The World is Round, and Apparently So Are We0

According to a recent publication by the Organization for Economic Co-operation and Development (OECD), obesity has spread at “an alarming rate” since the 1980’s.  In countries affiliated with OECD, 1 in 2 is overweight and 1 in 6 is obese.  Obesity has been more defined by the National Institutes of Health (NIH) as a BMI of 30 and above (a BMI of 30 is about 30 pounds overweight).  The following table can help you identify your BMI: … Read more →

Understanding that “Freshman 15”0

With talk about health care and obesity making headlines just about every day, there is finally a study for the estimated 19.1 million students expected to attend college and university programs this fall.  What’s the story behind the legendary “freshman 15”?

A recent study conducted at the University of Michigan identified college students with overweight roommates as more likely to lose weight — up to 1.5 pounds — than those students with slim roommates.

According to one research scientist at the University of Michigan’s Institute for Social Research: “This finding seems counterintuitive, but there are some good explanations for why it may be happening. It’s not really the weight of your roommate that’s important, but the behaviors your roommate engages in. These behaviors are what may really be ‘contagious.’ “

The study is expected to continue, hoping to expand the understanding of this phenomenon at college campuses nation-wide.

The information from the University of Michigan’s Institute for Social Research comes courtesy of Medical News Today.

Live Well, Die Old(er)0

Apparently, being physically fit may lead to a healthier and longer life.  According to a recent study published in the British Medical Journal, individuals who are able to perform simple tasks such as gripping, walking, rising from a chair or even balancing on one leg may actually live longer.

According to the study:  “Objective measures of physical capability are predictors of all cause mortality in older community dwelling populations. Such measures may therefore provide useful tools for identifying older people at higher risk of death.”  Perhaps this study will revolutionize exercise in the future.

The Appendectomy0

Appendectomy

The first report of an appendectomy came in 1735 from a surgeon in the English army who performed the operation without anesthesia. Today, one out of every 2,000 people has an appendectomy, almost always with pain medication.

Although appendicitis is one of the more frequent surgical emergencies, there is no specific test to diagnose it with absolute certainty. Symptoms typically include abdominal pain. During early stages, the pain can be difficult to pinpoint, as inflammations of the small intestine and colon are not often localized, but other symptoms may include loss of appetite, fever, and/or nausea. … Read more →

EMTALA and Mental Health0

Federal law defines an “emergency medical condition” as “a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in . . . placing the health of the individual . . . in serious jeopardy.”  42 U.S.C. Section 1395dd(e)(1)(A)(i).
Passed in 1986, the Emergency Medical Treatment and Active Labor Act (EMTALA) is a United States Act of Congress that requires every hospital to treat any patient with an emergency condition in such a way that, upon the patient’s release, no further deterioration of the condition is likely.  No hospital may release a patient with an emergency medical condition without first determining that the patient has actually been stabilized, even if the hospital properly admitted the patient.
  • When a patient presents at a hospital with a severe mental disability, does this trigger the requirements under EMTALA?
  • When does a mental health emergency qualify as an “emergency medical condition” under EMTALA? … Read more →

PBS’s ‘This Emotional Life’: Surviving the Hospital Discharge

“Our goals can only be reached through a vehicle of a plan, in which we must fervently believe, and upon which we must vigorously act. There is no other route to success.”

Pablo Ruiz Picasso, Spanish painter, draughtsman and sculptor

“Nosocomephobia,” defined as an excessive fear of hospitals, is not a word you often hear in healthcare settings. But maybe you should. At any given moment, a typical hospital stay balances disease and diagnosis, joy and despair, pitting physical and mental tribulations against hope. Oddly enough, “Nostophobia,” the excessive fear of returning home, can be just as prevalent to patients who find themselves in need of long term medical care outside the safety and security of the hospital environment.

For most people, the most significant moment of any hospital stay is when they are told they can leave, and how carefully they prepare for this anticipated departure is in many ways as important as the treatment they receive while under a doctor’s care. Referred to as discharge planning, hospitals understand the importance of developing a careful and appropriate agenda to address what will inevitably occur outside the hospital walls. Whether the patient is headed to his or her own home, the home of a friend or loved one, or to a rehabilitation center or nursing home, knowing what to expect goes a long way toward reducing stress and ensuring the best outcome for everyone involved.

Discharge planners — who can be hospital administrators, social workers, doctors, or nurse case managers — often work closely with families to explain a patient’s outlook, offer direction on continued care and help identify the most appropriate facility to suit the patient’s needs. Depending on the patient’s condition, a good discharge plan may be as simple to execute as taking a few days off work to help at home or as complex as researching health care facilities and coordinating assistance among family members. Generally, discharge is a five stage process:

Stage One: The patient’s mental and physical conditions are evaluated by the attending physician and nursing staff, with particular focus on whether or not the patient can safely return to his or her original living situation.

Stage Two: The discharge planner explains the doctor’s evaluation to the patient and any available caregivers, focusing on future care, including whether to transfer the patient to his or her own home, that of a family member, a nursing home or rehabilitation facility.

Stage Three: The discharge planner will now begin to personalize the patient’s plan, discussing any necessary caregiver training, possible third party care, and whether any extra equipment (such as wheelchairs or breathing assistance devices) will be necessary.

Stage Four: The discharge planner may now recommend third party facilities or home care services that are available to suit the patient’s needs, taking into consideration geographic, religious, language and/or cultural issues that might affect quality of care.

Stage Five: This final phase is designed to ensure that the appointed caregiver has all the information necessary to carry out the task at hand, including a summary of the hospital stay, a list of medications and important contact information in case of questions or concerns. There may also be a discussion about potential warning signs in the event that a patient’s condition should worsen.

When you or a loved one are recommended to a third party medical facility for long or short-term care, there are many factors to review. Because your time to make a decision may be limited, it is a good idea to consider the following when making your selection:

  • Why was this type of facility chosen?
  • What specific medical needs does this facility address?
  • Is this facility capable of meeting all the patient’s needs, or will additional assistance be necessary?
  • How close and convenient is this facility for the primary caregivers and family?
  • Is it clean, quiet and comfortable?
  • Does this facility address any cultural or language related issues the patient might have?

When the Burden of Care Falls on a Loved One
Often, patients find themselves in a situation where their needs are not severe enough to require a third party service, but they cannot fully care for themselves in a home setting. In such instances, a patient’s family or friends may be called upon to assist during the rehabilitation process.

When a loved one returns home to recuperate, his or her needs are often diverse, and the job of the caregiver can be complicated. The following are the essential elements of primary care during recovery:

Health and Hygiene: The caregiver may assume such tasks as bathing and dressing the patient, as well as assisting the patient with going to the bathroom, grooming and eating.

Household Chores: While convalescing, the patient will most likely need help with cooking his or her food, cleaning the living quarters, and washing articles of clothing as well as shopping for supplies and medications.

Medical Services: The primary caregiver will likely need to provide a certain amount of medical assistance, helping the patient with everything from wound care and bandaging to administering medications, including the possibility of giving injections.

Companionship: The emotional aspect of rehabilitation are often directly linked to a patient’s physical progress, and positive daily conversations help to reassure the patient that he or she is not facing these challenges alone.

If you find yourself in the position of family caregiver, know what to expect as you take on these new responsibilities. Providing post-hospitalization support for anyone can be a time consuming, high pressure task. Those who find themselves undertaking such a role should be mindful not to ignore their own needs and obligations in their effort to assist a loved one.

While the discharge process marks the conclusion of the hospital stay, it is often just the first step on a long road to recovery. The challenges facing newly discharged patients and their caregivers can be a complex mix of mental, physical, emotional, and financial hurdles. By planning for this step at an early stage, both the patient and his or her caregivers will be more prepared to address the hurdles that go hand in hand with convalescence, leaving them free to focus their time and energy on the task of returning the patient to a healthy, productive lifestyle.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.

PBS’s ‘This Emotional Life’: The Hospital Menu in the Modern Age

Thomas Edison wrote: “The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.”

Medical technology has made dramatic leaps in the past 150 years. From the invention of the X-ray and the introduction of vaccines to the mind-blowing capabilities of high-tech 64 slice CT scanners that allow physicians to view the inner workings of the human form, the ways in which we practice medicine today seem light years ahead of our predecessors. And yet, oddly, one aspect of the hospital stay has remained surprisingly constant — the menu.

Until recently, that is. Today’s hospitals are learning how important a tool the menu can be when it comes to promoting healing, increasing nutritional awareness and improving their patients’ emotional well-being. The twenty-first century has brought with it new ideas and sound philosophies relating to the bond between what we eat and how we feel, and nowhere is that link more dramatically felt than when one is forced to dine from a hospital bed. In the past the focus of hospital food was primarily somatic, although the lackluster fare did not always provide the much-needed healthy boost of vitamins and minerals. Today’s hospitals have come to recognize not only the value of well prepared, fresh food in bolstering the immune system, but the benefits choice can have on a patient’s psychological outlook during trying times. Food, it seems, is powerful medicine not only for the body, but also for the mind.

Since study after study continues to stress the influence proper nutrition has on rates of healing and overall health, many of today’s hospitals have begun to address the tired stereotype befitting Jell-O cubes and ice chips, striving instead to serve fare that is both varied and enjoyable. In doing so, both patients and hospitals benefit. By allowing patients to choose their meals, they are given a degree of control over their situations, albeit small, which can go a long way toward reducing the stress of waiting for test results, exams or procedures.

Over time, it has become clear that the old methods of serving patients are no longer a match for the needs of the modern hospital or those it serves. Since the average age of the hospital patient continues to rise as Baby Boomers find themselves entering their sixties and demanding a standard of quality that they have grown to expect, many hospital administrators have opted to outsource food services in an effort to provide patients with quality meals that are prepared without taxing the hospital infrastructure itself.

Today, nearly 20 percent of American hospitals employ food service outsourcing in one form or another, and the trend is on the rise. By doing so, hospitals are able to focus solely on the task of ministering to patients, freeing up staff members who once doubled as waiters and providing patients with food prepared by culinary experts who take pride in conjuring up a variety of nutritious dishes guaranteed to surprise if not delight the most curmudgeonly gourmand. This not only increases efficiency, it results in improved service, better food, greater selection and higher patient satisfaction. To keep up with the modern patient’s need to be pampered, many outsourcing companies have even begun to offer room service dining, which is in many ways similar to a hotel experience. When hungry, patients simply place an order with the kitchen, and their request is brought up in a timely fashion after having been vetted by the hospital dietitian. Food is freshly prepared and the menus are extensive.

Whether outsourced or not, many modern hospitals have committed to improving the quality and scope of their menus in an effort to capitalize on the link between healthy eating and psychological well-being. With greater variety comes better nutrition, as patients are not only eating healthier food free of excess sugars, starches and preservatives, they are eating more of it. The concept of food as preventive medicine has resulted in some leading hospitals offering primarily organic and chemical free food, including hormone free milk, antibiotic free chicken and beef and locally grown fruits and vegetables.

This stands as an excellent example of the way in which hospitals are beginning to regard education as a key factor in the continued health of their patients. Most American hospitals employ registered dietitians to ensure that patients eat healthy, well-balanced meals during their stay and receive the necessary education to continue such patterns at home. In this way, hospitals can do their part to proactively treat patients before they become sick as a result of obesity or lack of nutrition.

Understanding the full impact of a proper diet is no easy task for anyone, hospital patient or not. Modern times can often blur the lines between healthy or unhealthy, too thin or too heavy, without even addressing nutrition. Whether the focus is on obesity-associated morbidity or orthorexia nervosa (an antiphrastic oxymoron which is used to describe an unhealthy obsession with eating healthy), a hospital stay can help patients recalibrate their eating habits and promote greater combined mental and physical health in the future.

If you or a loved one find yourself in a hospital for any length of time, consider using your stay to familiarize yourself with the basics of nutritional healing and overall healthy eating. This will help you not only during your visit, but as you return to your regular lifestyle.

Get to Know Your Dietitian. Dietitians create menus that meet healthy eating guidelines set by the American Dietetic Association, as well as satisfying regional tastes (foods that are familiar to a large immigrant community, for example) and addressing specific patient related health needs such as those exhibited by diabetics, breast-feeding moms, wheat-allergy sufferers, etc. Your hospital dietitian will gladly provide advice and information on ways to improve your dining habits and cooking preparation, taking into account any health-related issues.

Shop Around. If you are not in the hospital as a result of an emergency situation, take a few minutes to find out what each of your neighboring hospitals have to offer in the way of dietary education, menu preparation, and room service dining. While medical expertise should always be the primary concern, you might be surprised at the quality of food service now being offered by medical centers in your area.

Use Your Down Time. While no one ever wants to be in a hospital, the periods of waiting between tests or while healing do provide many people with the opportunity to think about their health and reflect on ways to improve their quality of life once they are discharged. Ask questions and use the experts around you. By thinking long-term, you may be surprised to see just how easy it is to adopt healthier patterns once you are back to your normal routine.

By bringing the menu into the twenty-first century, today’s hospitals hope to educate their patients in the ways in which proper nutrition can bolster not only the body, but the mind and spirit as well. As always, the evolution of medicine continues to take its cue from Hippocrates, who must have thought holistically when he said, “Let food be thy medicine and medicine be thy food.”

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.