Sources of Nutrition

Ensuring you receive adequate nutrition in your home is one of the main priorities of Total Home Health.  The nutrients you absorb from your diet determine, to a large extent, the overall health of your body.  An excess of nutrients or a lack thereof, can both contribute to a poor state of health.  There are nutrients in the body that are “essential” and those are the ones that your body cannot manufacture, so it is important that you have an adequate diet in order to get all the nutrients you need to keep you well-balanced.

At Total Home Health we know that your diet should consist of the following sources in order to be adequate no matter what your condition:

ü  Carbohydrates and fiber

ü  Protein

ü  Lipids (fats)

ü  Vitamins

ü  Minerals and electrolytes

ü  Water

The main function of carbohydrates is to provide energy for your body.  When you ingest carbohydrates they provide energy in order for your cells to work, while also helping to regulate metabolism of protein and fat.  Carbohydrates are essential to keep your heart and central nervous system (brain, spine, etc.) functioning normally.  Fiber is categorized as a carbohydrate but it does not provide any energy for your body.  Fiber is highly important to your body in order for proper bowel elimination, mainly to avoid constipation and hard stools.  Fiber works by adding bulk to your stool and stimulating your intestinal tract to move, which will make using the bathroom much easier for you, as bathroom habits are usually a complaint in the older adult population.

Now on to proteins.  Proteins have many different metabolic functions in your body including tissue-building and maintenance, providing back up energy, supporting your immune system, and more.  Tissue growth needs, quality of the dietary protein you ingest, and any added protein needs due to illness all influence your body’s requirement for protein.  If you do not ingest enough protein in your diet this could lead to many health issues, including developing a cachectic state, which is the wasting away of your tissues.

Lipids, or fats, are also an essential nutrient in your diet, and are available to you from many sources (dark meat, poultry skin, dairy foods, butter, etc).  Lipids are a more concentrated form of energy, coming in second to carbohydrates.  Lipids supply important tissue needs such as protecting your vital organs, and insulating your body to maintain a comfortable temperature.  It is important for you to know that a diet high in fat is linked to heart disease, high blood pressure and diabetes mellitus.  However, you must ingest a well-balanced amount of lipids for your body type in order to both stay away from that state of wasting we mentioned earlier, and avoid other health problems.

Vitamins are also important to squeeze into your diet because their main function is helping metabolic functions and other chemical reactions that occur in your body.  Vitamins are crucial to your state of well-being.  There are 13 essential vitamins, and they each have special functions.  Vitamins do not produce any energy that the body can use.  Following are explanations of some important and special vitamins your body uses in order to function correctly:

o   Vitamin C

·         Aids in tissue building, wound healing, production of adrenaline, and absorbs iron

·         Found in citrus fruits (oranges, lemons), tomatoes, peppers, green leafy vegetables, and strawberries.

·         Stress and illness increase the need for vitamin C.

·         Severe deficiency causes scurvy, a hemorrhagic disease with painful limbs/joints, weak bones, and swollen gums/loose teeth.

o   B-complex vitamins

·         Many functions occur with cell metabolism, each vitamin has their own duty.

·         Sources include green leafy vegetables and unprocessed or enriched grains.

o   Vitamin A

·         Contributes to vision health and growth/strength of tissues.

·         Sources include egg yolks, butter, cream, dark yellow/orange fruits and vegetables (carrots, yams, apricots, cantaloupe, squash).

·         Deficiency will result in vision changes and changes in skin cells (especially in the mouth and vagina).

o   Vitamin D

·         Helps the body use calcium and phosphorus, and aids in repair of skin.

·         Can be used preventively for function of your immune system.

·         Sources include fortified milk, cod liver oil, and eggs.

·         Deficiency results in your bones losing their minerals (osteoporosis).

·         Low levels of vitamin D may increase your risk for multiple sclerosis (MS), high blood pressure, Type I diabetes, and certain cancers.

o   Vitamin E

·         This vitamin is an antioxidant that works to preserve your muscles and red blood cells.

·         Sources include vegetable oils and certain nuts.

·         Deficiency results in anemia.

o   Vitamin K

·         Assists in blood clotting and maintenance of your bones.

·         Sources include some oils, liver, and green leafy vegetables (spinach, broccoli)

·         Deficiency causes your bleeding time to be increased.

Minerals and electrolytes are another category that should be adequate in your diet.  Minerals are available in an abundance of food sources, and are used at every cell level in your body.  There are both major minerals and trace minerals.  The seven major minerals include calcium, phosphorus, sodium, potassium, magnesium, chloride, and sulfur…we are sure you’ve heard of at least a few of them.  Then there are ten trace elements that also are important to your diet, but generally you have no problem ingesting them in your daily diet.

Finally there is water, which is the most basic of all the nutrients you need.  The body can maintain itself for several days or weeks on its food stores of energy, but it cannot survive without water and hydration for more than just a few days.  Water makes up the largest portion of our body weight, and is crucial for our health.  It is an important fact to know that thirst is a late sign of the need for hydration…especially in older adults.  Also, older adults dehydrate more rapidly than others. 

Ultimately at Total Home Health we know that your diet is very important related to your overall health.  It will be the goal of our compassionate professionals to see that you are consuming a well-balanced diet according to your specific needs in order for you to maintain your healthy lifestyle and enjoy it to its fullest.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disorder that typically affects the small joints that are located in your hands and feet.  Unlike osteoarthritis that causes wear-and-tear, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.  Rheumatoid arthritis is an autoimmune disorder that occurs when your immune system mistakenly attacks your own body tissues.  This condition may also affect other organs of the body such as the skin, eyes, lungs, and blood vessels.  Although rheumatoid arthritis can occur at any age, it usually begins after age 40 and is much more common in women.  With Total Home Health, we take the time to listen, to find you answers, and to provide you with the best care.  Our focus with this condition will be on controlling your symptoms and preventing any further damage to your joints.

Rheumatoid arthritis involves joints bilaterally and symmetrically, meaning that if you have RA in your hands, the joint damage will be the similar for both hands.  In addition, RA typically affects several joints at one time, and most generally it affects your upper joints first.  The joint deformity and bone erosion that may occur will decrease your range of motion (ROM) and function of your joints.  This decrease in ROM and function can prove to make your daily routine more difficult and time consuming.  Since RA is an autoimmune condition, its natural course will be one of flare-ups and remissions. 

Promotion of your health and prevention of RA will be our ultimate focus at Total Home Health.  Our professional staff will work hard to provide you with the best treatment for your specific condition.  Throughout the course of RA we will continually encourage you to use adaptive devices that will prevent deformities of your inflamed joints that could occur even while you engage in your normal daily activities.  Also, we will encourage and help you to continue using your affected joints, and see that you continue walking in order to maintain your body functions.  We understand that this process of maintaining your functioning can be painful, and our limitations for care will be totally up to you and to what extreme you can tolerate.  Remember related to your extremity functions with RA, “If you don’t use it, you’ll lose it.”

The risk factors and signs of RA are as follows:

§  Female gender

§  Age 20 to 50 years

§  Family history

§  Stress

§  Early signs of RA (fatigue, joint discomfort) are vague and may be mistaken for other disorders in older adult clients.

§  Joint deformities are late signs of RA.

§  Joint pain and dysfunction may have a greater effect on older adults than on those who are younger with this condition due to the presence of other chronic health problems.

§  Older adults may be less able to overcome and/or cope with joint pain and deformity

Upon being examined and assessed by your provider you will most likely have evident signs and symptoms of RA that will aid in making your diagnosis.  If you or your loved one has developed RA you may experience some of the following manifestations of the condition:

§  Pain both at rest and with movement

§  Stiffness in the morning

§  Pleuritic pain when you inhale; this pain comes from the space between your lungs and chest cavity.

§  Dry mouth

§  Fatigue

§  Paresthesia (tingling)

§  Recent illness or event that caused you stress

§  Joint pain

§  Lack of function

§  Joint swelling and deformity

§  Joints in your fingers, hands, wrists, and knees are generally affected.

§  Joints may become deformed just by doing your normal daily activities.

§  Fever (generally low grade)

§  Muscle weakness

§  Reddened sclera (the whites of your eyes)

§  Enlargement of lymph nodes

To aid in your diagnosis there are also several laboratory studies that will be performed as determined by your provider related to your specific condition.  Plus, you may also have x-rays completed to determine the degree of joint destruction, and to monitor the progression of RA.  There is also a more invasive procedure called an arthrocentesis that can be done to diagnose RA.  During an arthrocentesis a needle is placed into the area of your affected joints and some fluid is drawn from that space.  If you have RA, the fluid that was collected from your joints will show an increased amount of white blood cells, and rheumatoid factor will also be present upon evaluation by your provider.  After your diagnosis of RA is confirmed, your specialized treatment plan will be developed. 

Once treatment is prescribed to you, Total Home Health will take the reins with your care and provide you with the best of the best services in your own home.  We will work to minimize flare-ups and keep you as comfortable as we can while you go about your daily routines.  We are eager to become your friend, educator, caregiver, support system and more…so enroll today!

Osteoarthritis

Osteoarthritis (OA), sometimes known as degenerative joint disease (DJD) is the most common form of arthritis that affects millions of people worldwide.  It happens when the protective cartilage on the ends of your bones wears down over time.  OA can damage any joint in your body, however it most commonly affects joints in your hands, knees, hips and spine. 

This disorder is both noninflammatory (unless it’s localized) and nonsystemic. 

OA is known to gradually worsen over time, and unfortunately no cure exists.  The best thing you or your loved one can do if you are diagnosed with OA is to be proactive and do what can help your current condition, and slow down its progression.  For starters, being proactive means the least you can do is lead an active lifestyle and maintain a healthy weight.  Total Home Health has a program that is right for you and your osteoarthritis condition.  Our health professionals understand this condition, and will work alongside you to keep you as comfortable and independent in your home as possible.

With the progression of OA, as mentioned above your cartilage wears down over time and eventually the destruction outweighs the production of cartilage tissue, which causes damage and changes to your joints.  The changes within your joints will lead to pain, immobility, muscle spasms, and the potential for inflammation.  In the early disease process of OA, it could be difficult for your provider to distinguish it from rheumatoid arthritis, so close attention will need to be paid to your signs and symptoms to determine which route your treatment course will take.

Following is a reiteration of important characteristics of OA that are important for you and your loved ones to understand:

•   OA is the destruction of cartilage with the growth of bone spurs at ends of joints.

•  OA is a degenerative condition that gradually worsens.

•  Pain with this condition occurs during activity and improves with rest.

•  There could possibly be a localized inflammatory response.

•  Clients with this disease are usually overweight.

•  There are nodes, medically referred to as Heberden’s and Bouchard’s nodes that could be formed as a result of destruction of cartilage and changes to your joints.

•  OA is nonsystemic, which means that no other organs are involved…just the joints.

•  OA is not symmetrical, which means that you may have damage to joints in one hand, but not the other.

•  OA is diagnosed with x-rays.

Next are the risk factors that increase your chance of experiencing OA, which include:

•  Age (majority of adults over age 60 have joint changes on x-rays)

•  Women have a higher incidence of OA than men

•  Being overweight or obese

•  Smoking

•  Possible genetic link

•  History of repetitive stress on joints (marathon runners, manual laborers, athletes)

Now that you know some important facts and the risks, it is important to be able to recognize the signs and symptoms that could be indicative of OA that you can report to your provider to aid in your diagnosis.  The clinical manifestations of OA include:

•  Joint pain or stiffness that resolves with rest or when you stop the activity.

•  Activity and range of motion of joints is restricted or limited due to pain.

•  Crepitus (a grating sound or sensation produced by friction between bone and cartilage) in one or more of the affected joints.

•  Enlarged joint(s).

•  Inflammation, which means that the disease is advanced.

•  Joint effusion (excess joint fluid) that is easily moved from one area of the joint to another area.

With Total Home Health, our health professionals will implement several interventions that will help you to be as independent as possible in your home and enjoy life to its fullest.  It will be our goal to implement the following routines into your plan of care:

•  Create a routine with a proper balance of rest and activity, which will include completing tasks that require high-energy in the morning when you are the most rested.

•  Educate you about the use of analgesics (Tylenol) and NSAIDs (Motrin, naproxen) prior to activity and around the clock as needed to keep your pain level at a tolerable level.

•  Instruct you about proper body mechanics and importance of exercise.

•  Encourage you to use heat to alleviate pain in your joints, or ice in the case of inflammation.

•  Educate on use of assistive devices to promote your safety and independence, including an elevated toilet seat, shower bench, shoe horn, and long-handled grabber.

•  Encourage you to consume a well-balanced diet and maintain an ideal body weight, consultation with a dietician may be recommended to plan balanced nutrition for you.

There are several medications that could also be included in your treatment plan.  Once your provider confirms a diagnosis for your condition and its severity, a treatment plan will be developed that our Total Home Health nursing professionals will strictly follow in your home.

Total Home Health is ready to join your family and become your go to person for all of your at home, health care needs.  Our highly-skilled, professional, and compassionate staff are eager to increase your independence at home and watch you enjoy life, let’s get started today!