National Nutrition Month

Personalize Your Plate with National Nutrition Month® 2021

This year’s theme of “Personalize Your Plate” emphasizes the importance of understanding there is no ‘one-size-fits-all’ approach to nutrition and health. We are all unique and our approach to healthy living should be, too!

Creating healthy eating habits can be a daunting task, with an overwhelming amount of information thrown at us, the latest eating trends, and buzz-worthy ingredients. However, good nutrition really is all about having a well-rounded diet.

Nutrition Made Simple

Keeping in mind that we all have different nutrition goals which require different approaches, the CDC website provides the following four general tips for working towards a well-rounded diet:

  1. Add healthy fats, such as avocados, nuts, olives
  2. Reduce overall sodium intake – start by reading ingredient labels and recipes to find alternatives to sodium
  3. Increase fiber for digestion
  4. Aim for a variety of colors on your plate during every meal

Test Your Culinary Skills!

National Nutrition Month® is the perfect time to learn new and healthy recipes! With the internet at our fingertips, there are endless resources available to you. Most recipes include the nutrition information at the bottom that will help you to determine if the recipe meets your nutritional needs.

For those of us who just don’t know where to begin, there are meal kit services like ‘Hello Fresh’ and ‘Blue Apron’ that delivers recipes and the necessary ingredients to your home based on your nutritional preferences at a frequency of your choosing. These services can be a great starting point and helpful resource in a busy world where we don’t always have the time to dedicate to planning our meals.

If you are still lost on who to turn to for help, Registered Dietician Nutritionists can assist with developing a customized plan tailored to our unique bodies and nutritional needs.

So let’s use National Nutrition Month® as motivation to put our healthiest foot forward and strive for a well-rounded diet. And remember to Personalize Your Plate!

Impact of COVID-19 on Long Term Care Facilities

By: Patricia Hudak, RN and Chelsea Cassidy, LCSW

Dr. George J. Mehfoud, MD is a Primary Care Physician with Commonwealth Primary Care in Richmond, VA.  Dr. Mehfoud is an Internal Medicine Specialist with over 32 years of experience in the medical field.  He graduated from Eastern Virginia Medical School in 1989.  He believes knowledge is power and takes his time to educate the hospice team on best practices on quality of care on numerous topics.  Recently, he in-serviced hospice clinicians on the impact of COVID-19 in long term care facilities.

The geriatric population and residents of long-term care facilities were the hardest impacted and most vulnerable to COVID since the beginning of the pandemic.  In the beginning, lack of PPE, COVID testing, staff ratio, staff education, proper protocols, financial support, inadequate spacing (shared rooms/bathrooms or dining areas), worker fatigue and fear were all key factors in these facilities being at risk of infection and transmission.  Certified Nursing Assistant (CNAs) have been true pandemic heroes for their dedication on the front lines and financial sacrifice.  Many CNAs work multiple jobs to provide for their families and were forced to choose one job at a specific community for safety and transmission reasons.

Our state went through a period of lockdown to lower the curve of positive COVID-19 cases and needed time to develop and have access to adequate testing, PPE and educate as well as train on protocols for safety and providing care.

Once testing was readily available, facilities were then able to test residents and staff on a regular basis to have a more proactive approach to contain the spread.  Many of these facilities remain closed to the public.   Measures to prevent infection such as restricting visitors, wearing masks, symptom screening and adequate testing of both residents and healthcare personal continues to have a lasting effect on our elderly.   The result of these protective measures has led to social isolation which has caused residents to experience depression and anxiety, increase in dementia by 50% (according to the CDC), promotes Failure To Thrive (FTT) and hastens premature death.

Hospice historically has been centered around maximizing an individual’s quality of life.  Although this pandemic has created challenges for all healthcare providers, we as a hospice team have looked holistically at providing care in person and through a virtual lens for patients, families, and the communities we serve.  With the establishment of Medicare waivers for telehealth services our team can continue to provide the maximize support available.  Dr. Mehfoud outlined specific ways we can care for our patients during the pandemic:

  • Increasing social and spiritual interactions via in person and telehealth
  • Creating opportunities for residents to connect with their family through Zoom, Ring Central or FaceTime
  • Taking residents for a walk or wheelchair ride (when feasible)
  • Offering assistance with ADL care
  • Playing games, reading, and the power of holding someone’s hand

In the caring words of Abode Healthcare CEO, Mike McMaude, he has reminded our company that at our primary purpose is taking care of patients and taking care of each other.  When we do this – we can certainly come out of this pandemic hand in hand.

International Women’s Day

#ChoosetoChallenge

“A challenged world is an alert world. Individually, we are all responsible for our own thoughts and actions – all day, every day. We can all choose to challenge and call out gender bias and inequality. We can all choose to seek out and celebrate women’s achievements. Collectively, we can all help create an inclusive world.” -Unknown

International Women’s Day (IWD) is reserved to recognize the social, economic, cultural, and political achievements of women, as well as to raise awareness about women’s equality, lobby for accelerated gender parity, and fundraise for female-focused charities. Although we are only beginning the third month of 2021, it has already been a big year for women. The Business Insider has compiled a list of the most powerful women in 2021. Just to name a few…

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Kamala Harris  was sworn in as the first woman, black, and South Asian Vice President of the United States on January 20th, 2021. “While I may be the first woman in this office, I will not be the last, because every little girl watching tonight sees that this is a country full of possibilities.” – during her VP-acceptance speech in Nov. 2020
Kathrin Jansen is the head of vaccine research and development at Pfizer. Beginning in March 2020, she led a team of 650 experts to develop a successful vaccine against COVID-19.
Sheryl Sandberg is the current Chief Operating Officer of Facebook. Under her administration, Facebook managed to recover $22.1 billion in profits in 2018 after having suffered a $56 million loss previously. She became the first female member of the company’s board of directors in 2012, and in 2014, made the Forbes’ Billionaires list due to her vesting stake in Facebook.
Shonda Rhimes is an award-winning television writer and producer. She created the ABC drama ‘Grey’s Anatomy’, which currently is the longest-running medical drama on television, in addition to several other very popular shows. She is an activist and co-founder of the ‘Times Up’ movement, seeking to promote gender equality in the television and film industry, as well as to lobby for legislation that would penalize companies that tolerate sexual or gender-based harassment.

And Everyday Heroes

These are only a handful of the many incredible women changing the world each and every day. Please find time today to reflect and recognize the everyday heroes that make achievements and contributions to make a world a better place for everyone!

Learn more about International Women’s Day and the 2021 theme ‘Choose to Challenge!’ & view Business Insider’s full list of the most powerful women in 2021.

Protecting Your Heart

By: Patricia Hudak, RN and Chelsea Cassidy, LCSW

History of American Heart Month

It’s February – American Heart Month – a time when the nation spotlights heart disease, the number one killer of Americans. President Lyndon B. Johnson, among the millions of people in the country who have had a heart attack, issued the first proclamation in 1964.

Throughout the month, the American Heart Association’s “Heart to Heart: Why Losing One Woman Is Too Many” campaign will raise awareness about how one in three women are diagnosed with heart disease annually. The first Friday of American Heart Month, Feb. 5, is also National Wear Red Day as part of the AHA’s Go Red for Women initiative. This campaign recognizes that the risk factors of this silent killer can be vastly different in women than in men. Knowing and understanding your risk factors, whether male or female can literally save your life.  We encourage you to talk to a health professional about risk factors and prevention.

Traditional risk factors common to both women and men:

  • Obesity
  • Smoking
  • Diabetes
  • High blood pressure
  • Family history
  • High levels of C-reactive protein (a sign of inflammatory disease that can occur along with other cardiovascular risk factors)
  • Metabolic syndrome(the co-existence of high blood pressure, obesity, and high glucose and triglyceride levels)

Risk Factors Specific to Women:

  • Relatively high testosterone levels prior to menopause
  • Increasing hypertension during menopause
  • Autoimmune diseases such as rheumatoid arthritis(more common in women than in men)
  • Stress and depression (also more common among women)
  • Low risk factor awareness (lack of recognition of many of the above conditions as risk factors for heart disease is a risk factor in itself)

Since COVID-19 pandemic struck our world, people have been engaging in less than healthy activities while in lockdown. These activities may include overindulgence in food and beverage, isolating, lack of routine, and less than average movement can and do increase a person’s risk factors. The heart is an organ that acts like a muscle. The more you work a muscle the stronger and more supportive that muscle becomes even to the surrounding tissue. Everything in our bodies needs oxygen to function properly. COVID-19 has now become an added risk factor- for males and females. Atrial Fibrillation is a known heart related effect of COVID-19 in some patients as well as long term respiratory problems.

Pictured above is Anna Laughlin.  Anna is married to Dr. Jeff Laughlin, Pediatric Dentist (Virginia Family Dentistry) and they have three children, Charlie (15), Garnes (11) and Helena (8) and they live in Richmond, Virginia.  Anna is an educator and founder of Mission Equip, a non-profit organization focusing on the professional development of teachers and doctors in their Teacher to Teacher and Doctor to Doctor program.

Anna was unfortunately diagnosed with COVID-19 in March 2020 when our country was first digesting the news of coronavirus and the sudden impact it was having on our lives.  Anna recalls developing her first symptom on March 21, 2020 of chest pain.  She had run five miles that day and was unsure if the chest pain was related to her physical activity.  Her symptoms continued and five days later she was tested for COVID-19.  Nine days later her primary care doctor and the Virginia Health Department contacted her by phone to notify her that she was positive for COVID-19. During this time, she had mild to moderate symptoms that continued to improve 10 days following the diagnosis. However, on the 11th day, she experienced a steep decline. She had ongoing chest pain, breathing difficulty, and was fearful to go to sleep at night not knowing what could come next.  She felt the need to go to the emergency room several times though she was advised to only go to the hospital if she could not finish verbalizing a sentence.  She had feelings of fear and frustration throughout the process.

Anna voiced she felt “beyond alone” throughout this process. She was often asked “how did you get COVID?”  Her guess was as good as anyone’s and this type of question lead her to feelings of guilt and embarrassment.  She was one of the first to be diagnosed in Richmond even though she followed all the regulations to protect herself and her family.

Our polarized political climate in 2020 increased her feelings of despair.  There was misinformation given from a wide variety of sources causing our nation to have strong divisive opinions on COVID-19 and how to respond.  Our whole world has been in isolation which limits our support system in the ways we can be cared for.  One of the lessons she and her family have learned throughout this experience is how to respond to those suffering – she states the best response to someone experiencing a hardship is to say  “I am so sorry you are going through this.”  This statement gives acknowledgment, empathy, and validation of the person’s experience.  Her children are now implementing this into their conversations which will enhance their ability to connect and support others.  The best gift we can offer those in a crisis is no judgment.

Anna was one of the first people seen at VCU hospital cardiac and pulmonary clinic to be considered a “long hauler” which is now medically termed “long COVID”. Her COVID-19 symptoms lingered well into the summer and the most concerning physical symptom has been heart palpitations.  At first, she was unsure what was happening and labeled the symptom as anxiety, however she noticed that after experiencing the heart palpitation she would have a cough.  She had times that she could barely walk upstairs without being fatigued and sometimes even collapsed.

Anna spent time researching medical journals to best guide her.  One of the hardest realizations she has had to come to terms with is that each day is like a grab bag full of COVID-19 symptoms – you never know what symptoms you will get.

In September, Anna’s condition deteriorated, and her A-Fib episodes were increased from every two weeks to every 2-3 days. She reports that the most severe episode led to her to falling on the stairs and passing out in front of her young children. After consulting a Cardiologist at VCU Health she was admitted to the hospital for testing and what is considering ‘drug loading’.  She was unable to tolerate the medications, was discharged home, and was scheduled for a heart ablation procedure several weeks following. She is now three weeks post procedure and showing gradual signs of improvement of A-Fib.  The goal is for her A-Fib to be managed so she can focus on her ongoing healing and return to a healthy lifestyle to include participating in Yoga Therapy.

Healing Your Heart

This month is a reminder to evaluate your own heart health, and those we love.  Look at how we can make better choices to reduce and improve the risk factors that are within our control.  Practice relying on our health professionals, being honest if you are experiencing unusual symptoms such as shortness of breath, chest pain, indigestion, arm pain, and confusion.  These could be symptoms you may have not responded to in the past, however, please use these warnings signs to take care of you – and your heart.

COVID-19 has not only impacted our lives – it has also deeply affected our bodies.  Our bodies may be experiencing many forms of grief all at the same time.  Loss of jobs, income, people, lifestyle, homes, freedom, independence, and travel are just to name a few.  This can make the grieving process complicated and messy.  When grieving, people often refer to having a “broken heart” or feeling “heartbroken”.  Grief is a feeling and mourning is the action of grief.  These feelings can be intense at times and have significant impacts on our bodies – particularly, our hearts.

For example, high blood pressure, chest pain, heart palpitations, irregular heartbeat and/or heart attacks can be associated with the stress of grief on the cardiovascular system.  This condition is more clinically referred to as Takotsubo Syndrome (Psychology Today).  It is important for a person in the grieving process to be mindful of their body and assess how they are feeling, emotionally, physically, and spiritually.  Your body may feel torn apart and it needs extra attention and care.   When the body is under stress, it is more vulnerable to physical problems or chronic conditions could be exacerbated due to the emotional trauma you are experiencing.  During the grieving process, it would be good practice to notify your primary care physician of your recent loss.  Your physician may recommend scheduling an appointment to offer support and further asses your health.  When a patient under hospice services has a significant loss in their lives, the hospice team offers to increase their visits, makes a referral to the bereavement coordinator, and notifies the medical director.  This extra layer of communication and support is to help the patient have safe and healthy outlets to express their grief and monitor their health.  The medical director understands the impact of grief and that it can have a significant impact on the patient’s health. (Center for Loss and Life Transition)

Now that we have discussed the history and significance of heart health, as well as, the impacts grief can have on our body, let’s review good and nurturing tips on how to care for our heart:

  • Eat a heart-healthy diet: vegetables, fruit whole grains, fish, nuts (limit sodium, saturated fat, and added sugar)
  • Get active: 150 minutes of moderate intensity per week
  • Control your blood sugar: Aim for fasting blood glucose less than 100 mg/dL
  • Monitor your cholesterol: Strive for a total cholesterol less than 200 mg/dL
  • Maintain a healthy weight: Target a body mass index (BMI) of less than 25
  • Monitor your blood pressure: Keep your numbers below 120/80mm Hg
  • Live a smoke free life
  • Drink green tea
  • 30 minutes per day of meditation and practice deep breathing

We want to sincerely thank Anna for her open discussion and vulnerability walking us through her COVID experience.  Our hope and prayers are to watch her make a full recovery.