In addition to the local Visiting Nurse Association (VNS) there are several outstanding companies that also provide these services. SelectCare and Fox Rehabilitation have worked together for several years with outstanding client results.

Fox Rehabilitation is a private practice of full-time physical, occupational, and speech therapists who provide Geriatric House Calls™. Fox was the first to deliver these services to the older population in their home under Medicare Part B, a model that permits providing the correct intensity and duration of care as indicated by need.

Providing house calls allows our patients to relearn in the perfect environment- their home. It is not a simulated environment as you would find in an out patient facility. It is the setting where they “live” on a daily basis. This also allows the therapists to assess for possible hazards as well as make home safety recommendations to reduce the risk of falls.

In addition, treatment sessions are tailored the patient’s personal goals. If the patient wants to be able to safely walk up their stairs to sleep in the bed they have used for 30+ years, the Physical and Occupational Therapist can formulate treatment sessions that progress them to their end goal.

Fox staff members believe in treating patients proactively. Staying well and strong is much easier than rehabilitating after an illness or injury. Here are some clues to look for when determining if the older person you love could benefit from physical or occupational therapy:

• Parts of the home look unused. If your parent is no longer venturing from room to room, and instead isolates himself / herself in one room, this may be a sign of limited mobility or fear of falling
• You find spoiled food in the refrigerator or pantry, which can be a sign of difficulty in the kitchen.
• You see a distinct change in driving skills. Take special notice of dents or scrapes on your loved one’s car, or changes in the way he or she drives.
• You observe that Mom / Dad is using furniture, walls, and door jambs for support.
• Your loved one is noticeably less active. This may be a sign that they are fearful of falling. Falls can be a strong indication of declining function and strength.

For more information about Physical, Occupational and Speech Therapy in the home please call SelectCare or log onto www.fox.rehab.org.

SelectCare Nursing and Administrative staff practice emergency procedures twice a year which includes staff communication, triaging patient care and coordinating services with community resources.  We put our plans into action this summer during the heat waves and in preparation for the hurricane season.

SelectCare trains and reviews emergency preparedness practices with home care staff members during orientation and through out the year with inservices, newsletters and on site visits.  We base our training on materials supplied by the Office of Emergency Management and the NY State Department of Health regulations.

To learn more about how you can prepare yourself, your family, your community, visit the NYC Office of Emergency Management website:

New York City Office of Emergency Management

This project was funded by grants from several foundations to Weill Cornell Medical College, a top ranked clinical and medical research center located in New York City. Rosemary Bakker, MS, ASID is on academic staff at Weill Cornell Medical College and is the Director of ThisCaringHome.org. All materials on ThisCaringHome’s website have been reviewed by select members of the Advisory Board, composed of a wide variety of professionals, including nurses, dementia specialists, physical and occupational therapists, safety experts, social workers, and recreational therapists.

Although anyone can suffer from heat related illness, some people are at greater risk such as those who are in the following categories:
Age 65 or older and/or have one or more of medical conditions including:

• Heart disease
• High blood pressure
• Psychiatric or cognitive disorders
• Diabetes Mellitus
• Respiratory conditions
• Obesity

Certain prescribed medications that can increase the risk of heat-related illnesses include:

• Tricyclic antidepressants
• Antipsychotic or neuroleptic medications
• Certain tranquilizers
• Some medications for Parkinson’s Disease
• Diuretics
• Beta blockers
• Calcium channel blockers
• Antihistamines

Helping People Prepare for Extreme Heat:

Air Conditioners

Encourage at-risk individuals to use their air conditioners during periods of extreme heat. Many people do not like to use air conditioners either to save money or because they do not like cold air. Suggest tips to conserve energy and keep the climate comfortable such as setting the temperature at 78 degrees or higher. Make sure the air conditioners are in good working order and insulate any spaces between the air conditioner and window to make sure there is a tight fit.

If an at-risk individual does not have an air conditioner, discuss options they may have during extreme heat periods. If they are able to relocate, suggest locations that have air conditioning including:

• Libraries
• Shopping Malls
• Cooling Centers (located by calling in NYC by calling 311 or visit www.nyc.gov/oem for more information)
• Senior Centers
• Friends or neighbors that have air conditioners

Fans

Be careful about relying on FANS. When the room temperature is in the high 90’s fans will not prevent heat- related illnesses because they just blow hot air around. Fans may be useful at night, to help circulate cooler air from open windows or when used in conjunction with air conditioning.

Shades

Shades, draperies or awnings should cover windows that receive morning or afternoon sun.

Remind at-risk individuals about the following general tips:

Outside Activities

• Limit strenuous activities during an extreme heat period
• Dress in loose-fitting, light weight clothing
• Wear a wide brimmed hat
• Use sunscreen of SPF 15 or higher
• Schedule outdoor activity during morning or evening hours when temperatures are cooler

Fluids

• Drink plenty of non-alcoholic and non-caffeine beverages
• Avoid overly sugary drinks (sports drinks)
• Avoid hot foods and heavy meals
• Try cool (not cold) showers for relief
• Consult your doctor if you are on a fluid restricted diet or have heart, kidney, liver diseases or have a problem with fluid retention.

Air Quality and Respiratory Illnesses

Be aware of air quality-related respiratory problems. High levels of air pollutants including high levels of ozone can occur during heat waves. Ozone can cause breathing problems, especially among those with respiratory conditions. If you have a respiratory illness, limit outdoor activity when ozone levels are high especially in the afternoon and early evening hours. Staying in an air conditioned environment reduces ozone exposure.

This information is not intended to provide medical advice. Always seek the advice from a health care provider.

For more tips on preventing heat-related illnesses, visit www.fema.gov/areyouready/heat.shtm or
www.bt.cdc.gov/disaster/extremeheat/heat_guide.asp

When going out:

Canes and Walkers: Check the bottom of canes for worn tips. Easy Fix: Local pharmacies sell rubber tips for canes and walkers that can easily replace worn, split or broken tips.

Safe Footwear: Check the bottom of shoes and boots for traction. Easy Fix: Wear rubber soled shoes to prevent slipping on wet, uneven sidewalks or residual ice. Make sure your shoes fit comfortably and your foot does not slip inside the shoe.

Use Small Pocketbooks: Carrying heavy or large pocketbooks may cause balance problems. Smaller pocket books that can be slung around the body leave hands free and creates better balance.

Wheelchairs: Check the wheels for wear and tear and make sure the brakes are in good working order. All rented wheel chairs have the name and phone number of the supply company. Supply companies will arrange to repair or replace the wheelchairs if needed.

In Your Home:

Replace batteries in all smoke and CO2 alarms.  Batteries should be replaced every 6 months. An easy way to remember to check the batteries is to perform this check on Daylight Savings Days in the Spring and Fall.  Prevent falls or accidents by asking building maintenance personnel to change the batteries using a safe ladder or step stool.  Check batteries in flashlights, and the expiration date on the batteries.

Check the expiration dates of canned foods in your cupboards that have been put aside for emergency provisions.

Keep pathways clutter-free to prevent trips, slips and falls:

• Make sure newspapers, magazines papers are off the floor
• Area rugs are taped or tacked down
• Electrical cords are not in areas where an elder can trip

SelectCare takes client and caregiver safety very seriously. Part of the RN Field Nurse Supervisor’s monthly visit is dedicated to evaluate the above safety issues and assist in resolving any safety issues that are identified. We encourage our clients and families to call us with any concerns regarding safety.