quality of life
  • Self-esteem
  • Emotional expression
  • Breathing patterns

Through involvement in music-based interventions, these improvements allowed the patient to benefit from music therapy during hospice care. The patient often smiled, laughed and made positive comments about the music. After participating in deep breathing exercises and harmonica playing, the patient’s breathing became deeper and less labored. Additionally, the patient developed increased confidence in improvising harmonica music, and more open about expressing her emotions surrounding death.

Despite patient status or level of consciousness, music therapists can console and comfort them through music. Research has shown hearing is the last outside sensation that registers with a dying patient. Let us help your loved one make this experience more soothing.

To read the full case study, please click here.

Common Hospice Diagnoses

Oasis Healthcare is here for you – 24/7/365.

Choosing Hospice is often a difficult decision. We help lead this conversation and can ease the anxiety of the transition from cure to comfort for patients who are appropriate for hospice care. If two or more of these potential indicators are present, hospice should be considered.

Common Hospice Diagnoses

End Stages of: Cancer, Heart Disease/CHF, Pulmonary Disease/COPD, Dementia/Alzheimer’s Disease, Neurological Disease/CVA, Renal Disease & Liver Disease.

If your loved one is requiring increased assistance with Activities of Daily Living (ADLs) such as bathing, dressing, grooming, oral care, toileting, transferring to their bed/chair, walking, eating, etc.; this may be an indicator that hospice should be considered.

Additional indicators include:

  • Muscle Loss/Weakening or Weakness
  • Multiple Falls
  • Multiple ER Visits/Hospitalizations
  • Recurrent/Multiple Infections
  • Altered Mental Status
  • Unintentional Mental Status
  • Unintentional Weight Loss
  • Difficulty at Mealtime
  • Increasing Shortness of Breath
  • Multiple Medication/Frequent Medication Changes
  • Sleeping Longer/Napping More
  • Skin Breakdown/Wounds
  • Other Diagnoses that Contribute to Decline

If you have questions about the hospice benefit or when to elect your benefit, please contact Oasis Hospice at 205-640-3303 (Birmingham) · 205-210-4906.

One Word: Hospice

One word… One word that’s the most solidifying word you will ever hear. A word that can often be misinterpreted.

One word… Hospice.

This means you are dying. Maybe not dying today, tomorrow or the next day – but it is a word not many want to hear. As a hospice liaison, helping people understand to not be afraid is part of what makes my job so rewarding. Watching potential patients and their family member begin to ease as I explain the role of hospice is an incredible feeling.

As a hospice liaison, I help ease all your previous notions about what we do and assure you that we are here to help.

Hospice doesn’t mean you will die tomorrow. It does not mean you will be taken off all your medications or stay home while waiting for the end. What it does mean is that you have a terminal illness and instead of continuing to seek aggressive treatment, it is better for you to be comfortable and have a quality of life with loved ones, however that may be defined by you.

It is shown that a hospice patient lives more comfortably when: a nurse visits to manage pain and symptoms, a home health aide provides personal care, a social worker assists with community resources and counseling, a chaplain offers spiritual support, volunteers play cards with and a physician oversees it all to ensure you are as comfortable as possible for however long that may be.

That one word… Hospice. Let’s look at it in a more positive way, focusing on the benefits we can offer a patient and their family.

So, I ask both professionals and patients – Why would you not want to live more comfortably with support from hospice?

-Tracy Wagoner, Hospice Liaison

Our COVID-19 Response: A Letter from Our CEO Mike McMaude

To the Abode Healthcare Community,

I hope this note finds you and your loved ones safe and healthy. The COVID-19 pandemic is affecting each of us in different ways. As we navigate the current situation together, I want to provide an update on the steps we have taken to be there for our community, our employees, and our patients.

All of us at Abode Healthcare are focused on providing the highest quality of care to our patients. I provided an update at the end of March outlining the changes we implemented to prioritize safe patient care in this new environment. Every decision we have made, and continue to make, has been based on the priority of the health and wellbeing of our patients and employees.

I am deeply grateful for our employees who display incredible dedication by continuing to fulfill their commitment to our patients during this especially challenging time. These individuals, and everyone working on the frontlines of care, deserve to feel protected, confident, and taken care of.

In recent weeks we have made informed decisions and taken actions that ultimately support and benefit our entire community:

  • PPE: At the first sign of COVID-19, we prioritized spending where it’s needed most and to date, have purchased $1 million of Personal Protection Equipment (PPE) so no one reported to work without protection. I’m proud to say that we’ve not had to turn down any patients due to lack of PPE. We’ve even been able to assist other homecare and hospice organizations, and hospitals serving the Navajo nation as well as other underserved populations, in providing supplies for their employees by donating thousands of PPE items. In addition to our company’s commitment, several executives on our team have made personal PPE donations for local health organizations so they can work safely.
  • Paid Leave: To support employees who risk their own health and safety to care for patients, we instituted a special paid-time-off policy modeled after the Families First Coronavirus Response Act designated for companies with fewer than 500 employees. In Abode’s plan, employees receive unlimited leave for issues relating to COVID-19, including a newly instituted emergency paid time off (EPTO) benefit that is in addition to the PTO employees accrue with regular benefits. These additional benefits allow employees to potentially recover from COVID-19, care for a family member who is ill with the virus, or care for children whose schools and daycares have closed.
  • Business Investment: Rather than cut back, we’ve leaned into the business to make sure that we are even better prepared to care for patients. Some of these actions include:
    • Building out our telehealth and remote care solutions
    • Retaining a dedicated, talented workforce
    • Hiring new employees and growing our team locally and nationally
    • Expanding our team’s knowledge with the addition of an infectious disease physician, Dr. Shannon Thorn
  • Charitable Donations: As we have every year, we continue to support charitable organizations in our communities. That will not stop just because of COVID-19. Support for neighbors, near and far, is needed now more than ever.

I am extremely proud of how everyone at Abode has reacted and handled the unique situation that the COVID-19 pandemic has presented. It’s difficult to adequately express my appreciation for our community—patients, employees, and partners. I have been reminded, once again, what an incredible organization we have—one that is driven by a common purpose of caring for, and serving, vulnerable patients. Every member of our team has come together to do what’s right, and I thank you. We look forward to continuing to work together and supporting each other through this challenging time.

Stay safe and healthy,

Mike

Celebrating Nurses | Mattie May

Oasis Healthcare is celebrating nurses during the month of May! Meet Mattie and learn about her passion for hospice nursing.

Mattie May has spent much of her nursing career as a hospice nurse, and truly has a heart and a passion for her work after 27 years in the field. In honor of Nurses Week, Mattie reflects on why working as a hospice nurse is a ministry to her.

Hospice nursing has given Mattie the opportunity to help, guide, and teach patients and their families through one of the most difficult times of their lives. She said a successful hospice nurse is compassionate, patient, and understanding in the midst of a crisis, which is how her teammates describe her.

“There are times when, working as a nurse, one has to go beyond the call of duty, which means working long hours and doing whatever is necessary to help families effectively cope with their stress and grief,” Mattie said.

Mattie does this because being a hospice nurse is more than just a job to her. “Working hospice is indeed a challenge, but with a good team, anything can be accomplished. I love and enjoy my career,” she explained.

In her early years as a hospice nurse, she served a patient who had young grandchildren. She said every visit, when she arrived and got out of her car, the patient’s grandchildren would run outside to greet her. “They would scream to their parents, ‘the doctor is here!’,” Mattie remembered fondly. “They were genuine and sincere. The world would be a better place if we were all like little children.”

Years later, her patients and their families are still just excited for her visits. We are thankful that Mattie provides that comfort to all she serves, as she did with those small children years ago.