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Simple Steps

Simple Steps

As a Mom to two boys, I am reminded each day of the innate drive to move our bodies – that is evident from birth! As we grow older, the sedentary habits we adopt as adults become increasingly more challenging to overcome.  No matter the age bracket you find yourself in, make the choice today to take a simple step towards increased activity.

What could this look like? Perhaps today you’ll park in the far end of the grocery store lot and take a leisurely stroll rather than competing for a front row spot.  Take a look at community events and choose to attend an expo or craft fair that creates an opportunity to increase your level of activity.  Or maybe it’s as simple as making the decision to invite a neighbor to join you in taking a walk around the block.

The benefits of activity are undeniable. Perks such as improvement in mood and heart health, reduction of pain, increased social interaction, etc. are all free for the taking…just by making the choice to get out and move!

Take a moment to reflect back to the time when you just had to run and play – and each day take simple steps to steadily increase your level of activity.  Your joints, attitude, family and friends will thank you!

Tabitha Uitenbroek is a Registered Nurse and currently manages the Trauma Program at ThedaCare-Neenah. Tabitha has been working for ThedaCare for 10 years and finds great joy in ensuring that patients have access to the necessary resources to provide optimal care during their time of need.

Falls and Surgery

Falls and Surgery

Patients who have just had surgery are at an increased fall risk. The good news is there are measures that can be taken to lower the risk. Prevention and planning are the keys!

In the hospital, fall prevention is a major initiative for staff. But what happens when you get home? Before surgery happens, good planning starts with preparing your home environment.

Pre-op:

  1. Start with identifying a team to help you – limitations are inevitable.
  2. Clean and remove all clutter. Place extension cords and telephone cords out of walkways.
  3. Remove throw rugs and secure loose carpeting.
  4. Cut grass, take care of the garden and complete other yard work.
  5. Wash and put away laundry.
  6. Prepare meals and freeze them.
  7. Organize closets and drawers so clothes worn the most are within easy reach. DO NOT use bottom drawers or keep shoes on the closet door.
  8. Arrange frequently used items at waist level throughout the house to avoid bending and reaching.
  9. Put clean linens on your bed.
  10. Purchase or borrow any medical equipment you feel would assist with activities of daily living. This may include bathtub grab bar, toilet riser, bath or shower chair/bench, shoe horn, step stool, extended length grabber, etc.
  11. Prepare to have someone get your mail and care for your pets and/or loved ones as necessary.

Post-op:

  1. Don’t rush (e.g. to get the doorbell or telephone).
  2. Be sure to understand how to use any medical equipment provided for you.
  3. Do not use treadmills or unfamiliar exercise equipment until consulting your physician.
  4. Wear shoes that fit well and have soles with a good grip.
  5. Maintain adequate hydration and a proper diet.
  6. Balance rest with activity.

For many, walking is encouraged post operatively. Weaker muscles, joint pain/stiffness, decreased sensation in legs and feet can affect balance. After surgery you may become less agile, resulting in slower reaction times.  Pavement cracks, misaligned sidewalks, construction and slippery surfaces all contribute to increased fall risks.  It is encouraged to scout out and pre-plan a walking route to become familiar with such areas.  After surgery walking at a comfortable pace and remaining aware of self and surroundings during your walk will help reduce fall risks.

Medications are often prescribed for post-operative pain. Side effects can include dizziness, drowsiness, and confusion.  It is important to take only medication prescribed for you, and follow the directions provided. Consult with your physician or pharmacy if side effects are experienced.

Heather Gueller, BSN, RN is the Patient Educator at the NeuroSpine Center of Wisconsin. She is detailed oriented with a passion for providing exceptional patient care. Heather has worked as a Surgical Department Charge Nurse, Neuro/Spine Lead Nurse, and Circulating Operating Room Nurse for 9 years at a Level II Trauma Hospital.

Hobbies are important!

Hobbies are important!

Hobbies are what we live for and work for in life.  When it comes to Fall Prevention as we get older, we may need to think about adapting how we maneuver around while enjoying our hobbies.  When you think about your quality of life and what brings you joy, you may need to plan out obstacles before you have some fun in your day.

For example:

  • If you enjoy fishing- think about the ground you will be walking on:
    • Is it uneven?
    • Are there railings to hold onto as you walk to the shore?
    • Will you be in a boat? Consider the transition from dock to boat and prepare accordingly (use a railing, ask for a supportive arm, wear appropriate footwear).
    • Underestimating your balance is one mistake people make when trying to participate in activities that were enjoyed in the past.
  • If you enjoy tennis but haven’t played in a few years:
    • Do you have supportive shoes?
    • Are you playing with someone who understands your level of participation?

These are a few things to think about as we grow older and modify the hobbies we enjoy.  Don’t cut out the things that have always brought you joy, just find ways to adapt them to your level of ability.

And remember “We don’t stop playing because we grow old; we grow old because we stop playing.”

Carrie Esselman, TRS CDP is the Life Enrichment program Manager at Valley VNA Senior Care. She oversees a team of professionals and all programming stemming from Independent Care to Memory Care.  Our mission is to provide quality choices for senior care and through Life Enrichment we strive to provide evidence based programming that is specific to each individual that chooses to live at Valley VNA.

Light and Dark: How lighting plays a part in falls prevention

The human eye has a strong connection to light as the eye needs light in order to see. The following three tips are provided to help you manage the light in your life in order to reduce your risk of a fall.

  • Get more light

We humans cannot see as well in the dark. When we cannot see very well, our risk of a fall increases. For example, if we are walking around in the dark, we might not see the box that we left on the floor and trip over it, resulting in a fall. One of the best ways to avoid a fall in the first place would be to increase the light you already have or get more lights. There are several ways to do this: turn on the lights that you do have, get brighter light bulbs, add more lamps, install more light fixtures, and get nightlights. Not only does the human eye see better with light, but an older eye needs more light than a younger eye does. If you have older eyes, you need more light.

  • Use sunglasses and visors

There are times when more light or very bright light is actually uncomfortable for humans. The easiest way to control bright light is the use of sunglasses and caps with a visor or brim. Sunglasses come in many colors, shapes, and shades so make sure to try several different pairs of sunglasses to find two or three that will work for you. A bright, sunshiny day may call for dark gray sunglasses, whereas an overcast day may call for amber or brownish-orange colored sunglasses. Perhaps you prefer dark or medium gray sunglasses instead. Sunglasses that can fit over your prescription glasses can be found in many stores and at your eye doctor’s office. A visor or hat with a brim stops the sun or bright overhead lighting from shining directly into your eyes; this will help you see better and feel more comfortable too. Sunglasses and hats also protect your eyes (and skin) from sun damage. Secret tip: yellow sunglasses may help you in dim lighting as yellow sunglasses brighten things up

  • Stop and wait for your eyes to adjust

All eyes take time to adjust to changes in light. Older eyes will take up to three times longer to adjust to light changes. For instance, walking from the bright sunny daylight into a dark restaurant, it may take your eyes five seconds or longer to adjust. The best solution is to stop and wait. Stop walking and wait for your eyes to adjust before you move on. In addition, you can also use sunglasses and a cap with a brim to help your eyes adjust to light changes. Do not forget to take off your sunglasses after stepping into that dark restaurant.

Jean Kenevan works for the Department of Health Services, Office for the Blind and Visually Impaired, as a rehabilitation specialist. Jean is also a Certified Orientation and Mobility Specialist and the vision expert for the Stepping On falls prevention workshops in her territory. Her office is located in Appleton, Wisconsin. Contact her with any questions: 920-831-2090, jeannine.kenevan@wisconsin.gov.

Fall Prevention – Why is it Important to You?

I had just gotten done working a short shift at the hospital, it was late, I just wanted to go to bed. I couldn’t, I had to take my dogs out yet. I got home and quickly threw my purse down and grabbed the dogs. It was February and it had been warmer during the day so the snow melted, but now being 11:30 pm it was below freezing again and had iced up. I was still wearing my work shoes- my hard soled “nursing shoes”… I didn’t pause to put my winter boots on! It was late and I just wanted to go to bed.

I don’t even remember exactly how it happened- I was walking across the parking lot carrying my Boston Terrier who had decided his paws were just too cold…I started to slip- I threw him out of my arms and landed with a thud on the parking lot…what had just happened? My dogs ran off, I attempted to get up, but my right leg felt funny, I couldn’t stand. I yelled for help… my dogs ran off (luckily back to our front door) how was I going to get back in? I was still a good 500 feet from my apartment, not to mention I lived on the second floor, how was I going to get back upstairs…to my phone that I left in my purse. I couldn’t walk! No one heard me screaming for help!  I started to “crab crawl” back to my apartment, made it to my front door, opened and scooted up the stairs. I got to my phone and called my sister. I am an ER nurse, I wasn’t calling an ambulance! It was a long 30 minutes that it took my sister to drive to my apartment from Green Bay. She had flagged down a police officer (who flags down a police officer?!) to help carry me to the car. When they arrived, they determined it was too icy to risk them carrying me, so they called an ambulance. For crying out loud, I am 24 years old! I don’t need an ambulance because I fell on the ice!

My worse fear- I broke my leg! Spiral tibia fracture- I may need surgery…surgery? I am a healthy 24 year old!!  I fell on the ice, people fall on the ice all the time! Luckily I didn’t need surgery- it was only mildly displaced- the solution for that? 10 weeks in a thigh high cast- on week 3 they partially broke the cast, placed a wedge against my bone to help it grow in alignment and replaster over that…  I had to move into my parent’s house for 12 weeks- I couldn’t live on my own, I couldn’t work (a ER nurse on her feet for 12 hours…does not happen with a broken leg) I couldn’t shower, I didn’t leave the house for 10 weeks, I gained weight.

At 24 years old, or at any age, no one wants to depend on others to care for them. I think about it all the time- if I only had put my snow boots on, would it had made a difference? If I would have taken my time to see that it was too icy there and taken the longer way back perhaps I wouldn’t have been out of work for 12 weeks.

Amanda Daniels went to Nursing School at Bellin College of Nursing and graduated in 2008. She was an ER nurse for 8 years in ThedaCare and joined the Trauma Program at ThedaCare 2 years ago. She believes Fall Prevention is important in every age group.

Avoid Falls at Home – Checklist

Six out of every ten falls happen at home, where we tend to move around without consciously thinking about our safety. Sore muscles, broken bones, and painful bruises can be avoided by following these tips from the National Institute of Health:

  • Remove anything that could cause you to trip or slip while walking. Tripping on clutter, small furniture, pet bowls, and electrical or phone cords can cause you to fall.
  • Arrange furniture to give you plenty of room to walk freely. Also remove items from stairs, hallways, and pathways.
  • Be sure that carpets are secured to the floor and stairs. Remove throw rugs, use non-slip rugs, or attach rugs to the floor with double-sided tape.
  • Put non-slip strips or mat on floor, steps, and in your shower or bathtub.
  • Avoid wet floors and clean up spills right away. If you have waxed floors, use only non-skid wax.
  • Poor lighting – inside and outdoors – can increase your risk of falls. Make sure you have enough lighting in each room, at entrances, and on outdoor walkways. Use light bulbs that have the highest wattage recommended for the fixture.
  • Good lighting on stairways is especially important. Light switches at both the top and bottom of stairs can help.
  • Place a lamp within easy reach of your bed. Put night lights in the bathroom, hallways, bedroom, and kitchen. Also keep a flashlight by your bed in case the power is out and you need to get up.
  • Have handrails installed on both sides of stairs and walkways. If you must carry something while walking up or down stairs, hold the item in one hand and use the handrail with the other. When you’re carrying something, be sure you can see where you are stepping.
  • Properly placed grab bars in your tub and shower, and next to the toilet, can help you avoid falls, too. Have grab bars securely installed by a handyman, and use them every time you get in and out of the tub or shower.
  • You might find it helpful to rearrange often-used items in your home to make them more accessible. Store everyday items within easy reach.
  • Avoid using a stool or chair to reach something. Instead choose a safe stepladder or ask for help.
  • Be careful when walking outdoors, and avoid going out alone on ice or snow. A simple slip on a slick sidewalk, a curb, or icy stairs could result in a serious injury.
  • During the winter, ask someone to spread sand or salt on icy surfaces. Be sure to wear boots with good traction if you must go out when it snows.

As we age, we need to consider all the tips listed above. Use the list as a check off to go through your home being proactive in making improvements to your everyday environment.

By Pat Hoogervorst, R.N., Clinical Services Director, Valley VNA Senior Care

Pat oversees the clinical quality and operations of the Assisted Living. Her history with Valley VNA, along with her clinical expertise, is a wonderful resource for residents and families. Pat works closely with the Wisconsin Assisted Living Association and their program the Diamond Accreditation process and the Three Pillars of Care. The program criteria are designed to be a standard for excellence in assisted living organizations seeking the highest levels of customer-driven quality performance.

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