Nursing homes simply were not ready - Are we prepared to make them better?

Last week the Chicago Tribune reported 286 at nursing homes estimating 25% of our deaths in Illinois at the time. In the general population today it is an estimated 200,000 people worldwide. Considering our interventions out of 8 or 9 billion people those numbers are low compared to what it could've been.

 In the city of Joliet where I live, Symphony had 84 cases, and 24 deaths reported to lead the state. The caregivers at Symphony stated that they had the highest rate of testing in the state. They claim every nursing home needs testing to see what is going on. 

 The New York Times reported from the article 6,900 COVID 19 deaths were tied to nursing homes nationwide. About 20% of all the COVID 19 deaths reported. The State of Illinois has about 23% of those who died of COVID 19. The variance of numbers could be related to the testing done in the state compared to the national average. but a ballpark figure is relatively the same throughout the states. Any state with a higher population is going to have greater numbers. 

 Nursing homes provide a service in our country but they exist to be the lowest cost possible. The cost to the people in the nursing home usually dries up their life savings. If they live longer then projected their resources are less. Caregivers they use don't match the qualifications found in hospitals. Training and in-services do not match the same levels as hospitals. What are our expectations? We have the neediest with fewer resources. What did we expect as an outcome? I know our hospitals weren't ready and I know our nursing homes came into the virus war already stressed, overworked, and undertrained. 

 A reality check as we age our ability to fight diseases lessen. For many people who are older and healthy, 80-90’s it is the flu or other viruses that lead to pneumonia and death. A new virus-like COVID 19 which is a very contagious will, hit heavily in elderly care. 

What can we do?

• All of our retirement plans must invest in nursing home care. 
• We have to encourage qualifications with an incentive for education. I always knew to improve job performance as para pros in education, (they are good people) but to improve work there have to be incentives for education and qualifications. Many para pros in healthcare are there as aids. They are needed, but they need to be educated in qualified as professionals in their work. Nursing homes depend a lot on LPN’s. Their training is about a year unless it's been updated. But they need incentives for education for example level one two and three. Each with training to go with it. Their license may require education units to stay licensed. But these incentives have to be matched with pay. Not a lot of people are going to do this for nothing.
• Maybe it is time for nursing homes to employ physician assistants.
• Nursing homes can develop a mobile virtual assessment cart. Here the Dr. can see the patient and have the necessary vital signs the doctors looking for to help evaluate care. Working with the doctor's assistants, RNs, and staff. Puts the elderly patient in quarantine or even regularly in better contact with the physician. 
• We have on a personal level to expect as we get older will have more health issues. We are not all going to be working on a beach in the Caribbean. 
• I think about veterans in VA homes, many older people in nursing homes are lonely and forgotten. In what I hope is a historical event, not a regular one, we need to prepare virtual visits that we give regularly to the ones we love. Life isn't perfect but there's a lot of things we can do.

Desk top reminders this winter - goal to help aerobic capacity by 12%

With the use of sticky notes I can record my daily progress. My winter goal is to improve my overall aerobic fitness. Somethings I am already doing.
The fatman exercises, adapted body weight movements: pushups, dips, squats, lunges, heal raises, sit-ups; Hitt recumbent biking 20-45 minutes 3x's a week resistant band workouts 2, 3 times a week.
Adding on off bike days stair work 4 minutes and 4 minute run in place; 10 minute walk - Leslie Sansone, outdoor walk w poles or without. I will be adding knee pads. I know outdoor walking has risks; but I can't give up yet.
Stair workouts and running in place I may add time as with the walking. My immediate goal of 6 to 10 weeks is to improve my aerobic capacity by 12%. These activities can be done around my time of the computer.
All of this stuff has my doctor's consent, both GP and cardiologist. Alternating days biking with walking on stairs gives my knees is a chance to recover. I may find walking in stair work may have to be twice a week and go from there.
Right now biking and strength training works for me. My 10 minute walks right now are three and four minutes at a time. During the day I think many brief walks 30 seconds to a minute. My goal of a 10 minute walk is for practical applications.
I take time to give you a little detail because there are a lot of people who are sedimentary and need to think through how to get moving again. There are also people who are recovering and there are a lot of ways to get back on your feet.
What I am doing is based on my problems with cerebral palsy and mobility problems. Being overweight doesn't help. Taking psychotropic medicine that puts on weight doesn't help either. I have recently taken steps on that front as well. While I take the initiative for these changes it is based on health plans by my doctors and not self medicating.
In the picture are the Lockhorns, like Leroy I hate the scale at the doctor's office. (reality check) DBarb in contrast does not nag. But for many of us we are heavier than we need to be. All of the stickies remind me to move and eat smarter. Keep walking

My take on being Cooperized - What's that?

In living we face our three enemies of cardiovascular, cancer, and diabetes. These three diseases touch all of us no matter what age we are. Cooper from the Cooper aerobics Center has set up a health program he calls get Cooperized. In this months newsletter there are articles of interest for you.

https://forms.cooperaerobics.com/acton/fs/blocks/showLandingPage/a/2187/p/p-0155/t/page/fm/0

One article can give you the edge against diabetes if you get Cooprize. Seven of the steps everybody agrees with. There are different opinions about supplements but I think you're good to follow your doctors advice for your own personal plan of health. Each one of these steps can be a game changer with diabetes. Here is my take on the steps:

1. Get to a healthy weight. Personally I've been reading less health articles and I allow myself one day a week where I follow my sources to new information. I've been putting more my attention to quit eating insanely. Also I've been looking for opportunities throughout my day to move more an exercise. Mentally I've been focusing on my writing and ministry to Liberia.

2. Make healthy food choices most of the time. This is such a good point that's easy to forget. Life isn't perfect and if you have a weight problem being less-than-perfect can really mess with your head. Lately I have had more success looking at my crazy behavior and eating in being more mindful. I know how to eat right, but I also I'm very capable of doing the craziest things, like binge eating or eating large amounts of food in less than a minute. It's unbelievable.

Adaptive push up

3. Exercise most days of the week. 30 minutes of walking can really help someone with type II diabetes. A couple days a week I do a TRX program and resistance bands. Every day I do 2 or 3 sets of modified push-ups, situps, squats, Heel raises, dips and lunges. I call them my fat man exercises. 

4. Take the right supplements for you. Ask your doctor about supplements and which ones might fit you better. Most of these benefits can be obtained with healthy food. But there maybe things that help you and that's the bottom-line.

5. Do not use tobacco. If you have a death wish there is nothing better that you can do but smoke three packs a day of Lucky Strikes. For most people death comes a little earlier. But you have to be prepared to live a while and you can't breathe. You could be very likely have your mouth or jaw, or tongue, Voice box ripped out of your body. Maybe you'll be lucky to have hardened arteries due to smoking for a instant death of heart attack. But then you could be one of the few who lives into their 80s connected to an oxygen tank this cigarette in the hole of your neck. With tobacco you never know but there is no support whatsoever that it doesn't hurt your health. Do you feel lucky, well do you?

6. Control alcohol. If you drink 2 or less drinks a day alcohol may have some benefits. There are no benefits to your health with three or more drinks a day. Even a little alcohol that could help the heart may be an increasing your chances for certain cancers and diabetes. When you look at the big picture we have every reason to get control of our drinking.

7. Manage your stress. Stress kills and is a factor with the big three things that kill us. Stress can put us into a cycle where we quit doing the things that help us and increase the chances that we may lose in heart disease, cancer, and diabetes. Learn about the stress in your life and find ways to deal with it. I am a big fan that everybody should have a mental health professional on their medical team. Much of the way that exercise helps against the pain of arthritis and dependence on painkillers; learning how to deal with stress reduces the need for any kind of medication.

8. Get a regular, comprehensive physical exam. By the time you get to be 40 you need to develop a health team starting with a good GP. Never sit and stew with worry about what is going on your body. Please get over your fear and see your doctor. Being on top of your problems is a life saver. I get it, I have no idea when I will pass away. But getting check ups gives you a better chance to live a little longer and even a little better. Keep walking

The things I have learned being a professional patient...

Here I think is a good cartoon they have in every hospital room. My family will laugh at this because they side with the nurse, my wife.
In the past, hospital rooms we're actually wards. In the ward there would be ten to a hundred people in all different states of health. It had to be similar to experience I had in many intensive care waiting rooms.
I remember being in Children's Memorial Hospital intensive care unit where children miraculously survived or died every day. Our grandchild lived through several life or death emergencies. They finally found the rare disorder and fixed it. He lived. But children were not so lucky. In the waiting room was like living in war. I couldn't wait to leave.
Our feisty patient in the cartoon is very aware of obvious suffering. I have been there. When I have looked closer at the people the nurse was treating, I became aware that there were others indeed more sick then I. I then was also the patient another time who was so sick I was barely conscious.
All this experience doesn't necessarily change how much I've groan to Barb, which is why my family is still laughing. But the perspective we have is important both to the nurse and the complaining patient. The professional has seen it all, and yet they have to pay attention to the personal experience of the patient who may be at a low point and not at their best.
Overall my experiences I am very thankful for the caregivers. It is usually later at night when nobody's around that I come to my senses about the wonderful the care Barb gives me. Why I am such a baby with her is amazing. I guess it's why I found the cartoon funny. Keep walking