Transitional Care

How many times have you or your loved one been hospitalized and caught yourself wondering, “Well why didn’t my doctor tell them that?”  The ultimate goal is to get you stable enough to function in your own home either as you once did, or with the assistance of home health care professionals, such as Total Home Health.  Transitional care is a set of actions that is designed to ensure coordination and continuity of health care as clients transfer between different locations or different levels of care within the same location.  These locations could range from hospitals, to the client’s home, to their doctor’s office, and to the long-term care facility. 

The moment you are admitted into a health care facility your discharge planning begins and it will continue throughout your stay.  Transitional care planning is always client-centered and includes all members of the interdisciplinary team that will be involved in your care.  In order to keep up to date with client progress, ongoing consultation with members of the client care team and reassessment of the client’s changing medical functional, social, and cognitive capabilities will be carried out by Total Home Health professionals.  Clients and their families are always involved in decision-making processes and their opinions are highly valued.  Health care professionals will always inform clients and their families of any resources that are available in the community to work toward transitioning the client back into the community once they are stabilized.

Transitional care is based on a comprehensive care plan and the availability of the health care professionals who are highly-skilled in chronic care, and who have up to date information about the client’s goals, preferences, and clinical status.  It includes patient and family education and coordination among all the health care professionals involved in all levels of client care so that nothing goes unnoticed.  Transitional care, which encompasses both the sending and the receiving aspects of the transfer, is essential for individuals with complex care needs.  Following are some key factors in transitional care planning that you should be familiar with:

ü  Transitional care planning considers all aspects of your well-being, including your medical, physical, cognitive, economic and emotional strengths and abilities as well as your available support system.

ü  An assessment of your level of functioning prior to your admission will be carried out to provide insight into resources available after discharge.

ü  Your opinions, along with those in your support system will be valued and involved in decision-making to ensure your satisfaction with your care and allow you to be more in control of your condition.

ü  You and your family will be given the chance to select the providers of your care whenever possible.

Transitional care is also viewed like a bridge that extends between the health care facility you are in and getting you back home.  Care that is provided to you in transition should be excellent and delivered in the most optimal of environments that is dedicated to a quicker recovery for you in order to return you home as quickly as possible. 

Clients should always get the best possible care during their most vulnerable times if their health is compromised.  Included in providing the best care is to ensure continuity and that all professionals involved are fully aware of all pertinent information in order to ensure continued progress toward the ultimate goal of getting each client back home.  It is rather difficult to maintain strict continuity of care especially between different health care locations and between different health care professionals.  However, it is very crucial to providing the best care possible and maintaining therapeutic relationships with clients. 

Total Home Health has a program that is right for you and will welcome you home whole-heartedly as the next step in transitioning back to the way you used to be.  Our compassionate and highly skilled staff will be determined to work beside you to provide you with more support and motivation to get back to where you want to be.  The ultimate goal of Total Home Health is to see you in the element of your own home, satisfied, stable, and able to perform daily tasks just like you did before.  Don’t wait, enroll today! 

Skin Cancer

Skin cancer is the most common of all human cancers and the numbers of diagnosed cases keep growing year after year.  Cancer results when normal cells undergo a transformation that causes them to grow and multiply uncontrollably.  Following are the basics of cancer that you and your loved ones should be familiar with:

ü  As cancer cells multiply, they form a mass that is referred to as a tumor.

ü  Tumors are cancerous only if they are malignant, meaning they invade surrounding tissues because of their uncontrollable growth.

ü  Tumors may also travel to organs via the bloodstream, which indicates metastasis.

ü  Tumors may become a burden to surrounding tissues by invading their space, which depletes the oxygen and nutrients the tissues use to function.

There are three major types of skin cancer that you should know about to have a basic understanding.  The three types are basal cell carcinoma, squamous cell carcinoma, and melanoma.  The first two skin cancers are considered non-melanoma.  The majority of skin cancers are basal cell carcinoma and squamous cell carcinoma; while they can be malignant they are unlikely to spread to other parts of the body.  However, if left untreated or not caught early, they may be locally disfiguring.  A small but significant number of skin cancers then, are malignant melanomas.  Malignant melanoma is a highly aggressive cancer that tends to spread to other parts of the body and can be fatal if not treated in the early stages.  A good fact to know is that basal cell carcinomas and squamous cell carcinomas are more common in older people, whereas melanomas are more common in younger people, especially ages 25 to 29.

The following list contains certain populations along with risk factors and causes that may result in skin cancer.  It is important that you or your loved one be familiar with these in order to better prepare yourself.  Those at risk, along with other risk factors and causes include:

ü  Exposure to ultraviolet light, most commonly from sunlight

ü  Use of tanning booths

ü  Impairment of the immune system

ü  Exposure to high levels of radiation, such as from x-rays

ü  Contact with certain chemicals

ü  Increased chance if you have fair skin, especially types that freckle or sunburn easily

ü  People with light hair (blonde or red) and blue or green eyes

ü  Individuals with certain genetic disorders that deplete skin pigments (albinism)

ü  Those who have been previously treated for skin cancer

ü  Those with numerous moles, unusual moles, or large moles present since birth

ü  Individuals with close family members who have skin cancer

ü  Those who had at least one sunburn early in life

ü  Individuals with indoor occupations and outdoor recreational habits

Now that you know some causes and who in the population is more at risk for developing skin cancer it will be beneficial to know some of the symptoms to look for.  The symptoms will depend on the type of skin cancer that has developed.  A basal cell carcinoma usually looks like a raised, smooth, pearly bump on the sun exposed skin of the head, neck, or shoulders.  In addition, you may notice that it often appears as a sore that does not heal with time.  A squamous cell carcinoma is commonly a well-defined, red, scaling, thickened bump on sun-exposed skin.  It may ulcerate and bleed, and if left untreated it may develop into a large mass.

The majority of malignant or cancerous melanomas are brown-to-black pigmented lesions.  There are other signs of a cancerous melanoma which include:

ü  A change in size, shape, color or elevation of a mole

ü  The appearance of a new mole during childhood

ü  New pain, itching, ulceration, or bleeding of an existing mole

There is also a guideline that should ring a bell for you that is useful for identifying malignant melanoma, it is the “ABCDE” acronym and is described as followed:

·      Asymmetry – One side of the lesion does not match up with the other

·      Border irregularity – Margins of the lesion may be notched or irregular

·      Color – Melanomas are often a mixture of black, tan, brown, blue, red, or white

·      Diameter – Cancerous lesions can be larger than 6 millimeters across

·      Evolution – You must recognize and ask yourself, “Has this mole changed over time?”

Being familiar with the “ABCDE” guideline and being aware of who is at risk and what activities put you more at risk, you or your loved one could take many preventive steps to significantly decrease your chances of being diagnosed with skin cancer.  You know your body the best and should be alert to changes that could occur at any time.  The quicker you get a medical opinion and start treatment, the better your prognosis.

Total Home Health has a program that is right for you and any kind of skin cancer that you may be experiencing.  It can be very devastating to hear the word cancer in your diagnosis.  Our professional and caring staff will be with you to answer any questions and tend to any concerns that you may have.  Whether we help you carry out your treatment or are just there when you need someone to listen, our program at Total Home Health is definitely right for you!

Edema

Edema is the medical term for swelling.  I am sure we have all noticed some sort of swelling before, whether it is after a long day of being on our feet, or from a bee sting we got at the pool.  Edema is a general response of the body to any type of injury or inflammation.  Edema can be isolated to just a small area of the body, or affect it entirely.  Many medical problems can lead to edema.  Medications, infections, and pregnancy are other reasons edema may occur.  Edema results whenever small blood vessels begin to leak and release fluid into the nearby tissues.  The accumulation of the excess fluid causes the swelling.

Since edema is a normal response of the body to inflammation or injury, it can be beneficial.  For example, if you or your loved one acquires a skin infection that results in edema, the increase in fluid from the leaky blood vessels will allow more infection-fighting white blood cells to enter the affected area, which will result in a faster healing time.

Edema may also result from medical conditions or problems in how substances are balanced in the bloodstream.  Therefore, edema may also be detrimental to your health.  Following are some of the causes of edema:

·      Low albumin.  Albumin is a type of protein that circulates in the bloodstream.  Albumin acts like a sponge to help keep fluid in the blood vessels.  Therefore, if albumin is low, the bloodstream is low on sponges, so fluid begins to accumulate.

·      Allergic reactions.  The body allows nearby blood vessels to lead fluid into the affected area.  This increases the infection fighters in the blood so that the allergies resolve more quickly.

·      Obstruction of flow.  If drainage of fluid from a body part is blocked, the fluid will back up causing edema.  An example of this would be a blood clot in the deep veins of the leg.

·      Critical illness.  Burns, infections, and other critical illnesses can cause a reaction throughout the entire body that allows excess fluid to leak into tissues everywhere, causing widespread edema.

·      Edema and heart disease.  Congestive heart failure (CHF) occurs when the heart weakens and pumps blood less effectively throughout the body.  The inadequate blood supply causes fluids to slowly build up, creating edema in the legs.  Individuals also experience shortness of breath.  Fluid buildup may also occur rapidly, and fluid buildup in the lungs can cause pulmonary edema. 

·      Edema and liver disease.  Severe liver disease (cirrhosis) results in an increase in fluid retention.  Cirrhosis also leads to low levels of albumin.  Generally with liver disease the edema will be prominent in the abdomen, which is called ascites.

·      Cerebral edema.  This is swelling in the brain.  This type of edema can be caused by head trauma, low sodium levels, being at high altitudes, brain tumors, or an obstruction to fluid drainage.  Headaches, confusion, and unconsciousness or coma can be symptoms of cerebral edema that individuals should be familiar with.

Symptoms of edema depend upon the amount of edema and the body part that is affected.  Edema in a small area such as from a mosquito bite may cause no noticeable symptoms at all.  However, a large local allergic reaction from a bee sting for instance, may cause edema that affects the entire arm.  Tense skin, pain, and limited movement of the affected body part can be symptoms of edema.  Food allergies are another category to be familiar with because this type may cause edema to occur in the tongue or throat, which can be life-threatening because it may interfere with breathing.

Edema that occurs in the legs is the general complaint of aging individuals.  Edema of the legs can cause the legs to feel heavy and interfere with walking.  For example, in edema that occurs with heart disease the legs may easily weigh an extra 5 pounds each.  Also, accumulation of fluid in the lungs may cause pulmonary edema which causes shortness of breath that is accompanied by low oxygen levels in the blood.  The hallmark of pulmonary edema is a cough with frothy sputum.

Treatment of edema involves treating the underlying cause.  This could range from medications to removal of an obstruction.  A rule of thumb that is used often if your legs are swollen is to elevate them above the level of your heart.  Edema can occur at any time and from an array of causes; after your provider discovers the underlying cause of your edema your treatment regimen will then be established.

Total Home Health has a program that is right for you and all the problems edema causes in your daily life.  We will provide you with professional staff that will be beside you every step of the way to modify your daily routines so that you may maintain your optimal level of functioning while being treated for edema.  Total Home Health has many years of experience in dealing with edema and will introduce you to the best ways to cope with your condition.