The Family Dog Helps Keep Older Adults Active



Reuters Health reported the results of a study this week that senior citizens who live with dogs meet exercise goals simply by walking them. Researchers matched 43 older adults with dogs to another 43 without dogs and measured their time spent walking. Compared to those without canine companions, dog owners walked on average 23 minutes more a day – enough to meet U.S. and international exercise recommendations for substantial health benefits, the research found.

“We saw a big increase in healthy activity and at a level that is considered to be health promoting.”


“If you’d like to get a dog, don’t be put off by the fact you’re elderly. It’s good for the dog, and it’s good for you.”

The U.S. Centers for Disease Control and Prevention recommends that adults do a minimum of 150 minutes a week of moderate-intensity exercise or 75 minutes of vigorous-intensity aerobic activity a week.

Exercise is one of the most important things you can do for overall health and it is the one intervention that in and of itself has been proven to decrease the risk of falling. Lack of exercise/movement leads to weakness, decreased balance, and decreased circulation, which will increase your falls risk and make you more vulnerable to other medical conditions.

You are never too old to start exercising. For fall prevention, focus on lower extremity strengthening and flexibility exercises along with specific balance exercises. If you do not know how to start exercising please consult your doctor and local physical therapist.

SOURCE: BMC Public Health 2017. Reuters Health Information © 2017 Walking Their Dogs Keeps Elderly Active – Medscape – Jun 09, 2017.

9 Steps to a Smooth Recovery after Total Knee Replacement Surgery


Below is a list of important things to do after a total knee replacement to help you have a successful and easier recovery.

1) Prepare a Safe Home Environment

You will be using a walker or crutches the first few weeks after total knee replacement surgery. You want to make sure your furniture is arranged so that you can fit the walker/crutches through all pathways. There should be no cords or throw rugs in the pathways for you to trip over.

Tub seats, grab bars, and dressing aids will make your activities of daily living safer and this equipment will be recommended to you by your occupational therapist. Showering is not recommended until a home safety evaluation is performed by your home care occupational therapist.

Also remember footwear is important. You want to make sure you are wearing non-skid socks/shoes. Do NOT walk wearing only regular socks, TEDS, or bare feet because your walking and balance will be different the first few weeks after surgery and you do not want to slip and fall.

2) Balance Activity and Rest

Some of you have been looking forward to resting as you recover, others are afraid to move, and then we have those of you who do not know how to rest and overdo it when you return home.

In order for you to have a successful recovery after a total knee replacement, it is very important for you to move. Get up and walk or stand at least once every hour during the day. You want to focus your activity on your therapy program to restore motion and strength, while avoiding strenuous activities.

As much as it is important to move, it just as important to rest and allow your body to heal.

3) Position Your New Knee Correctly

Whenever you are resting with your leg up, keep the operated leg as STRAIGHT as possible. This means NO pillows under the knee. Having the knee bent throughout the day/night, will cause knee flexion contractures, decreased motion of your joint, and poor surgical outcomes.

Total knee replacement leg position

4) Chill Out

Use an ice or cold pack surrounding the operated knee to control pain and swelling. It is important to ice the whole knee, placing the ice/cold pack on top AND underneath the knee.

Cold Pack Placement

Make sure you place a towel between the ice/cold pack and your operated leg and keep in place for 20 minutes. Use the ice immediately after performing your exercises and throughout the day to control pain and swelling.

You can make your own cold packs by squeezing a bottle of dish soap into a one quart Ziploc bag, then place that bag into a second Ziploc bag (in case it leaks) and place it flat in the freezer.

5) Keep Wound Infection Free

Keep the incision clean and dry. Do not use any lotion on the incision unless instructed by your doctor or nurse. If you note any new redness, swelling, or drainage from the incision call your home care team right away. If your incision does drain, cover it with a sterile dressing.

6) Prevent Blood Clots

There are several methods used to prevent blood clots after surgery and they will vary depending on your needs and surgeon recommendations.

TEDS or other anti-embolic stockings are compression stockings that are effective in preventing blood clots and to help control the swelling. Follow your doctor’s orders for wear schedule of the stockings.

Blood thinners are usually started after surgery. Coumadin (warfarin), Lovenox (enoxaparin), Xarelto (rivaroxaban), and aspirin are the most common blood thinners. If you are on Coumadin, you will need to have your blood level checked periodically to make sure you are getting the appropriate dose.
Movement is also an important step in blood clot prevention. This ankle pump exercise specifically will help with circulation and edema control. Perform 10 repitions of this exercise every hour while you are awake.

If you notice any of the following symptoms call your home care provider immediately as these are all possible signs of a blood clot:

tenderness, redness, or pain in your calf
increase swelling of the operated leg
increased warmth in the back of the leg
a red streak moving up the leg
If you develop sudden shorness of breath or chest pain call 911 immediately as this could be a sign of a blood clot in the lungs and can be life threatening.

7) Take Medication as Directed

It is important to take only the medication that you were instructed to take after surgery by your physician. You do NOT want to start taking any vitamins, supplements, or over the counter medication without your doctor’s permission as they could interact with the other medication you are taking, especially the blood thinner. Take medication at the same time every day as directed by your physician.

8) Manage Your Pain

Make sure you take adequate pain medication to allow you to sleep well at night and to participate in your exercise program with minimal discomfort. Do not be afraid to use the pain medication as directed by your physician. With less pain you will have a faster recovery. Remember to take your pain medication with food. Take action as soon as the pain starts. Use ice/cold pack along with the medication to help relieve the pain.

9) Eat a Balanced Diet

Your appetite may not be what it used to be before surgery, but you want to make sure you are getting the proper nutrition for healing. Continue to drink plenty of fluids. 8 cups of water a day will help you stay hydrated and help prevent constipation. Note that constipation often occurs after surgery as a side effect of the pain medication.

Try to limit your coffee intake and avoid alcohol altogether.

If you are taking Coumadin, you need to restrict your vitamin K intake. Foods rich in vitamin K include broccoli, cauliflower, brussel sprouts, liver, green beans, garbanzo beans, lentils, soybeans, soybean oil, spinach, kale, lettuce, turnip greens, cabbage, and onions.

Please remember you just went through major surgery. Your activity level and medications have changed. It is not unusual to experience difficulty concentrating or lack of interest in activities/hobbies after surgery. Muscle soreness, tightness, and stiffness are all normal after surgery.

These are general guidelines. If you have been instructed otherwise by your doctor or healthcare provider please follow their instructions. If you have any questions do not hesitate to contact your home care provider.

Happy Day! Here’s to a Speedy Recovery!

The Legacy of the Lamp


Florence Nightingale is reknowned as the guiding force in the philosophy of nursing. She was born in the English Victorian era of an upper class family who considered it beneath her class to provide menial labor in the service of the ill and disabled.

Florence is attributed with defining what would be considered major health care reform today, for her era of the 1850’s.

She turned around the rodent-infested, cess-pool infected, deplorable conditions for the Crimean war soldiers who were dying in the hospital to which she was summoned and assigned. It is documented that she was able to reduce the death rate of the wounded soldiers by 2/3 by establishing principles of infection control, nutrition and nursing care.

Referred to as “the lady with the lamp” for her lamp-light guided nightly rounds in that Crimean hospital, Florence changed projected fatality for countless soldiers then and future generations of soldiers and civilians. Many would not have survived the deplorable conditions of that war without her direction and care. She established basic changes that we consider to be common sense today, from establishing the use of a hospital laundry, to routine cleaning of patient rooms, use of nutritious food, and assuring proper hand washing to prevent transfer of infection from patient to patient.

Florence Nightingale’s Birthday is May 12. Every year, her birthday is celebrated by nurses and recognized as National Nurse’s Day. Her writings and teachings are memorialized and remain the basic nursing principles of modern nursing. In fact, most allied health sciences including nursing, physical therapy, occupational therapy, speech therapy, nutrition therapy, respiratory therapy are derived from Florence Nightingale’s basic teachings she wrote through the course of her very short life.

This week, National Nurses Week, is celebrated on behalf of the 3.6 million nurses who carry Florence’s lamp and legacy with them in the care they employ on behalf of every patient they encounter. Protecting, advocating, managing, educating, counseling, assessing, comforting, caring are just a few verbs to describe the role. Nurses do many different things and today there are over 100 nursing specialties. Practicing both science and art, nurses direct care of each patient in their charge to prevent harm, maintain and promote health, and improve each patient’s outcome. All nurses are asked to provide care with ethics and to practice at their highest level of training.

The Nightingale Pledge

I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in con dence all personal matters committed to my keeping and all family a airs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.

A Newborn Baby’s Experience Tells The Story: Health Care Policy Effects All of Us


Anyone who has needed to use their health care policy to remain healthy, get care for a health condition, or plan to use their health insurance is faced with a challenge. Most of Americans agree that health care is a right, not a privilege and we all want access to it. We believe most agree that we don’t want to go back to the terrible place where people are denied health insurance because they have a pre-existing condition.

However, we still have a lot of work to do, because small businesses in America are being penalized with ever increasing insurance rates because something unplanned or catastrophic fell on one or more of the business’s employees and insurance rates are increasing in an exponential manner for these families who subscribe to the business’s plan.

Jimmy Kimmel highlighted some of these issues last night in his monologue as he told the tale of his son’s birth last week with a congenital heart defect. He decried the idea that anyone should be denied access to health insurance and to coverage for pre-existing medical conditions, about which President Trump has been unclear. Many people are concerned about the loss of such coverage, and Mr. Kimmel captured their fears:

We were brought up to believe that we live in the greatest country in the world, but until a few years ago, millions and millions of us had no access to health insurance at all. Before 2014, if you were born with congenital heart disease like my son was, there was a good chance you’d never be able to get health insurance because you had a pre-existing condition. You were born with a pre-existing condition. And if your parents didn’t have medical insurance, you might not live long enough to even get denied because of a pre-existing condition.

If your baby is going to die, and it doesn’t have to, it shouldn’t matter how much money you make. I think that’s something that, whether you’re a Republican or a Democrat or something else, we all agree on that, right?”
“This isn’t football,” Mr. Kimmel added. “There are no teams. We are the team, it’s the United States. Don’t let their partisan squabbles divide us on something every decent person wants.”

Kimmel began his monologue describing how incredibly, his baby boy was identified by a nurse to have a life-jeapordizing heart murmur during her routine assessment a few hours after his birth.

An example of excellence that those of us working in health care are trained to provide. This is set in motion daily in countless ways and in countless places. Without funding for education, opportunity for astute assessment and quick action diminish exponentially. We need to support continued funding to assure training so that all health care professionals function with full competency and capacity.

Kimmel also congratulated Congress on doing the right thing in not decreasing, but increasing funding for medical research for the National Institute of Health, rather than decreasing the funding by billions as President Trump proposed.

All is not fixed. There is much work to do. Cost of health care continues to increase, especially for those who have needed to use the benefits. Share your story. Contact your legislator. Keep the conversation going.



While Health Calls doesn’t have Administrative Assistants in the pure sense of the word, we have an awesome support team who register our patients, schedule visits, bill for our services, obtain insurance authorization for visits, provide payroll and human resource support to our staff and medical records management.

Danielle Yoder provides telecommunications and referral support part time. She is a full time Occupational Therapy student at Alvernia University. Ali Radwanski has worked at Health Calls since high school and is now Health Calls Human Resource Generalist and assures staff benefits and payroll operate smoothly along with referral management support. Donna Noray is one of Health Calls longest employed staff, working for Health Calls for over 10 years. Starting as a field employee, Donna now provides referral and admission support in addition to therapy scheduling. Michelle Sedlack also started in the field as a Certified Nurse Assistant and today coordinates the skilled nursing visit schedules. Diana Perkins has also worked for Health Calls since high school in a variety of capacities and today manages the insurance authorization process for the agency caseload. Kris Seabron provides medical record management and assures that we have the necessary documentation and current signed physician orders for patients we treat.

We count on our Administrative Support Team everyday and we are so fortunate to have them. They are key to smooth, efficient operations. Without them, we would be reduced to chaos.

“No one is more cherished in this world than someone who lightens the burden of another. Thank you.” — Joseph Addison

Thank you for all that you do everyday!

Advocating for family care: Speak up, prevent infections

It’s amazing, but hand washing of your loved ones hands is not top of mind when in the hospital! I saw this first hand during a recent 11 day hospital stay with a family member. Staff are very good at this point of consistently washing their own hands but forget about the patient. 

You have a right as a family advocate to speak up for best care. Prevent infections. Ask healthcare providers to clean their hands AND be sure your loved ones hands are clean too! 

This infographic from the Center for Disease Control offers great advice. #cleanhandscount

Depression: let’s talk.




Depression affects people of all ages, from all walks of life, in all countries. It causes mental anguish and impacts on people’s ability to carry out even the simplest everyday tasks, with sometimes devastating consequences for relationships with family and friends and the ability to earn a living. At worst, depression can lead to suicide, now the second leading cause of death among 15-29-year olds.

Each year, the World Health Organization (WHO) focuses on a universal health issue on World Health Day, which is observed around the world today. This year, WHO has chosen to focus on depression for World Health Day.

WHO reports that the cost of lost productivity in the workplace due to depression and anxiety is very high. For the United States, it is an estimated $1 trillion each year. WHO also estimates that $1 invested in treatment for depression and anxiety leads to a return of $4 in better health and ability to work, be productive, and lead better quality life.

Most people with depression and anxiety don’t seek treatment. Yet, depression can be prevented and treated. A better understanding of what depression is, and how it can be prevented and treated, will help reduce the stigma associated with the condition, and lead to more people seeking help.

Depression is an illness characterized by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities, for at least two weeks. In addition, people with depression normally have several of the following symptoms: a loss of energy; a change in appetite; sleeping more or less; anxiety; reduced concentration; indecisiveness; restlessness; feelings of worthlessness, guilt, or hopelessness; and thoughts of self-harm or suicide.


  • Depression can affect anyone, at any age, sex, or social status. Three groups of people are disproportionally affected: adolescents and young adults, women of childbearing age (particularly following childbirth), and older adults (over 60 years of age).
  • Depression is a common mental disorder that affects people of all ages, from all walks of life, in all countries.
  • The risk of becoming depressed is increased by poverty, unemployment, life events such as the death of a loved one or a relationship break-up, physical illness and problems caused by alcohol and drug use.
  • Depression causes mental anguish and can impact on people’s ability to carry out even the simplest everyday tasks, with sometimes devastating consequences for relationships with family and friends.
  • Untreated depression can prevent people from working and participating in family and community life. At worst, depression can lead to suicide.
  • Depression can be effectively prevented and treated. Treatment usually involves either a talking therapy or antidepressant medication or a combination of these.
  • Overcoming the stigma often associated with depression will lead to more people getting help.
  • Talking with people you trust can be a first step towards recovery from depression.


World Health Organization

Suicide Prevention 1-800-273-8255

World Health Day WHO

Depression and Mental Health Screening Tools

Anxiety and Depression Association of America Screening tool

WebMD Depression

VOA News