Giving Thanks and Giving Back
To celebrate the Thanksgiving holiday, the RVNAhealth team put together plentiful Thanksgiving baskets and took to the road, partnering with local community organizations to deliver meals to those in need. In addition to our basket tradition, RVNAhealth has a food pantry that supports our own patients who are short on supplies and food. Schools, civic organizations and individuals make contributions and host food drives to help us keep the shelves stocked. Interested in helping out? Learn more and get details on making a donation at rvnahealth.org/support-us/food-pantry/.
It’s a Beauty, but is it Safe?
According to the CDC, handling poultry (chicken and turkey) incorrectly and undercooking it are the most common problems that lead to foodborne disease outbreaks linked to poultry. These outbreaks increase every November and December due to improper food handling at holiday parties and dinners.
Follow these five tips to safely prepare your next holiday turkey meal:
- Thaw your turkey safely.
- In the refrigerator in a container, or
- In a leak-proof plastic bag in a sink of cold water (change the water every 30 minutes), or
- In the microwave, following manufacturer’s instructions
NEVER thaw your turkey by leaving it out on the counter. Bacteria can grow quickly if left out at room temperature for more than 2 hours. The danger zone for bacteria to grow is between 40 degrees F and 140 degrees F.
- Clean all surfaces that the turkey comes into contact with – including your hands! Raw poultry can contaminate anything it comes into contact with and the germs that cause food poisoning are stealthy — they can survive in many places and spread around your kitchen.
- Separate raw poultry from ready-to-eat foods by using different cutting boards, utensils and plates while preparing the meal, and by separating raw poultry from other foods in the refrigerator.
- Cook poultry to the right internal temperature. Place the turkey in a roasting pan that is at least 2″ to 2.5″ inches deep and set oven temperature to at least 325 degrees F. Cooking times will vary according to the weight of the turkey and whether it contains any stuffing. Use a food thermometer to be sure that the internal temperature of the turkey AND the stuffing is at least 165 degrees F. You cannot determine if a turkey is safely cooked by checking its color and texture. Check by inserting the food thermometer into the center of the stuffing and the thickest portions of the breast, thigh, wing joint. Even if your turkey has a pop-up thermometer, still use a meat thermometer to be absolutely certain that your turkey is safely cooked. Let the turkey stand for 20 minutes before removing the stuffing or carving the turkey so that it can finish cooking.
- Chill to the right temperature. Refrigerate leftovers as soon as possible and within 2 hours of preparation (within 1 hour of preparation if outside temperature is greater than 90 degrees) in order to prevent food poisoning. Slice or divide big cuts of meat into smaller quantities for refrigeration so they cool quickly. Reheat all leftovers to at least 165 degrees F.
Eat WELL!
Source: Centers for Disease Control and Prevention
Hospice Music Therapy Provides Comfort and Memories
Above: Tammy Strom, MA-MTBC, plays her guitar at RVNAhealth’s headquarters on Governor Street in Ridgefield.
When Tammy Strom, MA-MTBC, visits RVNAhealth hospice patients, she’s equipped with a distinctive set of clinical tools. A guitar. Piles and piles of sheet music and songbooks. And a variety of handheld musical instruments (think tambourines, shakers, bells and other fun accessories).
As our hospice music therapist, Tammy also brings healthy doses of compassion and positivity, alongside a dedication to helping patients experience the best possible quality of life in their final months, weeks and days.
“Many people have the misconception that working with hospice patients is somber,” she says. “But as a music therapist I get to see, and be a part of, a lot of life and creativity.”
Individualized Goals and Approaches
When hearing the term “music therapy,” you might think of listening to music performed by someone else. Or the opportunity for a patient and perhaps the family to play, sing or even write songs. The reality is that it depends – on what goals are appropriate for the patient and family.
Tammy shares how, in the case of a patient who had difficulty speaking, the simple act of slowing down a beloved song so she could sing brought “great joy” to both the patient and her family.
“If you’re with them for several months, as their condition progresses, it might be more about soothing with music that carries meaning,” she adds. She recalls this being the situation with a patient who was no longer alert, but the husband requested their wedding song from long ago.
“Musical interventions aren’t about being note-perfect, and it isn’t about teaching music,” explains Tammy. “It’s focused on providing comfort and memories. The goal might be to alleviate isolation; help a family connect with a patient who is unable to speak due to dementia; or distract from the patient’s physical discomfort or soothe the emotional pain the patient and family are experiencing.”
Music therapy can also be used as a restorative therapy in the bereavement process, especially with children mourning a loss.
The Science Behind Music Therapy
Hospice music therapy is administered by a credentialed professional who has completed an approved music therapy program and passed a national exam offered by the Certification Board for Music Therapists. In addition to being board certified in music therapy, Tammy holds a master’s degree in expressive therapies with a concentration in music therapy and mental health counseling. A lifelong musician, she has sung with the Ridgefield Chorale for two decades, and has performed with Troupers Light Chorale in the past.
“Music stimulates many parts of the brain – from auditory to motor to emotional – and it is often one of the last memories to remain intact,” she stresses. “Many studies have found that music therapy positively affects patients’ quality of life by addressing their spectrum of needs: Physical, psychological, emotional, spiritual, social and family support.”
Also, as she is fond of saying, in the words of Hans Christian Andersen: “Where words fail, music speaks.”
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Hospice is for Living
The following essay was written in 2019 by Keri Linardi, RN, BSN, PHN, CHPCA, Chief Clinical Officer of RVNAhealth. Keri is, has been, and always will be a hospice nurse — in addition to the other roles she assumes. Hospice care is part of Keri’s being, part of her heart and the key to how she approaches her life.
This month, November, is Hospice and Palliative Care Month. In her words below, Keri shares her perspective on how hospice has impacted her and her children’s lives, and what we can do this month to plan for our own futures.
Children raised in the home of a hospice nurse, like me, live in a world where death and dying, and ending suffering are talked about freely. During my years of night shifts, my young children would ask over breakfast, when I returned home, how many people had died last night, and we would talk about the beautiful deaths I was privileged to bear witness to.
Some of the stories were funny, like the husband who called me when his wife had passed in the middle of the night, only for me to discover, when I touched her and she sat up, that she was still very much with us. To the ones that touched too close to home, like the children near to my own children’s ages, so that when I went to the car after leaving their homes, I sobbed uncontrollably for what seemed like forever, for a life lost too soon and for families who would have holes in their hearts that would never be repaired, just healed with memories over time.
We are a country that has plans for everything from birth, to vacations, yet we don’t plan for our own mortality. Dying sneaks up on families and throws them into decision making in moments of crisis — a time when decisions should not be made!
Honoring Wishes Versus Making Decisions
Being a child of a hospice nurse is a double-edged sword: we never hang up the phone without saying ‘I love you;’ I have never sweated the small stuff with them, you want magenta hair?, it’s your head, go for it! The flip side is we talk about mortality – particularly my own — over family dinners. This bothers my children a little, now ages 22, 19 and 13, but I need them to understand in simple terms what my wishes are if anything were to happen to me, and I need them to know that they will not be making decisions but simply honoring my wishes, decisions I have already made. They also fully understand that dying is a natural part of living, the circle of life.
In times of crisis, these ‘already-had conversations’ can be the greatest gift you give your loved ones, the gift of them knowing exactly what you would want to do. The gift of them knowing that they are not making the decisions for you when you aren’t able, they are honoring you one last time by following your wishes.
As a hospice nurse, who has seen families grappling with decisions at critical times, this is a gift I would like everyone to give their loved ones.
But we aren’t there yet.
In this country we have disparities in care that interfere with individuals’ abilities to access hospice care when it is needed most. A study from Duke University in 2018 outlines that African Americans, 13.4% of the population, make up only 8% of hospice patients in America and are more likely to suffer from untreated pain; Hispanic patients, who represent 18.3% of the US population, make up 7% of hospice patients nationally. There are cultural barriers that interfere with their access to hospice care.
We need to work together to change this and to provide culturally competent care at the right time – and we need to dispel the many myths around hospice care.
The hospice Medicare benefit is a six-month – approximately 180 day — benefit of care that provides support from a whole team of professionals who wrap themselves around the patient and family to help them through one of the most challenging times of their lives. In my 26 years of nursing, I have never had a family tell me they came on to hospice too soon. I have had many families tell me, “If I had only known what hospice was, I would have called sooner.”
Care, Comfort and Treasured Moments for Patients and Families
Despite the 180-day benefit, the national average length of stay for hospice care in the country right now is 21.5 days; for the state of Connecticut it is 14 days. This means that as a state, we aren’t doing a very good job at acknowledging life-limiting conditions head on — in a direct, kind, caring manner. We are introducing hospice care too late in the process and we are denying patients and their families care, comfort and treasured time when they need it the most.
Often when hospice is offered as an option, it is presented in negative terms – “There isn’t anything more to do;” Do not resuscitate,” — when in fact there is a lot of living and a lot of joy that occurs in hospice.
When life-limiting conditions occur, we in hospice care talk about allowing natural deaths, managing symptoms, and living every day to its fullest. Imagine if you knew you only had six months left to live — would you do anything differently?
Hospice care has filled my cup these past 20 plus years in nursing. I am appreciative and grateful to the patients whose hands I have held; to those whose windows I have gazed out of, together enjoying their favorite hydrangeas; the families whose strength and grace I have marveled at as they cared for their loved ones through to the end. The kindness they have shown me as guests in their home.
I am amazed daily at the wonderful team of hospice people at RVNAhealth that come to work and give of themselves every day for our community and patients and families. And to you, our RVNAhealth hospice families. I am in awe of you and thank you for allowing us to be guests in your home and into your lives during this very private time. I honor you during this special month.
In closing, I would encourage anyone who has not yet started their Advanced Care Planning conversations to use this November as your springboard to make the move! Start the conversation about Advanced Care Planning, visit our hospice and palliative care team at RVNAhealth. Let us help you start the conversation during non-crisis times. We have educational handouts to guide you, as well as team members to speak with. Nobody has ever regretted the decision to plan in advance. On the contrary. It’s a gift to yourselves and your loved ones.
To learn more, contact 203-438-5555 or visit our Hospice Services page.
Read More Hospice & Palliative Care Month Articles
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How Spiritual Care Providers Help Hospice Patients and Their Families
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Brand New Day. Brand New …
Preparing for Joint Replacement Surgery
Let’s talk about that dreaded moment … when knee pain prevents you from getting into the car. Or your hips are so sore that putting on socks seems impossible.
If this sounds familiar, you’re in good company. By 2030, about 11 million Americans will have either a hip or knee replacement — making joint replacements one of our most common elective surgical procedures.
Being prepared in advance, and receiving the right care immediately following, is key to an excellent recovery, according to Crystal Madyda, PT, RVNAhealth Rehabilitation Services Team Lead.
“Patients used to spend days in the hospital, and then weeks in a short-term rehab facility,” Madyda says. “Now, most spend a maximum of two days in the hospital, followed by in-home therapy and then outpatient care. People tend to do better at home; hospitalization increases their risk of infection.”
Home Safety and Post-Surgery Therapy
RVNAhealth’s Motion Matters programs — designed for those getting joint replacements or other significant surgeries — include a home safety evaluation to ensure that your home is properly equipped for potential physical limitations and begin aftercare promptly after surgery (often within 24 hours of returning home).
Physicians rely on the home safety recommendations to determine if it’s safe for a patient to return home post-surgery, says Gigi Weiss, MSPT, director of RVNAhealth Rehabilitation Services.
Recommendations might include installing a shower chair, grab bar or elevated toilet seat in the bathroom. The therapist making the assessment will also note if a home has lots of stairs and the quality of handrails.
“We also look at factors including the height of your bed. Is it on the ground level. Do you have someone to help you?” she says.
“We want to keep you safe so that upon arrival home, recovery and recuperation can begin in earnest,” Weiss explains. “Within two weeks, eighty percent of our in-home therapy patients have recovered enough to begin outpatient therapy.”
To learn more, visit rvnahealth.org/services/get-well/rehabilitation-therapies.