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Cognitive Health and Older Adults

June 17, 2024

Cognitive health is the ability to think, learn, and remember clearly. It is needed to carry out many everyday activities effectively. Cognitive health is just one aspect of overall brain health.

Many factors contribute to cognitive health. Genetic, environmental, and lifestyle factors may contribute to a decline in thinking skills and the ability to perform everyday tasks, such as driving, paying bills, taking medicine, and cooking. Although genetic factors can’t be controlled, many environmental and lifestyle factors can be changed or managed.

Scientific research suggests that there are steps you can take to reduce your risk of cognitive decline and help maintain your cognitive health. These small changes can add up: Making them part of your routine can support your brain function now and in the future.

What is brain health?

Brain health refers to how well a person’s brain functions across several areas. Aspects of brain health inclide:

  • Cognitive health – how well you think, learn, and remember
    • Motor function – how well you make and control movements, including balance
    • Emotional function – how well you interpret and respond to emotions (both pleasant and unpleasant)
    • Tactical function – how well you feel and respond to sensations of touch, including pressure, pain, and temperature
    • Sensory function – how well you see, hear, taste, and detect odors

Brain health can be affected by age-related changes in the brain, injuries such as stroke or traumatic brain injury; mood disorders such as depression, substance use disorder, or addiction; and diseases such as Alzheimer’s and related dementias.

Take care of your physical health

Taking care of your physical health may also help your cognitive health. You can:

Manage high blood pressure

Preventing or controlling high blood pressure not only helps your heart but can also help your brain. Decades of observational studies have shown that having high blood pressure in midlife — from the 40s to the early 60s — increases the risk of cognitive decline later in life. Further, in the large SPRINT MIND study, researchers found that people age 50 and older who lowered their systolic blood pressure to less than 120 mmHg reduced their risk of developing mild cognitive impairment, which is often a precursor to dementia, over five years of treatment.

High blood pressure often does not cause signs of illness that you can see or feel. Annual screenings at your doctor’s office can help determine if your blood pressure is elevated, even though you might feel fine. To control or lower high blood pressure, your doctor may suggest exercise; changes in your diet; and, if needed, medication.

Eat healthy foods

Many studies suggest that a healthy diet can help reduce the risk of many chronic diseases such as heart disease or diabetes.  

In general, a healthy, balanced diet consists of fruits and vegetables; whole grains; lean meats, fish, and poultry; and low-fat or nonfat dairy products. You should also limit solid fats, sugar, and salt. Be sure to control portion sizes and drink enough water and other fluids.

There is also mixed evidence that certain diets can help keep your brain healthy, preserve cognitive function, or reduce the risk of Alzheimer’s. For example, some observational studies reported that people who eat a Mediterranean diet have a lower risk of developing dementia. Another diet, called MIND, is a combination of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. The MIND diet has also been associated with a reduced risk of Alzheimer’s and a slower rate of cognitive decline in some studies. Still, despite these promising findings, results are not conclusive. For example, a recent clinical trial found that participants who followed the MIND diet had only small improvements in cognition that were similar to those who followed a control diet with mild caloric restriction.

Researchers continue to study these diets as well as individual foods and dietary supplements to learn more about possible effects on cognitive health.

At this time, no vitamin or supplement is recommended for preventing Alzheimer’s or other forms of cognitive decline. However, recent clinical trials have shown that taking a daily multivitamin may improve memory and cognition in older adults.

Learn more about diet and prevention of Alzheimer’s.

Be physically active

Being physically active — through regular exercise, household chores, or other activities — has many benefits. Physical activities can help you:

  • Maintain and improve your strength
  • Have more energy
  • Improve your balance
  • Prevent or delay heart disease, diabetes, and other disorders
  • Improve your mood and reduce depression

Several studies have supported a connection between physical activity and brain health. For example, one study found that higher levels of a protein that boosts brain health were present in both mice and humans who were more physically active than in sedentary peers. An observational study with cognitively normal, late-middle age participants found that more time spent doing moderate levels of physical activity was associated with a greater increase in brain glucose metabolism — how quickly the brain turns glucose into fuel — which may reduce the risk for developing Alzheimer’s. And a randomized controlled trial showed that exercise can increase the size of a brain structure important to memory and learning, resulting in better spatial memory. Although these results are encouraging, more research is needed to determine what role exercise may play in preventing cognitive decline.

Federal guidelines recommend that all adults get at least 150 minutes (2.5 hours) of physical activity each week. Walking is a good start. You can also join programs that teach you to move more safely and help prevent falls. This is important because falling can lead to serious injury, including injuries to the brain. Check with your health care provider if you are not currently active but want to start a vigorous exercise program.

Keep your mind engaged

Cognitive training, which is designed to improve specific cognitive skills, appears to have benefits for maintaining cognitive health in older adults. A large randomized, controlled trial called the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial tested the effects of cognitive training — specifically memory, reasoning, or speed of processing — on cognitive abilities and everyday function over 10 years. The study found that participants who had training in reasoning and speed of processing experienced less decline than those in the memory and control groups. Building on the ACTIVE study, NIA is supporting a large clinical trial to assess whether speed of processing training can reduce incidence of cognitive impairment and dementia.

Beware of claims that playing certain computer and online games can improve your memory and thinking. There currently is not enough evidence available to suggest that commercially available computer-based brain-training applications have the same impact on cognitive abilities as the ACTIVE study training.

Staying engaged in other meaningful activities as you grow older may also have important cognitive benefits. For example, one study found that older adults who learned quilting or digital photography had more memory improvement than those who only socialized or did less cognitively demanding activities. Research on engagement in activities such as music, theater, dance, and creative writing has shown promise for improving quality of life and well-being, from better memory and self-esteem to reduced stress and increased social interaction, but more research is needed in these areas.

Overall, it’s important to know that evidence for a lasting beneficial cognitive effect of these types of activities is not definitive. NIA supports expanding studies in this area to include larger numbers of a diverse range of older adults in order to further test how such activities may help reduce cognitive decline or maintain healthy cognition.

Stay connected with social activities

Staying connected with your family, friends, and neighbors through social activities and community programs is a great way to ward off isolation and loneliness. But did you know it may also help support your cognitive function? For example, early results from a clinical trial of almost 200 adults age 75 and older — the Conversational Engagement Randomized Controlled Clinical Trial (I-CONECT) — showed that regular internet calls could help lower the risk of cognitive decline and social isolation. Another example comes from the Health and Retirement Study, a long-term study funded by NIA. Researchers analyzed data from more than 7,000 participants age 65 and older and found that high social engagement, including visiting with neighbors and doing volunteer work, was associated with better cognitive health in later life.

If you would like to strengthen your social connections, consider volunteering for a local organization or joining a group focused on an activity you enjoy, such as walking. You can find available programs through your Area Agency on Aging, senior center, public library, or other community organizations. Increasingly, there are groups that meet online, providing a way to connect from home with others who share your interests or to get support.

Address physical and mental health problems

Many health conditions affect the brain and pose risks to cognitive function. These conditions include:

  • Stroke — can damage blood vessels in the brain and increase risk for vascular dementia.
  • Depression — can lead to confusion or attention problems and has been linked to dementia.
  • Delirium — shows up as a sudden state of confusion, often during a hospital stay, and is frequently followed by cognitive decline or impairment.

If you have symptoms of any of these serious health problems, it is important to seek treatment. Effective management of health conditions like these may help prevent or delay cognitive decline or thinking problems.

Understand how medicines can affect the brain

Some medicines and combinations of medicines can cause confusion, memory loss, hallucinations, and delusions in older adults.

Medicines can also interact with food, dietary supplements, alcohol, and other substances. Some of these interactions can affect how your brain functions. Drugs that can impair older adults’ cognition include:

  • Antihistamines for allergy relief
  • Sleep aids
  • Antipsychotics
  • Muscle relaxants
  • Drugs that treat urinary incontinence
  • Medications for relief of cramps in the stomach, intestines, and bladder

Talk with your doctor if you have any concerns about your medications or possible side effects. Do not stop taking any prescribed medications without consulting your health care provider first.

To learn more, please visit https://www.nia.nih.gov/health/brain-health/cognitive-health-and-older-adults.

Memory, Forgetfulness, and Aging: What’s Normal and What’s Not?

June 10, 2024

Older adults may worry about their memory and other thinking abilities, such as taking longer to learn something new. These changes are usually signs of mild forgetfulness — or age-related forgetfulness — and are often a normal part of aging.

However, more serious memory problems could be due to mild cognitive impairmentdementia such as Alzheimer’s disease, or other factors beyond normal aging.

MEMORY CHANGES WITH AGE

As people grow older, changes occur in all parts of the body, including the brain. As a result, some people notice that they don’t remember information as well as they once did and aren’t able to recall it as quickly. They may also occasionally misplace things or forget to pay a bill. These usually are signs of mild forgetfulness, not a serious memory problem.

It’s normal to forget things once in a while at any age, but serious memory problems make it hard to do everyday things such as driving, using the phone, and finding the way home.

Signs that it might be time to talk with a doctor include:

  • Asking the same questions over and over again
  • Getting lost in places you used to know well
  • Having trouble following recipes or directions
  • Becoming more confused about time, people, and places
  • Not taking care of yourself — eating poorly, not bathing, or behaving unsafely

Talk with a doctor if you are experiencing noticeable changes in your memory. A doctor can perform tests and assessments to help determine the source of memory problems. Your health care provider may also recommend that you see a neurologist, a doctor who specializes in treating diseases of the brain and nervous system.

You may also wish to talk with your doctor about opportunities to participate in research on cognitive health and aging.

TIPS FOR DEALING WITH FORGETFULNESS

There are a variety of techniques that may help you stay healthy and deal better with changes in memory and mental skills. Here are some tips:

  • Learn a new skill.
  • Follow a daily routine.
  • Plan tasks, make to-do lists, and use memory tools such as calendars and notes.
  • Put your wallet or purse, keys, phone, and glasses in the same place each day.
  • Stay involved in activities that can help both the mind and body.
  • Volunteer in your community, at a school, or at your place of worship.
  • Spend time with friends and family.
  • Get enough sleep, generally seven to eight hours each night.
  • Exercise and eat well.
  • Prevent or control high blood pressure.
  • Avoid or limit alcohol.
  • Get help if you feel depressed for weeks at a time.
  • Mild cognitive impairment
  • Some older adults have a condition called mild cognitive impairment — MCI — meaning they have more memory or thinking problems than other people their age. People with MCI can usually take care of themselves and are able to carry out their day-to-day tasks. MCI may be an early sign of Alzheimer’s disease, but not everyone with MCI will develop Alzheimer’s.
  • If you’re experiencing changes in your memory or think you may have MCI, talk with your doctor. Learn more about the symptoms of MCI.
  • Dementia versus age-related forgetfulness
  • Forgetfulness can be a normal part of aging. However, dementia is not a normal part of aging. Dementia includes the loss of cognitive functioning — thinking, remembering, learning, and reasoning — and behavioral abilities to the extent that it interferes with a person’s quality of life and activities. Memory loss, though common, is not the only sign of dementia. People with dementia may also have problems with language skills, visual perception, or paying attention. Some people experience personality changes.
  • There are different types of dementia, including Alzheimer’s diseaseLewy body dementiafrontotemporal dementia, and vascular dementia, and symptoms may vary from person to person. The chart below compares some differences between normal aging and the signs of dementia.

WHAT ELSE CAN AFFECT MEMORY?

It’s possible for memory problems to stem from factors unrelated to dementia or normal aging. For example, medical conditions, such as depression or blood clots, can cause memory problems. These problems usually go away once the condition is successfully treated.

Factors that may cause memory problems include:

Major, traumatic, or stressful life events can also cause memory problems. For example, someone who has recently retired or who is coping with the death of a spouse may feel sad, lonely, worried, or bored. Stress and negative emotions are powerful. Trying to deal with such life changes and emotions leaves some people confused or forgetful.

These memory problems from negative emotions are usually temporary and will improve as the stress and emotions fade. Being active, socially engaged, and experiencing a sense of accomplishment by learning new skills can help with both memory and improving mood. If memory problems persist after a few weeks, talk with your doctor as this may be a sign of something more serious.

Finding the cause of memory problems is important for determining the best course of action. Once the cause is diagnosed, you and your doctor can determine the best treatment plan. People with memory problems should make a follow-up appointment to check their memory every six to 12 months.

To learn more, please visit https://www.nia.nih.gov/health/memory-loss-and-forgetfulness/memory-problems-forgetfulness-and-aging.

Alzheimer’s and Brain Awareness Month 2024

June 3, 2024

In recognition of Alzheimer’s & Brain Awareness Month in June, NIA is raising awareness about Alzheimer’s disease among the Latino community including Latinos living with dementia, their caregivers, and their families. Throughout the month we will share information, research, and resources on dementia, caregiving, and clinical trials in English and Spanish using the #NIAAlzheimers hashtag. Each week will focus on a different topic related to Alzheimer’s:

  • June 3-7: Learn about the basics of Alzheimer’s disease and risk in the Latino community
  • June 10-14: Explore Alzheimer’s causes and tips for reducing risk
  • June 17-21: Find resources for caregivers
  • June 24-28: Get the facts on clinical trials

How To Participate?

Everyone can play a role in promoting dementia resources. Consider taking the following actions:

  • Help spread the word by sharing NIA’s X and Facebook posts and follow NIA on X and Facebook.
  • Use the #NIAAlzheimers hashtag to follow along and share your own resources.
  • Share NIA’s infographics and videos or use one of the following sample posts:
    • Join @NIHAging throughout June for a conversation on #Alzheimers, #ClinicalTrials, and #caregiving among the Latino community. Each week NIA will share tips and resources in English and Spanish. Don’t miss out on this valuable conversation! #NIAAlzheimers https://go.nia.nih.gov/3wD1rOd 
    • We are excited to celebrate #AlzheimersAndBrainAwarenessMonth this June. Follow @NIHAging and #NIAAlzheimers for a bilingual conversation on #Alzheimers, #ClinicalTrials, and more all month long! https://go.nia.nih.gov/3wD1rOd

Health Professionals and Community Organizations

If you’re a health care professional or organization that works closely with the Latino community, NIA offers free print publications in English and Spanish and you can request copies of NIA’s Spanish and English resources postcard to distribute at your clinic, health fairs, or other community events. You can also explore more resources for providers.

To learn more, please visit https://www.nia.nih.gov/news/alzheimers-and-brain-awareness-month-2024.

Preventing Falls at Home: Room by Room

May 28, 2024

Many falls happen at home, where we spend much of our time and tend to move around without thinking about our safety. There are many changes you can make to your home that will help prevent falls and better ensure your safety.

On this page:

Floors, stairways, and hallway

  • Ensure there are handrails on both sides of any stairs, and make sure they are secure. Hold the handrails when you go up or down stairs, even when you are carrying something. Don’t let anything you’re carrying block your view of the steps.
  • Ensure there is good lighting with light switches at the top and bottom of stairs and on each end of a long hall. Consider using motion-activated lights that plug into electrical outlets and automatically turn on when you walk by them to help illuminate stairwells and pathways.
  • Keep areas where you walk tidy. Don’t leave books, papers, clothes, or shoes on the floor or stairs.
  • Check that all carpets are fixed firmly to the floor, so they won’t slip. Put no-slip strips, which you can buy at any hardware store, on tile and wooden floors.
  • Don’t use throw rugs or small area rugs.
  • Don’t walk on slippery, newly washed floors.

Bathrooms

  • Mount grab bars near toilets and on both the inside and outside of your tub and shower.
  • Place nonskid mats, strips, or carpet on all surfaces that may get wet.
  • Remember to leave a light on in the bathroom at night or use a night light that turns on automatically in the dark.

Bedrooms

  • Put night lights and light switches close to your bed.
  • Keep a flashlight by your bed in case the power goes out and you need to get up.
  • Place a landline or well-charged phone near your bed.

Kitchen

  • Keep frequently used pots, pans, and kitchen utensils in a place where they are easy to reach.
  • Clean up spills immediately.
  • Prepare food while seated to prevent fatigue or loss of balance.

Outdoor spaces

  • If you have steps leading to your front door, make sure they are not broken or uneven.
  • Add non‐slip material to outdoor stairways.
  • Keep the lawn, deck, or porch areas clear of debris, such as fallen branches.
  • Consider installing a grab bar near the front door to provide balance while you are locking or unlocking the door.
  • Turn on your porch light at night and if you leave during the day but plan on returning home after dark.
  • In the winter, treat outdoor walkways with an ice melt product or sand to make them less slippery.

Other living areas

  • Keep electrical cords near walls and away from walking paths.
  • Arrange your furniture (especially low coffee tables) and other objects so they are not in your way when you walk.
  • Make sure your sofas and chairs are the right height for you to get in and out of easily.
  • Keep items you use often at waist level or within easy reach.
  • Don’t stand on a chair or table to reach something that’s too high — use a “reach stick” instead or ask for help. Reach sticks are special grabbing tools that you can buy at many hardware or medical-supply stores. If you use a step stool, make sure it’s steady and has a handrail on top. Have someone stand next to you.
  • Don’t let your cat or dog trip you. Know where your pet is whenever you’re standing or walking.
  • Keep a list of emergency numbers in large print near each landline phone and save them under “favorites” on your mobile phone.

If you have fallen, your doctor might suggest that an occupational therapist, physical therapist, or nurse visit your home. These health care providers can assess your home’s safety and advise you about making changes to lower your risk of falls.

Tools to get help

Read and share this infographic and help spread the word about how to help prevent falls.

If you’re concerned about falling, set up systems to ensure you can get help if you fall. One option is installing an emergency response system. If you fall or need emergency help, you push a button on a special necklace or bracelet to alert 911. There is a fee for this service, and it’s usually not covered by insurance.

Another option is to carry a well-charged cordless or mobile phone with you as you move throughout the house. Have close friends and family on speed dial. Consider setting up a smart home device (a small speaker that listens and responds to commands when you call its name) that can quickly connect you to contacts or emergency response teams. Some smartwatches can be set up to make emergency calls at the push of a button and others can even detect sudden fall-like movements and automatically call for help. Ask family and friends for help setting up these tools.

Home improvement resources

Many state and local governments have education and/or home modification programs to help older people prevent falls. Check with your local health department, search the Eldercare Locator, or call 800-677-1116 to find your local Area Agency on Aging to see if there is a program near you.

To learn more, please visit https://www.nia.nih.gov/health/falls-and-falls-prevention/preventing-falls-home-room-room.

Healthy Aging Tips for the Older Adults in Your Life

May 21, 2024

If you have older family members or loved ones, you may worry about their health as they age. Aging increases the risk of chronic diseases such as heart disease, type 2 diabetes, arthritis, cancer, and dementia. The good news is that adopting and maintaining a few key behaviors can help older adults live longer, healthier lives. As a family member, it’s important to encourage healthy lifestyle behaviors in your loved ones — it’s never too late to start!

Healthy behavior changes can help older adults live more independently later in life. That’s important both for their quality of life and for yours. If a family member loses independence — whether it’s due to disability or chronic disease — you may find yourself in a caregiving role earlier than expected, which can affect family dynamics as well as finances.

So what can you do to help the older adults in your life manage their health, live as independently as possible, and maintain quality of life as they age? Read on to learn about four ways to help support and promote healthy habits in your older loved ones’ lives.

PREVENT SOCIAL ISOLATION AND LONELINESS

As people age, they often find themselves spending more time alone. Poor health, the death of a partner, caring for a loved one, and other situations that are more likely as people age can all lead to being socially isolated or feeling lonely.

Although they sound similar, social isolation and loneliness are different. Loneliness is the distressing feeling of being alone or separated, while social isolation is the lack of social contacts and having few people to interact with regularly. Increased social isolation and loneliness are associated with higher risks for health problems, such as depression; heart disease; and cognitive decline, which is a decrease in the ability to think, learn, and remember.

As a family member, you can play an important role in helping the older adults in your life to stay socially connected. Here are some ways you can help:

  • Schedule daily, weekly, or biweekly phone calls or video chats.
  • Encourage them to seek out others with shared interests, such as through a garden club, volunteer organization, or walking group.
  • Search the Eldercare Locator or call 800-677-1116. The Eldercare Locator is a nationwide service that connects older adults and their caregivers with trustworthy local support resources.

Find additional tips to help your loved one stay socially connected.

PROMOTE PHYSICAL ACTIVITY

There are lots of reasons to make physical activity a part of daily life. Exercise can help reduce levels of stress and anxiety, improve balance and lower risk of falls, enhance sleep, and decrease feelings of depression. Most importantly, people who exercise regularly not only live longer, but also may live better — meaning they enjoy more years of life with less pain or disability. On the other hand, lack of physical activity can lead to increased visits to the doctor, more hospitalizations, and increased risk of certain chronic conditions.

Encouraging the older adults in your life to exercise may not be easy — it can be difficult to get someone to start a new activity — but the rewards are worth the effort. Following are some suggestions to help encourage exercise or other daily movement:

  • Help your loved ones aim for a mix of activities, including aerobics, strength training, balance, and flexibility. This could include walking around the neighborhood, lifting weights, gardening, or stretching.
  • Discuss how much activity is recommended and brainstorm ways to work it into their daily lives. Experts recommend at least 150 minutes per week of moderate-intensity aerobic exercise, and muscle-strengthening activities at least two days each week.
  • Help them shop for appropriate clothing and equipment for their exercise activities. Remember, many activities don’t require expensive equipment. For example, they can use filled water bottles as weights for strength training or walk outside or at a mall rather than on a treadmill.
  • Share your favorite activities that get you moving. Are there any you could do together? If so, that’s a bonus because you’re not only helping promote physical activity but also helping to prevent loneliness and social isolation.

Learn more about the different types of exercises and find examples to help get started.

ENCOURAGE HEALTHY EATING

Healthy eating is an important part of healthy aging. As with exercise, eating well is not just about weight. Having a healthy diet can help support muscles and strengthen bones, which can help with balance and independence. A nutritious diet involving a variety of fresh fruits and vegetables, whole grains, healthy fats, and lean proteins also can help boost immunity and lower the risk of certain health problems such as heart disease, high blood pressure, obesity, type 2 diabetes, stroke, and some cancers.

While it can be meaningful to share meals based on traditional family recipes, in some cases, those favorite dishes can be loaded with unhealthy fats and sugars. Changing long-held habits can be tough, but before you know it, there may be some new favorite foods on the table! Consider these tips to help incorporate a healthy diet in your loved ones’ routines:

  • Take them on a trip to the grocery store and pick out healthy options.
  • Discuss their favorite traditional recipes and talk about whether you can make them healthier; for example, by substituting olive oil for butter, or yogurt for sour cream.
  • Visit them once a week and make a healthy meal together. Consider cooking extra and packaging leftovers so they have individual servings to enjoy later in the week.
  • Look inside their fridge and pantry when you visit. You can check for healthy options, and also ensure they aren’t eating expired food or drinks.
  • Encourage them to talk with their doctor or pharmacist about their diet and any vitamin and mineral supplements they may need.

Learn more about healthy eating patterns and ways to create a nutritious meal plan.

SCHEDULE REGULAR CHECK-UPS WITH A DOCTOR

It’s important for your older loved ones to have regular health exams and medical screenings. Visit MedlinePlus to learn about health screenings for women and men. Checking in with doctors annually, and possibly more often, depending on overall health, may help reduce risk factors for disease such as high blood pressure and cholesterol levels. Regular check-ups can also help catch concerns early and improve the chances for effective treatment.

Some people visit their doctors routinely, while others avoid these types of appointments at all costs. Here are some ways to support your family members’ visits with health care providers:

  • Encourage them to reach out to their doctor immediately if they’re experiencing pain or any new symptoms.
  • Ask about their upcoming visits to doctors, including any specialists. Do they have the appropriate appointments scheduled and marked on a calendar? Do they need any help scheduling appointments?
  • Offer to drive them to the appointment, or even go with them and take notes.
  • Ask about communication with their health care providers. Are the doctors responsive to their questions?
  • Help them manage medications if needed. Make sure they maintain a current list of their medications, including both prescription and over-the-counter medications and any supplements, and are sharing this list with their health care providers.
  • Ask your older family member if they’d feel comfortable allowing you or another family member access to their medical records and permission to talk with their doctors. This could help them stay on top of their appointments and medications.

Find tips to help prepare for a doctor’s appointment.

HOW CAN I ENCOURAGE HEALTHY BEHAVIORS FROM AFAR?

Even if you don’t live close to your parents or other aging family members, you can still help promote healthy habits in their lives. Schedule phone calls to check in and ask about their daily meals, how active they are, and if they’re taking their medications properly. After your discussion, if needed, you can gently talk with them about ways to incorporate healthier approaches. If your family member uses video technology for visits with health care professionals, you could join them to help take notes and ask questions. If you can’t visit your loved ones frequently, ask a trusted family member or friend who is close by to check in on them.

Learn more about long-distance caregiving.

Behavior changes can be difficult and take time. If you’re committed to helping your older loved ones adopt healthier lifestyles, try to be patient. If something isn’t working right away, stick with it or try a different approach. Your support and encouragement can make a difference!

To learn more, please visit https://www.nia.nih.gov/health/caregiving/healthy-aging-tips-older-adults-your-life

Healthy Meal Planning: Tips for Older Adults

May 13, 2024

Eating healthfully and having an active lifestyle can support healthy aging. Use the resources below to learn about different patterns of healthy eating and ways to create a nutritious meal plan.

Older adults’ unique nutrition needs

Simple adjustments can go a long way toward building a healthier eating pattern. Follow these tips to get the most out of foods and beverages while meeting your nutrient needs and reducing the risk of disease:

Read and share this infographic and spread the word about ways that may help foster healthy aging.

  • Enjoy a variety of foods from each food group to help reduce the risk of developing diseases such as high blood pressure, diabetes, and heart disease. Choose foods with little to no added sugar, saturated fats, and sodium.
  • To get enough protein throughout the day and maintain muscle, try adding seafood, dairy, or fortified soy products along with beans, peas, and lentils to your meals. Learn more about protein and other important nutrients.
  • Add sliced or chopped fruits and vegetables to meals and snacks. Look for pre-cut varieties if slicing and chopping are a challenge for you.
  • Try foods fortified with vitamin B12, such as some cereals, or talk to your doctor about taking a B12 supplement. Learn more about key vitamins and minerals.
  • Reduce sodium intake by seasoning foods with herbs and citrus such as lemon juice.
  • Drink plenty of water throughout the day to help stay hydrated and aid in the digestion of food and absorption of nutrients. Avoid sugary drinks.

It can be hard for some people to follow through on smart food choices. Read about common roadblocks and how to overcome them and check out the USDA’s tips for older adults.

USDA Food Patterns

Eating habits can change as we grow older. The USDA has developed Food Patterns to help people understand different ways they can eat healthy. The food patterns include:

  • Healthy U.S.-Style Eating Pattern: This is based on the types of foods Americans typically consume. The main types of food in this eating pattern include a variety of vegetables, fruits, whole grains, fat-free or low-fat dairy, seafood, poultry, and meat, as well as eggs, nuts, seeds, and soy products. Check out this sample menu to get started.
  • Healthy Mediterranean-Style Eating Pattern: This one contains more fruits and seafood and less dairy than the Healthy U.S.-Style Eating Pattern.
  • Healthy Vegetarian Eating Pattern: This pattern contains no meat, poultry, or seafood, but does contain fat-free or low-fat dairy. Compared with the Healthy U.S.-Style Eating Pattern, it contains more soy products, eggs, beans and peas, nuts and seeds, and whole grains.

Visit the USDA Food Patterns webpage for more information on each eating pattern and recommended daily intake amounts for each food group.

Meal planning

Read and share this infographic to learn about making healthier food choices as you age.

Answering the question “what should I eat?” doesn’t need to leave you feeling baffled and frustrated. In fact, when you have the right information and motivation, you can feel good about making healthy choices. Use these tips to plan healthy and delicious meals:

  • Plan in advance. Meal planning takes the guesswork out of eating and can help ensure you eat a variety of nutritious foods throughout the day.
  • Find budget-friendly foods. Create a shopping list in advance to help stick to a budget and follow these SNAP-friendly recipes.
  • Consider preparation time. Some meals can be made in as little as five minutes. If you love cooking, or if you’re preparing a meal with or for friends or family, you may want to try something a little more challenging.
  • Keep calories in mind. The number of calories people need each day varies by individual. Always discuss your weight and fitness goals with your health care provider before making big changes. Read about calorie goals and healthy food swaps.

Find Recipes

When planning meals, looking for recipes that sound delicious to you can be a good place to start. The USDA features the MyPlate Kitchen, a resource that helps you find healthy recipes that fit your nutrition needs and create a shopping list. The MyPlate Plan tool will create a customized food plan for you based on your age, height, weight, and physical activity level.

Some of the recipes available at MyPlate Kitchen include:

  • 20-Minute Chicken Creole: This Creole-inspired dish uses chili sauce and cayenne pepper. It can be cooked on the stovetop or with an electric skillet in just 20 minutes.
  • Five A Day Salad: This nutrient-packed salad uses 10 different vegetables, and each serving is equal to five cups of vegetables.
  • Apple Carrot Soup: Ginger and orange peel are the secret ingredients to this pork, apple, and carrot soup.

When you create your shopping list, don’t forget nutritious basics such as fresh fruits and vegetables and whole-grain bread. This sample shopping list (PDF, 108 KB) includes a variety of healthy foods you may want to have in your kitchen.

Sample menus

Here are some meal options for breakfast, lunch, dinner, and snacks, including links to recipes as well as simpler choices that can be put together without a recipe.

DinnerSnack
Chicken breast, roasted vegetables, hummus Roasted salmon, zucchini, and sweet potato Whole-wheat pasta, ground turkey, and tomato sauce Argentinean grilled steak with salsa criolla Eve’s tasty turkey tetrazzini Fish with spinachBaby carrots and hummus Celery with natural peanut butter Fruit and yogurt Banana cocoa yogurt pops Chili popcorn Yummy bean dip

National Nurses Week 2024: Deals, Discounts, Gifts & Freebies!

May 8, 2024

We are preparing for an amazing celebration of National Nurses Week this year! Many companies are showing their gratitude for nurses and healthcare workers by offering awesome deals and freebies during Nurses Week and throughout the year. Whether you are a healthcare worker looking for a good deal or you’re shopping for a healthcare hero in your life, check out these great deals!

Electronics & Technology

  • Verizon – Nurses and their families can get welcome unlimited for $20 per line for four lines. Available for new or existing customers. The new discounts will be available to eligible new and existing Verizon customers. Must confirm eligibility through ID.me. Nurses can also get Verizon’s Fios 1 Gig Internet plan for $49.99/month.
  • AT&T Wireless – During Nurse/Physician Appreciation Week, nurses, physicians, and their families get 25% off their best-unlimited plans.
  • Bose – Nurses will get a special discount on orders of $199 or more. Verification with ID.me.
  • Lenovo – Save an extra 5% off new tech like smartphones, laptops, and more with ID.me during checkout.
  • Ring.com Doorbell – One-time discount on select Ring.com purchases after verification with VerifyPass. 
  • SONOS – 15% off for nurses through the ID.me page. 
  • PC Liquidations – Healthcare workers receive 10% off any refurbished gadget products with no minimum purchase.
  • MedShop – Nurses can get 10% off on nursing scrubs and other product lines through May 19 by using the discount code “NURSE2024”.
  • Therabody – Therabody is offering 20% off regular-priced Theragun or Theraone CBD for nurses.
  • Philips – Philips is offering 25% off purchases. Use ID.me for verification.
  • Samsung – Samsung offers up to 30% off for all first responders.
  • iRobot – iRobot offers up to 15% off select robots for nurses.
  • Leatherman – Leatherman offers 30% off multi-tools for all healthcare professionals.

Scrubs

  • Figs Scrubs – Get a 20% OFF discount on Figs scrubs. 
  • Jaanuu Scrubs – Get a 30% OFF discount on Jaanuu scrubs.
  • Fabletics Scrubs – Nurses Week promo (20% off scrubs + free embroidery) for VIP Members only May 6-12. Our activating offer for those who want to become a VIP Member is $19 for a set
  • OliveUs Scrubs – Get a 10% OFF on OliveUs scrubs.
  • Dickies – Get a 20% discount on scrubs from May 1 – May 14.
  • AllSeasonsUniforms.com – Get a 20% OFF discount on our medical scrubs and lab coat lines.

Food & Dining

  • Buffalo Wild Wings – Nurses get 20% off their orders from May 6-12. 
  • Chick-Fil-A – Chick-fil-A doesn’t offer a national nurses’ week discount, but local franchises do. Check their website to find your local restaurant.
  • Chipotle – Chipotle is continuing its annual recognition of the healthcare community by awarding 100,000 healthcare workers with free burrito e-cards, equivalent to over $1M in free food. From Monday (5/6) through Friday (5/10), healthcare workers can sign up for a chance to win a free burrito e-card. Read more about Chipotle’s Nurses Week deals.
  • Cinnabon – Nurses get a FREE Classic cinnamon roll or a Minibon roll, at select locations. 
  • Dunkin Donuts – Get a FREE medium hot/iced coffee on May 6 at select locations. No purchase necessary.
  • MOD Pizza – MOD Pizza is recognizing both teachers and nurses with a BOGO deal available from May 6th to 9th.
  • G.O.A.T. Fuel – Get this health-forward energy drink from NFL G.O.A.T. Jerry Rice and his daughter Jaqui Rice Gold for 15% off. 
  • Outback Steakhouse – Get 10% off your entire check with a valid medical ID.
  • Mrs. Fields  Cookies – Save as much as 25% off the entire Heroes Collection of gifts for Nurses weeks. 
  • Texas de Brazil – Bring your ID to any Texas de Brazil locations in the continental U.S. to get 15% off your dine-in dinner or lunch for up to 4 people. (Not valid on U.S. holidays.)
  • Kind – Kind has not announced their nurse’s week discount yet, check back for updates. 
  • Thrive Market – Thrive Market offers free memberships to nurses. Use ID.me for verification.
  • Hello Fresh – Hello Fresh is offering 55% off and free shipping on their first Hello Fresh box. Plus ongoing 15% off for all nurses. 
  • Yogurtland – Nurses get FREE delivery on orders of more than $15 made through the website or mobile app (use the code FREEDELIVERY).

Shoes

  • STAND+ (formerly Gales) – STAND+ is giving away 5 pairs of our new AntiGrav1 style using this application. The contest will be open from the 6th-12th and winners will be contacted on the 17th. 
  • Crocs Shoes – 15% off after verifying your ID through SheerID.
  • NurseMates.com – Get a 25% OFF discount for Nurses Appreciation from 4/26 – 5/12. Use code: NURSE25
  • AlignShoe.com – Get a 25% OFF discount for Nurses Appreciation from 4/26 – 5/12. Use code: NURSE25
  • Clove Shoes – Get a FREE pair of socks with your purchase.
  • Clove x Owala Nurse Week Collaboration – In addition to this limited edition collaboration, the first 500 purchases will be able to secure an exclusive bundle: The Limited-edition Owala® FreeSip® 24oz bottle plus a FREE Clovey™ shoe accessory in Owala® bottle design.
  • The Good Feet Store – From May 6th to May 12th, with a valid nurse’s ID and the purchase of a Good Feet Arch Support System, nurses will receive three pairs of OS1st Comfort socks and a pair of architek Comfort Slip-On shoes completely free!
  • Nike – After verification through SheerID, get a 10% off discount code. 
  • Asics Shoes – Nurses and medical professionals get 25% off full-priced products at Asics. You’ll need to verify with SheerID to get a one-time promo code. 
  • Adidas – Nurses and medical professionals get 30% off in-store and on the Adidas website, along with 20% off at factory outlet stores with ID.me
  • Reebok – Get an impressive 50% off discount online after verification. 
  • Nurse Mates Shoes – NurseMates.com and AlignShoe.com will both be running a 25% off promotion for Nurses Appreciation! 4/26 – 5/12 with code: NURSE25
  • Rothy’s – Verify your ID to get 20% off any pair of shoes. Limit one discount code per person per calendar year.
  • Hunter Boots – Score 20% off. 
  • Uni Shoes – 15% off with discount code: NURSEORG

Stethoscopes

  • Eko Stethoscope – Month-long E-commerce Promotions (5/1-5/31) – Free Case with purchase of the CORE 500™ or 3M™ Littmann® CORE Digital Stethoscope. Plus save $80 on the 3M™ Littmann® CORE Digital Stethoscope all month long.
  • MDF Stethoscopes – Celebrate Nurses Week and shop select glitter stethoscopes on sale at 30% off while supplies last! Add a free large case and free engraving for a total savings value of $104. Nurses Week Sale 5/5-5/11 – Free Engraving on all stethoscopes. Plus, save $30 on the CORE 500™ Digital Stethoscope. Don’t see the glitter stethoscope of your dreams? Get a free large case and free engraving with any ProCardial® Titanium Mprint printed stethoscope and save $44! 

Furniture, Bedding & Home Goods

Glasses & Eyewear

Apparel

Wellness – Vitamins & Supplements

  • replenishift – During the month of May, use code NURSEWEEK2024 for 30% off, plus a free gift with purchase!
  • Pachamama CBD Oil – 30% off for all frontline workers: get it here.
  • GNC – GNC is giving 10% off purchases. Use ID.me for verification. 
  • Ritual – Ritual is giving 20% off your first three months. Use ID.me for verification. 
  • Natural Cycles – Natural Cycles: Healthcare workers & first responders get 20% off.

Tumblers & Drinkware

  • Stanley – Stay hydrated with a new Stanley that’s up to 20% off through ID.me. 
  • Yeti – Shop for coolers, tumblers, drinkware, and more for 20% off through ID.me. 

Study Guides & NCLEX Prep

  • Nursing.com – NURSING.com FREE Access. 2,500+ Clear, Concise, Visual Nursing School/NCLEX Videos.  10 Minutes Of FREE Video Viewing Unlocked Every Day.
  • Simplenursing.com – Get 35% off on SimpleNursing memberships from 5/3 to 5/10
  • Nurseinthemaking.com – Get 10% off your next purchase of Custom-Made Nursing School Study Guides on NurseInTheMaking.com. May 6 – Sunday, May 12, get 15% OFF all physical products and 20% off all digital products. 

Entertainment & Sporting Events

Nurse Appreciation Nights at Baseball Games Across The Country!

Nurse.org teamed up with MLB teams across the country to offer special discounts, recognition, and appreciation events for nurses during Nurse’s Month in May 2024! Buy DISCOUNT tickets, vote for nurses to throw the first pitch, and get all the details about Nurse Night in a city near you. 

Beauty Products & Cosmetics

  • Tula – Tula Skincare is giving 20% off purchases for nurses. Use ID.me for verification.
  • Josie Maran – Josie Maran is giving 10% off purchases. Use ID.me for verification.
  • Grande Cosmetics – Grande Cosmetics is giving 15% off purchases. Use ID.me for verification.
  • e.l.f – E.l.f is giving nurses 25% off purchases.
  • Beekman – Beekman is giving 20% off purchases. Use ID.me for verification.
  • Hairstory – Hairstory is giving 15% off purchases. Use ID.me for verification. 
  • Colorescience – Colorescience will apply a 15% discount on purchases after verification through ID.me 
  • R + Co – R + Co is giving 20% off purchases. Use ID.me for verification.
  • Joy Organics – Joy Organics is giving 50% off purchases. Use ID.me for verification. 

Travel & Vacations

  • Walt Disney World Swan and Dolphin – Walt Disney World has multiple discounts available when booking using code “Y7N.” Valid ID must be shown at check-in. 
  • Hotwire – Hotwire offers 10% off “Hot Rate” hotel and car deals after verification. Use ID.me for verification.
  • Budget – Verified ID.me nurses receive up to 25% off on a rental car at locations nationwide. 
  • Wyndham – How does a complimentary Gold membership sound? It’s yours as a healthcare worker! All you have to do is sign in and describe your job. 
  • Great Wolf Lodge – Great Wolf Lodge is offering savings of up to 25% off your next getaway. Use promo code “HEROES”
  • Caesars – Caesars offers nurses up to 30% off hotel stays. Use ID.me for verification.
  • Paris Las Vegas – For more Las Vegas fun, score 30% off on a luxury room through ID.me
  • Caribe Royale Orlando / Buena Vista Suites – Nurses can receive 20% off the Best Available Rate year-round at both resorts. Valid for up to 2 Rooms. Caribe Royale Orlando: https://bit.ly/3QTJcf4 Buena Vista Suites:  https://bit.ly/3YSq2Ir 

Other Nurses Week Awards & Freebies

  • Bayada Giveaway:
    • 25 winners will receive a $300 gift package! Enter to win at nursesweek.com – gift packages include:
      • Keep Calm and Lead On:  Drinkware | The North Face backpack | Compression socks | Beats Pro headphones
      • Healing Meals:  Smart meat thermometer | Omaha Steaks | Vegetable chopper | Pasta machine
      • Rise & Thrive:  Drinkware | Herschel Supply Co. backpack | Apple Watch
      • Get in Your Comfort Zone:  Tea mug Massage gun | Organic tea sampler | Blanket | UGG pillows
      • Refine Your Shine:  Drinkware | The North Face backpack | Premium bento box | Bose noise-cancelling headphones
  • Vivian Nurses Week Leadership Award: 
    • Vivian is launching its Nurses Week Leadership Award, giving away $5,000 to one outstanding nurse to offset their student loan debt:
    • To enter, nurses are invited to share a 200-word story highlighting an instance of compassion, leadership, or positive impact on patients or colleagues. 
    • The contest is open from April 1 – May 12, 2024. Click here for full details.

Source: https://nurse.org/articles/free-nurse-week-giveaways/#Nurses-week-giveaway

Safety Tips for Exercising Outdoors for Older Adults

May 7, 2024

Staying safe when exercising outdoors for older adults

You’ve made a plan to be more active, and you’re ready to go outside and get started. But before you do, make sure that you can exercise safely in your neighborhood. Here are a few tips that can help you stay safe as you get moving.

Think ahead about safety.

  • Carry your ID with emergency contact information and bring a small amount of cash and a cell phone with you, especially if walking alone. Stay alert by not talking on the phone as you walk and keeping the volume low on your headphones.
  • Let others know where you’re going and when you plan to be back.
  • Stick to well-lit places with other people around.
  • Be seen to be safe. Wear light or brightly colored clothing during the day. Wear reflective material on your clothing and carry a flashlight at night. Put lights on the front and back of your bike.
  • Wear sturdy, appropriate shoes for your activity that give you proper footing.

Walk safely in rural areas.

  • If possible, walk during daylight hours.
  • Choose routes that are well-used, well-lit, and safe. Choose routes with places to sit in case you want to stop and rest.
  • Stay alert at all times. If you’re listening to music as you walk, turn down the volume so you can still hear bike bells and warnings from other walkers and runners coming up behind you.
  • Always walk facing oncoming traffic.
  • Walk on a sidewalk or a path whenever possible. Watch out for uneven sidewalks, which are tripping hazards.
  • Look for a smooth, stable surface alongside the road.

Walk safely in urban areas.

  • If the road has guardrails, see if there’s a smooth, flat surface behind the barrier where you can walk. If you need to walk on a paved shoulder, stay as far away from traffic as possible.
  • Watch for bridges and narrow shoulders.
  • Cross at crosswalks or intersections. Jaywalking increases your risk of a serious accident. Pay attention to the traffic signal. Cross only when you have the pedestrian crossing signal.
  • Never assume a driver sees you crossing the street. Try to make eye contact with drivers as they approach. Before you start to cross a street, make sure you have plenty of time to get across. Rushing increases your risk of falling.
  • Look across ALL lanes you must cross and make sure each lane is clear before proceeding. Look left, right, and left again before crossing. Just because one driver stops, don’t presume drivers in other lanes will stop for you.
  • Check out city parks. Many parks have walking or jogging trails away from traffic.

If you don’t feel safe exercising outdoors, be active inside.

Bicycle safety for older adults

Riding a bicycle is not only a fun family activity, it’s also a great way to exercise. Some people even use their bicycle to commute to work, go to the grocery store, or visit friends and family. When you’re out and about on your bike, it’s important to know how to be safe.

For more information about biking safely, visit the National Highway Traffic Safety Administration.

Tips for exercising in hot weather

Many people enjoy warm-weather outdoor activities like walking, gardening, or playing tennis. Make sure to play it safe in hot weather. Too much heat can be risky for older adults and people with health problems. Being hot for too long can cause hyperthermia — a heat-related illness that includes heat stroke and heat exhaustion.

If you want to be active when it’s hot outside:

  • Check the weather forecast. If it’s very hot or humid, exercise inside with videos online, or walk in an air-conditioned building like a shopping mall.
  • Drink plenty of liquids. Water and fruit juices are good options. Avoid caffeine and alcohol. If your doctor has told you to limit liquids, ask what to do when it is very hot outside.
  • Wear light-colored, loose-fitting clothes in natural fabrics.
  • Dress in layers so you can remove clothing as your body warms up from activity.
  • Know the signs of heat-related illnesses and get medical help right away if you think someone has one.

Tips for exercising in cold weather

You can exercise outdoors in the winter, but take a few extra steps to stay safe before braving the cold. Exposure to cold can cause health problems such as hypothermia, a dangerous drop in body temperature.

If you want to do outdoor activities when it’s cold outside:

  • Check the weather forecast. If it’s very windy or cold, exercise inside with videos online and go out another time.
  • Watch out for snow and icy sidewalks.
  • Warm up your muscles first. Try walking or light arm pumping before you go out.
  • Pick the right clothes. Wear several layers of loose clothing. The layers will trap warm air between them. Avoid tight clothing, which can keep your blood from flowing freely and lead to loss of body heat.
  • Wear a waterproof coat or jacket if it’s snowy or rainy. Wear a hat, scarf, and gloves.
  • Learn the signs of hypothermia.

To learn more, please visit https://www.nia.nih.gov/health/exercise-and-physical-activity/safety-tips-exercising-outdoors-older-adults.

Beware of Scams Targeting Older Adults

April 30, 2024

Older adults are often the target of scams. Scammers are savvy and convincing, and their scams are designed to catch people off guard. Don’t be ashamed if you think you or someone you know has been a victim of a scam — it can happen to anyone.

Common scams aimed at older adults include:

What can you do?

Here are a few steps you can take to help protect yourself and your loved ones from scams:

  • Don’t give out sensitive personal information over the phone or in response to an email, social media post, or text message. Sensitive information includes your Social Security number, bank account information, credit card numbers, PINs, and passwords.
  • Check incoming bills, including utility bills and credit card statements, for charges that you didn’t authorize. Contact the utility provider, credit card company, or bank if you see any charges you don’t recognize.
  • Protect your electronic accounts by keeping the security software on your computer and smartphone up to date and by using multifactor authentication when possible.
  • Don’t transfer money to strangers or to someone over the phone. Similarly, never buy a gift card to pay someone over the phone. Once you transfer money or share the numbers on the back of a gift card, there’s usually no way to get your money back.
  • If someone is trying to scam you, they may threaten you or pressure you to act immediately. If this happens to you, don’t panic. Slow down and think about what the person is saying. If you suspect it’s a scam, end the call and talk to someone you trust.

One reason that scammers target older adults is that they are less likely to report suspected fraud. If you think that you or someone in your life has been the target of a scam, contact the National Elder Fraud Hotline at 833–372–8311. You can also contact your local police department or the attorney general of your state or territory, and you can report the scam to the Federal Trade Commission.

To learn more, please visit https://www.nia.nih.gov/health/safety/beware-scams-targeting-older-adults.

Success Story: Dale Brown

April 29, 2024

Greenville Nursing and Rehabilitation is excited to share resident Dale Brown’s Success Story!

Dale entered Greenville Nursing and Rehabilitation post-hospitalization, needing significant support with mobility and daily activities due to reduced muscle strength, endurance, and communication ability. Throughout his therapy sessions with Reliant Rehabilitation, Mr. Brown displayed exceptional dedication and collaboration. Thanks to his perseverance, he successfully regained independence and was discharged home, where he joyfully reunited with his wife. Congratulations, Dale, on meeting your rehabilitation goals!

Providing Care to a Diverse Older Adult Population

April 22, 2024

Your patients bring diverse backgrounds, customs, abilities, and experiences to their health care. Some differences are apparent, while others are not. Factors that contribute to diversity include:

  • Geographic and cultural background
  • Race and ethnicity
  • Age
  • Gender identity, gender expression, and sexual orientation
  • Preferred language(s)
  • Religious and family traditions
  • Education and socioeconomic background
  • Neurodiversity
  • Cognitive, sensory, and physical abilities

Recognizing and appreciating diversity is an essential part of patient-centered care. It can lead to improved patient safety, more open communication, increased health equity, and better patient outcomes. By respecting each patient’s values and preferences, you’ll be more likely to engage them as collaborative partners in their care.

How is diversity related to health?

A patient’s culture and background will affect whether and where they seek health care, their understanding of medical information, and how they make health care decisions. Recognizing the different health issues your older patients are likely to face, as well as the factors that contribute to these differences, will help you provide the most effective care.

Many complex and interacting factors, lifelong and current, underlie disparities in health risk and disease burden. These factors include:

  • Unequal access to health care services
  • Availability of social support
  • Neighborhood and workplace environments
  • Food availability and accessibility
  • Wealth and income gaps
  • Racism, sexism, and other forms of discrimination

Age-related health disparities affect the health of older adults. For example:

Scientists have also observed sex and gender differences in health and longevity. For example, women live longer than men, on average. They are also more likely to develop osteoporosis or depressive symptoms and to report functional limitations as they age. Men, on the other hand, are more likely to develop heart disease, cancer, or diabetes.

Other studies have found that lower socioeconomic status is associated with poorer health and reduced lifespan in the United States. Economic circumstances can determine whether an individual can afford quality health care and proper nutrition from early life into old age. Financial resources and health insurance often determine whether an older adult enters an assisted living facility or nursing home or stays at home to be cared for by family members.

Health care workforce diversity is important

Providers representing a variety of backgrounds and cultures can help meet the health needs of an increasingly diverse population. Some patients feel more comfortable with health care providers who share or understand their language, race, ethnicity, or other cultural characteristics. Research suggests that a diverse health care workforce may also improve patient satisfaction, patient-clinician communication, and access to care.

Communicating with a diverse patient population

Your conversational style can be a subtle but powerful way to connect with your patients. Being thoughtful about how you communicate with each individual can promote understanding, trust, and satisfaction in the patient-provider relationship.

Practical tips for effective communication include:

  • Ask patients which name and other descriptive terms they prefer and use those consistently. This small effort can go a long way toward making patients feel welcome, safe, and accepted.
  • Use person-first language. This language avoids defining someone by their condition or disability (e.g., people with diabetes instead of diabetics).
  • Try to match your communication style to that of your patient. Conventions such as the speed and volume of speech vary across cultures. To some people, interrupting an individual who is speaking is acceptable and even expected, while it is considered rude and off-putting to others. 
  • Use plain language. Avoid using medical terminology or abbreviations that your patients might not understand. Remember that certain idioms and figures of speech in English may be unfamiliar or confusing to people who have a different primary language.
  • Be aware of nonverbal communication (such as hand gestures) that may have a different meaning to patients from different backgrounds. People also differ in the amount of eye contact, smiling, touching, and physical distance that are comfortable.

Tailoring how you talk with patients can help them better understand the information you are providing. Communicating in a way that makes your patients feel comfortable may help them open up about their health concerns and be more receptive to your guidance.

Providing language assistance in health care settings

Overcoming language barriers is critical for effective patient-provider communication. It allows for mutual understanding, informed decision-making, and better quality of care.

In any type of health care setting, you are likely to encounter patients with a primary language other than English. Here are several ways to support these patients:

  • Identify the main languages spoken by your patient population and, whenever possible, match patients with qualified bilingual staff or have other trained medical interpretation services available.
  • Start appointments by asking all new patients which language they prefer to speak and read, and whether they would like an interpreter. An “I Speak” card (PDF, 4.6M) can help patients identify their preferred language. Note preferences in their medical records.
  • Provide important written materials in your patients’ preferred languages. For example, have office signage, intake and consent forms, prescription labels, and patient instructions available in multiple languages when possible. NIA provides health information for older adults in both English and Spanish as well as links to resources in other languages.
  • Maintain a list of referrals to local clinicians and community service providers who speak your patients’ preferred languages, when available.

It can be logistically challenging to provide language assistance services. As a result, some clinicians rely on interpretation by patients’ family members or on bilingual staff members who are untrained in medical interpretation. However, experts strongly discourage this practice. An informal interpreter may be unable to convey medical terminology accurately, may inadvertently misinterpret information, or may be reluctant to share difficult news. Informal interpretation can also interfere with patient privacy.

Using qualified medical interpreters can improve communication, understanding, clinical outcomes, and patient satisfaction with care. Trained interpreters will help ensure that everything said during a medical appointment is relayed accurately and objectively. This checklist (PDF, 207K) provides tips for working with an interpreter.

Providing language assistance isn’t just good medical practice: In some cases, it’s also required by law. Federal policies require health care providers who receive government funds, such as Medicare and Medicaid payments, to make interpretive services and written translations of critical documents available at no cost to people with limited English proficiency. Visit LEP.gov for details about these requirements.

Some states have professional associations and foundations that may provide funding for medical interpreters. Additionally, Medicaid offers reimbursement for some medical interpretation services.

If you are looking for a qualified medical interpreter, the National Board of Certification for Medical Interpreters and the Certification Commission for Healthcare Interpreters have online registries of certified interpreters. The Registry of Interpreters for the Deaf provides a searchable list of certified interpreters in American Sign Language. Many state government websites also provide directories of interpreters and translators to help you locate services in your area.

Tips for culturally sensitive care

How can you work with your patients in a way that respects their diversity? To start, avoid making assumptions about a person’s beliefs, attitudes, or behaviors based on their culture or background. Instead, engage with patients to find out about their individual values and preferences.

Additional ideas for providing culturally sensitive care include:

  • Reflect on your own background, beliefs, and values, and consider how they inform your practice. For example, think about your own feelings about aging and how they might influence your interactions with your older patients.
  • Get to know the community that you serve. What are the most common racial and ethnic groups? Which languages do they speak? What health, social, and environmental issues do they face? Adapt programs and health care practices so they are appropriate to the groups you serve most often.
  • Recognize that a healthy diet plan may differ among cultural traditions. Patients will have difficulty following dietary advice if it doesn’t take their food preferences and cooking methods into account. The Nutrition.gov Culture and Food page provides nutrition guidance, food options, and recipes from around the world.
  • Understand that some patients may value having other family members involved in their health care decisions. Clarify how the patient sees the role of family and any specific information they want shared with relatives.
  • For patients nearing the end of life, ask about their health care goals. There may be cultural or religious differences in attitudes toward end-of-life decision-making, such as creating advance directives; disclosing a terminal diagnosis to the sick person or family members; and pursuing life-prolonging treatments, such as a feeding tube.

Different beliefs about aging

People from different cultures and traditions have varied attitudes about aging. For example, in some cultures, older adults are customarily respected for their wisdom and experience. Other cultures tend to be more youth-centered, valuing the qualities of youth over those of old age.

When societies prefer youth over old age, it can lead to ageism. This often underrecognized form of discrimination comprises stereotypes and prejudices directed toward people on the basis of their age. Ageism has serious implications for the health of older people: Studies have associated age-based discrimination with poorer physical and mental health, reduced quality of life, and even earlier death.

Because ageism is so pervasive, it’s easy for well-intentioned health care providers to make assumptions about their older patients and inadvertently reinforce harmful stereotypes. For example, patients and their providers may dismiss otherwise treatable health problems as an inevitable part of aging. As a result, older patients may suffer preventable discomfort and disability.

For tips on avoiding ageism when talking with your patients, see the World Health Organization’s Quick Guide to Avoid Ageism in Communication.

Clinical research needs diversity

It is important for clinical trials and studies to include a diverse range of participants so the results will have broader applicability. Researchers need older adults from many different backgrounds to participate in research so they can learn more about how new drugs, tests, and other interventions will work in diverse populations.

Clinical research also needs scientists from diverse backgrounds, particularly from groups that have been historically underrepresented. Diversity in scientific teams can lead to more creative and innovative thinking, which can help biomedical research represent and benefit people from all backgrounds.

To learn more, please visit https://www.nia.nih.gov/health/health-care-professionals-information/providing-care-diverse-older-adult-population.

Success Story: Roger Lewis

April 16, 2024

Greenville Nursing and Rehabilitation is excited to share resident Roger Lewis’ Success Story!

Roger Lewis became a long-term care resident at Greenville Nursing and Rehabilitation in June 2023 due to various medical complexities. Initially, Roger relied heavily on assistance for self-care, struggled with dysphagia and cognitive deficits, and faced challenges with functional transfers.

Under the guidance of his therapy team, Roger engaged in intensive physical, occupational, and speech therapy sessions. His dedication and hard work resulted in remarkable progress, significantly reducing his dependence on caregivers.

Roger’s cheerful demeanor and engaging conversations with staff brought smiles and laughter to everyone around him. Both Roger and the staff are delighted to see him return to long-term care with increased independence, continuing to spread joy throughout the facility.

Participating in Activities You Enjoy As You Age

April 15, 2024

ere are many things you can do to help boost your health as you age, including making healthy food choices and not smoking. But did you know that participating in social and other activities you enjoy can also help support healthy aging?

As you grow older, you may find yourself spending more time at home alone. Being lonely or socially isolated is not good for your overall health. For example, it can increase feelings of depression or anxiety, which can have a negative impact on many other aspects of your health. If you find yourself spending a lot of time alone, try participating in activities you find meaningful — those that create a sense of purpose in your daily life. These can include hobbies, volunteer activities, or time with family and friends.

BENEFITS OF AN ACTIVE LIFESTYLE

Engaging in social and productive activities you enjoy, such as taking an art class, joining a hiking club, or becoming a volunteer in your community, may help to maintain your well-being and independence as you age. An active lifestyle is more than just getting your daily steps in. It includes doing activities that are meaningful to you and benefit your mind, spirit, and body.

Research has shown that older adults with an active lifestyle:

  • Are less likely to develop certain diseases. Participating in hobbies and other social activities may lower risk for developing some health problems, including dementiaheart diseasestroke, and some types of cancer.
  • Have a longer lifespan. Studies looking at people’s outlooks and how long they live show that happiness, life satisfaction, and a sense of purpose are all linked to living longer. Doing things that you enjoy may help cultivate those positive feelings.
  • Are happier and less depressed. Studies suggest that older adults who participate in activities they find meaningful, such as volunteering in their communities or being physically active, say they feel happier and healthier.
  • Are better prepared to cope. When people feel happier and healthier, they are more likely to be resilient, which is our ability to bounce back and recover from difficult situations. Positive emotions, optimism, physical and mental health, and a sense of purpose are all associated with resilience.
  • May be able to improve their thinking abilities. Research suggests that participating in certain activities, such as those that are mentally stimulating or involve physical activity, may have a positive effect on memory — and the more variety the better. Other studies are providing new information about ways that creative activities, such as music or dance, can help older adults with memory problems or dementia.

FIND THE RIGHT BALANCE

Everyone has different limits to the amount of time they can spend on social or other activities. What is perfect for one person may be too much for another. You might start by adding one or two activities to your routine and see how you feel. You can always add more. Remember: Participating in activities you enjoy should be fun, not stressful.

ACTIVITIES TO CONSIDER

Read and share this infographic and spread the word about ways that may help foster healthy aging.

There are plenty of places to look for opportunities to engage in activities you enjoy, depending on your interests and ability. Following are ideas that might work for you. Some of these include activities that can be enjoyed even from a distance using phones, computers, and other devices. Others can be done alone. So even if you’re in a rural area or have other restrictions, you can still find ways to engage in activities you like.

CONNECT WITH FAMILY AND FRIENDS

  • Play cards or other games with friends in person or online.
  • Travel with a group of older adults, such as a retiree group.
  • Video chat or call your friends and family members.
  • Try different restaurants with your loved ones.
  • Listen and share favorite music with your family.
  • Join a group interested in a hobby, such as knitting, hiking, birdwatching, painting, or wood carving.
  • Reconnect with old friends through your high school or college alumni association.

LEARN SOMETHING NEW

  • Take a cooking, art, dance, language, or computer class. Get in touch with your local community college or library. Many offer free or discounted courses for older adults. You may even be able to find classes online.
  • Form or join a book or film club
  • Try yoga, tai chi, or another new physical activity
  • Learn (or relearn) how to play a musical instrument
  • Visit local museums. Many offer free group tours and educational programs.

BECOME MORE ACTIVE IN YOUR COMMUNITY

  • Visit a community or senior center and take part in its events and activities
  • Serve meals or organize clothing donations for people in need
  • Run errands for people with limited mobility or access to transportation
  • Join a committee or help out with an activity at your place of worship
  • Volunteer at a school, library, museum, hospital, or animal shelter
  • Help with gardening at a community garden or park
  • Organize a park clean-up through your local recreation center or community association
  • Sing in a community choral group, or play in a local band or orchestra
  • Take part in a local theater troupe
  • Get a local part-time job or explore opportunities online
  • Teach a favorite pastime or skill, such as embroidery, photography, building models, chess, baking, woodworking, calligraphy, or quilting, to a new generation

GO OUT AND GET MOVING

  • Garden (indoors or out) or do yard work
  • Take an exercise class or do exercises at home
  • Go dancing
  • Join a sports club for older adults, like a bowling club or bocce league
  • Walk or bicycle with a friend or neighbor
  • Take a swimming class
  • Play with your grandchildren. Teach them a game or dance you remember from childhood
  • Take a stroll around the neighborhood or on nature trails

ADOPT HEALTHY STRESS-RELIEVING HABITS

  • Read a good book, magazine, or newspaper
  • Practice gratitude and mindfulness
  • Do tai-chi or yoga
  • Cook your favorite healthy meal
  • Enjoy the little things, such as a cup of coffee or sunrise

To learn more, please visit https://www.nia.nih.gov/health/healthy-aging/participating-activities-you-enjoy-you-age.

What Are Palliative Care and Hospice Care?

April 8, 2024

Many Americans die in facilities such as hospitals or nursing homes receiving care that is not consistent with their wishes. It’s important for older adults to plan ahead and let their caregivers, doctors, or family members know your end-of-life preferences in advance. For example, if an older person wants to die at home, receiving end-of-life care for pain and other symptoms, and makes this known to health care providers and family, it is less likely he or she will die in a hospital receiving unwanted treatments.

If the person is no longer able to make health care decisions for themselves, a caregiver or family member may have to make those decisions. Caregivers have several factors to consider when choosing end-of-life care, including the older person’s desire to pursue life-extending treatments, how long he or she has left to live, and the preferred setting for care.

WHAT IS PALLIATIVE CARE?

Palliative care is specialized medical care for people living with a serious illness, such as cancer or heart failure. Patients in palliative care may receive medical care for their symptoms, or palliative care, along with treatment intended to cure their serious illness. Palliative care is meant to enhance a person’s current care by focusing on quality of life for them and their family.

WHO CAN BENEFIT FROM PALLIATIVE CARE?

Palliative care is a resource for anyone living with a serious illness, such as heart failurechronic obstructive pulmonary diseasecancerdementiaParkinson’s disease, and many others. Palliative care can be helpful at any stage of illness and is best provided soon after a person is diagnosed.

In addition to improving quality of life and helping with symptoms, palliative care can help patients understand their choices for medical treatment. The organized services available through palliative care may be helpful to any older person having a lot of general discomfort and disability very late in life.

WHO MAKES UP THE PALLIATIVE CARE TEAM?

A palliative care team is made up of multiple different professionals that work with the patient, family, and the patient’s other doctors to provide medical, social, emotional, and practical support. The team is comprised of palliative care specialist doctors and nurses, and includes others such as social workers, nutritionists, and chaplains. A person’s team may vary based on their needs and level of care. To begin palliative care, a person’s health care provider may refer him or her to a palliative care specialist. If he or she doesn’t suggest it, the person can ask a health care provider for a referral.

WHERE IS PALLIATIVE CARE PROVIDED?

Palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics and certain other specialized clinics, or at home. MedicareMedicaid, and insurance policies may cover palliative care. Veterans may be eligible for palliative care through the Department of Veterans Affairs. Private health insurance might pay for some services. Health insurance providers can answer questions about what they will cover.

Visit the National Hospice and Palliative Care Organization website to find palliative care near you.

In palliative care, a person does not have to give up treatment that might cure a serious illness. Palliative care can be provided along with curative treatment and may begin at the time of diagnosis. Over time, if the doctor or the palliative care team believes ongoing treatment is no longer helping, there are two possibilities. Palliative care could transition to hospice care if the doctor believes the person is likely to die within six months (see What does the hospice six-month requirement mean?). Or, the palliative care team could continue to help with increasing emphasis on comfort care.

WHAT IS HOSPICE CARE?

Increasingly, people are choosing hospice care at the end of life. Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life.

At some point, it may not be possible to cure a serious illness, or a patient may choose not to undergo certain treatments. Hospice is designed for this situation. The patient beginning hospice care understands that his or her illness is not responding to medical attempts to cure it or to slow the disease’s progress.

Like palliative care, hospice provides comprehensive comfort care as well as support for the family, but, in hospice, attempts to cure the person’s illness are stopped. Hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course.

It’s important for a patient to discuss hospice care options with their doctor. Sometimes, people don’t begin hospice care soon enough to take full advantage of the help it offers. Perhaps they wait too long to begin hospice and they are too close to death. Or, some people are not eligible for hospice care soon enough to receive its full benefit. Starting hospice early may be able to provide months of meaningful care and quality time with loved ones.

WHERE IS HOSPICE CARE PROVIDED AND WHO PROVIDES IT?

Hospice is an approach to care, so it is not tied to a specific place. It can be offered in two types of settings — at home or in a facility such as a nursing home, hospital, or even in a separate hospice center.

Read more about where end-of-life care can be provided.

Hospice care brings together a team of people with special skills — among them nurses, doctors, social workers, spiritual advisors, and trained volunteers. Everyone works together with the person who is dying, the caregiver, and/or the family to provide the medical, emotional, and spiritual support needed.

A member of the hospice team visits regularly, and someone is usually always available by phone — 24 hours a day, seven days a week. Hospice may be covered by Medicare and other insurance companies. Check to see if insurance will cover the person’s particular situation.

It is important to remember that stopping treatment aimed at curing an illness does not mean discontinuing all treatment. A good example is an older person with cancer. If the doctor determines that the cancer is not responding to chemotherapy and the patient chooses to enter into hospice care, then the chemotherapy will stop. Other medical care may continue as long as it is helpful. For example, if the person has high blood pressure, he or she will still get medicine for that.

Although hospice provides a lot of support, the day-to-day care of a person dying at home is provided by family and friends. The hospice team coaches family members on how to care for the dying person and even provides respite care when caregivers need a break. Respite care can be for as short as a few hours or for as long as several weeks.

To learn more, please visit https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care.

Welcome New Chief Medical Officer, Dr. Robert L. Russell, MD, MBA

April 8, 2024

We are thrilled to announce the addition of Dr. Robert L. Russell, MD, MBA, to our team as our new Chief Medical Officer! Dr. Russell brings with him a wealth of experience and expertise in internal medicine and geriatric care, with a specific focus on post-acute care.

Prior to joining our team, Dr. Russell served as the former Regional Medical Director for the Midwest at CommuniCare Healthcare, where he honed his skills in long-term care. Currently, Dr. Russell holds pivotal roles in shaping geriatric healthcare in Indiana. He serves as Chairman of the Medical Advisory Committee for CICOA Aging & In-Home Solutions, the state’s largest Area Agency on Aging, where he leads strategic planning efforts and oversees the Medical Nutrition Therapy Program. 

Dr. Russell is a committed advocate for healthcare excellence, having held leadership positions in various organizations, including two terms as President of the Indiana Medical Directors Association and membership on the executive board of the Alzheimer’s Association of Greater Indiana. His collaborative efforts were recognized with the Collaborator of the Year award by CICOA Aging & In-Home Solutions in 2023. Dr. Russell is also a respected keynote speaker and panelist on topics ranging from Alzheimer’s Disease to caregiver burden and value-based care.

Beyond his professional achievements, Dr. Russell is a devoted husband and father of three. He finds joy in family time, basketball games, travel, and community service.

With his heart for healthcare and passion for making a difference, Dr. Russell’s addition will undoubtedly have a profound and lasting impact in the field of geriatric medicine. Please join us in welcoming Dr. Robert L. Russell as our Chief Medical Officer! We look forward to the invaluable contributions he will make to our organization and the community we serve.

Success Story: Mattie “Mae” Logsdon

April 3, 2024

Greenville Nursing and Rehabilitation is excited to share resident Mattie “Mae” Logsdon’s Success Story!

Mattie “Mae” Logsdon was admitted to Greenville Nursing and Rehabilitation in December 2023 following a fall at home resulting in a fractured hip, which rendered her weak and in need of extensive assistance with self-care tasks and mobility. Driven by her desire to reunite with her husband, Mae actively participated in skilled physical and occupational therapy sessions. Through her dedication, Mae made significant progress, enhancing her independence with both self-care and mobility. Ultimately, she achieved her goal of returning home! Congratulations to Mae and her Care Team on their success!

How the Aging Brain Affects Thinking

April 3, 2024

The brain controls many aspects of thinking — remembering, planning and organizing, making decisions, and much more. These cognitive abilities affect how well we do everyday tasks and whether we can live independently.

Some changes in thinking are common as people get older. For example, older adults may:

  • Be slower to find words and recall names
  • Have problems with multitasking
  • Experience mild decreases in the ability to pay attention

Aging may also bring positive cognitive changes. For example, many studies have shown that older adults have larger vocabularies and greater knowledge of the depth of meaning of words than younger adults. Older adults may also have learned from their many years of accumulated knowledge and experiences. Whether and how older adults apply this knowledge, and how the brain changes as a result, is an area that researchers are actively exploring.

Despite the changes in cognition that may come with age, older adults can still do many of the things they have enjoyed their whole lives. Research shows that older adults can still:

  • Learn new skills
  • Form new memories
  • Improve vocabulary and language skills

How the brain changes as people age

As a person gets older, changes occur in all parts of the body, including the brain.

  • Certain parts of the brain shrink, including those important to learning and other complex mental activities.
  • In certain brain regions, communication between neurons may be less effective.
  • Blood flow in the brain may decrease.
  • Inflammation, which occurs when the body responds to an injury or disease, may increase.

These changes in the brain can affect mental function, even in healthy older people. For example, some older adults may find that they don’t do as well as younger individuals on complex memory or learning tests. However, if given enough time to learn a new task, they usually perform just as well. Needing that extra time is normal as people age. There is growing evidence that the brain maintains the ability to change and adapt so that people can manage new challenges and tasks as they age.

Talk with your doctor if you’re concerned about changes in your thinking and memory. They can help you determine whether those changes are normal or whether it could be something else.

The brain-body connection

There is growing scientific evidence of the brain-body connection. Not only can changes in our brain affect our thinking, but also changes in our physical health may affect our brains.

For example, an NIA-funded study of almost 3,000 older adults showed that healthy lifestyle factors — physical activity, not smoking, not drinking heavily, following the Mediterranean-style diet, and engaging in mentally stimulating activities — can have important benefits. People who engaged in four or five of these behaviors had a 60% lower risk of developing Alzheimer’s compared to those who only followed one or none. People who followed two or three of the activities had a 37% lower risk.

In another study, older adults with higher levels of physical activity showed slower rates of cognitive decline than peers who were less active. Another example of how physical health can affect brain health has to do with the heart. Observational studies have found that high blood pressure in middle age, along with other cerebrovascular risk factors, such as diabetes and smoking, increase the risk of developing dementia.

Results from observational studies such as these can’t prove cause and effect, but they point to how a combination of modifiable behaviors may affect the brain as people age and identify promising avenues to be tested further.

To learn more, please visit https://www.nia.nih.gov/health/brain-health/how-aging-brain-affects-thinking

Emergency Readiness for Older Adults and People with Disabilities

March 25, 2024

In recent years, the United States has experienced a number of significant natural disasters. Several of these events happened with little or no warning. One key lesson that we have learned from these unfortunate circumstances is to “be prepared,” a message that is especially important for older Americans and people with disabilities. September is officially designated National Preparedness Month, but preparedness is something we should be thinking about all year long.

Unfortunately, natural disasters can disproportionately impact older people and those with disabilities. These populations are frequently less able to withstand periods of time without food, water, medication, and rest—and they may have mobility or communications limitations that impact their ability to respond. Half of the people who died during and after Hurricane Katrina were over the age of 75. People with disabilities who rely on service providers for meals, personal care, and medical assistance often go without critical support systems during a crisis. As we saw during Hurricane Sandy, the loss of electricity to power medical devices, such as ventilators, or assistive technology, can be life-threatening.

That is why it is critical that older adults and people with disabilities plan for emergencies before they happen. Here are three important steps to consider in preparing for a natural disaster:

  • Involve your community. When putting together a plan, individuals with disabilities and older adults should talk with their neighbors, family members, caregivers, and community members about emergency preparedness. Planning should be informed by individuals’ needs and preferences and should focus on creating a support team that can assist with evacuation, finding appropriate shelter, and meeting basic needs during a crisis. Planning should also take into account those situations when local services and supports are not available, and an individual needs to relocate out of the community. Consider including out-of-town relatives or friends in disaster preparedness plans.
  • Pack an emergency medical kit. People with disabilities and older people with chronic health conditions should pack an emergency kit. It should contain food, water, medication, copies of medical records, instructions for medical devices, and, if necessary, things like extra wheelchair batteries and oxygen tanks.
  • Make a plan for pets and service animals. Millions of people have pets and service animals that they love dearly. Owners should create evacuation and emergency response plans that include the needs of their animals. This includes packing an emergency kit for animals with food, water, and medication Pet owners should learn which shelters in their communities accept non-service animals and enlist the support of friends and neighbors to help with pet care if local shelters are not an option.

Every state is unique in terms of the local risks and types of natural disasters that can take place. But no matter where you are, it is important to take time to ensure that older Americans and people with disabilities engage in emergency planning so they are prepared to weather the storms that come.

For more information and links to resources about emergency preparedness for older adults and people with disabilities, please visit ACL’s emergency preparedness webpage.

Social Work Month: Tehya Robinson

March 20, 2024

Greenville Nursing and Rehabilitation is excited to highlight our outstanding Social Work team! Introducing Tehya Robinson!

Name: Tehya Robinson

Years of Experience: 4 years 

What has ‘empowered’ you to become a social worker?: What has empowered me to become a Social Worker is the opportunity to spend each day with the vulnerable population and fill the gap that no one else can.

As we celebrate Social Work Month, what message or advice would you like to share with the community about the importance of social work in long-term care?: The importance in social work in long term care is you give them a voice that they may not have. Social work is a key player in long-term care facilities

Risk and Protective Factors for Older Adults

March 19, 2024

A combination of individual, relational, community, and societal factors contribute to the risk of becoming a perpetrator of elder abuse. They are contributing factors and may or may not be direct causes. Understanding these factors can help identify various opportunities for prevention.

Watch Moving Forward to learn more about how increasing what protects people from violence and reducing what puts people at risk for it benefits everyone.

RISK FACTORS FOR PERPETRATION

Individual Risk Factors

  • Current diagnosis of mental illness
  • Current or past abuse of drugs or alcohol
  • Current physical health problem
  • Past experience of disruptive behavior
  • Past experience of traumatic events
  • High levels of stress
  • Poor or inadequate preparation or training for caregiving responsibilities
  • Inadequate coping skills
  • Exposure to or witnessing abuse as a child
  • Social isolation

Relationship Risk Factors

  • High financial and emotional dependence upon a vulnerable elder
  • Past family conflict
  • Inability to establish or maintain positive prosocial relationships
  • Lack of social support

Societal Risk Factors

There are specific characteristics of institutional settings such as nursing homes and residential facilities, that can increase the risk for perpetration including:

  • Staffing problems and lack of qualified staff
  • Staff burnout and stressful working conditions

PROTECTIVE FACTORS FOR ELDER ABUSE

Protective factors reduce risk for perpetrating or experiencing abuse and neglect. Protective factors have not been studied as extensively as risk factors. However, identifying and understanding protective factors are equally as important as researching risk factors.

PROTECTIVE FACTORS FOR VICTIMIZATION

Individual Protective Factors

  • Emotional intelligence

Relationship Protective Factors

  • Having social support

Community Protective Factors

  • Sense of community, meaning, residents feel connected to each other and are involved in the community

To learn more, please visit https://www.cdc.gov/violenceprevention/elderabuse/riskprotectivefactors.html

Productive Aging and Work

March 11, 2024

Aging is a process experienced by all workers throughout their life. Although there is no consensus on the age at which workers are considered “older workers,” the aging workforce phenomenon is real. For many older adults, work is increasingly an important avenue to economic security, enhanced social interaction, and improved quality of life. According to the U.S. Bureau of Labor Statistics, in 2021 nearly one in four American workers was age 55 or older. Moreover, labor force participation rates for workers aged 55 and older are projected to increase through 2030, while participation rates for those in younger and middle-aged groups are projected to remain relatively level or decline. These demographic shifts have made the issue of supporting and protecting the health and safety of workers, especially those of advanced age, much more pressing. Vital to any workplace is the safety, health, and well-being of all workers, from their first day on the job to their last.

National Center for Productive Aging and Work

The National Center for Productive Aging and Work (NCPAW) advances lifelong well-being for workers of all ages and supports productive aging across the working life. The Center works on important issues such as how organizations are addressing the needs of an aging workforce and identifying interventions and strategies to support both workers of all age groups and organizations that employ them. The Center is hosted by the NIOSH Office for Total Worker Health®

Benefits of an Aging Workforce and Age-Friendly Work Practices

Employers increasingly see the value that older workers bring to the job. Older workers have greater institutional knowledge and usually more applicable experience. They report lower levels of stress on the job, and in general, they get along better with their coworkers. Finally, they tend to be more cautious on the job and more likely to follow safety rules and regulations.

A well-designed, employee-centered approach that focuses on multiple aspects of the workplace, including the nature of work, benefits all workers regardless of age. Many workplace accommodations are easy to make and are inexpensive. Modern orthotics, appropriate flooring and seating, optimal lighting, and new information technology hardware and software can smooth the way to continued work for older individuals. A new emphasis on job sharing, flexible work schedules, and working from home can support added years in the job market for many.

Simple Strategies for an Age-Friendly Workplace

These solutions can have large benefits if implemented properly with worker input and support throughout all levels of management. Moreover, these strategies can benefit workers regardless of age.

  • Prioritize workplace flexibility. Workers prefer jobs that provide more flexibility over those that offer more vacation days. To the extent possible, give workers a say in their schedule, work conditions, work organization, work location, and work tasks.
  • Match tasks to abilities. Use self-paced work, self-directed rest breaks, and less repetitive tasks.
  • Avoid prolonged, sedentary work. Prolonged, sedentary work is bad for workers at every age. Consider sit/stand workstations and walking workstations for workers who traditionally sit all day. Design work to include a variety of tasks and skills. Provide onsite physical activity opportunities or connections to low-cost community options.
  • Manage hazards. Including noise, slip/trip hazards, and physical hazards – conditions that may result in harm to workers of all ages, but can be more challenging to an aging workforce.
  • Provide and design ergonomic-friendly work environments. Examples include adjustable workstations, minimize vibration and noise from tools, floor surfaces that reduce the impact on joints, adjustable seating, good lighting, and screens and surfaces with less glare.
  • Utilize teams and teamwork strategies for identifying and solving problems. Workers closest to the problem are often best equipped to find the fix.
  • Provide health promotion and lifestyle interventions including encouraging physical activity and healthy meal options, tobacco cessation assistance, screenings for health risk factors, strategies for reducing health risks, health coaching, and onsite medical care. Accommodate medical self-care in the workplace and time away for health visits.
  • Invest in training and building worker skills and competencies at all age levels. Help older employees learn and adapt to new technologies, often a concern for employers and older workers. Provide workers the opportunities to practice and apply new skills as they are learning.
  • Proactively manage reasonable accommodations and the return-to-work process after illness or injury absences.
  • Provide age inclusive workforce management skills training for supervisors. Include a focus on the varying needs of workers at different life stages, and effective ways to manage a multi-generational workplace.

To learn more, please visit https://www.cdc.gov/niosh/topics/productiveaging/.

Success Story: Gregory Lemons

March 11, 2024

Greenville Nursing and Rehabilitation is excited to share resident Gregory Lemons’ Success Story!

Gregory entered Greenville Nursing and Rehabilitation requiring assistance with daily activities and transfers. The therapy team promptly implemented a comprehensive plan aimed at enhancing Gregory’s strength and overall well-being. Through unwavering dedication and collaborative efforts, Gregory experienced significant improvements in his independence! After just 17 days of rehabilitation, he was discharged, reflecting the remarkable progress achieved during his time in therapy! Congratulations Gregory, on your remarkable rehabilitation success!

Learn About Alzheimer’s Disease & 8 ways to Lower Your Risk of Getting It

March 4, 2024

What is Alzheimer’s Disease?

Alzheimer’s disease is the most common type of dementia. Alzheimer’s disease involves parts of the brain that control thought, memory, and language. It begins with mild memory loss and can lead to losing the ability to carry on a conversation and respond to the environment. If not treated, it can affect a person’s ability to go about their normal routines.

  • Alzheimer’s disease and related dementias can seriously affect a person’s ability to carry out daily activities. This memory loss is not a normal part of aging.

Scientists don’t know what causes Alzheimer’s. However, like other chronic conditions, it is probably a result of several things.

How many people have Alzheimer’s disease?

Nearly 6.7 million people in the United States have Alzheimer’s disease.1  By 2060, that number is expected to grow to 13.9 million.2 You may have a friend or loved one who has been diagnosed with Alzheimer’s disease or another type of dementia.

  • Most people living with Alzheimer’s disease are 65 or older. People younger than 65 can have Alzheimer’s disease, but it’s uncommon.

Is there a cure for Alzheimer’s Disease?

There is no cure for Alzheimer’s disease at this time, but there are things you can do to help lower your risk.

  1. Controlling high blood pressure
  2. Maintaining a healthy weight
  3. Quitting smoking
  4. Being physically active
  5. Eating healthy meals
  6. Getting enough sleep
  7. Avoiding alcohol or drinking alcohol in moderation
  8. Managing diabetes

You don’t have to make these changes all at once. For example, getting an extra 30 minutes of sleep at night, getting an annual physical exam, or simply taking a walk every day may make a big difference in brain health.3

If you notice that your memory is changing or getting worse, you should talk to a medical professional.

To learn more, please visit https://www.cdc.gov/aging/publications/features/what-is-alzheimers-disease/index.html.

The Mental Health of People with Disabilities

February 26, 2024

Adults with disabilities report experiencing frequent mental distress almost 5 times as often as adults without disabilities.  Call your doctor if your mental health gets in the way of your daily activities for at least 14 days in a month.

December 3rd is International Day of Persons with Disabilities. In the United States, up to 1 in 4 adults have a disability. Many people will experience a disability at some point during their lives. Disabilities limit how a child or adult functions. These limitations may include difficulty walking or climbing stairs; hearing; seeing; or concentrating, remembering, or making decisions.

Although “people with disabilities” sometimes refers to a single population, this is a diverse group of people with a wide range of needs. Two people with the same type of disability can be affected in very different ways. Some disabilities may be hidden or not easy to see.

Many Adults with Disabilities Report Frequent Mental Distress

A CDC study found that adults with disabilities report experiencing more mental distress than those without disabilities.1 In 2018, an estimated 17.4 million (32.9%) adults with disabilities experienced frequent mental distress, defined as 14 or more reported mentally unhealthy days in the past 30 days. Frequent mental distress is associated with poor health behaviors, increased use of health services, mental disorders, chronic disease, and limitations in daily life.1

During the COVID-19 pandemic, isolation, disconnect, disrupted routines, and diminished health services greatly impacted the lives and mental well-being of people with disabilities.2

Call your healthcare provider if stress gets in the way of your daily activities for several days in a row. Free and confidential resources can also help you or a loved one connect with a skilled, trained counselor in your area.

It’s Okay Not to Feel Okay

Everyone reacts differently to stressful situations. How you respond to stressful situations, such as the COVID-19 pandemic, can depend on your background, your support systems (e.g., family or friends), your financial situation, your health and emotional background, the community you live in, and many other factors.

People with disabilities or developmental delays may respond strongly to the stress of a crisis, particularly if they are also at higher risk for serious illness from COVID-19 and other respiratory viruses (for example, older people and people of any age with certain underlying medical conditions).

How Are You Feeling?

We are often asked this question, and many of us say we’re “fine.” But this has been a difficult time lately, and emotions can be complex. You may be feeling sad, worried, or stressed.

It helps to stay positive and remind yourself of your strengths. Visit How Right Now for inspiration and resources to find what helps.

Healthy Ways to Cope with Stress

  • Know what to do if you are sick and are concerned about COVID-19. Contact a health provider before you start any self-treatment for COVID-19.
  • Know where and how to get mental health treatment and other support services and resources, including counseling or therapy (in person or through telehealth services).
  • Take care of your emotional health. Taking care of your emotional health will help you think clearly and react to urgent needs to protect yourself and your family.
  • Take breaks from watching, reading, or listening to news stories, including those on social media. Hearing about the pandemic repeatedly can be upsetting.
  • Take care of your body.
  • Make time to unwind. Try to do some other activities you enjoy.
  • Connect with others. Talk with people you trust about your concerns and how you are feeling.  During times of increased social distancing, people can still maintain social connections and care for their mental health. Phone calls or video chats can help you and your loved ones feel socially connected, less lonely, or isolated.
  • Connect with your community- or faith-based organizations. While social distancing measures are in place, consider connecting online, through social media, or by phone or mail.
  • Improving the Mental Health of People with Disabilities
  • CDC provides funding for two National Centers on Disability that focus on improving the quality of life for people living with disabilities.
  • Special Olympics’ Inclusive Health programming focuses on improving the physical and social-emotional well-being of people with intellectual disabilities by increasing inclusion in health care, wellness, and health systems for Special Olympics athletes and others with intellectual disabilities.
  • “I learned relaxation techniques and now always try these when I find myself overwhelmed. I would recommend these strategies to others, too. A strong mind is an important part to a happy body,” shares Kayte Barton, a Special Olympics athlete from Minnesota.  Barton was a part of the Special Olympics committee to help develop emotional health programming for Special Olympics athletes across the world in its flagship Special Olympics Healthy Athletes® program.
  • Special Olympics’ Strong Mindfulness program offers free, 1-hour mindfulness sessions for people with intellectual disabilities and their families. Participants learn deep breathing techniques, body awareness and progressive muscle relaxation, mindful movement, and guided meditation. They also receive a Strong Minds Activity Guide designed to help them develop their coping skills in everyday life.
  • The National Center on Health, Physical Activity and Disability (NCHPAD) seeks to help people with disabilities and other chronic health conditions achieve health benefits through increased participation in all types of physical and social activities. NCHPAD’s M.E.N.T.O.R program, which stands for Mindfulness, Exercise and Nutrition to Optimize Recovery, takes a holistic approach to restoring, improving, and protecting health. The program divides health into three domains: physical, mental, and emotional.  Through this program, people who have acquired a new disability (e.g., spinal cord injury, stroke, traumatic brain injury), a new diagnosis (e.g., multiple sclerosis, Parkinson’s disease), or have a congenital condition (e.g., cerebral palsy, spina bifida) learn the many ways life can be enhanced through health and wellness activities.

Disability and Mental Health Resources

As CDC honors International Day of Persons with Disabilities, we ask that you join us in being a part of the global movement to change attitudes toward, and promote the inclusion of, people with disabilities.

To learn more, please visit https://www.cdc.gov/ncbddd/disabilityandhealth/features/mental-health-for-all.html

Safer Food Choices for Adults 65 and Over

February 20, 2024

Help Prevent Food Poisoning

Older adults have a higher risk of getting sick from food poisoning and having a more serious illness.

To prevent food poisoning, some foods are safer choices than others. That’s because some foods—such as undercooked meat and eggs, unwashed fruits and vegetables, and unpasteurized milk — are more often associated with foodborne illnesses. Use the table below as a guide to safer food choices.

To learn more, please visit https://www.cdc.gov/foodsafety/communication/adults-65-over.html

Success Story: Exie Gilland

February 19, 2024

Greenville Nursing and Rehabilitation is excited to share resident Exie Gilland’s Success Story! 

Exie Gilland’s journey at Greenville Nursing and Rehabilitation began as a long-term care patient, facing challenges with mobility and self-care independence. With a comprehensive therapy plan in place, encompassing all forms of therapy, Exie embarked on her path to progress! Thanks to the collaborative efforts of the therapy team and Exie’s unwavering dedication, remarkable improvements were achieved. Exie regained her independence in mobility and selfcare, culminating in her successful transition back into long-term care after just 16 days. Congratulations to Exie and her Care Team on their success!

Older Adult Drivers

February 12, 2024

In 2020, there were almost 48 million licensed drivers ages 65 and older in the United States. This is a 68% increase since 2000.

Driving helps older adults stay mobile and independent. But the risk of being injured or killed in a traffic crash increases as people age. Thankfully, older adults can take steps to stay safer on the roads.

Thousands of older adults are injured or killed in the United States every year in traffic crashes.

In 2020, about 7,500 older adults were killed in traffic crashes, and almost 200,000 were treated in emergency departments for crash injuries. This means that each day, 20 older adults are killed and almost 540 are injured in crashes.

Age, gender, and age-related changes are major risk factors
  • Drivers aged 70+ have higher crash death rates per 1,000 crashes than middle-aged drivers (aged 35-54). Higher crash death rates among this age group are primarily due to increased vulnerability to injury in a crash.
  • Across all age groups, males have substantially higher crash death rates than females.
  • Age-related changes in vision, physical functioning, and the ability to reason and remember, as well as some diseases and medications, might affect some older adults’ driving abilities.
Key steps to staying safe on the roads
  • The good news is that older adults are more likely to have safer driving behaviors than other age groups.
  • Taking these key steps can help adults of all ages, including older adults, stay safe on the road:
  • Always wear a seat belt as a driver or passenger
    Seat belt use is one of the most effective ways to save lives and reduce injuries in crashes.
  • Drive when conditions are safest
    Drive during daylight and in good weather. Conditions such as poor weather and driving at night increase the likelihood of crash injuries and deaths.
  • Don’t drink and drive
    Drinking and driving increases the risk of being in a crash because alcohol reduces coordination and impairs judgment.
Additional steps to stay safe on the road
  • Use CDC’s MyMobility Plan, a plan to stay mobile and independent as you age.
  • Follow a regular activity program to increase strength and flexibility.
  • Ask your doctor or pharmacist to review medicines—both prescription and over-the counter—to reduce side effects and interactions. Read the Are Your Medicines Increasing Your Risk of a Fall or a Car Crash fact sheet to learn more.
  • Have your eyes checked by an eye doctor at least once a year. Wear glasses and corrective lenses as required.
  • Plan your route before you drive.
  • Find the safest route with well-lit streets, intersections with left-turn signals, and easy parking.
  • Leave a large following distance between your car and the car in front of you.
  • Avoid distractions in your car, such as listening to a loud radio, talking or texting on your phone, and eating.
  • Consider potential alternatives to driving, such as riding with a friend, using ride share services, or taking public transit.

To learn more, please visit https://www.cdc.gov/transportationsafety/older_adult_drivers/index.html

Adding Physical Activity as an Older Adult

February 7, 2024

Adults 65 and older need a mix of aerobic, muscle-strengthening, and balance activities each week to keep their bodies strong. Regular physical activity can help you live independently, have a better quality of life, and prevent or manage chronic disease.

It’s never too late to start being physically active! Pick activities you enjoy and that match your abilities. This will help ensure that you stick with them.

Tips for Being Physically Active

  • Try to do a variety of activities. This can make physical activity more enjoyable and reduce your risk of injury.
  • Even if it’s hard to do some types of activities such as climbing stairs or walking, you can safely do other types of physical activity. Try airplane stretches [PDF-2.9MB] and chair [PDF-2.9MB] or desk exercises [PDF-1.3MB].
  • Lots of activities count, even things like mowing the lawn or carrying groceries, and it all adds up. Find what works for you.
  • If you take a break from your regular activity due to an illness or travel, start again at a lower level and slowly work back up to your usual level of activity.
  • If it is too hot, cold, or wet to be outside, try walking in a mall or look for an online fitness program you can do at home.
  • If losing weight is your goal, you may need to reduce the number of calories you eat and do more than the recommended amounts of physical activity.

Recommended Weekly Physical Activity

Every week, adults 65 and older need physical activities that include:

  • At least 150 minutes (for example, 30 minutes a day, 5 days a week) of moderate-intensity aerobic activity such as brisk walking. Or you need 75 minutes a week of vigorous-intensity aerobic activity such as hiking, jogging, or running.
  • At least 2 days of activities that strengthen muscles.
  • Activities to improve balance such as standing on one foot.

See examples of how to fit this into a week.

What if You Have a Chronic Condition?

If you have a health condition such as arthritis, diabetes, or heart disease, it doesn’t mean you can’t be active. Regular physical activity can improve your quality of life and even reduce your risk of developing other conditions.

Ask your doctor if your health condition limits your ability to be active in any way. Then, work with your doctor to come up with a physical activity plan that matches your abilities.

If your condition stops you from meeting the minimum recommended activity levels, try to do as much as you can. What’s important is that you avoid being inactive.

What if You Have a Disability?

Regular physical activity provides people with disabilities  important health benefits, like a stronger heart, lungs, and muscles; improved brain health; and a better ability to do everyday tasks. Talk with your doctor before you begin a physical activity routine. A professional with experience in physical activity and disabilities can tell you more about the amounts and types of physical activity appropriate for you.

Other Reasons to Check With Your Doctor

Doing physical activity that requires moderate effort is safe for most people. But if you have been inactive, are not too fit, or are overweight, and want to do vigorous-intensity physical activity, such as jogging, it is safest to discuss this with your doctor.

To learn more, please visit https://www.cdc.gov/physicalactivity/basics/adding-pa/activities-olderadults.htm.

Maintaining a Care Plan for Older Adults

January 29, 2024

Developing and maintaining a care plan will help you balance both your life and that of the person to whom you are providing care!

Are you a caregiver for an older adult with dementia or another chronic health condition? If so, do they have a care plan? Having a care plan can help you as a caregiver, especially if there are multiple caregivers, to aid with transitions and to have all important information in one place.

WHAT IS A CARE PLAN?

A care plan is a form [1.48 MB] where you can summarize a person’s health conditions, specific care needs, and current treatments. The care plan should outline what needs to be done to manage the care needs. It can help organize and prioritize caregiving activities. A care plan can give you a sense of control and confidence when managing caregiving tasks and help assure you that the care recipient’s needs are being met.

Care plans can especially be helpful if you care for more than one person.  Forty-two million Americans are caring for someone aged 50 or older; 24% are providing care for at least two people.

WHAT SHOULD I INCLUDE IN THE CARE PLAN?

The plan should include information about:

  • Personal Information (name, date of birth, contact information)
  • Health conditions
  • Medicines, dosages, and when/how given
  • Health care providers with contact information
  • Health insurance information
  • Emergency Contacts

HOW DO I DEVELOP A CARE PLAN?

  • Begin a care planning conversation with the person you care for. Use Complete Care Plan [PDF – 1 MB] to help start and guide the discussions.
  • If the care recipient is unable to provide all the information needed, talk to others who regularly interact with them (a family member or home nurse aide) and invite them to join the discussions and help complete the form.
  • Ask about suitable care options for the person you care for. Medicare covers appointments to manage chronic conditions and discuss advanced care plans, including planning appointments for people with Alzheimer’s, other dementias, memory problems, or suspected cognitive impairment.
  • Try to update the care plan every year, or more often if the person you care for has a change in health or medicines. Remember to respect the care recipient’s privacy after reviewing their personal information and discussing their health conditions.

WHAT ARE THE BENEFITS OF A CARE PLAN?

  • Care plans can reduce emergency room visits and hospitalizations and improve overall medical management for people with a chronic health condition, like Alzheimer’s disease.
  • Care plans can support you, the caregiver, so you can stay healthy.
  • Care plans can help retain quality of life and independence for the care recipient.

WHAT ABOUT MY OWN HEALTH?

If you’re a caregiver, taking care of yourself is crucial. Make sure to discuss any concerns you have as a caregiver with your health care provider. Caregivers can experience emotional, psychological, and physical strain. In addition, caregivers often neglect their own health. This neglect can increase their risk of having multiple chronic conditions. Nearly 2 in 5 caregivers have at least two chronic health conditions. Caregivers of people with dementia or Alzheimer’s are at greater risk for anxiety, depression, and lower quality of life than caregivers of people with other chronic conditions.

To learn more, please visit https://www.cdc.gov/aging/publications/features/caregivers-month.html.

Seniors in Care Facilities Have More Protection Available This Year: CDC Encourages Vaccination Against Flu, COVID-19, and RSV

January 22, 2024

New research in this week’s MMWR finds that most nursing home residents haven’t received an updated COVID-19 vaccine or the new RSV vaccine.

This year, for the first time, vaccines are available to protect older adults in the United States against all three fall/winter respiratory illnesses: flu, COVID-19 and RSV. Older Americans who are not vaccinated are at greater risk of serious illness.

Leading up to this virus season, and throughout the fall, CDC has worked with other federal agencies, state and local health departments, and health care partners to address vaccine access issues and encourage uptake. CDC was a key participant in the Long Term Care Facility Summit on October 18, 2023, which was co-hosted by the Secretary of Health and Human Services and the Director of the Office of Pandemic Preparedness and Response Policy. In addition to other activities, CDC regularly:

  • Monitors all reports and data about the safety and effectiveness of these vaccines.
  • Convenes bi-weekly calls with long-term care partners to address challenges/develop solutions.
  • Works to improve equitable access to vaccines by connecting manufacturers with long-term care pharmacies to prioritize vaccine distribution for the Bridge Access Program.
  • Distributes a weekly newsletter with respiratory virus resources and information specific to long-term care providers. (e.g., toolkits, FAQs, clinical resources, vaccine confidence resources)
  • Supports the education of partners through participation in speaking engagements and webinars.
  • Engages with the Centers for Medicare and Medicaid Services (CMS) toidentify solutions to address feedback from long-term care  partners around billing and reimbursement challenges which have been a barrier to vaccine administration. As a result, CMS issued a letter to plans and pharmacy benefit managers to outline the concerns and provide guidance on ways to improve practices.

Health care providers can continue to do their part by offering recommended vaccinations to residents. Nursing homes are encouraged to collaborate with state, local and federal public health, and long-term care pharmacy partners to address barriers contributing to low vaccination coverage. Vaccination is a key way to prevent severe disease, hospitalization, and death from flu, COVID-19 and RSV.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

Success Story: Emma Walker

January 17, 2024

Greenville Nursing and Rehabilitation is excited to share resident Emma Walker’s Success Story!

Ms. Emma Walker was admitted to Greenville Nursing and Rehabilitation on November 16, 2023, as a long-Term Care resident following a hospital stay for multiple medical complexities. Before her hospitalization, Ms. Emma lived independently at home but received assistance from her family for certain instrumental daily activities. Upon admitting to Greenville Nursing and Rehabilitation, Emma required moderate assistance with transfers and needed support for functional mobility and self-care tasks. These challenges were attributed to decreased standing, balance and muscle strength as well as endurance loss in both upper and lower extremities.

Emma worked hard with our physical and occupational therapy team and actively participated in each session, demonstrating a strong commitment to her rehabilitation. She not only engaged well in therapy, but also found joy in socializing with fellow residents, fostering meaningful connections! The community at Greenville Nursing and Rehabilitation expresses great satisfaction in having Ms. Emma as part of their long-term care program. Congratulations to Emma and her Care Team on their success!

Recognizing Symptoms of Dementia and Seeking Help

January 8, 2024

As we age, our brains change, but Alzheimer’s disease and related dementias are not an inevitable part of aging. In fact, up to 40% of dementia cases may be prevented or delayed. It helps to understand what’s normal and what’s not when it comes to brain health.

Normal brain aging may mean slower processing speeds and more trouble multitasking, but routine memory, skills, and knowledge are stable and may even improve with age. It’s normal to occasionally forget recent events such as where you put your keys or the name of the person you just met.

SYMPTOMS OF DEMENTIA OR ALZHEIMER’S DISEASE

In the United States, 6.2 million people age 65 and older have Alzheimer’s disease, the most common type of dementia. People with dementia have symptoms of cognitive decline that interfere with daily life—including disruptions in language, memory, attention, recognition, problem solving, and decision-making. Signs to watch for include:

  • Not being able to complete tasks without help.
  • Trouble naming items or close family members.
  • Forgetting the function of items.
  • Repeating questions.
  • Taking much longer to complete normal tasks.
  • Misplacing items often.
  • Being unable to retrace steps and getting lost.

CONDITIONS THAT CAN MIMIC DEMENTIA

Symptoms of some vitamin deficiencies and medical conditions such as vitamin B12 deficiency, infections, hypothyroidism (underactive thyroid), or normal pressure hydrocephalus (a neurological condition caused by the build-up of fluid in the brain) can mimic dementia. Some prescription and over-the-counter medicines can cause dementia-like symptoms. If you have these symptoms, it is important to talk to your health care provider to find out if there are any underlying causes for these symptoms.

For more information, see What Is Dementia?

HOW IS DEMENTIA DIAGNOSED?

A healthcare provider can perform tests on attention, memory, problem solving and other cognitive abilities to see if there is cause for concern. A physical exam, blood tests, and brain scans like a CT or MRI can help determine an underlying cause.

WHAT TO DO IF A LOVED ONE IS SHOWING SYMPTOMS

Talk with your loved one about seeing a health care provider if they are experiencing symptoms of Alzheimer’s dementia to get a brain health check up.

BE EMPOWERED TO DISCUSS MEMORY PROBLEMS

More than half of people with memory loss have not talked to their healthcare provider, but that doesn’t have to be you. Get comfortable with starting a dialogue with your health care provider if you observe any changes in memory, or an increase in confusion, or just if you have any questions. You can also discuss health care planning, management of chronic conditions, and caregiving needs.

To learn more, please visit https://www.cdc.gov/aging/publications/features/dementia-not-normal-aging.html.

Success Story: Dorothy Gwitt

December 22, 2023

Greenville Nursing and Rehabilitation is excited to share resident Dorothy Gwitt’s Success Story!

Ms. Dorothy Gwitt has been with Greenville Nursing and Rehabilitation since June of this year. She was admitted to our community due to a right hip fracture. She worked hard with our Care Team, receiving physical, occupational and speech therapy. Ms. Gwitt eventually decided to stay at Greenville Nursing and Rehabilitation for long-term care.

Ms. Gwitt loves to socialize with her fellow residents, enjoys playing Bingo, and going to the beauty shop to get her hair done. Greenville Nursing and Rehabilitation’s Care Team members and residents are delighted to have Ms. Gwitt here with us and can always count on her to give us a smile and friendly conversation. It is such a pleasure to have Ms. Gwitt in our community!

Prevention Strategies for Seasonal Influenza in Healthcare Settings

December 18, 2023

Influenza is primarily a community-based infection that is transmitted in households and community settings. Each year, 5% to 20% of U.S. residents acquire an influenza virus infection, and many will seek medical care in ambulatory healthcare settings (e.g., pediatricians’ offices, urgent-care clinics). In addition, more than 200,000 persons, on average, are hospitalized each year for influenza-related complications. Healthcare-associated influenza infections can occur in any healthcare setting and are most common when influenza is also circulating in the community. Therefore, the influenza prevention measures outlined in this guidance should be implemented in all healthcare settings. Supplemental measures may need to be implemented during influenza season if outbreaks of healthcare-associated influenza occur within certain facilities, such as long-term care facilities and hospitals [refs: Infection Control Measures for Preventing and Controlling Influenza Transmission in Long-Term Care Facilities].

Influenza Modes of Transmission

Traditionally, influenza viruses have been thought to spread from person to person primarily through large-particle respiratory droplet transmission (e.g., when an infected person coughs or sneezes near a susceptible person). Transmission via large-particle droplets requires close contact between source and recipient persons, because droplets generally travel only short distances (approximately 6 feet or less) through the air. Indirect contact transmission via hand transfer of influenza virus from virus-contaminated surfaces or objects to mucosal surfaces of the face (e.g., nose, mouth) may also occur. Airborne transmission via small particle aerosols in the vicinity of the infectious individual may also occur; however, the relative contribution of the different modes of influenza transmission is unclear. Airborne transmission over longer distances, such as from one patient room to another has not been documented and is thought not to occur. All respiratory secretions and bodily fluids, including diarrheal stools, of patients with influenza are considered to be potentially infectious; however, the risk may vary by strain. Detection of influenza virus in blood or stool in influenza infected patients is very uncommon.

Fundamental Elements to Prevent Influenza Transmission

Preventing transmission of influenza virus and other infectious agents within healthcare settings requires a multi-faceted approach. Spread of influenza virus can occur among patients, HCP, and visitors; in addition, HCP may acquire influenza from persons in their household or community. The core prevention strategies include:

  • administration of influenza vaccine
  • implementation of respiratory hygiene and cough etiquette
  • appropriate management of ill HCP
  • adherence to infection control precautions for all patient-care activities and aerosol-generating procedures
  • implementing environmental and engineering infection control measures.

Successful implementation of many, if not all, of these strategies is dependent on the presence of clear administrative policies and organizational leadership that promote and facilitate adherence to these recommendations among the various people within the healthcare setting, including patients, visitors, and HCP. These administrative measures are included within each recommendation where appropriate. Furthermore, this guidance should be implemented in the context of a comprehensive infection prevention program to prevent transmission of all infectious agents among patients and HCP.

To learn more, please visit https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm.

People at Higher Risk for Flu Complications

December 11, 2023

Getting an annual flu vaccine is the best way to protect yourself and your loved ones from flu.

If you are at higher risk of developing serious flu complications, flu vaccination is especially important. When you get vaccinated, you reduce your risk of getting sick with flu and possibly being hospitalized or dying from flu.

Following is a list of all the health and age factors that are known to increase a person’s risk of getting serious flu complications:

  • Adults 65 years and older
  • Children younger than 2 years old1
  • Asthma
  • Neurologic and neurodevelopment conditions
  • Blood disorders (such as sickle cell disease)
  • Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
  • Endocrine disorders (such as diabetes mellitus)
  • Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
  • Kidney diseases
  • Liver disorders
  • Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
  • People who are obese with a body mass index [BMI] of 40 or higher
  • People younger than 19 years old on long-term aspirin- or salicylate-containing medications.
  • People with a weakened immune system due to disease (such as people with HIV or AIDS, or some cancers such as leukemia) or medications (such as those receiving chemotherapy or radiation treatment for cancer, or persons with chronic conditions requiring chronic corticosteroids or other drugs that suppress the immune system)
  • People who have had a stroke

Other people at higher risk from flu:

  • Pregnant people and people up to 2 weeks after the end of pregnancy
  • People who live in nursing homes and other long-term care facilities
  • People from certain racial and ethnic minority groups are at increased risk for hospitalization with flu, including non-Hispanic Black persons, Hispanic or Latino persons, and American Indian or Alaska Native persons
  • 1 Although all children younger than 5 years old are considered at higher risk of serious flu complications, the highest risk is for those younger than 2 years old, with the highest hospitalization and death rates among infants younger than 6 months old.

Information on groups at higher risk from COVID-19 is available.’

To learn more information, please visit https://www.cdc.gov/flu/highrisk/index.htm.

Take Steps to Help You Stay Healthy During the Holidays

November 27, 2023

What to know about respiratory viruses during the holidays

  • Many different viruses spread more during fall and winter, including those that cause flu, COVID-19, and RSV illness.
  • Large gatherings, crowded travel, and more time indoors can mean more viruses spreading around the holidays.
  • This is the first year that there are vaccines to protect against all three of these viruses. These vaccines have been shown to prevent severe disease and can be lifesaving. They can also help ensure you are able to enjoy valuable time with loved ones.
  • There also are other healthy habits you can practice to stay healthy.
  • If you do get sick, there are tests and treatments to help get you feel better sooner.

It all starts with you! Here’s an action plan you can take to help you stay healthy during the holidays

Get vaccinated.

  • Many viruses spread more during the holiday season, so it is important to get all recommended vaccines, including flu, COVID-19 and RSV, as soon as possible. This will give you the best protection against these respiratory diseases, including while traveling and gathering with family and friends. These vaccines will also make your illness less severe if you do get sick.
  • Everyone ages 6 months and older should get a flu vaccine and updated COVID-19 vaccination this fall.
  • CDC recommends an RSV immunization for some groups at higher risk for severe RSV illness.
    • Adults ages 60 and older: talk to your healthcare provider to see if RSV vaccination is right for you.
    • Parents: CDC recommends using one of these two tools to protect your baby – an RSV vaccine given during weeks 32-36 of pregnancy or an RSV preventive antibody given to infants. The RSV preventive antibody is also recommended for some older babies at higher risk for severe RSV disease.
  • Vaccination is the most important step you can take to protect yourself and your loved ones. Vaccines help the body learn how to defend itself from disease without the danger of an infection.
  • You may be able to get flu, COVID-19, and RSV vaccines during the same visit. Talk with a healthcare provider or pharmacist if you have questions about these vaccines and how or when you should get them.

 Take action to stop respiratory viruses from spoiling holiday cheer.

  • If you are sick, stay home to avoid putting others at risk. You should also avoid others in the household to lessen their risk. If you have severe or worsening symptoms, call your healthcare provider.
  • Cover coughs and sneezes when around others to help protect them.
  • Stay away from others who are sick, if possible. Usually, there are more droplets and particles that can make you sick closer to the person who is infected.
  • Masks can help reduce the spread of respiratory viruses. Wearing a high-quality mask while you travel, for example, can help protect you and others. This might be especially important if you are at higher risk of developing serious complications from these illnesses.
  • Avoid touching your eyes, nose, and mouth. Germs spread easily this way.
  • Handwashing often with soap removes most germs, including respiratory viruses, from your hands. If soap and water are not available, using a hand sanitizer with at least 60% alcohol can kill many germs.
  • Viral particles in the air spread between people more easily indoors than outdoors. Any way you can improve air quality, such as opening windows or using air purifiers, can help reduce the amount of virus you are exposed to.

If you do feel sick, there are tests and treatments.

  • If you have signs or symptoms of a respiratory virus, like a cough, runny nose, or fever, tests can help figure out which illness you have.
  • Free at-home COVID-19 tests are available. A healthcare provider may also test you for flu, COVID-19, and RSV.
  • In addition to diagnostic testing, you can work with a healthcare provider to figure out the next steps you should take. Remember: antibiotics do not work on viruses. CDC has more information about antibiotic do’s and don’ts.
  • Prescription antiviral treatments for COVID-19 and flu are available.
    • These treatments can lessen your symptoms and reduce the risk of hospitalization. They work best if they are started soon after you become infected.
    • If you are at higher risk of severe illness, and develop symptoms including cough, fever and sore throat, talk to your healthcare provider sooner rather than later. CDC recommends people at higher risk be treated with antiviral medications.
  • Be sure to store all medications up and away, and out of reach and sight of young children.

The holiday season can be stressful with all the hustle and bustle, responsibilities, and obligations. Good eating, sleeping, and exercise habits can help keep you healthy also. Be sure to make time to take care of yourself!

To learn more, please visit https://www.cdc.gov/respiratory-viruses/whats-new/stay-healthy-during-holidays.html.

Success Story: Diana Grayson

November 20, 2023

Greenville Nursing and Rehabilitation is excited to share resident Diana Grayson’s Success Story!

Mrs. Diana Grayson “Tiny” lived at home with her husband before a fall that left her with a broken left hip and left shoulder. Tiny was admitted to Greenville Nursing and Rehabilitation in July for rehabilitation and has worked extremely hard over the last few months with our therapy team. She never missed a session; she was always willing to participate. Tiny enjoyed socializing with her fellow residents and Care Team members, many she already knew and always enjoyed talking about her husband and grandchildren. Tiny stated on day one that her main goal was to return home to her husband and grandchildren.

Upon admission, she required moderate to maximum assistance for most tasks. In October, Tiny reached her goal of returning home to her husband and spending time with her grandchildren! She is returning home walking with a walker, able to complete steps and completing her activities of daily living with very minimum assistance. It was a pleasure working with such a sweet, determined, and friendly woman. We wish Tiny the best of luck and will miss her dearly!

Misconceptions about Seasonal Flu and Flu Vaccines

November 20, 2023

MISCONCEPTIONS ABOUT FLU VACCINES

Can a flu vaccine give you flu?

No, flu vaccines cannot cause flu illness. Flu vaccines given with a needle (i.e., flu shots) are made with either inactivated (killed) viruses, or with only a single protein from the flu virus.  The nasal spray vaccine contains live viruses that are attenuated (weakened) so that they will not cause illness.

Are any of the available flu vaccines recommended over the others?

Yes, for some people. For the 2022-2023 flu season, there are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccineFlublok Quadrivalent recombinant  flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine. This recommendation was based on a review of available studies which suggests that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines. There is no preferential recommendation for people younger than 65 years.

What if a preferentially recommended flu vaccine is not available?

If none of the three flu vaccines preferentially recommended for people 65 years and older is available at the time of administration, people in this age group should get any other age-appropriate flu vaccine instead.

Is it better to get sick with flu than to get a flu vaccine?

No. Flu can be a serious disease, particularly among young children, older adults, and people with certain chronic health conditions, such as asthma, heart disease or diabetes. Any flu infection can carry a risk of serious complications, hospitalization or death, even among otherwise healthy children and adults. Therefore, getting vaccinated is a safer choice than risking illness to obtain immune protection.

Do I really need a flu vaccine every year?

Yes. CDC recommends a yearly flu vaccine for everyone 6 months of age and older with rare exception. The reason for this is that a person’s immune protection from vaccination declines over time, so an annual vaccination is needed to get the “optimal” or best protection against the flu. Additionally, flu viruses are constantly changing, so the vaccine composition is reviewed each year and updated as needed.

Why do some people not feel well after getting a seasonal flu vaccine?

Some people report having mild side effects after flu vaccination. The most common side effects from flu shots are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur. If these reactions occur, they usually begin soon after vaccination and last 1-2 days.

Side effects from the nasal spray flu vaccine may include: runny nose, wheezing, headache, vomiting, muscle aches, fever, sore throat and cough. If these problems occur, they usually begin soon after vaccination and are mild and short-lived. The most common reactions people have to flu vaccines are considerably less severe than the symptoms caused by actual flu illness.

What about serious reactions to flu vaccine?

Serious allergic reactions to flu vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after vaccination. While these reactions can be life-threatening, effective treatments are available.

What about people who get a seasonal flu vaccine and still get sick with flu symptoms?

There are several reasons why someone might get flu symptoms even after they have been vaccinated against flu.

  • Someone can get sick with another respiratory virus besides flu such as rhinoviruses or SARS-CoV-2 (the virus that causes COVID-19). Other respiratory viruses can cause symptoms similar to flu, and they can also spread and cause illness during flu season. Flu vaccines only protect against flu and its complications, not other illnesses.
  • Someone can be exposed to flu viruses shortly before getting vaccinated or during the two-week period after vaccination that it takes the body to develop immune protection. This exposure may result in a person becoming sick with flu before protection from vaccination takes effect.
  • Flu vaccines vary in how well they work, and someone can get vaccinated but still get sick with flu. There are many different flu viruses that spread and cause illness among people, so this can happen if someone is exposed to a flu virus that is very different from the viruses in the flu vaccine. The ability of a flu vaccine to protect a person depends partially on the similarity or “match” between the vaccine viruses chosen to make vaccine and those spreading and causing illness. Even when that happens though, flu vaccination can still reduce severity of illness.

Can vaccinating someone twice provide added immunity?

In adults, studies have not shown a benefit from getting more than one dose of vaccine during the same influenza season, even among elderly persons with weakened immune systems. Except for children getting vaccinated for the first time, only one dose of flu vaccine is recommended each season.

Is it true that getting a flu vaccine can make you more susceptible to other respiratory viruses?

Flu vaccines are not thought to make people more susceptible to other respiratory infections.

A 2012 study that suggested that flu vaccination might make people more susceptible to other respiratory infections. After that study was published, many experts looked into this issue further and conducted additional studies to see if the findings could be replicated. No other studies have found this effect. It’s not clear why this finding was detected in the one study, but the majority of evidence suggests that this is not a common or regular occurrence and that flu vaccination does not, in fact, make people more susceptible to other respiratory infections.

Does a flu vaccination increase your risk of getting COVID-19?

There is no evidence that getting a flu vaccination increases your risk of getting sick from a coronavirus, like the one that causes COVID-19.

You may have heard about a study published in January 2020 that reported an association between flu vaccination and risk of four commonly circulating seasonal coronaviruses, but not the one that causes COVID-19. This report was later found to be incorrect.

The results from that initial study led researchers in Canada to look at their data to see if they could find similar results in their population. The results from this study showed that flu vaccination did not increase risk for these seasonal coronaviruses. The Canadian findings highlighted the protective benefits of flu vaccination.

The Canadian researchers also identified a flaw in the methods of the first study, noting that it violated the part of study design that compares vaccination rates among patients with and without flu (test negative design). This flaw led to the incorrect association between flu vaccination and seasonal coronavirus risk. When these researchers reexamined data from the first study using correct methods, they found that flu vaccination did not increase risk for infection with other respiratory viruses, including seasonal coronaviruses.

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MISCONCEPTIONS ABOUT FLU VACCINE EFFECTIVENESS

Influenza (flu) vaccine effectiveness (VE) can vary. The protection provided by a flu vaccine varies from season to season and depends in part on the age and health status of the person getting the vaccine and the similarity or “match” between the viruses in the vaccine and those in circulation. During years when the flu vaccine match is good, it is possible to measure substantial benefits from flu vaccination in terms of preventing flu illness and complications. However, the benefits of flu vaccination will still vary, depending on characteristics of the person being vaccinated (for example, their health and age), what flu viruses are circulating that season and, potentially, which type of flu vaccine was used. More information is available at Vaccine Effectiveness – How well does the Flu Vaccine Work.

Below is a summary of the benefits of flu vaccination and selected scientific studies that support these benefits.

  • Flu vaccination can keep you from getting sick with flu.
    • Flu vaccine prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020, the last flu season prior to the COVID-19 pandemic, flu vaccination prevented an estimated 7.5 million influenza illnesses, 3.7 million influenza-associated medical visits, 105,000 influenza-associated hospitalizations, and 6,300 influenza-associated deaths.
    • During seasons when flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40% to 60%.
  • Flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.
    • 2021 study showed that among adults hospitalized with flu, vaccinated patients had a 26% lower risk of intensive care unit (ICU) admission and a 31% lower risk of death from flu compared with those who were unvaccinated.
    • 2018 study showed that among adults hospitalized with flu, vaccinated patients were 59% less likely to be admitted to the ICU than those who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent four fewer days in the hospital than those who were not vaccinated.
  • Flu vaccination can reduce the risk of flu-associated hospitalization.
    • Flu vaccine prevents tens of thousands of hospitalizations each year. For example, during 2019-2020 flu vaccination prevented an estimated 105,000 flu-related hospitalizations.
    • 2018 study showed that from 2012 to 2015, flu vaccination among adults reduced the risk of being admitted to an ICU with flu by 82%.
    • 2017 study found that during 2009-2016, flu vaccines reduced the risk of flu-associated hospitalization among older adults by about 40% on average.
    • 2014 study showed that flu vaccination reduced children’s risk of flu-related pediatric intensive care unit (PICU) admission by 74% during flu seasons from 2010-2012.
  • Flu vaccination is an important preventive tool for people with certain chronic health conditions.
    • Flu vaccination has been associated with lower rates of some cardiac events among people with heart disease, especially among those who have had a cardiac event in the past year.
    • Flu vaccination can reduce the risk of a flu-related worsening of chronic lung disease (for example, chronic obstructive pulmonary disease (COPD) requiring hospitalization).
    • Among people with diabetes and chronic lung disease,flu vaccination has been shown in separate studies to be associated with reduced hospitalizations from a worsening of their chronic condition.
  • Flu vaccination during pregnancy helps protect pregnant people from flu during and after pregnancy and helps protect their infants from flu in their first few months of life.
    • 2013 study showed that during the 2010–2011 and 2011–2012 flu seasons vaccination reduced the risk of flu-associated acute respiratory infection in pregnant people by about one-half.
    • 2018 study showed that getting a flu shot reduced a pregnant person’s risk of being hospitalized with flu by an average of 40% from 2010-2016.
    • A number of studies have shown that in addition to helping to protect pregnant people from flu, a flu vaccine given during pregnancy helps protect the baby from flu for several months after birth, when babies are too young to be vaccinated.
  • Flu vaccine can be lifesaving in children.
    • 2022 study showed that flu vaccination reduced children’s risk of severe life-threatening influenza by 75%.
    • 2020 study found that during the 2018-2019 flu season, flu vaccination reduced flu-related hospitalization by 41% and flu-related emergency department visits by half among children (aged 6 months to 17 years old).
    • A 2017 study was the first of its kind to show that flu vaccination can significantly reduce children’s risk of dying from flu.
  • Getting vaccinated yourself may also protect people around you, including those who are more vulnerable to serious flu illness, like babies and young children, older people, and people with certain chronic health conditions.

Despite the many benefits offered by flu vaccination, only about half of Americans get an annual flu vaccine. During an average flu season, flu can cause millions of illnesses, hundreds of thousands of hospitalizations and tens of thousands of deaths. Many more people could be protected from flu if more people got vaccinated.

*References for the studies listed above can be found at Publications on Influenza Vaccine Benefits.

MISCONCEPTIONS ABOUT THE TIMING OF SEASONAL INFLUENZA VACCINATION

Should I wait to get vaccinated so that my immunity lasts through the end of the season?

How long you are immune or your “duration of immunity” is discussed in the ACIP recommendations. While delaying getting of vaccine until later in the fall may lead to higher levels of immunity during winter months, this should be balanced against possible risks, such as missed opportunities to receive vaccine and difficulties associated with vaccinating a large number of people within a shorter time period.

Is it too late to get vaccinated after Thanksgiving (or the end of November)?

No. Vaccination can still be beneficial as long as flu viruses are circulating. If you have not been vaccinated by Thanksgiving (or the end of November), it can still be protective to get vaccinated in December or later. Flu is unpredictable and seasons can vary. Seasonal flu disease usually peaks between December and March most years, but disease can occur as late as May.

MISCONCEPTIONS ABOUT PHYSICIAN CONSENT FOR VACCINATION

Do pregnant people or people with pre-existing medical conditions need special permission or written consent from their doctor to get a flu vaccine?

No. There is no recommendation for pregnant people or people with pre-existing medical conditions to seek special permission or secure written consent from their doctor for vaccination if they get vaccinated at a worksite clinic, pharmacy or other location outside of their physician’s office. With rare exception, CDC recommends an annual flu vaccine for everyone 6 months of age and older, including pregnant people and people with medical conditions.

A variety of flu vaccines are available (Table 1). Vaccine providers should be aware of the approved age indications of the vaccine they are using and of any contraindications or precautions. Providers also should appropriately screen all people getting vaccinated for allergies to vaccine components or other contraindications. People who have previously had a severe allergic reaction to influenza vaccine or any of its ingredients should generally not be vaccinated.

There are some people who should not get a flu vaccine without first speaking with their doctor. These include:

  • People who have a moderate-to-severe illness with or without a fever (they should wait until they recover to get vaccinated), and
  • People with a history of Guillain-Barré Syndrome (a severe paralytic illness, also called GBS) that occurred after receiving influenza vaccine and who are not at risk for severe illness from influenza should generally not receive vaccine. Tell your doctor if you ever had Guillain-Barré Syndrome. Your doctor will help you decide whether the vaccine is recommended for you.

Pregnant people or people with pre-existing medical conditions who get vaccinated should get a flu shot.

If a person is vaccinated by someone other than their primary health care provider, the vaccinating provider should ensure that the patient and, if possible, the patient’s medical provider have documentation of vaccination.

For a complete list of people who should not get a flu vaccine before speaking with their doctor, please review the influenza Vaccine Information Statement for the inactivated or recombinant flu vaccine or live, intranasal influenza vaccine.

MISCONCEPTIONS ABOUT “STOMACH FLU”

Is the “stomach flu” really flu?

No. Many people use the term “stomach flu” to describe illnesses with nausea, vomiting or diarrhea. These symptoms can be caused by many different viruses, bacteria or even parasites. While vomiting, diarrhea, and being nauseous or “sick to your stomach” can sometimes be related to flu — more commonly in children than adults — these problems are rarely the main symptoms of influenza. Flu is a respiratory disease and not a stomach or intestinal disease.

To learn more, please visit https://www.cdc.gov/flu/prevent/misconceptions.htm.

Older Adults and Vision Health – Vision Loss: A Public Health Problem

November 14, 2023

1. Does vision loss affect a lot of people?

Yes. More than 3.4 million Americans aged 40 years and older are blind (having a visual acuity of 20/200 or less or a visual field on 20 degrees or less) or visually impaired (having a visual acuity of 20/40 or less). Other estimates of “vision problems” range as high as 21 million, and a total of 80 million Americans have potentially blinding eye diseases. The major causes of vision loss are cataracts, age-related macular degeneration, diabetic retinopathy, and glaucoma.

2. Does vision loss contribute a large burden in terms of morbidity, quality of life, and cost?

Yes. People with vision loss are more likely to report depression, diabetes, hearing impairment, stroke, falls, cognitive decline, and premature death. Decreased ability to see often leads to the inability to drive, read, keep accounts, and travel in unfamiliar places, thus substantially compromising quality of life. The cost of vision loss, including direct costs and lost productivity, is estimated to exceed $35 billion (Rein, Zhang, Wirth, et al., 2006)

3. Has vision loss recently increased and will it increase in the future?

Yes. As the population of older people continues to accelerate, the number of people experiencing vision loss will continue to increase. And as the population of people experiencing diabetes increases, consequent increases will occur in diabetic retinopathy and other eye diseases. Prevent Blindness America estimates that the population of people experiencing blindness and visual impairment will double by 2030 unless corrective actions are taken.

4. Is vision loss perceived to be a threat by the public?

Yes. Vision loss ranks among the top ten causes of disability in the United States, and it is a condition feared by many.

5. Is it feasible to act on vision loss at a community or public health level?

Yes. Scientific evidence shows that early detection and treatment can prevent much blindness and vision impairment. Efficacious and cost-effective strategies to detect and treat diabetic retinopathy are available, but among people with diabetes, screening is received only by about two-thirds of persons for whom the exam is recommended and varies significantly across health care settings. Cataract removal surgery can restore vision, and this surgery is cost effective; however, among African Americans, unoperated senile cataracts remain a major cause of blindness. Glaucoma can be controlled, and vision loss stopped by early detection and treatment. Nevertheless, half the people with glaucoma are not diagnosed, and glaucoma is still the number one blinding disease among African Americans.

Public health serves to address each of these questions by conducting population-based investigations to determine the population, characteristics, circumstances, and trends of vision loss, as well as developing and implementing evidence based, cost-effective interventions to assure access to vision care and health behaviors to prevent the onset of vision loss and to improve the health and quality of life for those who have lost vision.

To learn more, please visit https://www.cdc.gov/visionhealth/basic_information/vision_loss.htm.

Be a Safe Resident

November 6, 2023

Patients and residents of nursing homes, assisted living facilities, and other long-term care facilities should be aware of the risks of developing infections due to comorbidities and associated disease processes.

CRE Infection (Carbapenem-resistant Enterobacterales)

CRE are germs that are difficult to treat because they are resistant to the drugs (antibiotics) used to treat them.

You are most at risk for a CRE infection if you require a device like a:

  • ventilators (breathing machines)
  • urinary (bladder) catheters
  • intravenous (vein) catheters

C. diff Infection (Clostridioides difficile)

C. diff is a germ that causes an inflammation of the colon, called colitis. Diarrhea and fever are the most common symptoms. Overuse of antibiotics is the most important risk for getting a C. diff infection.

CAUTI (Catheter-Associated Urinary Tract Infection)

An indwelling urinary catheter is a drainage tube that is inserted into the urinary bladder, which is left in place and connected to a collection bag. A CAUTI occurs when germs (usually bacteria) enter the urinary tract through the urinary catheter and cause infection.

Flu (Influenza)

You can get the flu anywhere, including healthcare settings such as nursing homes and long-term care facilities. Therefore, influenza prevention measures should be implemented in all healthcare settings.

MRSA Infection (Methicillin-resistant Staphylococcus aureus)

MRSA is a type of bacteria that is resistant to many antibiotics used to treat them. Severe MRSA infections occur most frequently among patients in healthcare settings such as nursing homes and long term care facilities.

Stomach Flu (Norovirus)

Stomach flu is caused by the Noroviruses. Symptoms include severe vomiting and diarrhea. Stomach flu is usually brief in people who are otherwise healthy. Young children, the elderly, and people with other medical illnesses are most at risk for more serious infection. Like all viral infections, noroviruses should not be treated with antibiotics.

To learn more, please visit https://www.cdc.gov/longtermcare/resident/index.html.

Success Story: Charlotte Dockery

October 30, 2023

Greenville Nursing and Rehabilitation is excited to shine the spotlight on resident Charlotte Dockery’s Success Story!

Ms. Charlotte Dockery was admitted to Greenville Nursing and Rehabilitation for short-term rehabilitation after a recent hospitalization. She required increased assistance with self-care tasks, transfers, and walking. Ms. Dockery received skilled physical and occupational therapy and demonstrated great participation and progress, and was able to increase her balance, muscle strength, endurance, and independence with her self-care needs! Our Care Team members also completed training for her and her spouse to manage her glucose levels and administer her insulin medication. Ms. Charlotte made gains rapidly and could return home after a brief period! Congratulations, Ms. Dockery!

Transportation Safety: Older Adult Drivers

October 30, 2023

In 2020, there were almost 48 million licensed drivers ages 65 and older in the United States. This is a 68% increase since 2000.1

Driving helps older adults stay mobile and independent. But the risk of being injured or killed in a traffic crash increases as people age.

Thankfully, older adults can take steps to stay safer on the roads.

Thousands of older adults are injured or killed in the United States every year in traffic crashes.

In 2020, about 7,500 older adults were killed in traffic crashes, and almost 200,000 were treated in emergency departments for crash injuries.2 This means that each day, 20 older adults are killed and almost 540 are injured in crashes.

Age, gender, and age-related changes are major risk factors.

  • Drivers aged 70+ have higher crash death rates per 1,000 crashes than middle-aged drivers (aged 35-54).3 Higher crash death rates among this age group are primarily due to increased vulnerability to injury in a crash.
  • Across all age groups, males have substantially higher crash death rates than females.4
  • Age-related changes in vision, physical functioning, and the ability to reason and remember, as well as some diseases and medications, might affect some older adults’ driving abilities.5

Key steps to staying safe on the roads.

The good news is that older adults are more likely to have safer driving behaviors than other age groups.

Taking these key steps can help adults of all ages, including older adults, stay safe on the road:

  • Always wear a seat belt as a driver or passenger
    Seat belt use is one of the most effective ways to save lives and reduce injuries in crashes.6
  • Drive when conditions are safest
    Drive during daylight and in good weather. Conditions such as poor weather7 and driving at night8 increase the likelihood of crash injuries and deaths.
  • Don’t drink and drive
    Drinking and driving increases the risk of being in a crash because alcohol reduces coordination and impairs judgment.

Additional steps to stay safe on the road

  • Use CDC’s MyMobility Plan, a plan to stay mobile and independent as you age.
  • Follow a regular activity program to increase strength and flexibility.
  • Ask your doctor or pharmacist to review medicines—both prescription and over-the counter—to reduce side effects and interactions. Read the Are Your Medicines Increasing Your Risk of a Fall or a Car Crash fact sheet to learn more.
  • Have your eyes checked by an eye doctor at least once a year. Wear glasses and corrective lenses as required.
  • Plan your route before you drive.
  • Find the safest route with well-lit streets, intersections with left-turn signals, and easy parking.
  • Leave a large following distance between your car and the car in front of you.
  • Avoid distractions in your car, such as listening to a loud radio, talking or texting on your phone, and eating.
  • Consider potential alternatives to driving, such as riding with a friend, using ride share services, or taking public transit.

To learn more, please visit https://www.cdc.gov/transportationsafety/older_adult_drivers/index.html.

RSV in Older Adults and Adults with Chronic Medical Conditions

October 23, 2023

RSV infections can be dangerous for certain adults. Each year, it is estimated that between 60,000-160,000 older adults in the United States are hospitalized and 6,000-10,000 die due to RSV infection. Adults at highest risk for severe RSV infection include:

  • Older adults
  • Adults with chronic heart or lung disease
  • Adults with weakened immune systems
  • Adults with certain other underlying medical conditions
  • Adults living in nursing homes or long-term care facilities

An RSV vaccine protects against serious disease

RSV vaccines can help protect adults aged 60 years and older from RSV. Talk to your healthcare provider to see if vaccination is right for you.

You can get an RSV vaccine at the same time you get other recommended vaccines, such as flu or COVID-19 vaccines. For information about where to find vaccines in your area, visit Vaccine Information for Adults | Where to Find Adult Vaccines | CDC.

Severe RSV Infection

When an adult gets RSV infection, they typically have mild cold-like symptoms, but some may develop a lung infection or pneumonia.

RSV can sometimes also lead to worsening of serious conditions such as:

  • Asthma
  • Chronic obstructive pulmonary disease (COPD) – a chronic disease of the lungs that makes it hard to breathe
  • Congestive heart failure – when the heart can’t pump enough blood and oxygen through the body

Older adults who get very sick from RSV may need to be hospitalized. Some may even die. Older adults are at greater risk than young adults for serious complications from RSV because our immune systems weaken when we are older.

What you should do if you or a loved one is at high risk for severe RSV disease

RSV season in most regions of the U.S. starts in the fall and peaks in winter. If you are at high risk for severe RSV infection, or if you interact with an older adult, you should take extra care to keep them healthy:

  • Wash your hands often
    Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer. Washing your hands will help protect you from germs.
  • Avoid touching your face with unwashed hands
    Avoid touching your eyes, nose, and mouth with unwashed hands. Germs spread this way.
  • Avoid close contact with sick people
    Avoid close contact, such as kissing, and sharing cups or eating utensils with people who have cold-like symptoms.
  • Cover your coughs and sneezes
    Cover your mouth and nose with a tissue or your upper shirt sleeve when coughing or sneezing. Throw the tissue in the trash afterward.
  • Clean frequently touched surfaces
    Clean surfaces and objects that people frequently touch, such as toys, doorknobs, and mobile devices. When people infected with RSV touch surfaces and objects, they can leave behind germs. Also, when they cough or sneeze, droplets containing germs can land on surfaces and objects.
  • Stay home when you are sick
    If possible, stay home from work, school, and public areas when you are sick. This will help protect others from catching your illness.

To learn more, please visit https://www.cdc.gov/rsv/high-risk/older-adults.html.

Success Story: Belinda Rose

October 17, 2023

Greenville Nursing and Rehabilitation is excited to share resident Belinda Rose’s Success Story!

Ms. Belinda Rose is one of Greenville Nursing and Rehabilitation’s long-term care residents who admitted in February 2017. She has received skilled physical and occupational therapy throughout her time with us here due to increased weakness, limited independence with self-care needs, and balance issues. Each time, she has consistently demonstrated significant progress and has been able to return to her prior level of function.

Ms. Belinda is an outgoing and friendly lady who is always available to talk to her fellow residents and Care Team. She enjoys participating in the morning coffee social, attending Bingo, and all other community activities, so it is important we keep her as strong and independent as possible.
We are incredibly happy to have Ms. Belinda here at Greenville Nursing and Rehabilitation and we can always count on Belinda to make us laugh and smile!

Older Adults and Extreme Cold

October 17, 2023

Older adults are more sensitive to cold (and heat) than younger adults. Body temperature below 95°F, or hypothermia, increases their risk of heart disease and kidney or liver damage, especially if they have a history of low body temperature or have had hypothermia in the past.

What is Hypothermia?

Hypothermia is often caused by being in very cold temperatures. When you are cold, you begin to lose heat faster than your body can produce it. Eventually, you will use up your stored energy, causing your body temperature to go down.

  • Hypothermia affects the brain, making it hard to move or think clearly. That’s why it’s dangerous—because you may be unaware of what’s happening and how to stop it.
  • While hypothermia is most common at very cold temperatures, it can occur even at cool temperatures (above 40°F) if you become chilled from rain, sweat, or being in cold water.
  • If you have a chronic condition such as diabetes, Parkinson’s, memory loss, or thyroid problems, you may take medicines that make it hard to regulate your body temperature. Ask your doctor if this is an issue for you or any questions you might have about hypothermia.

How to Tell if Someone Has Hypothermia and What to do

  • Early signs include cold feet or hands, swollen face, slower-than-normal speech, and feeling sleepy, angry, or confused. The person’s skin may become pale, and they may begin shivering.
  • Later signs include jerking movements that the person can’t control in their arms and legs, slow heartbeat, slow, shallow breathing, and going in and out of consciousness.
  • If you see someone showing signs of hypothermia, call 911. While waiting for 911:
    • Move the person to a warmer place.
    • Wrap them in warm, dry clothes,
    • If necessary, remove all clothing and make skin-to-skin contact with the person to transfer body heat. Wrap yourself and the person in dry blankets to stay warm.
    • Give them something warm to drink (no alcohol or caffeine).

Learn more about hypothermia and frostbite prevention and steps to take when you recognize someone else has hypothermia.

How to Help Someone with Dementia Avoid Hypothermia

About 1 in 4 people who have dementia live alone. People with dementia may not be aware of their surroundings. Learn how to make a home safe for someone with dementia, and use these tips to help someone with dementia stay safe during very cold weather.

  • Remove portable space heaters and don’t leave the person alone with an open fireplace. Use safety knobs and use a stove with automatic shutoff settings.
  • Advise the person to carefully use electric blankets and sheets or heating pads; explain they can cause burns.
  • Put red tape around vents, radiators, and other heating components to remind the person to avoid touching them.
  • Keep the water heater set to 120°F to prevent burns. Consider installing faucets that mix hot and cold water.
  • Leave an extra house key outside the home in case a caregiver or emergency responder needs to get inside.

How to Avoid Hypothermia at Home When It’s Very Cold Outside

You can get hypothermia while indoors if outside cold weather persists or when you are working in cold environments, such as a storage freezer.  Use the steps below to prevent hypothermia while indoors.

  • Eat a healthy diet every day to make sure your body has enough energy to keep you warm.
  • Make sure to stay hydrated
  • Limit your alcohol intake.
  • Wear warm, thick clothing, including a hat and scarf if needed. Try to keep a blanket nearby.
  • If you live alone, ask friends and family to check on you.
  • Check your thermostat or an easy-to-read indoor thermometer often. If you don’t have an easy-to-read thermometer, try to have one installed if possible.
    • Keep the house around 68°F to 70°F.
      • Maintain your heating and air conditioning system.
      • Block off any unused rooms and drafts from windows and doors.
      • If you use a fireplace or wood stove as your main heating source, have your chimney or flue inspected every year.
      • If your home doesn’t hold heat well, have the insulation checked.

Financial help is sometimes available for people who can’t afford to weatherize their home or pay their heating bills.

For financial help getting your windows, doors, and furnace checked to make sure they are cold-weather-ready, or for other weather-related changes to your home, contact your local Weatherization Assistance Program.

For help with your energy bills, contact:

If you are using a portable heater, here are 7 Safety Tips from Consumer Product Safety Commission.

How to Avoid Hypothermia if you Go Outside During Cold Winter

  • Wear warm, thick clothing, including a hat, scarf, and gloves, as well as loose layers to increase the amount of body heat.
  • Change your clothes as soon as you get inside. Wearing wet clothes causes your body temperature to drop. Dry clothes allow your body to

warm itself.

  • If you drive somewhere, be prepared in case you get stranded.
    • Keep warm blankets and clothing in your car.
    • Keep food and water in your car.
    • Keep a phone charger in your car.
    • Take any necessary medicines with you.

Create a winter emergency supply kit to keep in your car

How to Avoid Falling if You Go Outside in Icy Weather

During the winter months, it’s important to make sure that surfaces are dry and safe for walking to reduce the risk of falling. These tips can you help prevent falls in icy and snowy weather:

  • Make sure there is enough lighting outdoors, especially near walkways and stairs. Low lighting is a major cause of falls. Motion-sensor lights might be useful.
  • Keep outside walkways and steps clear of snow, ice, and any objects
  • If your home’s main entrance is often icy during the winter months, use a different entrance if you can.
  • Make sure your steps are sturdy and have textured grip to reduce falls if the weather is icy or wet.
  • If you use walking aids such as a cane, walker, or a wheelchair, dry the wheels or tips of each before entering your home.
  • Keep a small table or shelf near the entry door to put items while unlocking the door. This reduces distractions and dangers of slipping or tripping while trying to enter your home.

How You Can Help an Older Adult Avoid Hypothermia

As a friend, family member, or caregiver to an older adult during the winter months, you can:

  • Consider having a remote indoor air temperature sensor or monitor installed.
  • Have the name and contact information of a nearby family member or friend who can regularly check in on them.
  • Create a care plan with them to provide structure for both of you. The care plan should include ways to maintain a healthy body temperature and note if any medicines they take affect their ability to regulate body temperature.
  • If you are checking in on an older adult, try to check in on them in person or by telephone as often as possible or at agreed times to make sure they:
    • Are staying hydrated.
    • Have the living space set to a comfortable temperature.
    • Are keeping warm.
    • Don’t show signs of hypothermia.

To learn more, please visit https://www.cdc.gov/aging/emergency-preparedness/older-adults-extreme-cold/index.html.

Older Adults and Social Isolation

October 9, 2023

Loneliness and social isolation in older adults are serious public health risks affecting a significant number of people in the United States and putting them at risk for dementia and other serious medical conditions.

report from the National Academies of Sciences, Engineering, and Medicine (NASEM) points out that more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated.1 Older adults are at increased risk for loneliness and social isolation because they are more likely to face factors such as living alone, the loss of family or friends, chronic illness, and hearing loss.

Loneliness is the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated.

Health Risks of Loneliness

Although it’s hard to measure social isolation and loneliness precisely, there is strong evidence that many adults aged 50 and older are socially isolated or lonely in ways that put their health at risk. Recent studies found that:

  • Social isolation significantly increased a person’s risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity.1
  • Social isolation was associated with about a 50% increased risk of dementia.1
  • Poor social relationships (characterized by social isolation or loneliness) was associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.1
  • Loneliness was associated with higher rates of depression, anxiety, and suicide.
  • Loneliness among heart failure patients was associated with a nearly 4 times increased risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits.1

Immigrant, LGBT People Are at Higher Risk

The report highlights loneliness among vulnerable older adults, including immigrants; lesbian, gay, bisexual, and transgender (LGBT) populations; minorities; and victims of elder abuse. It also points out that the literature base for these populations is sparse and more research is needed to determine risks, impacts, and appropriate actions needed.

Current research suggests that immigrant, and lesbian, gay, bisexual populations experience loneliness more often than other groups. Latino immigrants, for example, “have fewer social ties and lower levels of social integration than US-born Latinos.” First-generation immigrants experience stressors that can increase their social isolation, such as language barriers, differences in community, family dynamics, and new relationships that lack depth or history, the report states. Similarly, gay, lesbian, and bisexual populations tend to have more loneliness than their heterosexual peers because of stigma, discrimination, and barriers to care.

What Can You Do If You Are Experiencing Loneliness?

Your doctor can assess your risk for loneliness and social isolation and get you connected to community resources for help, if needed. The following national organizations also offer helpful resources:

AARP—Provides helpful information to seniors to help improve quality of life and provides access to Community Connection Tools.

Area Agencies on Aging (AAA)—A network of over 620 organizations across America that provides information and assistance with programs including nutrition and meal programs (counseling and home-delivered or group meals), caregiver support, and more. The website can help you find your local AAA, which may provide classes in Tai Chi and diabetes self-management.

Eldercare Locator—A free national service that helps find local resources for seniors such as financial support, caregiving services, and transportation. It includes a brochure that shows how volunteering can help keep you socially connected.

National Council on Aging—Works with nonprofit organizations, governments, and businesses to provide community programs and services. This is the place to find what senior programs are available to assist with healthy aging and financial security, including the Aging Mastery Program® that is shown to increase social connectedness and healthy eating habits.

National Institute on Aging (NIA)– Provides materials on social isolation and loneliness for older adults, caregivers, and health care providers. Materials include health information, a print publication available to view or order no-cost paper copies, a health care provider flyer, and social media graphics and posts.

Health Care System Interventions Are Key

People generally are social by nature, and high-quality social relationships can help them live longer, healthier lives. Health care systems are an important, yet underused, partner in identifying loneliness and preventing medical conditions associated with loneliness.

Nearly all adults aged 50 or older interact with the health care system in some way. For those without social connections, a doctor’s appointment or visit from a home health nurse may be one of the few face-to-face encounters they have. This represents a unique opportunity for clinicians to identify people at risk for loneliness or social isolation.

NASEM recommends that clinicians periodically assess patients who may be at risk and connect them to community resources for help. In clinical settings, NASEM recommends using the Berkman-Syme Social Network Index (for measuring social isolation) and the three-item UCLA Loneliness Scale (for measuring loneliness).

But patients must make their own decisions. Some people may like being alone. It is also important to note that social isolation and loneliness are two distinct aspects of social relationships, and they are not significantly linked. Both can put health at risk, however.

To learn more, please visit https://www.cdc.gov/aging/publications/features/lonely-older-adults.html.

Supporting Caregivers for Older Adults

October 2, 2023

An Emerging Public Health Issue

Millions of older adults and people with disabilities could not maintain their independence without the help of unpaid caregivers. This care would cost nearly $470 billion a year if purchased. That’s one of the reasons that caregiving is an essential public health service and should be prioritized as an emerging public health issue [PDF – 1 MB].1

Caregivers are family members or friends who typically provide unpaid, long-term, community-based care and assistance to older adults and people with chronic health conditions or disabilities.  Caregivers help with a variety of routine tasks such as shopping, paying bills, bathing, dressing, and managing medicines.  They are often a source of emotional support and companionship for care recipients.

Caregivers: A Snapshot

Increasing Demand for Caregivers

The need for caregivers is growing along with the aging of the US population. The number of caregivers increased from 43.5 million in 2015 to about 53 million in 2020, or more than 1 in 5 Americans.3 By 2030, an estimated 73 million people in the United States will be 65 years or older.4 Many will require daily assistance from at least one caregiver to maintain quality of life, independence, and physical and social well-being. More than two-thirds of the US population will likely need help with tasks at some point in their lifetime.5

Benefits of Caregiving for Recipients and Caregivers

Caregiving allows recipients to:

  • Retain their quality of life and independence.
  • Avoid living in a group setting (institutionalization).
  • Have less depression.
  • Self-manage their chronic conditions better.

Caregiving can also benefit caregivers by helping them:

  • Increase their self-confidence and fulfillment from helping others.
  • Start or add to social networks of friendships associated with caregiving.
  • Feel needed and useful.
  • Learn and develop new skills.

Caregiving Burdens and Stress

Caregiving is also a public health concern because it can lead to physical, emotional, psychological, and financial strain.  Providing personal care and helping with behavioral and cognitive issues can be stressful for caregivers and result in depression and anxiety. Nearly 1 in 5 caregivers reports fair or poor health.6 Caregivers often neglect their own health needs, increasing their risk of having multiple chronic conditions. Nearly 2 in 5 caregivers have at least two chronic diseases:

  • 1 in 7 caregivers has heart disease and/or stroke.
  • 1 in 5 caregivers aged 65 and older have coronary heart disease and/or stroke.

A recent study by the National Alliance for Caregiving and AARP found nearly 1 in 4 US caregivers says caregiving has made their health worse.3

Financial Strains of Caregiving

Caregiving can have a negative financial effect on caregivers. Many employed caregivers have had to leave work early or take time away from work, resulting in lost wages. Nearly 2 in 10 employed caregivers had to stop working, while 4 in 10 had to reduce their working hours to care for a loved one.7 Caregivers sometimes pay out-of-pocket for caregiving services, meals, medical supplies, and other expenses. Almost 80% of caregivers report paying out-of-pocket for routine expenses for care recipients. The average annual out-of-pocket cost for caregivers is $7,200, and this cost rises to nearly $9,000 per year for caregivers of someone with dementia. 8

How to Support Caregivers?

  • Help them with errands, chores, and other tasks.
  • Provide emotional and social support.
  • Negotiate times to check in on them.
  • Make sure they are managing their own health care needs.
  • Help them create and manage a care plan for the person they care for.
  • Encourage them to seek mental health services if necessary.

If you are a caregiver, read about respite care.

To learn more, please visit https://www.cdc.gov/aging/publications/features/supporting-caregivers.htm.

Are You Socially Engaged?

September 26, 2023

Keeping Engaged Socially is good for your health!

We are not talking about your marital status. We mean, do you participate in activities that connect you with other people? As people get older, their social lives oftentimes slow down for a variety of reasons. When it is unwanted, this can lead to loneliness and isolation. Research has shown that for older adults, staying engaged in enjoyable activities is associated with better physical and mental health. As we age, being involved with others is strongly associated with better brain function. So it is not only fun, it is good for you! You might not have ever imagined that while you were singing in the church choir, or meeting with your book club, or volunteering at the animal shelter that you were actually improving your brain health!

In addition, research has shown that learning a new activity for older people can provide some “insurance” against memory loss. However, it cannot prevent progressive diseases like Alzheimer’s and other dementias.

There are many ways to get involved in your local community. Some to consider include:

  • Participate in sports—whether tai chi or tennis, there’s something for every interest and ability.
  • Head outdoors—join a walking, hiking, or bird watching group.
  • Make music—join a choir or band or take lessons.
  • Get involved—participate with a church, temple, or other religious organization.
  • Read, join, participate, or start a book club.
  • Volunteer for a cause or group you’re passionate about.
  • Take classes at a gym.
  • Find (or start!) a group that fits your passion —whether it’s knitting or carpentry.
  • Indulge your creativity —stage a play with friends, create a themed-dining dinner club, or take an art class.

There are national organizations that can help connect you with these kinds of activities, including:

  • Websites like VolunteerMatchIdealist, and AARP’s Create the Good help connect people and nonprofits who care about similar causes.
  • AARP’s Experience Corp  is an AmeriCorps program that trains adults 50+ to tutor elementary students who aren’t reading at grade level.
  • The American Volkssport Association is a national organization promoting physical fitness, with has many local clubs that sponsor walks and other fitness events.
  • Meetup is a website that helps connect people with common interests of all kinds, so they can meet up and enjoy discussions and activities.
  • SilverSneakers is a national network of gyms with free membership for those with participating health plans, and a community of other adults seeking to remain fit and involved.
  • The Senior Theater Resource  provides information for older adults interested in performing.
  • Encore.org is an online resource for those interested in utilizing their experience and knowledge to do work—paid or unpaid—with social impact, to benefit future generations.

So why not take some steps to stay connected and keep your brain healthy – through an activity you enjoy – with your community?

SHARP Program

An example of a memory prompt for walkers in the SHARP Program.

Portland, Oregon is one community where theories about the benefits of increasing social engagement and brain health are being put into action. The Sharing History through Active Reminiscence and Photo-imagery (SHARP) Program, run by the Oregon Health & Science University (OHSU), brings together small groups of older African Americans for mile-long GPS-guided walks. Historic photos of local interest, like the one above, appear on the group’s digital device at selected locations. At each of these Memory Markers, the group pauses to discuss the photograph and flex their memories. The SHARP program specifically targets African Americans, who may be less aware than white Americans of the risk of Alzheimer’s Disease, have higher rates of some possible dementia risk factors, and be slower to seek care.

OHSU runs the SHARP program as part of the Healthy Brain Research Network, a thematic network of CDC Prevention Research Centers that promotes cognitive health and supports older Americans with cognitive decline as well as their caregivers. Through a unique combination of social engagement, exercise, and memory stimulation, the SHARP program aims to promote healthy aging of mind and body, preserve neighborhood memories, and increase awareness of Alzheimer’s Disease in a local community.

To learn more, please visit https://www.cdc.gov/aging/publications/features/social-engagement-aging.html.

Get Ready for Flu Season

September 19, 2023

Updates to the Advisory Committee on Immunization Practices (ACIP) Flu Vaccine Recommendations for the 2023-2024 season

A couple of things are different for the 2023-2024 influenza (flu) season:

  • The composition of flu vaccines has been updated. Flu vaccines for the U.S. 2023-2024 season will contain the following:
    Egg-based vaccines
    • an A/Victoria/4897/2022 (H1N1)pdm09-like virus; (Updated)
    • an A/Darwin/9/2021 (H3N2)-like virus;
    • a B/Austria/1359417/2021 (B/Victoria lineage)-like virus; and
    • a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

  • Cell- or recombinant-based vaccines
    • an A/Wisconsin/67/2022 (H1N1)pdm09-like virus; (Updated)
    • an A/Darwin/6/2021 (H3N2)-like virus;
    • a B/Austria/1359417/2021 (B/Victoria lineage)-like virus; and
    • a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.
    • These recommendations include one update compared to the 2022-2023 U.S. flu vaccine composition. The influenza A(H1N1)pdm09 vaccine virus component was updated for egg-based and cell- or recombinant-based flu vaccines.

  • People with egg allergy may get any vaccine (egg-based or non-egg-based) that is otherwise appropriate for their age and health status. Previously, it was recommended that people with severe allergy to egg (those who have had any symptom other than hives with egg exposure) be vaccinated in an inpatient or outpatient medical setting. Beginning with the 2023-2024 season, additional safety measures are no longer recommended for flu vaccination of people with an egg allergy beyond those recommended for receipt of any vaccine, regardless of the severity of previous reaction to egg. All vaccines should be given in settings where allergic reactions can be recognized and treated quickly.

Projected U.S. Flu Vaccine Supply for the 2023-2024 Season

  • Vaccine manufacturers have projected that they will supply the United States with as many as 156.2 million to 170 million doses of influenza vaccines for the 2023-2024 season. These projections may change as the season progresses.
    • All flu vaccines for the 2023-2024 season will be quadrivalent (four-component).
    • Most will be thimerosal-free or thimerosal-reduced vaccines (91%), and about 21% of flu vaccines will be egg-free.

To learn more, please visit https://www.cdc.gov/flu/season/faq-flu-season-2023-2024.htm.

Healthy Body, Healthier Brain

September 11, 2023

Brain health and physical health are both important, especially as we age. A recent CDC study found that people with one or more chronic health conditions were more likely to report worsening or more frequent memory problems, also called subjective cognitive decline (SCD).

Chronic health conditions included in the report were diabetes, heart disease, arthritis, stroke, chronic obstructive pulmonary disease (COPD), asthma, and kidney disease. SCD was most common among adults with COPD or heart disease, or who had had a stroke.

Worsening or more frequent confusion or memory loss, combined with chronic health conditions, can make it especially hard to live independently and do everyday activities like cooking, cleaning, managing health conditions and medicines, and keeping medical appointments. This may lead to worse health, and preventable hospitalizations or more severe memory loss or confusion. In some cases, SCD may put people at greater risk for Alzheimer’s disease.

What Can People With Memory Loss and Chronic Health Conditions Do?

It’s important to talk to your healthcare provider. Researchers found that only half of adults with SCD and a chronic condition had discussed their memory loss with a health care professional. Early diagnosis of memory loss is especially important for people with chronic health conditions. Getting checked by your healthcare provider can help determine if the symptoms you are experiencing are related to dementia, including Alzheimer’s disease, or a more treatable condition such as a vitamin deficiency or medication side effects. Early diagnosis also provides an opportunity to participate in clinical trials, and more time to plan for the future.

8 Ways to Help Improve Your Brain Health

There is growing scientific evidence that healthy behaviors, which have been shown to prevent cancer, diabetes, and heart disease, also may reduce risk for SCD. Here are eight steps you can take for a healthy body and healthier brain.

  1. Quit Smoking—Quitting smoking now improves your health and reduces your risk of heart disease, cancer, lung disease, and other smoking-related illnesses. Free quitline: 1-800-QUIT-NOW (1-800-784-8669).
  2. Prevent and Manage High Blood Pressure—Tens of millions of adults in the United States have high blood pressure, and many do not have it under control. Learn the facts.
  3. Prevent and Manage High Cholesterol—Nearly 1 in 3 American adults has high cholesterol. Learn how to manage your cholesterol levels and lower your risk.
  4. Maintain a Healthy Weight—Healthy weight isn’t about short-term dietary changes. Instead, it’s about a lifestyle that includes healthy eating and regular physical activity.
  5. Get Enough Sleep—A third of American adults report that they usually get less sleep than the recommended amount.
  6. Stay Engaged—There are many ways for older adults to get involved in their local community. Here are some activities to consider.
  7. Manage Blood Sugar—Learn how to manage your blood sugar if you have diabetes.
  8. If You Drink, Do So in Moderation—Learn about alcohol use and your health.

To learn more, please visit https://www.cdc.gov/aging/publications/features/healthy-body-brain.html.

Recognizing Symptoms of Dementia and Seeking Help

September 5, 2023

As we age, our brains change, but Alzheimer’s disease and related dementias are not an inevitable part of aging. In fact, up to 40% of dementia cases may be prevented or delayed. It helps to understand what’s normal and what’s not when it comes to brain health.

Normal brain aging may mean slower processing speeds and more trouble multitasking, but routine memory, skills, and knowledge are stable and may even improve with age. It’s normal to occasionally forget recent events such as where you put your keys or the name of the person you just met.

SYMPTOMS OF DEMENTIA OR ALZHEIMER’S DISEASE

In the United States, 6.2 million people age 65 and older have Alzheimer’s disease, the most common type of dementia. People with dementia have symptoms of cognitive decline that interfere with daily life—including disruptions in language, memory, attention, recognition, problem solving, and decision-making. Signs to watch for include:

  • Not being able to complete tasks without help.
  • Trouble naming items or close family members.
  • Forgetting the function of items.
  • Repeating questions.
  • Taking much longer to complete normal tasks.
  • Misplacing items often.
  • Being unable to retrace steps and getting lost.

CONDITIONS THAT CAN MIMIC DEMENTIA

Symptoms of some vitamin deficiencies and medical conditions such as vitamin B12 deficiency, infections, hypothyroidism (underactive thyroid), or normal pressure hydrocephalus (a neurological condition caused by the build-up of fluid in the brain) can mimic dementia. Some prescription and over-the-counter medicines can cause dementia-like symptoms. If you have these symptoms, it is important to talk to your health care provider to find out if there are any underlying causes for these symptoms.

For more information, see What Is Dementia?

HOW IS DEMENTIA DIAGNOSED?

A healthcare provider can perform tests on attention, memory, problem solving and other cognitive abilities to see if there is cause for concern. A physical exam, blood tests, and brain scans like a CT or MRI can help determine an underlying cause.

WHAT TO DO IF A LOVED ONE IS SHOWING SYMPTOMS

Talk with your loved one about seeing a health care provider if they are experiencing symptoms of Alzheimer’s dementia to get a brain health check up.

BE EMPOWERED TO DISCUSS MEMORY PROBLEMS

More than half of people with memory loss have not talked to their healthcare provider, but that doesn’t have to be you. Get comfortable with starting a dialogue with your health care provider if you observe any changes in memory, or an increase in confusion, or just if you have any questions. You can also discuss health care planning, management of chronic conditions, and caregiving needs.

To learn more, please visit https://www.cdc.gov/aging/publications/features/dementia-not-normal-aging.html.

To learn more about the Alzheimer’s Association, please visit Alzheimer’s Association | Alzheimer’s Disease & Dementia Help

Older Adult Fall Prevention

August 28, 2023

Facts About Falls

Each year, millions of older people—those 65 and older—fall. In fact, more than one out of four older people falls each year, 1 but less than half tell their doctor.2 Falling once doubles your chances of falling again.3

Falls Are Serious and Costly

  • One out of five falls causes a serious injury such as broken bones or a head injury.4,5
  • Each year, 3 million older people are treated in emergency departments for fall injuries.6
  • Over 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture.6
  • Each year at least 300,000 older people are hospitalized for hip fractures.7
  • More than 95% of hip fractures are caused by falling,8 usually by falling sideways.9
  • Falls are the most common cause of traumatic brain injuries (TBI).10
  • In 2015, the total medical costs for falls totaled more than $50 billion.11 Medicare and Medicaid shouldered 75% of these costs.

What Can Happen After a Fall?

Many falls do not cause injuries. But one out of five falls does cause a serious injury such as a broken bone or a head injury.4,5 These injuries can make it hard for a person to get around, do everyday activities, or live on their own.

  • Falls can cause broken bones, like wrist, arm, ankle, and hip fractures.
  • Falls can cause head injuries. These can be very serious, especially if the person is taking certain medicines (like blood thinners). An older person who falls and hits their head should see their doctor right away to make sure they don’t have a brain injury.
  • Many people who fall, even if they’re not injured, become afraid of falling. This fear may cause a person to cut down on their everyday activities. When a person is less active, they become weaker and this increases their chances of falling.12

What Conditions Make You More Likely to Fall?

Research has identified many conditions that contribute to falling. These are called risk factors. Many risk factors can be changed or modified to help prevent falls. They include:

  • Lower body weakness
  • Vitamin D deficiency (that is, not enough vitamin D in your system)
  • Difficulties with walking and balance
  • Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.
  • Vision problems
  • Foot pain or poor footwear
  • Home hazards or dangers such as
    • broken or uneven steps, and
    • throw rugs or clutter that can be tripped over.

Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling.

Healthcare providers can help cut down a person’s risk by reducing the fall risk factors listed above.

To learn more, please visit https://www.cdc.gov/falls/facts.html.

Success Story: Mr. Cottongim

August 25, 2023

Greenville Nursing and Rehabilitation is excited to shine the spotlight on Mr. Cottongim’s Success Story!

After a hospital stay, Mr. Cottongim was admitted to Greenville Nursing and Rehabilitation in July of this year. Upon admission, he was weak and required assistance with his mobility and self-care. He received physical, occupational, and speech therapy to be independent with his mobility self-care tasks, improve cognitive skills, and return home to live with his wife.

Mr. Cottongim worked with physical therapy to improve his standing balance, transfers, ambulation, and ability to go up and down steps. He worked with occupational therapy to increase his independence to perform self-care without assistance. Mr. Cottongim also participated in speech therapy to improve short-term memory and safety in decision-making. Mr. Cottongim was very motivated to return home. He demonstrated significant progress with therapy and was able to complete functional mobility, complete stairs, self-care and improve cognition and decision-making with independence-modified independence. We are proud to announce that Mr. Cottongim successfully discharged from our community and returned home with his wife! Congratulations to Mr. Cottongim and his Care Team on their success!

Oral Health for Older Adults

August 21, 2023

Facts About Older Adult Oral Health

By 2060, according to the US Census, the number of US adults aged 65 years or older is expected to reach 98 million, 24% of the overall population.1 Older Americans with the poorest oral health tend to be those who are economically disadvantaged, lack insurance, and are members of racial and ethnic minorities. Being disabled, homebound, or institutionalized (e.g., seniors who live in nursing homes) also increases the risk of poor oral health. Adults 50 years and older who smoke are also less likely to get dental care than people who do not smoke.6 Many older Americans do not have dental insurance because they lost their benefits upon retirement and the federal Medicare program does not cover routine dental care.2

Oral health problems in older adults include the following:

  • Untreated tooth decay. Nearly all adults (96%) aged 65 years or older have had a cavity; 1 in 5 have untreated tooth decay.3
  • Gum disease. A high percentage of older adults have gum disease. About 2 in 3 (68%) adults aged 65 years or older have gum disease.4
  • Tooth loss. Nearly 1 in 5 of adults aged 65 or older have lost all of their teeth. Complete tooth loss is twice as prevalent among adults aged 75 and older (26%) compared with adults aged 65-74 (13%).3  Having missing teeth or wearing dentures can affect nutrition, because people without teeth or with dentures often prefer soft, easily chewed foods instead of foods such as fresh fruits and vegetables.
  • Oral cancer. Cancers of the mouth (oral and pharyngeal cancers) are primarily diagnosed in older adults; median age at diagnosis is 62 years.5
  • Chronic disease. People with chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) may be more likely to develop gum (periodontal) disease, but they are less likely to get dental care than adults without these chronic conditions.6 Also, most older Americans take both prescription and over-the-counter drugs; many of these medications can cause dry mouth. Reduced saliva flow increases the risk of cavities.7

To learn more, please visit https://www.cdc.gov/oralhealth/basics/adult-oral-health/adult_older.htm.

Success Story: Beatrice Shultz

August 18, 2023

Greenville Nursing and Rehabilitation is excited to share resident Beatrice Shultz’s Success Story!

Ms. Beatrice Shultz, a long-term Greenville Nursing and Rehabilitation resident, was referred to therapy to address UE weakness and improve functional mobility to improve independence with self-care tasks.
Beatrice demonstrated great participation and progress and is at her prior level of function, requiring decreased assistance with her self-care task and functional mobility! Beatrice enjoys her morning coffee group, playing bingo, and talking to her fellow residents. She always has a smile on her face and enjoys participating in therapy and joking around with the therapists. Greenville Nursing and Rehabilitation is proud to have Beatrice with us and looks forward to the smile she gives to everyone! Congratulations to Beatrice and her Care Team on their success!

Healthy People 2030, Dementias Including Alzheimer’s

August 15, 2023

By 2060, almost a quarter of the U.S. population will be age 65 or older. Healthy People 2030 focuses on reducing health problems and improving quality of life for older adults.

Older adults are at higher risk for chronic health problems like diabetes, osteoporosis, and Alzheimer’s disease.

Core Objectives: Dementias Including Alzheimer’s Disease (DIA)

The Healthy People 2030 Core Objectives relate to improving the health and quality of life for people with Alzheimer’s Disease and related dementias. Measuring these objectives will provide valuable data to track progress throughout the decade.

  • Increase the proportion of older adults with dementia, or their caregivers, who know they have it. Learn more
  • Reduce the proportion of preventable hospitalizations in older adults with dementia.  Learn more
  • Increase the proportion of adults with subjective cognitive decline (SCD) who have discussed their confusion or memory loss with a health care professional. Learn more

All Healthy People 2030 core objectives meet several criteria, including having baseline data, a direct impact on health, and an evidence base, and they address the goals related to health, function, and quality of life. The Healthy People 2030 framework sets important health priorities for the nation over the next decade and will measure progress towards meeting those objectives.

For more information and an overview of all older adult objectives, please visit https://health.gov/healthypeople/objectives-and-data/browse-objectives/older-adults.

Dance Your Way to Better Brain Health!

August 7, 2023

JOIN A DANCE CLASS TO EXERCISE YOUR BRAIN AND BODY.

Exercise is not only good for your body, it’s good for your brain! Sticking to a regular workout plan can be tough, but including activity in your routine doesn’t need to be boring. Scientists have found that the areas of the brain that control memory and skills such as planning and organizing improve with exercise.1,2 Dance has the added dimensions of rhythm, balance, music, and a social setting that enhances the benefits of simple movement – and can be fun!

THE SCIENCE OF DANCE

At the University of Illinois at Chicago, through the CDC-funded Prevention Research Centers’ Healthy Brain Research Network, researchers designed a Latin ballroom dance program for older sedentary adults. Participants in the program, BAILAMOS©, reported improvements in memory, attention, and focus.3 In a separate ballroom dance program, older people experiencing mild cognitive impairment improved their thinking and memory after a 10-month-long ballroom dancing class.4

SO, HOW CAN YOU GET MOVING?

  • Sign up for a dance class and invite your friends to join. Find classes at your local community college, YMCA, dance studio, or community center.
  • Try dancing at home by following along with a DVD or videos on YouTube. Easy-to-follow, free exercise videos are available at the National Institute on Aging’s YouTube channel.
  • For an extra challenge, try using small weights to build strength. Keep a 2-pound or 5-pound weight in each hand while doing your dance routine. For more ideas on strength exercises, visit the Exercise and Physical Activity page on the NIH website.

Help for Caregivers of People with Alzheimer’s – Are you a caregiver for someone with Alzheimer’s disease or a related dementia? You can help the person you care for get moving, too.5

  • Split dance moves and exercises into small, easy-to-follow steps. Use exercise videos and follow along with the person you’re caring for.
  • At first, try shorter 5- or 10-minute mini dancing sessions to slowly build endurance.
  • Take breaks when needed and make sure you are both drinking plenty of water.

To learn more, please visit https://www.cdc.gov/aging/publications/features/alzheimers-and-exercise.html.

National Healthy Brain Initiative

July 31, 2023

The Healthy Brain Initiative improves understanding of brain health as a central part of public health practice. The initiative creates and supports partnerships, collects and reports data, increases awareness of brain health, supports populations with a high burden of Alzheimer’s disease and related dementias, and promotes the use of its Road Map series: State and Local Public Health Partnerships to Address Dementia: The 2018–2023 Road Map, and the Healthy Brain Initiative Road Map for Indian Country. The Road Map series provides actionable steps to promote brain health, address cognitive impairment, and address the needs of caregivers. In addition, the Healthy Brain Initiative supports the development of future Road Maps.

CDC is working with funded partners to accomplish the Road Map’s recommended actions. For example, the Alzheimer’s Association helps develop and track Road Map action items, and helps state public health agencies use them. Given that one out of every three American Indian and Alaskan Native elders develops dementia, the Association for State Territorial Health Officials (ASTHO) developed a series of health communication materials to improve quality, availability, and accessibility of public health resources to address the connection between brain health and heart health, Healthy Heart, Healthy Brain.

To learn more, please visit https://www.cdc.gov/aging/nationalinitiatives/national-healthy-nhbi.html.

Success Story: Phyllis Allen

July 31, 2023

Greenville Nursing and Rehabilitation is excited to shine the spotlight on resident Phyllis Allen’s Success Story!

Ms. Phyllis Allen was admitted to Greenville Nursing and Rehabilitation on May 31st of this year after a recent stay in the hospital with encephalopathy. Upon admission, Ms. Allen required extensive assistance with her transferring and walking, decreased endurance and muscle strength, required assistance with self-care tasks, and a severe decline in cognition.

Ms. Allen was very motivated to return home, where she lived independently on one level of her son’s home. Ms. Allen received skilled physical, occupational, and speech therapy during her short stay with us at Greenville Nursing and Rehabilitation. Ms. Allen also enjoyed socializing with fellow residents and enjoyed attending therapy sessions. Ms. Allen received skilled therapy for only 20 days, and she demonstrated great progress because of her hard work, determination, and motivation to return home. Ms. Allen was discharged to home on June 20th, where she was at the prior level of function she needed to live independently. Congratulations to Ms. Allen and her Care Team on their success!

Success Story: Bobby Gregory

July 21, 2023

Greenville Nursing and Rehabilitation is excited to share resident Bobby Gregory’s Success Story!

Mr. Bobby Gregory was admitted to Greenville Nursing and Rehabilitation on July 1st, 2022, due to his decline in functional endurance, decreased muscle strength, functional mobility, and poor carryover with energy conservation techniques and transfer, which led to his decreased ability to live at home.

Mr. Gregory received skilled Occupational Therapy and Physical therapies during his stay here. Because of his motivation and participation, he can perform his functional mobility, transfers, and self-care task with modified independence. Besides Mr. Gregory being a fun and sociable resident, he is also the community’s residential artist with several paintings he has drawn displayed throughout. He enjoys painting and giving his artwork to Care Team members and fellow residents. Various artwork by Mr. Gregory was displayed at a local art show. Mr. Gregory has even donated many of his beautiful paintings to be auctioned off here at Greenville Nursing and Rehabilitation Center, where he requested the proceeds go to the Activities department to benefit his fellow residents! Congratulations to Mr. Gregory and his Care Team on their success!

Mental Health and Aging

July 17, 2023

Mental health is important at every stage of life and it includes emotional, psychological, and social well-being.  As people age, they may experience certain life changes that impact their mental health, such as coping with a serious illness or losing a loved one. Although many people will adjust to these life changes, some may experience feelings of grief, social isolation, or loneliness. When these feelings persist, they can lead to mental illnesses, such as depression and anxiety.  Effective treatment options are available to help older adults and people at every stage of life to manage their mental health and improve their quality of life. Recognizing the signs and seeing a health care provider are the first steps to getting treatment.

Depression and Aging

Depression is not a normal part of growing older

Depression is a true and treatable medical condition, not a normal part of aging. However older adults are at an increased risk for experiencing depression. If you are concerned about a loved one, offer to go with him or her to see a health care provider to be diagnosed and treated.

Depression is not just having “the blues” or the emotions we feel when grieving the loss of a loved one. It is a true medical condition that is treatable, like diabetes or hypertension.

How do I know if it’s Depression?

Someone who is depressed has feelings of sadness or anxiety that last for weeks at a time. He or she may also experience–

  • Feelings of hopelessness and/or pessimism
  • Feelings of guilt, worthlessness and/or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details and making decisions
  • Insomnia, early–morning wakefulness, or excessive sleeping
  • Overeating or appetite loss
  • Thoughts of suicide, suicide attempts
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not get better, even with treatment

How is Depression Different for Older Adults?

  • Older adults are at increased risk. We know that about 80% of older adults have at least one chronic health condition, and 50% have two or more. Depression is more common in people who also have other illnesses (such as heart disease or cancer) or whose function becomes limited.
  • Older adults are often misdiagnosed and undertreated. Healthcare providers may mistake an older adult’s symptoms of depression as just a natural reaction to illness or the life changes that may occur as we age, and therefore not see the depression as something to be treated. Older adults themselves often share this belief and do not seek help because they don’t understand that they could feel better with appropriate treatment.

How do I Find Help?

Most older adults see an improvement in their symptoms when treated with antidepression drugs, psychotherapy, or a combination of both. If you are concerned about a loved one being depressed, offer to go with him or her to see a health care provider to be diagnosed and treated.

If you or someone you care about is in crisis, please seek help immediately.

To learn more, please visit https://www.cdc.gov/aging/olderadultsandhealthyaging/mental-health-and-aging.html.

Social Determinants of Health and Alzheimer’s Disease in Older Adults

July 10, 2023

The conditions in places where people are born, live, learn, work, and play are known as social determinants of health (SDOH). These conditions can have a profound effect on a person’s health, including their risk for Alzheimer’s disease and related dementias.

Differences in SDOH contribute to the stark and persistent chronic disease disparities in the United States among racial, ethnic, and socioeconomic groups by systematically limiting opportunities for members of some groups to be healthy. While public health crises and economic uncertainty may focus attention on disparities, health inequities have persisted across generations because policies and practices have systematically limited access to health care and other opportunities.

A growing body of work exists around social and economic factors that may contribute to a person’s health status, including a person’s risk for dementia. Although more work needs to be done to determine the exact relationship between these factors and dementia, here are a few areas that could be considered:

EDUCATION

Studies show an association between a higher level of education and better brain health. For example, among adults aged 45 years or older, the proportion experiencing subjective cognitive decline was lowest for college graduates and nearly three times greater for those without a high school diploma. One theory being considered by researchers as to why education levels may affect the risk of developing dementia has to do with cognitive reserve. Cognitive reserve refers to the level of knowledge and education “banked” in early years that may protect and compensate for a decline in cognitive health in later years.

ACCESS TO HEALTH CARE

Access to health care affects many facets of a person’s physical and brain health. Consistent access to health care services gives people the opportunity for regular preventive health services and early diagnosis of many health conditions, such as diabetes, heart disease, and dementia. Access can also help prevent hospitalizations through the successful management of chronic health conditions. People with dementia often have one or more other chronic health conditions, and care coordination with providers and family care partners is essential to better care and improves health outcomes.

BUILT ENVIRONMENT

The built environment is the physical environment around us. It includes the spaces where we live, learn, work, and play—our homes, schools, businesses, streets and sidewalks, open spaces, and the options people have for transportation. Built environments can influence overall community health and individual behaviors, such as physical activity and healthy eating. Built environments can affect health both positively and negatively. Healthy community design can improve opportunities for exercise, access to services, and community supports—all of which have a positive impact on brain and physical health.

LONELINESS AND SOCIAL ISOLATION

A number of studies indicate that maintaining strong social connections and keeping mentally active as we age may lower the risk of cognitive decline and dementia. Experts are not certain about the reason for this association, but it may be due to a strengthening of connections between nerve cells in the brain.

Although it’s hard to precisely measure social isolation and loneliness, there is strong evidence that many adults aged 50 and older are socially isolated or lonely in ways that put their health at risk. Recent studies found that:

  • Social isolation significantly increased a person’s risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity.1
  • Social isolation was associated with about a 50% percent increased risk of dementia.1
  • Poor social relationships were associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.1
  • Loneliness was associated with higher rates of depression, anxiety, and suicide.1

1National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies

To learn more, please visit https://www.cdc.gov/aging/disparities/social-determinants-alzheimers.html.

Success Story: Robin Slaton

July 6, 2023

Greenville Nursing and Rehabilitation is excited to shine the spotlight on resident Robin Slaton’s Success Story!

Ms. Robin Slaton was admitted to Greenville Nursing and Rehabilitation in March after an extensive hospital stay in critical condition. When Robin was first admitted, she could not transfer out of bed, stand, or walk and needed help with most of her activities of daily living. She could not swallow solid foods and required a puree diet. Robin’s goal was to return home with her husband, and she had family and friends cheering her on throughout her stay!

Robin is a very friendly, caring person who enjoys socializing with fellow residents and participating in facility activities. She worked with physical, occupational, and speech therapy and was motivated to participate even when she was not feeling well or emotionally having a bad day. She worked hard each day and was able to regain her ability to eat regular foods again. When the day came for her to discharge, she was walking with a walker, transferring with minimal assistance, and able to attend to her daily tasks! Because of her determination and hard work, Robin was able to meet her goal and was discharged back home with her husband in May! Congratulations to Robin and her Care Team on their success!

Caregiving for a Person with Alzheimer’s Disease or a Related Dementia

June 26, 2023

What is Alzheimer’s Disease?

Alzheimer’s disease is the most common form of a group of brain diseases called dementias. Alzheimer’s disease accounts for 60% to 80% of dementia cases. Other forms of dementia include vascular dementia, mixed dementia, dementia with Lewy bodies, and frontotemporal dementia.

Alzheimer’s disease, like all dementias, gets worse over time and there is no known cure. Nearly 6 million Americans are living with Alzheimer’s disease. Alzheimer’s disease destroys brain cells causing problems with memory, thinking, and behavior that can be severe enough to affect work, lifelong hobbies, and social life. Eventually, it can affect one’s ability to carry out routine daily activities. Today, it is the sixth leading cause of death in the United States. It is the fifth leading cause of death for those aged 65 years and older.

For more information, see www.alz.org/alzheimers-dementia/facts-figuresexternal icon.

What is known about caregiving for a person with Alzheimer’s disease or another form of dementia?

People with Alzheimer’s disease and related dementias are usually cared for by family members or friends. The majority (80%) of people with Alzheimer’s disease and related dementias are receiving care in their homes. Each year, more than 16 million Americans provide more than 17 billion hours of unpaid care for family and friends with Alzheimer’s disease and related dementias. In 2019, these caregivers will provide an estimated 18.5 billion hours of care. Approximately two-thirds of dementia caregivers are women, about one in three caregivers (34%) is age 65 or older, and approximately one-quarter of dementia caregivers are “sandwich generation” caregivers, meaning that they care not only for an aging parent, but also for children under age 18.

Caregivers of people with Alzheimer’s and related dementias provide care for a longer duration than caregivers of people with other types of conditions (79% versus 66%). Well over half (57%) of family caregivers of people with Alzheimer’s and related dementias provide care for four years or more. More than six in ten (63%) Alzheimer’s caregivers expect to continue having care responsibilities for the next 5 years compared with less than half of caregivers of people without dementia (49%).

The demands of caregiving can limit a caregiver’s ability to take care of themselves. Family caregivers of people with Alzheimer’s and related dementias are at greater risk for anxiety, depression, and poorer quality of life than caregivers of people with other conditions.

To learn more, please visit https://www.cdc.gov/aging/caregiving/alzheimer.htm.

Success Story: Reathel Carter

June 19, 2023

Greenville Nursing and Rehabilitation is excited to share resident Reathel Carter’s Success Story!

Ms. Reathel Carter was re-admitted to Greenville Nursing and Rehabilitation from home on January 13th, 2023 where she decided to stay in long-term care. Upon admission, Ms. Carter required assistance with her transfers, walking, and daily living activities. She worked with therapy to determine a plan to regain strength and independence. When she was discharged from therapy services, she was able to transfer and walk short distances with minimal assistance and had increased her independence with daily activities!

Ms. Carter enjoys joking around, socializing with fellow Care Team members and residents, and participating in community activities, especially Bingo. We are so happy she has decided to call Greenville her home. Congratulations to Ms. Carter and her Care Team on their success!

Older Adults and Extreme Heat

June 12, 2023

People aged 65 or older are more prone to heat-related health concerns. Older adults can’t adjust to sudden temperature changes as fast as younger people. This may happen because of certain medicines they take or chronic illnesses that affect their ability to regulate body temperature. When not treated properly, heat-related illnesses can lead to death. But you can take steps to stay cool during hot weather.

SIGNS AND SYMPTOMS OF HEAT-RELATED ILLNESS

If your body becomes overheated, you can be in danger of heat-related illness. These illnesses can includeexternal icon :

  • Heat syncope, or sudden dizziness.
  • Heat cramps.
  • Heat edema, or swelling in your legs and ankles.
  • Heat exhaustion—when your body can no longer stay cool. This often appears as feeling thirsty, dizzy, weak, uncoordinated, or nauseated. You may sweat a lot and have cold and clammy skin or a rapid pulse.
  • Heat stroke, which is a medical emergency. Signs can include fainting, behavior changes, high body temperature (over 104° F), dry skin, a strong and rapid pulse, a slow and weak pulse, and no longer sweating even though it’s hot.

HOW TO STAY COOL IF YOU ARE AN OLDER ADULT

  • Drink water regularly. Do NOT wait until you’re thirsty to start drinking water.
  • Avoid using your oven or stove to prepare meals.
  • Wear loose-fitting clothes.
  • Take showers to cool down.
  • Maintain the heating and air conditioning system in your home, so your home cools properly.
  • If you don’t have air conditioning, consider staying with a friend or family member during a heatwave. It may be enough to take an “air conditioning break” at a local mall or library during the heat of the day.
  • Don’t overwork yourself, and make sure you rest.
  • Have others check up on you, and vice versa.
  • Wear sunscreen and clothing to protect yourself from sunburns, which make it hard for your body to cool down.
  • When outside in the heat, wear a hat, try to stay in the shade, and move slowly so you won’t become overheated.

Seek medical care immediately if you have symptoms of heat-related illness like muscle cramps, dizziness, headaches, nausea, weakness, or vomiting.

HOW TO HELP AN OLDER ADULT AVOID HEAT-RELATED ILLNESS

As a friend, family member, or caregiver, you can help an older adult avoid heat-related illness during the warmer months. Some things you can do are:

  • Know what medicines they are taking and find out if they affect body temperature.
  • Call or connect regularly and ask if they are cool enough. Listen for patterns or shared concerns. Consider having a remote body or home temperature sensor or monitor installed.
  • If you don’t live nearby, have the contact information for someone who does and who can regularly check in on them.
  • Complete a care plan together to provide structure and direction. The care plan should include ways to stay cool during extreme heat and should note if any medicines the person takes may affect body temperature regulation.
  • If you are the one checking in on older adult, make sure they
    • Stay hydrated
    • Have the living space set to a comfortable temperature
    • Know how to stay cool during extreme heat
    • Don’t show signs of heat stress
  • Seek medical care immediately if the person has symptoms of heat-related illness like muscle cramps, dizziness, headaches, nausea, weakness, or vomiting.

HOW TO HELP SOMEONE WITH DEMENTIA AVOID HEAT-RELATED ILLNESS

About 25% of people with dementia live alone, and they may not always have awareness about their surroundings. Learn how to make a home safety checklistexternal icon for someone with Alzheimer’s or related dementias. During the warmer months:

  • If the person is using a portable fan, make sure that objects can’t be placed in the blades. Place fans near electrical outlets to avoid using an extension cord. If an extension cord must be used, attach it to the baseboards to reduce the risk of tripping.
  • Install alarms that alert you if a door or window is opened. This can reduce the risk of wandering in hot weather and keep cool air inside the home.
  • Fence off swimming pools with a locked gate, cover if possible, and closely monitor the person when they are in the pool.
  • Hide an extra key outside the home in case the person with dementia locks the door and a caregiver or emergency responder needs to get inside.
  • Keep a list of all medicines the person takes and ask the doctor if any of them increase the risk of becoming overheated.

To learn more, please visit https://www.cdc.gov/aging/emergency-preparedness/older-adults-extreme-heat/index.html.

National Healthcare Recruiter Recognition Day: Meet the Team

June 6, 2023

Happy National Healthcare Recruiter Recognition Day to our AMAZING Talent Acquisition team! These individuals go above and beyond for our communities every single day. Learn more about the team:

Laurel Lingle

Vice President of Talent Acquisition

Being in Senior Care for over 20 years continues to be a passion of mine. Knowing every hire makes a difference in our residents’ lives keeps me energized and passionate about my work. Bluegrass is a place that allows you to have a seat at the table and really contribute to how we adapt to the change of our labor market. We continue to strive to be the best Senior Care provider by ensuring our Care Team members are provided a positive work environment.


Linda Barnoski

Director of Talent Acquisition

“I have been working in Senior healthcare for over 25 years and I love being apart of providing the best care to our local seniors. I feel supported because our leadership team guides, supports and encourages us all to live our mission every day. What I love most about Bluegrass is that we are a great team that strives to make positive impact in our communities and care for those in need. We believe and live our mission of Leading with Love every day.”


Cindy Beasley

Talent Acquisition Sourcer

I love being able to assist candidates find a new position as well as helping our locations get to the proper staffing numbers needed to make the building run smoothly. We have a wonderful supervisor Laurel and everyone on the team has been very helpful in making sure we keep the recruiting process flowing. I love being part of a team that leads with love!

Barriers to Equity in Alzheimer’s and Dementia Care

June 5, 2023

People of color face discrimination when seeking health care for Alzheimer’s disease and related dementias. Findings from two national surveys conducted by the Alzheimer’s Association show that Black Americans reported the highest level of discrimination in dementia health care followed by Native Americans, Asian Americans, and Hispanic Americans.

Special Report on Race, Ethnicity and Alzheimer’s in America pdf icon[PDF–787 KB]external icon from the Alzheimer’s Association shows these populations reported higher rates of discrimination when seeking health care than non-Hispanic White Americans:

  • 50% of Black Americans.
  • 42% of Native Americans.
  • 34% of Asian Americans.
  • 33% of Hispanic Americans.

Non-Hispanic White Americans reported discrimination at a much lower rate of 9%.

With the projected increases in Alzheimer’s disease among minority populations, it is more important to address these care inequities.

Elements of Cultural Competence

  • A culturally diverse staff that reflects the population served.
  • Ability to overcome language barriers, either with bilingual staff or interpreters.
  • Training for providers on the cultures and languages represented in the population.
  • Patient materials and practice signage that are translated and sensitive to cultural norms.

Hispanics and African Americans, for example, will see the largest increases in Alzheimer’s disease and related dementias in the future. By 2060, the number of Alzheimer’s disease cases is predicted to rise to an estimated 14 million people, with minority populations being affected the most.1

  • Cases among Hispanics will increase seven times over today’s estimates.
  • Cases among African Americans will increase four times over today’s estimates.

What Is a Health Disparity?

A health disparity is when a group of people experience a higher rate of illness, injury, disability, or death than another group.

Health disparities can have a profound, negative effect on entire populations or individual communities. Dementia care and support services can vary widely depending on race, ethnicity, geography, and social and economic factors. Stigma, cultural differences, awareness, and understanding about Alzheimer’s disease and related dementias can all be factors leading to health disparities. In addition, the ability for a person to get a diagnosis, manage the disease, and be able to access quality health care contribute to health disparities.

These disparities reach beyond clinical care to include uneven representation of Black, Hispanic, Asian, and Native Americans in Alzheimer’s research in clinical trials.

Alzheimer’s Caregivers Also Face Discrimination

The surveys show that among non-White caregivers, half or more say they have also faced discrimination when navigating health care settings for their care recipient. Their top concern being that providers or staff do not listen to what they are saying because of their race, color, or ethnicity. This concern was especially high among Black caregivers (42%), followed by Native American (31%), Asian American (30%), and Hispanic (28%) caregivers. Fewer than 1 in 5 White caregivers (17%) expressed this view.

Health Disparity vs. Health Care Disparity

Health disparity: a higher burden of illness, injury, disability, or mortality experienced by one group relative to another.

Health care disparity: differences between groups in health insurance coverage, access to and use of care, and quality of care.

Both: differences that are not explained by variations in health needs, patient preferences or treatment recommendations and are closely linked with social, economic and/or environmental disadvantage.

Lack of Diversity Among Health Care Staff Creates Barriers

Understanding how different racial and ethnic groups view, access, and experience health care is critical to improving the health care system and helping health providers care for an increasingly diverse population. It is projected that people of color will account for over half (52%) of the population in 2050.

Characteristics of health care systems that contribute to disparities should be acknowledged. These include implicit bias on the part of health care providers. Cultural and language barriers can also hinder patient-provider relationships.

Minority Populations Desire Health Care Providers Who Understand Their Ethnic or Racial Background

Given their own experiences with discrimination, it is not surprising that non-White racial/ethnic populations feel it is important for Alzheimer’s and dementia care providers to be more culturally competent. Responses from surveys indicate a strong desire for dementia health care providers who understand different racial and ethnic backgrounds, but many survey respondents say access to these providers is lacking.

As shown in the graphic from the Alzheimer’s Association Special Report, 92% of Native Americans say they want dementia health care providers who understand their ethnic background, yet only 47% have confidence they currently have access to them. Black Americans, Hispanic Americans, and Asian Americans felt similar.

Graphic used with permission from the Alzheimer’s Association, 2021 Alzheimer’s Disease Facts and Figures, Special Report: Race, Ethnicity and Alzheimer’s in America pdf icon[PDF–787 KB]external icon. Accessed March 31, 2021.

A Path Forward—Bridging Racial and Ethnic Barriers in Alzheimer’s and Dementia Care

Findings from the Alzheimer’s Association surveys indicate that, despite ongoing efforts to address health and health care disparities in Alzheimer’s and dementia care, there is still much work to do.

Based on the surveys’ findings, paths forward should address three areas:

  1. Preparing the workforce to care for a racially and ethnically diverse older adult population.
    1. This includes cultural competence education, and training providers to recognize and overcome implicit bias. (See sidebar: Elements of Cultural Competence)
  2. Increasing diversity among providers for dementia care.
    1. Currently, only 1 in 3 US physicians are Black, American Indian or Alaska Native, Hispanic, or Asian. Primary care is more diverse with approximately 40% of physicians coming from diverse racial and ethnic backgrounds. Ensuring diversity in these frontline providers may help reduce future disparities in dementia care. Developing a workforce that reflects the demographics of individuals with Alzheimer’s disease or other dementias should begin during outreach and recruitment to training programs, continue with programming designed to support racially and ethnically diverse students during their training years, and extend to offering residency opportunities in health care settings that treat diverse populations. In addition, hiring practices should consider diversity and inclusion to meet the needs of local patient populations.
  3. Engaging, recruiting, and retaining diverse populations in Alzheimer’s research and clinical trials.
    1. A critical first step to increase diverse participation and representation in clinical research is building and restoring trust in underrepresented communities. One way to do so is through community-based organizations and other respected local partners. The Healthy Brain Initiative State and Local Public Health Partnerships to Address Dementia: 2018–2023 Road Map, launched in partnership with the Alzheimer’s Association and the Centers for Disease Control and Prevention (CDC), is organized around a core principle of “eliminating disparities and collaborating across multiple sectors.”

To learn more, please visit https://www.cdc.gov/aging/publications/features/barriers-to-equity-in-alzheimers-dementia-care/index.html.

Alzheimer’s Disease and Related Dementias

May 22, 2023

WHAT IS ALZHEIMER’S DISEASE?

  • Alzheimer’s disease is the most common type of dementia.
  • It is a progressive disease beginning with mild memory loss and possibly leading to loss of the ability to carry on a conversation and respond to the environment.
  • Alzheimer’s disease involves parts of the brain that control thought, memory, and language.
  • It can seriously affect a person’s ability to carry out daily activities.

WHO HAS ALZHEIMER’S DISEASE?

Alzheimer’s Disease and Racial and Ethnic Disparities infographic

All Alzheimer-related infographics

  • In 2020, as many as 5.8 million Americans were living with Alzheimer’s disease.1
  • Younger people may get Alzheimer’s disease, but it is less common.
  • The number of people living with the disease doubles every 5 years beyond age 65.
  • This number is projected to nearly triple to 14 million people by 2060.1
  • Symptoms of the disease can first appear after age 60, and the risk increases with age.

WHAT IS KNOWN ABOUT ALZHEIMER’S DISEASE?

Scientists do not yet fully understand what causes Alzheimer’s disease. There likely is not a single cause but rather several factors that can affect each person differently.

  • Age is the best known risk factor for Alzheimer’s disease.
  • Family history—researchers believe that genetics may play a role in developing Alzheimer’s disease. However, genes do not equal destiny. A healthy lifestyle may help reduce your risk of developing Alzheimer’s disease. Two large, long term studies indicate that adequate physical activity, a nutritious diet, limited alcohol consumption, and not smoking may help people. To learn more about the study, you can listen to a short podcast.
  • Changes in the brain can begin years before the first symptoms appear.
  • Researchers are studying whether education, diet, and environment play a role in developing Alzheimer’s disease.
  • There is growing scientific evidence that healthy behaviors, which have been shown to prevent cancer, diabetes, and heart disease, may also reduce risk for subjective cognitive decline. Here’s 8 ways.

WHAT ARE THE WARNING SIGNS OF ALZHEIMER’S DISEASE?

Alzheimer’s disease is not a normal part of aging. Memory problems are typically one of the first warning signs of Alzheimer’s disease and related dementias.

In addition to memory problems, someone with symptoms of Alzheimer’s disease may experience one or more of the following:

  • Memory loss that disrupts daily life, such as getting lost in a familiar place or repeating questions.
  • Trouble handling money and paying bills.
  • Difficulty completing familiar tasks at home, at work or at leisure.
  • Decreased or poor judgment.
  • Misplacing things and being unable to retrace steps to find them.
  • Changes in mood, personality, or behavior.

Even if you or someone you know has several or even most of these signs, it doesn’t mean it’s Alzheimer’s disease. Know the 10 warning signs (also available in Spanish).

WHAT TO DO IF YOU SUSPECT ALZHEIMER’S DISEASE

Getting checked by your healthcare provider can help determine if the symptoms you are experiencing are related to Alzheimer’s disease, or a more treatable conditions such as a vitamin deficiency or a side effect from medication. Early and accurate diagnosis also provides opportunities for you and your family to consider financial planning, develop advance directives, enroll in clinical trials, and anticipate care needs.

HOW IS ALZHEIMER’S DISEASE TREATED?

Medical management can improve quality of life for individuals living with Alzheimer’s disease and for their caregivers. There is currently no known cure for Alzheimer’s disease. Treatment addresses several areas:

  • Helping people maintain brain health.
  • Managing behavioral symptoms.
  • Slowing or delaying symptoms of the disease.

SUPPORT FOR FAMILY AND FRIENDS

Currently, many people living with Alzheimer’s disease are cared for at home by family members. Caregiving can have positive aspects for the caregiver as well as the person being cared for. It may bring personal fulfillment to the caregiver, such as satisfaction from helping a family member or friend, and lead to the development of new skills and improved family relationships.

Although most people willingly provide care to their loved ones and friends, caring for a person with Alzheimer’s disease at home can be a difficult task and may become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. As the disease gets worse, people living with Alzheimer’s disease often need more intensive care.

You can find more information about caring for yourself and access a helpful care planning form.

WHAT IS THE BURDEN OF ALZHEIMER’S DISEASE IN THE UNITED STATES?

  • Alzheimer’s disease is one of the top 10 leading causes of death in the United States.2
  • The 6th leading cause of death among US adults.
  • The 5th leading cause of death among adults aged 65 years or older.3

In 2020, an estimated 5.8 million Americans aged 65 years or older had Alzheimer’s disease.1 This number is projected to nearly triple to 14 million people by 2060.1

In 2010, the costs of treating Alzheimer’s disease were projected to fall between $159 and $215 billion.4 By 2040, these costs are projected to jump to between $379 and more than $500 billion annually.4

Death rates for Alzheimer’s disease are increasing, unlike heart disease and cancer death rates that are on the decline.5 Dementia, including Alzheimer’s disease, has been shown to be under-reported in death certificates and therefore the proportion of older people who die from Alzheimer’s may be considerably higher.6

WHAT IS KNOWN ABOUT REDUCING YOUR RISK OF ALZHEIMER’S DISEASE?

The science on risk reduction is quickly evolving, and major breakthroughs are within reach. For example, there is growing evidence that people who adopt healthy lifestyle habits — like regular exercise and blood pressure management — can lower their risk of dementia. There is growing scientific evidence that healthy behaviors, which have been shown to prevent cancer, diabetes, and heart disease, may also reduce risk for subjective cognitive decline. To learn more about the current state of evidence on dementia risk factors and the implications for public health, please read the following summaries on Cardiovascular HealthExerciseDiabetes and ObesityTraumatic Brain Injury (TBI)Tobacco and AlcoholDiet and Nutrition,  SleepSensory Impairment, and Social Engagement or the Compiled Report (includes all reports in this list).

To learn more, please visit https://www.cdc.gov/aging/aginginfo/alzheimers.htm.

Emergency Preparedness for Older Adults

May 17, 2023

Follow these easy steps to make sure you’re protected.

Natural disasters, such as hurricanes, tornadoes, and blizzards, may force you to evacuate your home or shelter-in-place at short notice. It is important to know what to do in case of an emergency well before disaster strikes.

If you are an older adult living in the community, you may face some challenges during an emergency. For example, you may have mobility problems, or chronic health conditions, or you may not have any family or friends nearby to support you. Support services that are usually available, such as help from caregivers or in-home health care and meal delivery services, may be unavailable for a period of time. In addition, older adults may experience challenges that come with advanced age, such as hearing or vision problems or cognitive impairment, which may make it difficult to access, understand, and respond to emergency instructions.

You or the person you care for can be prepared for emergency situations by creating a plan, reviewing or practicing it regularly, and keeping an emergency supply kit.

CREATING A PLAN

The first step in preparing for an emergency is creating a plan. Work with your friends, family, and neighbors to develop a plan that will fit your needs.

  • Choose a contact person who will check on you during a disaster, and decide how you will communicate with each other (for instance, by telephone, knocking on doors). Consider speaking with your neighbors about developing a check-in system together.
  • Create a list of contact information for family members and friends. Leave a copy by your phone(s) and include one in your Emergency Supply Kit.
  • Plan how you will leave and where you will go during an evacuation. If you are living in a retirement or assisted living community, learn what procedures are in place in case of emergencies. Keep a copy of exit routes and meeting places in an easy-to-reach place.
  • Create a care plan and keep a copy in your Emergency Supply Kit. Try out CDC’s easy-to-use care plan template pdf icon[ PDF – 1 MB ]Español (Spanish) pdf icon[PDF – 1 MB]
  • If you have medical, transportation, or other access needs during an emergency, consider signing up for SMART911, Code Red, or your local county registry, depending upon which service your area uses to helps first responders identify people who may need assistance right away.

CREATING AN EMERGENCY SUPPLY KIT

After an emergency, you may not have access to clean water or electricity. Make sure you are prepared with your own supply of food, water, and other items to last for at least 72 hours.

  • Visit Ready.govexternal iconexternal icon for a list of basic items to gather for your Disaster Supply Kit.
  • Medical-Related Items:
    • A 3-day supply of medicine, at a minimum. If medications need to be kept cold, have a cooler and ice packs available.
    • ID band (full name, contact number for family member/caregiver, and allergies)
    • Hearing aids and extra batteries
    • Glasses and/or contacts and contact solution
    • Medical supplies like syringes or extra batteries
    • Information about medical devices such as wheelchairs, walkers, and oxygen including model numbers and vender.
  • Documents (Keep physical copies in a waterproof bag and take photos of each document for backup):
    • Your Care Plan pdf icon[PDF – 1 MB]        Español (Spanish) pdf icon[PDF – 1 MB]
    • Contact information for family members, doctors, pharmacies and/or caregivers
    • List of all medications, including the exact name of the medicine and the dosage, and contact information for pharmacy and doctor who prescribed medicine
    • List of allergies to food or medicines
    • Copies of medical insurance cards
    • Copies of a photo ID
    • Durable power of attorney and/or medical power of attorney documents, as appropriate.

To learn more, please visit https://www.cdc.gov/aging/emergency-preparedness/index.html

National Nurses Week: The History of Florence Nightingale

May 11, 2023

During National Nurses Week, take time to celebrate the founder of modern nursing, Florence Nightingale! Her endeavors to improve the aspect of healthcare has greatly shaped the quality of care by nurses in the 19th and 20th centuries. 

Currently, there are nurses all around the world putting their lives on the line. It’s clear that Florence Nightingale’s impact on healthcare also helped pave the way for modern-day nurses and healthcare professionals to follow suit.

“With nurses around the world on the front lines of a global pandemic, it’s a poignant time to reflect on how Nightingale’s legacy laid the groundwork for their heroic work in hospitals today.” Says Greta Westwood, CEO of the Florence Nightingale Foundation. “She never took no for an answer – anything was possible.”

Also known as “The Lady with the Lamp”, Florence Nightingale started her nursing career in London, and later became appointed as the head nurse of the 1854 Crimean War. Nightingale’s passion and determination set her apart from others and got her the famous nickname “Lady with the Lamp” for checking on her patients via lamplight during the war. Not only did she care for her patients’ health, but she also often wrote letters to soldiers’ loved ones on their behalf.

The “Angel of the Crimea” made it her goal to lower death rates by improving hygiene practices in hospitals. She created numerous patient services that improved each patient’s quality of care while admitted in the hospital. She oversaw “invalid’s kitchen” where she set out food plans for patients that had dietary requirements. She also secured a laundry area so patients could have clean bed sheets and towels.

After the Crimean War, Nightingale wrote a book called Matters Affecting the Health, Efficiency and Hospital Administration of the British Army to share her observations and experiences while tending wounded soldiers. In 1857, the War Office’s administrative department was completely reconstruction due to Nightingale’s book and her experiences during the Crimean War, reforming several military hospitals that were under very poor conditions. (History.com Editors 2009)

In August of 1910, Nightingale became ill and was battling with heart failure. She died a week later at her home in London, bringing her life to an end at 90 years old. (History.com Editors 2009) Two years after her death, the Florence Nightingale Medal was created by the International Committee of the Red Cross, dedicated to be given to exceptional nurses every 2 years. In 1965, International Nurses Day was also created, residing on Nightingale’s birthday to continue celebrating her accomplishments. (Alexander 2018)

Despite her unexpected death, her legacy continues to live on at the Florence Nightingale Museum, which is located at the exact same spot of the original Nightingale Training School for Nurses. The museum holds over 2,000 artifacts to memorialize the mother of modern nursing. (History.com Editors 2009)

Florence Nightingale’s legacy is important to note during significant time for nurses courageously fighting on the frontlines during the pandemic. Notes Westwood, “Florence would be so proud of what nurses have managed to achieve during the pandemic.” (Haynes 2020)

References:

https://time.com/5835150/florence-nightingale-legacy-nurses/

http://history.com/topics/womens-history/florence-nightingale-1

https://www.womenshistory.org/education-resources/biographies/florence-nightingale

Caring for Yourself When Caring for Another

May 9, 2023

You are a caregiver if you care for someone who needs help. Caregiving can be hard on you despite the great sense of reward you may feel. To continue being a good caregiver, you need to take care of yourself. One way you can do that is to make sure you have consistent breaks from your caregiving responsibilities. This is called respite. Short breaks can be a key part of maintaining your own health.

WHAT IS RESPITE CARE?

You are a caregiver if you are caring for someone who needs help. Taking short breaks can be the key to maintaining your own health.

Respite care allows the caregiver some time off from their caregiving responsibilities. It can take the form of different types of services in the home, adult day care, or even short-term nursing home care so caregivers can have a break or even go on vacation. Research shows that even a few hours of respite a week can improve a caregiver’s well-being.1 Respite care may be provided by family, friends, a nonprofit group, or government agency. Some of these services may be free or low-cost.

FAMILY AND FRIENDS

Make Your Needs Known

Here are some suggestions for getting help from people you know.

  1. Identify a caregiving task or a block of time that you would like help with. Perhaps there’s a book club meeting you’d like to go to that you’ve been missing because of your caregiving responsibilities. Be ready when someone says, “What can I do to help?” with a specific time or task, such as, “It would be really helpful for me if you could stay with Mom Tuesday night so I can go to my book club for 2 hours.”
  2. Be understanding if you are turned down. The person may not be able to help with that specific request, but they may be able to help another time. Don’t be afraid to ask again.
  3. If you have trouble asking for help face to face, try writing an e-mail to your friends and family members about your needs. Set up a shared online calendar or scheduling tool where people can sign up to provide you with regular respite.

YOUR DOCTOR OR OTHER HEALTH CARE PROVIDER

Does your doctor know you are a caregiver?

  • You have special needs as a caregiver that your doctor should be aware of. Be sure to let your doctor know if your caregiving responsibilities are making you feel depressed or anxious. Health care professionals may also know about support groups offered in the community.
  • Let your doctor (or your care recipient’s doctor) know that you need help finding respite care. A doctor may be able to write you a “prescription” for respite services via Medicare’s PACE program. PACE services are available to Medicare and Medicaid beneficiaries in some states.

NONPROFIT ORGANIZATIONS OR GOVERNMENT AGENCIES

Here’s how to get back some of your “me time”

A great source for respite services is the Area Agencies on Aging. Check the website for the agency in your area. Other resources include:

  • Organizations that advocate for people with specific diseases. If you care for someone with Alzheimer’s disease, heart disease, cancer, or lung disease, respite care services may be available from the following organizations.

The Department of Veterans Affairs offers respite resources for veterans or their spouses.

STILL NOT ABLE TO GET A BREAK?

Consider joining an online support group. It’s important for you to have an opportunity to share your experiences with others in similar circumstances and to get support and new resources from them.

  • Family Alliance on Caregiving—The Caregiver-online support group is an unmoderated group for families, partners, and other caregivers of adults with disorders such as Alzheimer’s, stroke, brain injury, and other chronic debilitating health conditions. The group offers a safe place to discuss the stresses, challenges, and rewards of providing care for another.
  • Caring.com Resource Center—Offers key resources to help you better navigate caregiving and access to online support groups, such as the Alzheimer’s Caregiver Support Group.

Remember—To be an effective caregiver, you must take care of yourself. Your care recipient is counting on you.

To learn more, please visit https://www.cdc.gov/aging/publications/features/caring-for-yourself.html.

Nurses Week 2023: Discounts and Freebies All Month Long!

May 8, 2023

We are preparing for an amazing celebration of National Nurses Week this year! Many companies are showing their gratitude for nurses and healthcare workers by offering awesome deals and freebies during Nurses Week and throughout the year. Whether you are a healthcare worker looking for a good deal or you’re shopping for a healthcare hero in your life, check out these great deals valid for the entire month of May for Nurses Week 2023!

Food & Grocery

Electronics

  • Bose – Special discount on orders over $199
  • Samsung – 30% off
  • HP – Savings up to 40% off & free shipping
  • McAfee – Special discount on 10-Device McAfee Total Protection for Nurses
  • Therabody – 20% off regularly-priced Theragun or TheraOne CBD for Nurses
  • Sennheiser – Up to 20% off & free shipping for Nurses
  • Netgear – 15% off
  • Leatherman – 30% off multi-tools
  • Ember – 20% off
  • Sonos – 15% off
  • Lenovo – 5% off

Apparel, Shoes, & Accessories

Entertainment & Services

Cosmetics, Skincare, & Nutrition

Outdoors, Sports, & Fitness

In addition to this month’s discounts and freebies, we are proud to partner with Panda Perks to give our Care Team members 24/7 access to discounts and perks on the brands you love!

Success Story: Randy Markham

April 29, 2023

Greenville Nursing and Rehabilitation is excited to highlight resident Randy Markham’s Success Story!

Mr. Randy Markham has been a long-term Greenville Nursing and Rehabilitation resident since May 2021. He has a great sense of humor and enjoys participating in community activities. He loves to have fun, and loves good food. He enjoys being mobile in his wheelchair, going around the community and talking to caregivers and fellow residents. In the middle of December, Mr. Markham was diagnosed with COVID-19 and experienced and medical decline. He lost interest in talking to fellow residents and required increased assistance with self-feeding, required to thicken liquids. With his functional decline, he could not transfer and propel himself in his wheelchair.

Therapy evaluated Mr. Markham and devised and planned to address his decline so he could return to his prior level of function. With much encouragement and his participation in therapy, he can now perform self-feeding with set-up help only and is back on a regular liquid consistency. He can complete functional transfers with limited assistance and walk with someone assisting him utilizing a rolling walker. Mr. Markham can also propel himself within the community independently and visit with his fellow residents and caregivers, and at times you can hear him even singing! Congratulations to Mr. Markham and his Care Team on their success!

Implementation of Personal Protective Equipment (PPE) Use in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MDROs)

April 25, 2023

Background

Residents in nursing homes are at increased risk of becoming colonized and developing infection with MDROs [2]. As described further in Consideration for the Use of Enhanced Barrier Precautions in Skilled Nursing Facilities [PDF – 9 pages], more than 50% of nursing home residents may be colonized with an MDRO, nursing homes have been the setting for MDRO outbreaks, and when these MDROs result in resident infections, limited treatment options are available [1-9]. Implementation of Contact Precautions, as described in the CDC Guideline for Isolation Precautions, is perceived to create challenges for nursing homes trying to balance the use of PPE and room restriction to prevent MDRO transmission with residents’ quality of life. Thus, many nursing homes only implement Contact Precautions when residents are infected with an MDRO and on treatment.

Focusing only on residents with active infection fails to address the continued risk of transmission from residents with MDRO colonization, who by definition have no symptoms of illness. MDRO colonization may persist for long periods of time (e.g., months) [10] which contributes to the silent spread of MDROs.

With the need for an effective response to the detection of serious antibiotic resistance threats, there is growing evidence that the traditional implementation of Contact Precautions in nursing homes is not implementable for most residents for prevention of MDRO transmission.

This document is intended to provide guidance for PPE use and room restriction in nursing homes for preventing transmission of MDROs, including as part of a public health response. For the purposes of this guidance, the MDROs for which the use of EBP applies are based on local epidemiology. At a minimum, they should include resistant organisms targeted by CDC but can also include other epidemiologically important MDROs [9, 10].

Examples of MDROs Targeted by CDC include:

  • Pan-resistant organisms,
  • Carbapenemase-producing carbapenem-resistant Enterobacterales,
  • Carbapenemase-producing carbapenem-resistant Pseudomonas spp.,
  • Carbapenemase-producing carbapenem-resistant  Acinetobacter baumannii, and
  • Candida auris

Additional epidemiologically important MDROs may include, but are not limited to:

  • Methicillin-resistant Staphylococcus aureus (MRSA),
  • ESBL-producing Enterobacterales,
  • Vancomycin-resistant Enterococci (VRE),
  • Multidrug-resistant Pseudomonas aeruginosa,
  • Drug-resistant Streptococcus pneumoniae

This document is not intended for use in acute care or long-term acute care hospitals and does not replace existing guidance regarding use of Contact Precautions for other pathogens (e.g., Clostridioides difficile, norovirus) in nursing homes.

Description of Precautions

Standard Precautions are a group of infection prevention practices that apply to the care of all residents, regardless of suspected or confirmed infection or colonization status. They are based on the principle that all blood, body fluids, secretions, and excretions (except sweat) may contain transmissible infectious agents. Proper selection and use of PPE, such as gowns and gloves, is one component of Standard Precautions, along with hand hygiene, safe injection practices, respiratory hygiene and cough etiquette, environmental cleaning and disinfection, and reprocessing of reusable medical equipment. Use of PPE is based on the staff interaction with residents and the potential for exposure to blood, body fluids, or pathogens (e.g., gloves are worn when contact with blood, body fluids, mucous membranes, non-intact skin, or potentially contaminated surfaces or equipment are anticipated). More detail about Standard Precautions is available as part of the Core Infection Prevention and Control Practices for Safe Healthcare Delivery in all Settings.

Contact Precautions are one type of Transmission-Based Precaution that are used when pathogen transmission is not completely interrupted by Standard Precautions alone. Contact Precautions are intended to prevent transmission of infectious agents, like MDROs, that are spread by direct or indirect contact with the resident or the resident’s environment.

Contact Precautions require the use of gown and gloves on every entry into a resident’s room. The resident is given dedicated equipment (e.g., stethoscope and blood pressure cuff) and is placed into a private room. When private rooms are not available, some residents (e.g., residents with the same pathogen) may be cohorted, or grouped together. Residents on Contact Precautions should be restricted to their rooms except for medically necessary care and restricted from participation in group activities.

Because Contact Precautions require room restriction, they are generally intended to be time limited and, when implemented, should include a plan for discontinuation or de-escalation.

More detail about Transmission-Based Precautions, including descriptions of Droplet Precautions and Airborne Precautions are available in the CDC Guideline for Isolation Precautions. In addition, other infections (e.g. norovirus, C. difficile, and scabies) and conditions for which Contact Precautions are indicated are summarized in Appendix A – Type and Duration of Precautions Recommended for Selected Infections and Conditions of the guideline.

Enhanced Barrier Precautions expand the use of PPE and refer to the use of gown and gloves during high-contact resident care activities that provide opportunities for transfer of MDROs to staff hands and clothing [11-15]. MDROs may be indirectly transferred from resident-to-resident during these high-contact care activities. Nursing home residents with wounds and indwelling medical devices are at especially high risk of both acquisition of and colonization with MDROs [3,5,6]. The use of gown and gloves for high-contact resident care activities is indicated, when Contact Precautions do not otherwise apply, for nursing home residents with wounds and/or indwelling medical devices regardless of MDRO colonization as well as for residents with MDRO infection or colonization.

Examples of high-contact resident care activities requiring gown and glove use for Enhanced Barrier Precautions include:

  • Dressing
  • Bathing/showering
  • Transferring
  • Providing hygiene
  • Changing linens
  • Changing briefs or assisting with toileting
  • Device care or use: central line, urinary catheter, feeding tube, tracheostomy/ventilator
  • Wound care: any skin opening requiring a dressing

In general, gown and gloves would not be required for resident care activities other than those listed above, unless otherwise necessary for adherence to Standard Precautions. Residents are not restricted to their rooms or limited from participation in group activities. Because Enhanced Barrier Precautions do not impose the same activity and room placement restrictions as Contact Precautions, they are intended to be in place for the duration of a resident’s stay in the facility or until resolution of the wound or discontinuation of the indwelling medical device that placed them at higher risk.

Implementation

When implementing Contact Precautions or Enhanced Barrier Precautions, it is critical to ensure that staff have awareness of the facility’s expectations about hand hygiene and gown/glove use, initial and refresher training, and access to appropriate supplies. To accomplish this:

  • Post clear signage on the door or wall outside of the resident room indicating the type of Precautions and required PPE (e.g., gown and gloves)
    • For Enhanced Barrier Precautions, signage should also clearly indicate the high-contact resident care activities that require the use of gown and gloves
  • Make PPE, including gowns and gloves, available immediately outside of the resident room
  • Ensure access to alcohol-based hand rub in every resident room (ideally both inside and outside of the room)
  • Position a trash can inside the resident room and near the exit for discarding PPE after removal, prior to exit of the room or before providing care for another resident in the same room
  • Incorporate periodic monitoring and assessment of adherence to determine the need for additional training and education
  • Provide education to residents and visitors

Note: Prevention of MDRO transmission in nursing homes requires more than just proper use of PPE and room restriction. Guidance on implementing other recommended infection prevention practices (e.g., hand hygiene, environmental cleaning, proper handling of wounds, indwelling medical devices, and resident care equipment) are available in CDC’s free online course — The Nursing Home Infection Preventionist Training. Nursing homes are encouraged to have staff review relevant modules and to use the resources provided in the training (e.g., policy and procedure templates, checklists) to assess and improve practices in their facility.

To learn more, please visit https://www.cdc.gov/hai/containment/PPE-Nursing-Homes.html.

Success Story: Lois Woodall

April 25, 2023

Greenville Nursing and Rehabilitation is excited to share resident Lois Woodall’s Success Story!

Ms. Lois Woodall was admitted to Greenville Nursing and Rehabilitation after a left-toe amputation. Upon admission, Ms. Woodall was unable to bare full weight on her left leg, causing increased difficulty with transfers. She struggled with ambulation and completing her activities of daily living. She received skilled physical and occupational therapy to address her functional decline to return home to live with her husband. While at Greenville Nursing and Rehabilitation, she had a few setbacks due to vitamin deficiency and required several infusions. Ms. Woodall did not let this deter her from her goal and she was always ready and motivated to participate in her skilled therapy, participate in facility activities, and enjoy socializing with fellow residents. She has demonstrated excellent progress, and at discharge, she completed her transfers and ambulation utilizing a rolling walker with only supervision. She was discharged home and was given a “Red Carpet” send-off. Congratulations to Ms. Woodall and her Care Team on their success!

Older Adult Fall Prevention

April 18, 2023

Each year, millions of older people—those 65 and older—fall. In fact, more than one out of four older people falls each year, 1 but less than half tell their doctor. 2  Falling once doubles your chances of falling again.

Falls Are Serious and Costly

  • One out of five falls causes a serious injury such as broken bones or a head injury,4,5
  • Each year, 3 million older people are treated in emergency departments for fall injuries.6
  • Over 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture.6
  • Each year at least 300,000 older people are hospitalized for hip fractures.7
  • More than 95% of hip fractures are caused by falling,8 usually by falling sideways.9
  • Falls are the most common cause of traumatic brain injuries (TBI).10
  • In 2015, the total medical costs for falls totaled more than $50 billion.11 Medicare and Medicaid shouldered 75% of these costs.

What Can Happen After a Fall?

Many falls do not cause injuries. But one out of five falls does cause a serious injury such as a broken bone or a head injury.4,5 These injuries can make it hard for a person to get around, do everyday activities, or live on their own.

  • Falls can cause broken bones, like wrist, arm, ankle, and hip fractures.
  • Falls can cause head injuries. These can be very serious, especially if the person is taking certain medicines (like blood thinners). An older person who falls and hits their head should see their doctor right away to make sure they don’t have a brain injury.
  • Many people who fall, even if they’re not injured, become afraid of falling. This fear may cause a person to cut down on their everyday activities. When a person is less active, they become weaker and this increases their chances of falling.12

What Conditions Make You More Likely to Fall?

Research has identified many conditions that contribute to falling. These are called risk factors. Many risk factors can be changed or modified to help prevent falls. They include:

  • Lower body weakness
  • Vitamin D deficiency (that is, not enough vitamin D in your system)
  • Difficulties with walking and balance
  • Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.
  • Vision problems
  • Foot pain or poor footwear
  • Home hazards or dangers such as
    • broken or uneven steps, and
    • throw rugs or clutter that can be tripped over.

Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling.

Healthcare providers can help cut down a person’s risk by reducing the fall risk factors listed above. To learn more, please visit https://www.cdc.gov/falls/facts.html.

Transportation Safety for Older Adult Drivers

April 11, 2023

In 2020, there were almost 48 million licensed drivers ages 65 and older in the United States. This is a 68% increase since 2000. Driving helps older adults stay mobile and independent. But the risk of being injured or killed in a traffic crash increases as people age. Thankfully, older adults can take steps to stay safer on the roads.

Thousands of older adults are injured or killed in the United States every year in traffic crashes.

In 2020, about 7,500 older adults were killed in traffic crashes, and almost 200,000 were treated in emergency departments for crash injuries. This means that each day, 20 older adults are killed and almost 540 are injured in crashes.

Age, gender, and age-related changes are major risk factors

  • Drivers aged 70+ have higher crash death rates per 1,000 crashes than middle-aged drivers (aged 35-54). Higher crash death rates among this age group are primarily due to increased vulnerability to injury in a crash.
  • Across all age groups, males have substantially higher crash death rates than females.
  • Age-related changes in vision, physical functioning, and the ability to reason and remember, as well as some diseases and medications, might affect some older adults’ driving abilities.

Key steps to staying safe on the roads

  • The good news is that older adults are more likely to have safer driving behaviors than other age groups.
  • Taking these key steps can help adults of all ages, including older adults, stay safe on the road:
  • Always wear a seat belt as a driver or passenger
    Seat belt use is one of the most effective ways to save lives and reduce injuries in crashes.6
  • Drive when conditions are safest
    Drive during daylight and in good weather. Conditions such as poor weather7 and driving at night8 increase the likelihood of crash injuries and deaths.
  • Don’t drink and drive
    Drinking and driving increases the risk of being in a crash because alcohol reduces coordination and impairs judgment.

Additional steps to stay safe on the road

  • Use CDC’s MyMobility Plan, a plan to stay mobile and independent as you age.
  • Follow a regular activity program to increase strength and flexibility.
  • Ask your doctor or pharmacist to review medicines—both prescription and over-the counter—to reduce side effects and interactions. Read the Are Your Medicines Increasing Your Risk of a Fall or a Car Crash fact sheet to learn more.
  • Have your eyes checked by an eye doctor at least once a year. Wear glasses and corrective lenses as required.
  • Plan your route before you drive.
  • Find the safest route with well-lit streets, intersections with left-turn signals, and easy parking.
  • Leave a large following distance between your car and the car in front of you.
  • Avoid distractions in your car, such as listening to a loud radio, talking or texting on your phone, and eating.
  • Consider potential alternatives to driving, such as riding with a friend, using ride share services, or taking public transit.

To learn more, please visit https://www.cdc.gov/transportationsafety/older_adult_drivers/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmotorvehiclesafety%2Folder_adult_drivers%2Findex.html.

Patient Safety: What You Can Do to Be a Safe Patient

April 3, 2023

You go to the hospital to get well, right? Of course, but did you know that you can get infections in the hospital while you are being treated for something else?

Time in the hospital can put you at risk for a healthcare-associated infection (HAI), such as a blood, surgical site, or urinary tract infection.

Every day, patients get infections in healthcare facilities while they are being treated for something else. These infections can have devastating emotional, financial, and medical effects. Worst of all, they can be deadly.

Healthcare procedures can leave you vulnerable to germs that cause HAIs. These germs can be spread in healthcare settings from patient to patient on unclean hands of healthcare personnel or through the improper use or reuse of equipment.

These infections are not limited to hospitals. For example, in the past 10 years alone, there have been more than 30 outbreaks of hepatitis B and hepatitis C in non-hospital healthcare settings such as

5 Tips for Patients [Video – 2:32]

Protect yourself and your family from harmful germs that can cause infections

  • Keep your hands clean. Regular hand cleaning is one of the best ways to remove germs, avoid getting sick, and prevent spreading germs.
  • Take antibiotics only when your provider thinks you need them. Ask if your antibiotic is necessary. If you take antibiotics when you don’t need them, you’re only exposing yourself to unnecessary risk of side effects and potentially serious infections in the future. If you do need antibiotics, take them exactly as they’re prescribed.
  • Watch for signs of infection and its complications, like sepsis. Get care right away—don’t delay.
    • Tell your doctor if you think you have an infection, or if your infection is not getting better or is getting worse.
  • Watch out for life-threatening diarrhea caused by C. difficile. If you have been taking an antibiotic, tell your doctor if you have 3 or more diarrhea episodes in 24 hours.
  • Get vaccinated against flu and other infections to avoid complications.

Sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death. Learn more about sepsis.

Be a safe patient in the hospital

  • Tell your doctors if you have been hospitalized in another facility, have recently received health care outside of the United States, or have recently had an infection.
  • Ask your healthcare provider what they and the facility will do to protect you and your family from an antibiotic-resistant infection.
    • If you have a catheter, ask daily when it can be removed.
    • If you are having surgery, ask your doctor how they prevent infections. Also, ask how you can prepare for surgery to reduce your infection risk.
  • Keep your hands clean. Make sure everyone cleans their hands before touching you. Remind healthcare personnel and your visitors to clean their hands.
  • Let your doctors check you for resistant germs if needed. Hospitals need to screen patients if they’re exposed, and this helps protect you and those around you.
  • Understand that if you have a resistant bacteria, healthcare providers may use gowns and gloves when caring for you.
  • Allow people to clean your room while you’re in the hospital, even when it feels inconvenient for you.
    • Environmental services workers are the people who clean patient rooms in the hospital, and they are important members of the healthcare team.
    • Allowing them to clean and disinfect your room helps keep you safe by reducing your risk of developing an infection—don’t say, “come back later.”

To learn more, please visit https://www.cdc.gov/HAI/patientSafety/patient-safety.html.

Success Story: Gwendolyn Johnson

March 24, 2023

Greenville Nursing and Rehabilitation is excited to share resident Gwendolyn Johnson’s Success Story!

Ms. Gwendolyn Johnson was admitted to Greenville Nursing and Rehabilitation after a knee replacement which decreased her ability to complete transfers, walk and perform her activities of daily living without significant assistance. Before her admission, Ms. Johnson lived alone, and it was essential for her to return home Independently. While at Greenville Nursing and Rehabilitation, she enjoyed socializing with fellow therapy and facility patients, and she would participate in facility activities and parties frequently.
She participated in therapy five times weekly and was always eager to work hard. To make sure she was ready and safe for discharge, an at-home evaluation was completed with Ms. Johnson. She demonstrated good safety and modified independence during her assessment; minimal recommendations were only needed. Because of her determination and hard work with skilled therapy, she was discharged home Independently. She was given a “Red Carpet” farewell when leaving the facility, which greatly excited her!

Dementia Risk Reduction in Older Adults

March 21, 2023

Dementia: Not an Inevitable Part of Aging

recent survey revealed that nearly half of adults aged 40 years and older think they will likely develop dementia, such as Alzheimer’s disease.1

The truth is dementia is not a normal or inevitable part of typical brain aging. It is also important to remember that as we get older, it is common to experience some cognitive decline with typical brain aging, such as subtle changes in memory, thinking, and  reasoning. For example, you might not immediately remember where you left your car keys, but you can find them when retracing your steps, or you can’t think of the name of a person you just met; however, you remember meeting them. These subtle changes can be frustrating and should not be bad enough to affect your daily life.

Modifiable Risk Factors and Alzheimer’s Disease and Related Dementias

Modifiable risk factors are the lifestyle and behaviors that can reduce or increase a person’s chances of developing a disease. For example, there are modifiable risk factors that could reduce your risk of Alzheimer’s disease and related dementias (ADRD), slow its progression, or increase your risk of ADRD. Most modifiable risk factors for ADRD are related to cardiovascular disease and other chronic health conditions. They include hypertension, not getting enough physical exercise, obesity, diabetes, depression, smoking, hearing loss, and binge drinking. Maintaining a healthy lifestyle and managing related chronic conditions is good for your overall physical health, facilitates and improves brain health, and may help decrease the risk of dementia or slow its progression.

Common Risk Factors Among Adults 45 Years and Older

A new CDC study examined how common these eight risk factors (hypertension, not getting enough physical exercise, obesity, diabetes, depression, smoking, hearing loss, and binge drinking) were among adults 45 years and older: 2 

  • Nearly 50% had high blood pressure or did not meet the aerobic physical activity guideline.
  • Adults with cognitive decline were more likely to report at least 4 factors (34%) than those without cognitive decline (13%).
  • 34% of adults who reported cognitive decline—worsening confusion or memory loss in the previous year—had at least 4 risk factors compared with 13.1% of those without cognitive decline.
  • 9% of adults with no risk factors reported cognitive decline while 25% of those with at least 4 risk factors reported cognitive decline.
  • Several modifiable risk factors were more common among African American, Hispanic, and American Indian or Alaska Native populations than other races and ethnicities.

Older African Americans have twice the incidence and prevalence of ADRD and higher burdens of chronic disease, like hypertension, than non-Hispanic White Americans.3

Ways to Improve Your Brain Health

There is encouraging scientific news despite these risk factors: nearly 40% of all ADRD may be prevented or delayed.4 Since ADRD takes years to develop, there are opportunities to develop and maintain healthy lifestyle habits that could reduce your risk of ADRD or slow its progression. It is never too late to break old habits and start new ones.

This healthy lifestyle habits list consists of some things you can do and some things you should try to limit or avoid.

Things You Can Do: 

  • Manage Blood Sugar—Learn how to manage your blood sugar if you have diabetes.
  • Prevent and Manage High Blood Pressure—Tens of millions of adults in the United States have high blood pressure, and many do not have it under control. Learn the facts.
  • Prevent and Correct Hearing Loss—Make sure to talk to a hearing care professional to treat and manage hearing loss.
  • Find Support—Depression is not just having “the blues” or the emotions we feel when grieving the loss of a loved one. It is a medical condition that can be treatable.

Things You Should Try to Limit or Avoid:

  • Binge Drinking—If you drink, do so in moderation. Learn about alcohol use and your health.
  • Smoking—Quitting smoking improves your health and reduces your risk of heart disease, cancer, lung disease, and other smoking-related illnesses.

To learn more, please visit https://www.cdc.gov/aging/publications/features/dementia-risk-reduction-june-2022/index.html.

Success Story: Belinda Rose

March 14, 2023

Greenville Nursing and Rehabilitation is excited to share resident Belinda Rose’s Success Story!

Ms. Belinda Rose has been a long-term Greenville Nursing and Rehabilitation resident since February 2021. She is a very active and social lady who loves participating in all community activities and parties. She is a very “independent” person who likes to have as little help as possible with transfers and activities of daily living. She required hospitalization in November and when readmitted from the hospital, required increased assistance due to decreased muscle strength. Ms. Rose preferred participating in only one skilled service at a time and first participated in physical therapy. She demonstrated significant progress and regained her strength and endurance for transfers! Ms. Rose then participated in skilled occupational therapy, where she would gladly come 5 times per week and demonstrated significant progress. After experiencing a great deal of progress in strength and improvement in her independence again, she was recently discharged from therapy! We are happy to see Ms. Rose back to her prior level of function and be able to be her social and active self again. Congratulations to Ms. Rose and her Care Team on their success!

Types of Influenza Viruses

March 14, 2023

There are four types of influenza viruses: A, B, C, and D. Influenza A and B viruses cause seasonal epidemics of disease in people (known as flu season) almost every winter in the United States. Influenza A viruses are the only influenza viruses known to cause flu pandemics (i.e., global epidemics of flu disease). A pandemic can occur when a new and different influenza A virus emerges that infects people, has the ability to spread efficiently among people, and against which people have little or no immunity. Influenza C virus infections generally cause mild illness and are not thought to cause human epidemics. Influenza D viruses primarily affect cattle and are not known to infect or cause illness in people.

Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: hemagglutinin (H) and neuraminidase (N). There are 18 different hemagglutinin subtypes and 11 different neuraminidase subtypes (H1 through H18 and N1 through N11, respectively). While more than 130 influenza A subtype combinations have been identified in nature, primarily from wild birds, there are potentially many more influenza A subtype combinations given the propensity for virus “reassortment.” Reassortment is a process by which influenza viruses swap gene segments. Reassortment can occur when two influenza viruses infect a host at the same time and swap genetic information. Current subtypes of influenza A viruses that routinely circulate in people include A(H1N1) and A(H3N2). Influenza A subtypes can be further broken down into different genetic “clades” and “sub-clades.” See the “Influenza Viruses” graphic below for a visual depiction of these classifications.

This graphic shows the two types of influenza viruses (A and B) that cause most human illness and that are responsible for flu seasons each year. Influenza A viruses are further classified into subtypes, while influenza B viruses are further classified into two lineages: B/Yamagata and B/Victoria. Both influenza A and B viruses can be further classified into clades and sub-clades (which are sometimes called groups and sub-groups.) Note that this graphic is an example, and currently circulating influenza clades and subclades may differ from those presented here.

Influenza Vaccine Viruses

Current seasonal flu vaccines are formulated to protect against influenza viruses known to cause epidemics, including: one influenza A(H1N1) virus, one influenza A(H3N2) virus, one influenza B/Victoria lineage virus, and one influenza B/Yamagata lineage virus. Getting a flu vaccine can protect against these viruses as well as additional flu viruses that are antigenically similar to the viruses used to make the vaccine. Information about this season’s vaccine can be found at Preventing Seasonal Flu with Vaccination. Seasonal flu vaccines do not protect against influenza C or D viruses or against zoonotic (animal-origin) flu viruses that can cause human infections, such as variant or avian (bird) flu viruses. In addition, flu vaccines will NOT protect against infection and illness caused by other viruses that also can cause influenza-like symptoms. There are many other viruses besides influenza that can result in influenza-like illness (ILI) that spread during flu season.

To learn more, please visit https://www.cdc.gov/flu/about/viruses/types.htm.

Who Needs a Flu Vaccine?

March 6, 2023

Who should get a flu vaccine this season?

Everyone 6 months and older should get a flu vaccine every season with rare exceptions. Vaccination is particularly important for people who are at higher risk of serious complications from influenza. A full listing of people at Higher Risk of Developing Flu-Related Complications is available.

Flu vaccination has important benefits. It can reduce flu illnesses, visits to doctor’s offices, and missed work and school due to flu, as well as make symptoms less severe and reduce flu-related hospitalizations and deaths.

Different flu vaccines are approved for use in different age groups.

There are many vaccine options to choose from.

The most important thing is for all people 6 months and older to get a flu vaccine every year.

If you have questions about which flu vaccine to get, talk to your doctor or other health care professional. More information is available at Who Should and Who Should NOT Get a Flu Vaccine.

Who Should Not Receive a Flu Shot:

Different influenza (flu) vaccines are approved for use in people in different age groups. In addition, some vaccines are not recommended for certain groups of people. Factors that can determine a person’s suitability for vaccination, or vaccination with a particular vaccine, include a person’s age, health (current and past) and any allergies to flu vaccine or its components. More information is available at Who Should and Who Should NOT get a Flu Vaccine.

Are any of the available flu vaccines recommended over others?

Yes, for some people. For the 2022-2023 flu season, there are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccineFlublok Quadrivalent recombinant  flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine. This recommendation was based on a review of available studies which suggests that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines. There is no preferential recommendation for people younger than 65 years.

What if a preferentially recommended flu vaccine is not available?

If none of the three flu vaccines preferentially recommended for people 65 years and older is available at the time of administration, people in this age group should get any other age-appropriate flu vaccine instead.

Special Consideration Regarding Egg Allergy

People with egg allergies can receive any licensed, recommended age-appropriate influenza (flu) vaccine (IIV4RIV4ccIIV4, or LAIV4) that is otherwise appropriate. People who have a history of severe egg allergy (those who have had any symptom other than hives after exposure to egg) should be vaccinated in a medical setting, supervised by a health care provider who is able to recognize and manage severe allergic reactions. Two completely egg-free flu vaccine options are available: Flublok Quadrivalent recombinant flu vaccine and Flucelvax Quadrivalent cell-based flu shot.

Get vaccinated before flu season starts

It takes about two weeks after vaccination for antibodies that protect against flu to develop in the body.

When should I get vaccinated against flu?

For most people who need only one dose of flu vaccine for the season, September and October are generally good times to be vaccinated against flu. Ideally, everyone should be vaccinated by the end of October. Additional considerations concerning the timing of vaccination for certain groups of people include:

  • Most adults, especially those 65 years and older, and pregnant people in the first or second trimester should generally not get vaccinated early (in July or August) because protection may decrease over time. However, early vaccination can be considered for any person who is unable to return at a later time to be vaccinated.
  • Some children need two doses of flu vaccine. For those children it is recommended to get the first dose as soon as vaccine is available, because the second dose needs to be given at least four weeks after the first. Vaccination during July and August also can be considered for children who need only one dose.
  • Vaccination during July and August also can be considered for people who are in the third trimester of pregnancy during those months, because this can help protect their infants for the first few months after birth (when they are too young to be vaccinated).

To learn more, please visit https://www.cdc.gov/flu/prevent/vaccinations.htm.

Diagnosing Flu – Questions and Answers

February 24, 2023

How do I know if I have the flu?

Your respiratory illness might be influenza (flu) if you have fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and/or fatigue. Some people may have vomiting and diarrhea, though this is more common in children. People may be sick with flu and have respiratory symptoms without a fever. Flu viruses usually cause the most illness during the colder months of the year. However, flu can also occur outside of the typical flu season. In addition, other viruses can also cause respiratory illness similar to flu. So, it is impossible to tell for sure if you have flu based on symptoms alone. If your doctor needs to know for sure whether you are sick with flu, there are laboratory tests that can be done.

What kinds of flu tests are there?

A number of tests are available to detect flu viruses in respiratory specimens. The most common are called “rapid influenza diagnostic tests (RIDTs).” RIDTs work by detecting the parts of the virus (antigens) that stimulate an immune response. These tests can provide results within approximately 10-15 minutes but may not be as accurate as other flu tests. Therefore, you could still have flu, even though your rapid test result is negative. Other flu tests called “rapid molecular assays” detect genetic material of the flu virus. Rapid molecular assays produce results in 15-20 minutes and are more accurate than RIDTs.

In addition to RIDTs and rapid molecular assays, there are several more accurate flu tests available that must be performed in specialized laboratories, such as hospital and public health laboratories. These tests include reverse transcription polymerase chain reaction (RT-PCR), viral culture, and immunofluorescence assays. All of these tests require that a health care provider swipe the inside of your nose or the back of your throat with a swab and then send the swab for testing. Results may take one to several hours.

How well can rapid tests detect flu?

During a flu outbreak, a positive rapid flu test is likely to indicate flu virus infection. However, rapid tests vary in their ability to detect flu viruses, depending on the type of rapid test used, and on the type of flu viruses circulating. Also, rapid tests appear to be better at detecting flu in children than in adults. This variation in ability to detect viruses can result in some people who are infected with flu having a negative rapid test result. This situation is called a false negative test result. Despite a negative rapid test result, your health care provider may diagnose you with flu based on your symptoms and their clinical judgment.

Will my health care provider test me for flu if I have flu-like symptoms?

While your doctor may test you for flu, not everyone who goes to the doctor with flu-like symptoms will be tested. After evaluating you, your doctor may choose to diagnose you with flu without the need for testing based on your symptoms and his or her own clinical judgement.

Please visit diagnosing flu for more information.

Difference Between Flu and COVID-19

Influenza (Flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a coronavirus named SARS-CoV-2, and flu is caused by infection with influenza viruses. You cannot tell the difference between flu and COVID-19 by symptoms alone because some of the symptoms are the same. Some PCR tests can differentiate between flu and COVID-19 at the same time. If one of these tests is not available, many testing locations provide flu and COVID-19 tests separately. Talk to a healthcare provider about getting tested for both flu and COVID-19 if you have symptoms.

Can I have flu and COVID-19 at the same time?

Yes. It is possible to have flu as well as other respiratory illnesses including COVID-19 at the same time. Health experts are still studying how common this can be.

Is there a test that can detect both flu and COVID-19?

Yes. There is a test that will check for seasonal flu type A and B viruses and SARS-CoV-2, the virus that causes COVID-19. This test is being used by U.S. public health laboratories for surveillance purposes. Testing for these viruses at the same time will give public health officials important information about how flu and COVID-19 are spreading and what prevention steps should be taken. The test will also help public health laboratories save time and testing materials, and possibly to return test results faster.

The Food and Drug Administration (FDA) has given CDC an Emergency Use Authorization for this new test. Initial test kits were sent to public health laboratories in early August 2020. CDC will continue to manufacture and distribute these kits.

More information for laboratories is available.

To learn more, please visit https://www.cdc.gov/flu/symptoms/testing.htm.

Success Story: Mabel Weddington

February 17, 2023

Greenville Nursing & rehabilitation is excited to share resident Mabel Weddington’s Success Story!

Ms. Mabel Weddington was admitted to Greenville Nursing and Rehabilitation in May 2020 as a long-term care resident. She is a 99 year old who required full care and assistance from our Care Team for self-feeding and had a decline to where she was averaging only twenty-five percent or less of her meal intake of pureed foods and thickened liquids. After being assessed by our therapy department, Ms. Weddington demonstrated a good response to speech therapy. She has had her diet upgraded to thin liquids and is even able to safely eat soft snacks! She is also able to participate in feeding herself again. Her meal intake has increased significantly, which has helped with her overall quality of life. Greenville Nursing and Rehabilitation strives to support our residents, like Ms. Weddington, in achieving their highest quality of life.

Prevention Strategies for Seasonal Influenza in Healthcare Settings

February 13, 2023

Influenza is primarily a community-based infection that is transmitted in households and community settings. Each year, 5% to 20% of U.S. residents acquire an influenza virus infection, and many will seek medical care in ambulatory healthcare settings (e.g., pediatricians’ offices, urgent-care clinics). In addition, more than 200,000 persons, on average, are hospitalized each year for influenza-related complications. Healthcare-associated influenza infections can occur in any healthcare setting and are most common when influenza is also circulating in the community. Therefore, the influenza prevention measures outlined in this guidance should be implemented in all healthcare settings. Supplemental measures may need to be implemented during influenza season if outbreaks of healthcare-associated influenza occur within certain facilities, such as long-term care facilities and hospitals [refs: Infection Control Measures for Preventing and Controlling Influenza Transmission in Long-Term Care Facilities].

Influenza Modes of Transmission

Traditionally, influenza viruses have been thought to spread from person to person primarily through large-particle respiratory droplet transmission (e.g., when an infected person coughs or sneezes near a susceptible person). Transmission via large-particle droplets requires close contact between source and recipient persons, because droplets generally travel only short distances (approximately 6 feet or less) through the air. Indirect contact transmission via hand transfer of influenza virus from virus-contaminated surfaces or objects to mucosal surfaces of the face (e.g., nose, mouth) may also occur. Airborne transmission via small particle aerosols in the vicinity of the infectious individual may also occur; however, the relative contribution of the different modes of influenza transmission is unclear. Airborne transmission over longer distances, such as from one patient room to another has not been documented and is thought not to occur. All respiratory secretions and bodily fluids, including diarrheal stools, of patients with influenza are considered to be potentially infectious; however, the risk may vary by strain. Detection of influenza virus in blood or stool in influenza infected patients is very uncommon.

Fundamental Elements to Prevent Influenza Transmission

Preventing transmission of influenza virus and other infectious agents within healthcare settings requires a multi-faceted approach. Spread of influenza virus can occur among patients, HCP, and visitors; in addition, HCP may acquire influenza from persons in their household or community. The core prevention strategies include:

  • administration of influenza vaccine
  • implementation of respiratory hygiene and cough etiquette
  • appropriate management of ill HCP
  • adherence to infection control precautions for all patient-care activities and aerosol-generating procedures
  • implementing environmental and engineering infection control measures.

Successful implementation of many, if not all, of these strategies is dependent on the presence of clear administrative policies and organizational leadership that promote and facilitate adherence to these recommendations among the various people within the healthcare setting, including patients, visitors, and HCP. These administrative measures are included within each recommendation where appropriate. Furthermore, this guidance should be implemented in the context of a comprehensive infection prevention program to prevent transmission of all infectious agents among patients and HCP.

To learn more, please visit https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm.

Caring for Someone Sick

February 6, 2023

Steps to take if you get flu

  1. If you get very sick, are pregnant, or are 65 years or older, or are otherwise at high risk of flu-related complications, call your doctor. You might need antiviral drugs to treat flu.
  2. Stay at home and rest.
  3. Avoid close contact with well people in your house so you won’t make them sick.
  4. Drink plenty of water and other clear liquids to prevent fluid loss (dehydration).

When caring for people who have flu:

  • Avoid being face-to-face with the sick person. If possible, it is best to spend the least amount of time in close contact with a sick person.
  • When holding sick children, place their chin on your shoulder so they will not cough in your face.
  • Wash your hands often and right way.
  • If soap and water are not available, use an alcohol-based hand rub.
  • Make sure to wash your hands after touching the sick person. Wash after handling their tissues or laundry.

Emergency Warning Signs of Flu Complications

People experiencing these warning signs should obtain medical care right away.

In Children:

  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Robs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
  • Not alert or interacting when awake
  • Seizures
  • Fever above 104 degrees Fahrenheit that is not controlled by fever-reducing medicine
  • In children younger than 12, any fever
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

In Adults:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

These lists are not all-inclusive. Please consult your medical provider for any other symptom that is severe or concerning.

To learn more, please visit https://www.cdc.gov/flu/treatment/caring-for-someone.htm.

What You Should Know About Flu Antiviral Drugs

January 30, 2023

Can flu be treated?

Yes. There are prescription medications called “antiviral drugs” that can be used to treat flu illness. CDC recommends prompt treatment for people who have flu or suspected flu and who are at higher risk of serious flu complications, such as people with asthma, diabetes (including gestational diabetes), or heart disease.

What are flu antiviral drugs?

Flu antiviral drugs are prescription medicines (pills, liquid, an inhaled powder, or an intravenous solution) that fight against flu viruses in your body. Antiviral drugs are not sold over the counter. You can only get them if you have a prescription from a health care provider. Antiviral drugs are different from antibiotics, which fight against bacterial infections. Antiviral drugs for flu only work to treat flu. Flu antiviral drugs are different than antiviral drugs used to treat other infectious diseases such as COVID-19. Antiviral drugs prescribed to treat COVID-19 are not approved or authorized to treat flu.

What should I do if I think I am sick with flu?

If you get sick with flu, antiviral drugs are a treatment option. Check with your doctor promptly if you are at higher risk of serious flu complications (full list of higher risk factors) and you develop flu symptoms. Flu signs and symptoms can include feeling feverish or having a fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. However, not everyone with the flu has a fever. Your doctor may prescribe antiviral drugs to treat your flu illness.

Should I still get a flu vaccine?

Yes. Antiviral drugs are not a substitute for getting a flu vaccine. While flu vaccine can vary in how well it works, a flu vaccine is best way to help prevent seasonal flu and its potentially serious complications. Everyone 6 months and older should receive a flu vaccine every year. Antiviral drugs are a second line of defense that can be used to treat flu (including seasonal flu and variant flu viruses) if you get sick.

What are the benefits of antiviral drugs?

When treatment is started within two days of becoming sick with flu symptoms, antiviral drugs can lessen fever and flu symptoms and shorten the time you are sick by about one day. They also may reduce the risk of complications such as ear infections in children, respiratory complications requiring antibiotics, and hospitalization in adults. For people at higher risk of serious flu complications, early treatment with an antiviral drug can mean having milder illness instead of more severe illness that might require a hospital stay. For adults hospitalized with flu illness, some studies have reported that early antiviral treatment can reduce their risk of death.

When should antiviral drugs be taken for treatment?

Antiviral treatment provides the greatest benefit when started soon after flu illness begins. Studies show that flu antiviral drugs work best for treatment when they are started within two days of getting sick. However, starting them later can still be beneficial, especially if the sick person is at higher risk of serious flu complications or is in the hospital with more severe illness.  Follow instructions for taking these drugs. Follow your doctor’s instructions and the dose, frequency, and duration listed on the label instructions for taking these drugs.

What antiviral drugs are recommended this flu season?

There are four FDA-approved antiviral drugs recommended by CDC to treat flu this season.

  • oseltamivir phosphate (available as a generic version or under the trade name Tamiflu®),
  • zanamivir (trade name Relenza®)
  • peramivir (trade name Rapivab®), and
  • baloxavir marboxil (trade name Xofluza®).

Generic oseltamivir and Tamiflu® are available as a pill or liquid suspension and are FDA approved for early treatment of flu in people 14 days and older.

Zanamivir is a powdered medication that is inhaled and approved for early treatment of flu in people 7 years and older. (Note: Zanamivir (trade name Relenza®) is administered using an inhaler device and is not recommended for people with breathing problems like asthma or COPD.) Oseltamivir and zanamivir are given twice a day for five days.

Peramivir is given once intravenously by a health care provider and is approved for early treatment of flu in people 6 months and older.

Baloxavir is a pill given as a single dose by mouth and is approved for early treatment of flu in children aged 5 years to less than 12 years who do not have any chronic medical conditions, and for all people aged 12 years and older. (Note: Baloxavir (trade name Xofluza®) is not recommended for treatment of flu in pregnant people, lactating  people, or in outpatients with complicated or progressive illness because there is no information about use of baloxavir in these patients. Baloxavir is also not recommended for treatment of flu in hospitalized patients due to limited data.)

How long should antiviral drugs be taken?

To treat flu, oseltamivir or inhaled zanamivir are usually prescribed for five days, while one dose of intravenous peramivir or one dose of oral Baloxavir are usually prescribed.  Oseltamivir treatment is given to hospitalized patients, and some patients might be treated for more than five days.

What are the possible side effects of antiviral drugs?

Side effects vary for each medication. The most common side effects for oseltamivir are nausea and vomiting. Zanamivir can cause bronchospasm, and peramivir can cause diarrhea. Other less common side effects also have been reported. Your health care provider can give you more information about these drugs or you can check the Food and Drug Administration (FDA) website for specific information about antiviral drugs, including the manufacturer’s package insert.

Can pregnant people take antiviral drugs?

Yes. Oral oseltamivir is recommended for treatment of pregnant people with flu because compared to other recommended antiviral medications, it has the most studies available to suggest that it is safe and beneficial during pregnancy. Baloxavir is not recommended for pregnant people or while breastfeeding, as there are no available efficacy or safety data.

Who should take antiviral drugs?

It’s very important that flu antiviral drugs are started as soon as possible to treat patients who are hospitalized with flu, people who are very sick with flu but who do not need to be hospitalized, and people who are at higher risk of serious flu complications based on their age or health, if they develop flu symptoms. Although other people with mild illness who are not at higher risk of flu complications may also be treated early with antiviral drugs by their doctor, most people who are otherwise healthy and not at higher risk for flu complications do not need to be treated with antiviral drugs.

Following is a list of all the health and age factors that are known to increase a person’s risk of getting serious complications from the flu:

  • Asthma
  • Neurologic and neurodevelopment conditions
  • Blood disorders (such as sickle cell disease)
  • Chronic lung disease (such a chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
  • Endocrine disorders (such as diabetes mellitus)
  • Heart disease (such a congenital heart disease, congestive heart failure and coronary artery disease)
  • Kidney disorders
  • Liver disorders
  • Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
  • People who are obese with a body mass index [BMI] of 40 or higher
  • People younger than 19 years of age on long-term aspirin- or salicylate-containing medications.
  • People with a weakened immune system due to disease (such as people with HIV or AIDS, or some cancers such as leukemia) or medications (such as those receiving chemotherapy or radiation treatment for cancer, or persons with chronic conditions requiring chronic corticosteroids or other drugs that suppress the immune system)

Other people at higher risk from flu:

  • Adults 65 years and older
  • Children younger than 2 years old
  • Pregnant women and women up to 2 weeks after the end of pregnancy
  • People from certain racial and ethnic minority groups, including non-Hispanic Black, Hispanic or Latino, and American Indiana or Alaska Native persons
  • People who live in nursing homes and other long-term care facilities.
  • Although all children younger than 5 years old are considered at higher risk for serious flu complications, the highest risk is for those younger than 2 years old, with the highest hospitalization and death rates among infants younger than 6 months old.

To learn more, please visit https://www.cdc.gov/flu/treatment/whatyoushould.htm.

How Influenza Spreads

January 25, 2023

PERSON TO PERSON

People with flu can spread it to others. Most experts think that flu viruses spread mainly by droplets made when people with flu cough, sneeze, or talk. These droplets can land in the mouths or noses of people who are nearby (usually within about 6 feet away) or possibly be inhaled into the lungs. Less often, a person might get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose, or possibly their eyes.

WHEN ARE PEOPLE WITH FLU CONTAGIOUS?

Flu viruses can be detected in most infected persons beginning one day before symptoms develop and up to five to seven days after becoming sick. People with flu are most contagious in the first three to four days after their illness begins. However, infants and people with weakened immune systems who are infected with flu viruses may be contagious for longer than seven days.

Symptoms typically begin about two days (but can range from one to four days) after flu viruses infect a person’s respiratory tract. It is theoretically possible that before symptoms begin, an infected person can spread flu viruses to their close contacts. Some people can be infected with flu viruses and have no symptoms but may still be able to spread the virus to their close contacts.

To learn more, please visit https://www.cdc.gov/flu/about/disease/spread.htm.

People at Higher Risk of Flu Complications

January 18, 2023

Getting an annual flu vaccine is the best way to protect yourself and your loved ones from flu.

If you are at higher risk of developing serious flu complications, flu vaccination is especially important. When you get vaccinated, you reduce your risk of getting sick with flu and possibly being hospitalized or dying from flu.

Following is a list of all the health and age factors that are known to increase a person’s risk of getting serious flu complications:

  • Adults 65 years and older
  • Children younger than 2 years old1
  • Asthma
  • Neurologic and neurodevelopment conditions
  • Blood disorders (such as sickle cell disease)
  • Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
  • Endocrine disorders (such as diabetes mellitus)
  • Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
  • Kidney diseases
  • Liver disorders
  • Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
  • People who are obese with a body mass index [BMI] of 40 or higher
  • People younger than 19 years old on long-term aspirin- or salicylate-containing medications.
  • People with a weakened immune system due to disease (such as people with HIV or AIDS, or some cancers such as leukemia) or medications (such as those receiving chemotherapy or radiation treatment for cancer, or persons with chronic conditions requiring chronic corticosteroids or other drugs that suppress the immune system)
  • People who have had a stroke

Other people at higher risk from flu:

  • Pregnant people and people up to 2 weeks after the end of pregnancy
  • People who live in nursing homes and other long-term care facilities
  • People from certain racial and ethnic minority groups are at increased risk for hospitalization with flu, including non-Hispanic Black persons, Hispanic or Latino persons, and American Indian or Alaska Native persons
  • 1 Although all children younger than 5 years old are considered at higher risk of serious flu complications, the highest risk is for those younger than 2 years old, with the highest hospitalization and death rates among infants younger than 6 months old.

Information on groups at higher risk from COVID-19 is available.

To learn more information, please visit https://www.cdc.gov/flu/highrisk/index.htm.

Success Story: Jerry Rose

January 9, 2023

Greenville Nursing and Rehabilitation is excited to shine the spotlight on resident Jerry Rose’s Success Story!

Ms. Jerry Rose was admitted to Greenville Nursing and Rehabilitation in September of 2019 for long-term care. She is a very caring, spiritual woman who enjoys being around her friends at our community and loves to participate in community activities. In October of this year, she was evaluated by Physical Therapy after a fall for generalized weakness and difficulty with transfers and walking independently. Ms. Jerry’s motivation and participation in therapy to regain her independence was amazing! She demonstrated slow but steady progress with physical therapy goals. We are proud to announce that she was discharged from skilled physical therapy in December 2022, being able to complete her transfers and walk independently again! Congratulations to Ms. Jerry and her Care Team on their success!

Misconceptions about Seasonal Flu and Flu Vaccines

January 3, 2023

Misconceptions about Flu Vaccines

Can a flu vaccine give you flu?

No, flu vaccines cannot cause flu illness. Flu vaccines given with a needle (i.e., flu shots) are made with either inactivated (killed) viruses, or with only a single protein from the flu virus.  The nasal spray vaccine contains live viruses that are attenuated (weakened) so that they will not cause illness.

Are any of the available flu vaccines recommended over the others?

Yes, for some people. For the 2022-2023 flu season, there are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccineFlublok Quadrivalent recombinant  flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine. This recommendation was based on a review of available studies which suggests that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines. There is no preferential recommendation for people younger than 65 years.

What if a preferentially recommended flu vaccine is not available?

If none of the three flu vaccines preferentially recommended for people 65 years and older is available at the time of administration, people in this age group should get any other age-appropriate flu vaccine instead.

Is it better to get sick with flu than to get a flu vaccine?

No. Flu can be a serious disease, particularly among young children, older adults, and people with certain chronic health conditions, such as asthma, heart disease or diabetes. Any flu infection can carry a risk of serious complications, hospitalization or death, even among otherwise healthy children and adults. Therefore, getting vaccinated is a safer choice than risking illness to obtain immune protection.

Do I really need a flu vaccine every year?

Yes. CDC recommends a yearly flu vaccine for everyone 6 months of age and older with rare exception. The reason for this is that a person’s immune protection from vaccination declines over time, so an annual vaccination is needed to get the “optimal” or best protection against the flu. Additionally, flu viruses are constantly changing, so the vaccine composition is reviewed each year and updated as needed.

Why do some people not feel well after getting a seasonal flu vaccine?

Some people report having mild side effects after flu vaccination. The most common side effects from flu shots are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur. If these reactions occur, they usually begin soon after vaccination and last 1-2 days.

Side effects from the nasal spray flu vaccine may include: runny nose, wheezing, headache, vomiting, muscle aches, fever, sore throat and cough. If these problems occur, they usually begin soon after vaccination and are mild and short-lived. The most common reactions people have to flu vaccines are considerably less severe than the symptoms caused by actual flu illness.

What about serious reactions to flu vaccine?

Serious allergic reactions to flu vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after vaccination. While these reactions can be life-threatening, effective treatments are available.

What about people who get a seasonal flu vaccine and still get sick with flu symptoms?

There are several reasons why someone might get flu symptoms even after they have been vaccinated against flu.

  • Someone can get sick with another respiratory virus besides flu such as rhinoviruses or SARS-CoV-2 (the virus that causes COVID-19). Other respiratory viruses can cause symptoms similar to flu, and they can also spread and cause illness during flu season. Flu vaccines only protect against flu and its complications, not other illnesses.
  • Someone can be exposed to flu viruses shortly before getting vaccinated or during the two-week period after vaccination that it takes the body to develop immune protection. This exposure may result in a person becoming sick with flu before protection from vaccination takes effect.
  • Flu vaccines vary in how well they work, and someone can get vaccinated but still get sick with flu. There are many different flu viruses that spread and cause illness among people, so this can happen if someone is exposed to a flu virus that is very different from the viruses in the flu vaccine. The ability of a flu vaccine to protect a person depends partially on the similarity or “match” between the vaccine viruses chosen to make vaccine and those spreading and causing illness. Even when that happens though, flu vaccination can still reduce severity of illness.

Can vaccinating someone twice provide added immunity?

In adults, studies have not shown a benefit from getting more than one dose of vaccine during the same influenza season, even among elderly persons with weakened immune systems. Except for children getting vaccinated for the first time, only one dose of flu vaccine is recommended each season.

Is it true that getting a flu vaccine can make you more susceptible to other respiratory viruses?

Flu vaccines are not thought to make people more susceptible to other respiratory infections.

A 2012 study that suggested that flu vaccination might make people more susceptible to other respiratory infections. After that study was published, many experts looked into this issue further and conducted additional studies to see if the findings could be replicated. No other studies have found this effect. It’s not clear why this finding was detected in the one study, but the majority of evidence suggests that this is not a common or regular occurrence and that flu vaccination does not, in fact, make people more susceptible to other respiratory infections.

Does a flu vaccination increase your risk of getting COVID-19?

There is no evidence that getting a flu vaccination increases your risk of getting sick from a coronavirus, like the one that causes COVID-19.

You may have heard about a study published in January 2020 that reported an association between flu vaccination and risk of four commonly circulating seasonal coronaviruses, but not the one that causes COVID-19. This report was later found to be incorrect.

The results from that initial study led researchers in Canada to look at their data to see if they could find similar results in their population. The results from this study showed that flu vaccination did not increase risk for these seasonal coronaviruses. The Canadian findings highlighted the protective benefits of flu vaccination.

The Canadian researchers also identified a flaw in the methods of the first study, noting that it violated the part of study design that compares vaccination rates among patients with and without flu (test negative design). This flaw led to the incorrect association between flu vaccination and seasonal coronavirus risk. When these researchers reexamined data from the first study using correct methods, they found that flu vaccination did not increase risk for infection with other respiratory viruses, including seasonal coronaviruses.

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Misconceptions about Flu Vaccine Effectiveness

Influenza (flu) vaccine effectiveness (VE) can vary. The protection provided by a flu vaccine varies from season to season and depends in part on the age and health status of the person getting the vaccine and the similarity or “match” between the viruses in the vaccine and those in circulation. During years when the flu vaccine match is good, it is possible to measure substantial benefits from flu vaccination in terms of preventing flu illness and complications. However, the benefits of flu vaccination will still vary, depending on characteristics of the person being vaccinated (for example, their health and age), what flu viruses are circulating that season and, potentially, which type of flu vaccine was used. More information is available at Vaccine Effectiveness – How well does the Flu Vaccine Work.

Below is a summary of the benefits of flu vaccination and selected scientific studies that support these benefits.

  • Flu vaccination can keep you from getting sick with flu.
    • Flu vaccine prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020, the last flu season prior to the COVID-19 pandemic, flu vaccination prevented an estimated 7.5 million influenza illnesses, 3.7 million influenza-associated medical visits, 105,000 influenza-associated hospitalizations, and 6,300 influenza-associated deaths.
    • During seasons when flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40% to 60%.
  • Flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.
    • 2021 study showed that among adults hospitalized with flu, vaccinated patients had a 26% lower risk of intensive care unit (ICU) admission and a 31% lower risk of death from flu compared with those who were unvaccinated.
    • 2018 study showed that among adults hospitalized with flu, vaccinated patients were 59% less likely to be admitted to the ICU than those who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent four fewer days in the hospital than those who were not vaccinated.
  • Flu vaccination can reduce the risk of flu-associated hospitalization.
    • Flu vaccine prevents tens of thousands of hospitalizations each year. For example, during 2019-2020 flu vaccination prevented an estimated 105,000 flu-related hospitalizations.
    • 2018 study showed that from 2012 to 2015, flu vaccination among adults reduced the risk of being admitted to an ICU with flu by 82%.
    • 2017 study found that during 2009-2016, flu vaccines reduced the risk of flu-associated hospitalization among older adults by about 40% on average.
    • 2014 study showed that flu vaccination reduced children’s risk of flu-related pediatric intensive care unit (PICU) admission by 74% during flu seasons from 2010-2012.
  • Flu vaccination is an important preventive tool for people with certain chronic health conditions.
    • Flu vaccination has been associated with lower rates of some cardiac events among people with heart disease, especially among those who have had a cardiac event in the past year.
    • Flu vaccination can reduce the risk of a flu-related worsening of chronic lung disease (for example, chronic obstructive pulmonary disease (COPD) requiring hospitalization).
    • Among people with diabetes and chronic lung disease,flu vaccination has been shown in separate studies to be associated with reduced hospitalizations from a worsening of their chronic condition.
  • Flu vaccination during pregnancy helps protect pregnant people from flu during and after pregnancy and helps protect their infants from flu in their first few months of life.
    • 2013 study showed that during the 2010–2011 and 2011–2012 flu seasons vaccination reduced the risk of flu-associated acute respiratory infection in pregnant people by about one-half.
    • 2018 study showed that getting a flu shot reduced a pregnant person’s risk of being hospitalized with flu by an average of 40% from 2010-2016.
    • A number of studies have shown that in addition to helping to protect pregnant people from flu, a flu vaccine given during pregnancy helps protect the baby from flu for several months after birth, when babies are too young to be vaccinated.
  • Flu vaccine can be lifesaving in children.
    • 2022 study showed that flu vaccination reduced children’s risk of severe life-threatening influenza by 75%.
    • 2020 study found that during the 2018-2019 flu season, flu vaccination reduced flu-related hospitalization by 41% and flu-related emergency department visits by half among children (aged 6 months to 17 years old).
    • A 2017 study was the first of its kind to show that flu vaccination can significantly reduce children’s risk of dying from flu.
  • Getting vaccinated yourself may also protect people around you, including those who are more vulnerable to serious flu illness, like babies and young children, older people, and people with certain chronic health conditions.

Despite the many benefits offered by flu vaccination, only about half of Americans get an annual flu vaccine. During an average flu season, flu can cause millions of illnesses, hundreds of thousands of hospitalizations and tens of thousands of deaths. Many more people could be protected from flu if more people got vaccinated.

*References for the studies listed above can be found at Publications on Influenza Vaccine Benefits.

Misconceptions about the Timing of Seasonal Influenza Vaccination

Should I wait to get vaccinated so that my immunity lasts through the end of the season?

How long you are immune or your “duration of immunity” is discussed in the ACIP recommendations. While delaying getting of vaccine until later in the fall may lead to higher levels of immunity during winter months, this should be balanced against possible risks, such as missed opportunities to receive vaccine and difficulties associated with vaccinating a large number of people within a shorter time period.

Is it too late to get vaccinated after Thanksgiving (or the end of November)?

No. Vaccination can still be beneficial as long as flu viruses are circulating. If you have not been vaccinated by Thanksgiving (or the end of November), it can still be protective to get vaccinated in December or later. Flu is unpredictable and seasons can vary. Seasonal flu disease usually peaks between December and March most years, but disease can occur as late as May.

Misconceptions about Physician Consent for Vaccination

Do pregnant people or people with pre-existing medical conditions need special permission or written consent from their doctor to get a flu vaccine?

No. There is no recommendation for pregnant people or people with pre-existing medical conditions to seek special permission or secure written consent from their doctor for vaccination if they get vaccinated at a worksite clinic, pharmacy or other location outside of their physician’s office. With rare exception, CDC recommends an annual flu vaccine for everyone 6 months of age and older, including pregnant people and people with medical conditions.

A variety of flu vaccines are available (Table 1). Vaccine providers should be aware of the approved age indications of the vaccine they are using and of any contraindications or precautions. Providers also should appropriately screen all people getting vaccinated for allergies to vaccine components or other contraindications. People who have previously had a severe allergic reaction to influenza vaccine or any of its ingredients should generally not be vaccinated.

There are some people who should not get a flu vaccine without first speaking with their doctor. These include:

  • People who have a moderate-to-severe illness with or without a fever (they should wait until they recover to get vaccinated), and
  • People with a history of Guillain-Barré Syndrome (a severe paralytic illness, also called GBS) that occurred after receiving influenza vaccine and who are not at risk for severe illness from influenza should generally not receive vaccine. Tell your doctor if you ever had Guillain-Barré Syndrome. Your doctor will help you decide whether the vaccine is recommended for you.

Pregnant people or people with pre-existing medical conditions who get vaccinated should get a flu shot.

If a person is vaccinated by someone other than their primary health care provider, the vaccinating provider should ensure that the patient and, if possible, the patient’s medical provider have documentation of vaccination.

For a complete list of people who should not get a flu vaccine before speaking with their doctor, please review the influenza Vaccine Information Statement for the inactivated or recombinant flu vaccine or live, intranasal influenza vaccine.

Misconceptions about “Stomach Flu”

Is the “stomach flu” really flu?

No. Many people use the term “stomach flu” to describe illnesses with nausea, vomiting or diarrhea. These symptoms can be caused by many different viruses, bacteria or even parasites. While vomiting, diarrhea, and being nauseous or “sick to your stomach” can sometimes be related to flu — more commonly in children than adults — these problems are rarely the main symptoms of influenza. Flu is a respiratory disease and not a stomach or intestinal disease.

To learn more, please visit https://www.cdc.gov/flu/prevent/misconceptions.htm.

Success Story: Frank Huddleston

January 2, 2023

Greenville Nursing and Rehabilitation is excited to share resident Frank Huddleston’s Success Story!

Frank was admitted to Greenville Nursing and Rehabilitation from home after being diagnosed with Pneumonia. He needed short-term rehabilitation to regain his strength since he lives at home with his wife, and required increased assistances with transfers, walking, dressing and his daily activities of life.
When Mr. Huddleston first admitted, he was eager to get back to teaching his Sunday school classes again at his church. Because of his desire to return home as quickly as possible, he was ready to meet the challenges of getting stronger in therapy. With challenging work and eager participation, Mr. Huddleston showed great progress! When he discharged to home after a few short weeks, he was able to complete all his transfers and was walking with his rollator walker. His strength and endurance had increased and he was able to complete bathing, dressing with modified independence.
Keep up the excellent work Mr. Huddleston!

Flu: What to do if You Get Sick

December 29, 2022

WHAT SHOULD I DO IF I GET SICK?

Most people with flu have mild illness and do not need medical care or antiviral drugs. If you get sick with flu symptoms, in most cases, you should stay home and avoid contact with other people except to get medical care.

If, however, you have symptoms of flu and are in a higher-risk group, or are very sick or worried about your illness, contact your health care provider (doctor, physician assistant, etc.).

Certain people are at increased risk of serious flu-related complications (including young children, people 65 and older, pregnant people, and people with certain medical conditions). For a full list of people at increased risk of flu-related complications, see People at Higher Risk of Developing Flu–Related Complications. If you are in a higher-risk group and develop flu symptoms, it’s best for you to contact your doctor early in your illness. Remind them about your higher-risk status for flu. CDC recommends that people at higher risk for complications should get antiviral treatment as early as possible, because benefit is greatest if treatment is started within 2 days after illness onset.

DO I NEED TO GO TO THE EMERGENCY ROOM IF I AM ONLY A LITTLE SICK?

No. The emergency room should be used for people who are very sick. You should not go to the emergency room if you are only mildly ill.

If you have emergency warning signs of flu sickness, you should go to the emergency room. If you get sick with flu symptoms and are at higher risk of flu complications or you are concerned about your illness, call your health care provider for advice.

WHAT ARE EMERGENCY WARNING SIGNS OF FLU?

People experiencing any of these warning signs should obtain medical care right away.

In children

  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Ribs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
  • Not alert or interacting when awake
  • Seizures
  • Fever above 104°F
  • In children less than 12 weeks, any fever
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

In adults

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

These lists are not all inclusive. Please consult your medical provider for any other symptom that is severe or concerning.

ARE THERE MEDICINES TO TREAT FLU?

Yes. There are drugs your doctor may prescribe for treating flu called “antivirals.” These drugs can make you better faster and may also prevent serious complications. See Treatment – Antiviral Drugs for more information.

HOW LONG SHOULD I STAY HOME IF I’M SICK?

CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or other necessities. Your fever should be gone without the need to use a fever-reducing medicine, such as Tylenol®. Until then, you should stay home from work, school, travel, shopping, social events, and public gatherings.

CDC also recommends that children and teenagers (anyone aged 18 years and younger) who have flu or are suspected to have flu should not be given Aspirin (acetylsalicylic acid) or any salicylate containing products (e.g. Pepto Bismol); this can cause a rare, very serious complication called Reye’s syndrome. More information about Reye’s syndrome can be found here.

WHAT SHOULD I DO WHILE I’M SICK?

Stay away from others as much as possible to keep from infecting them. If you must leave home, for example to get medical care, wear a facemask if you have one, or cover coughs and sneezes with a tissue. Wash your hands often to keep from spreading flu to others.

To learn more, please visit https://www.cdc.gov/flu/treatment/takingcare.htm.

Success Story: Elnora Sherrod

December 27, 2022

Greenville Nursing and Rehabilitation is proud to shine the spotlight on resident Elnora Sherrod’s Success Story!

Ms. Elnora Sherrod is a long-term resident at Greenville Nursing and Rehabilitation. She was diagnosed with COVID-19 in August of this year and experienced a decline in her overall strength. She required increased dependency with transferring, walking, bathing, dressing, and over all activities of daily living.
Ms. Sherrod worked with occupational and physical therapy daily to regain her strength and independence. With a lot of hard work, Ms. Sherrod was discharged from therapy on November 26, 2022 and she was able to complete her transfers and walk with increased independence! She can now enjoy activities and be more engaged with her friends now that she has regained her strength. Congratulations to Ms. Sherrod and her Care Team on their success!

CDC Director Adopts Preference for Specific Flu Vaccine for Seniors

December 20, 2022

CDC Director Rochelle P. Walensky, M.D., M.P.H., adopted the Advisory Committee on Immunization Practices’ (ACIP) recommendation to preferentially recommend the use of specific flu vaccines for adults 65 years and older, including higher dose and adjuvanted flu vaccines. The preference applies to Fluzone High-Dose Quadrivalent, Flublok Quadrivalent and Fluad Quadrivalent flu vaccines.

While flu seasons vary in severity, during most seasons, people 65 years and older bear the greatest burden of severe flu disease, accounting for the majority of flu-related hospitalizations and deaths. Additionally, changes in the immune system with age mean that older adults often do not have as strong an immune response to vaccination as younger, healthy people. “Given their increased risk of flu-associated severe illness, hospitalization, and death, it’s important to use these potentially more effective vaccines in people 65 years and older,” said José R. Romero, M.D., Director of CDC’s National Center for Immunization and Respiratory Diseases. Additionally, data has shown that racial and ethnic health disparities exist in populations that receive a high-dose flu vaccine compared with standard-dose flu vaccines. “This recommendation could help reduce health disparities by making these vaccines more available to racial and ethnic minority groups,” said Dr. Romero.

ACIP voted to preferentially recommend the use of higher dose flu or adjuvanted flu vaccines over standard-dose unadjuvanted flu vaccines for people 65 years and older. This recommendation was based on a review of available studies which suggests that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines. Dr. Walensky’s adoption of the ACIP recommendation makes this recommendation official CDC policy, which will be further detailed in an upcoming Morbidity and Mortality Weekly Recommendation Report later this summer.

In recent years, CDC has not recommended any one flu vaccine over another for any age group, and there is still no preferential recommendation for people younger than 65. People 65 and older should try to get one of the three preferentially recommended vaccines, however, if one of these vaccines is not available at the time of administration, people in this age group should get a standard-dose flu vaccine instead.

To learn more, please visit https://www.cdc.gov/media/releases/2022/s0630-seniors-flu.html.

Flu Symptoms and Complications

December 12, 2022

Flu Symptoms

Influenza (flu) can cause mild to severe illness, and at times can lead to death. Flu symptoms usually come on suddenly. People who have flu often feel some or all of these symptoms:

  • fever* or feeling feverish/chills
  • cough
  • sore throat
  • runny or stuffy nose
  • muscle or body aches
  • headaches
  • fatigue (tiredness)
  • some people may have vomiting and diarrhea, though this is more common in children than adults.

*It’s important to note that not everyone with flu will have a fever.

More information is available at  Flu and COVID-19 symptoms.

Flu Complications

Most people who get flu will recover in a few days to less than two weeks, but some people will develop complications (such as pneumonia) as a result of flu, some of which can be life-threatening and result in death.

Sinus and ear infections are examples of moderate complications from flu, while pneumonia is a serious flu complication that can result from either flu virus infection alone or from co-infection of flu virus and bacteria. Other possible serious complications triggered by flu can include inflammation of the heart (myocarditis), brain (encephalitis) or muscle tissues (myositis, rhabdomyolysis), and multi-organ failure (for example, respiratory and kidney failure). Flu virus infection of the respiratory tract can trigger an extreme inflammatory response in the body and can lead to sepsis, the body’s life-threatening response to infection. Flu also can make chronic medical problems worse. For example, people with asthma may experience asthma attacks while they have flu, and people with chronic heart disease may experience a worsening of this condition triggered by flu.

People at Higher Risk from Flu

Anyone can get sick with flu, even healthy people, and serious problems related to flu can happen to anyone at any age, but some people are at higher risk of developing serious flu-related complications if they get sick. This includes people 65 years and older, people of any age with certain chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant people and children younger than 5 years, but especially those younger than 2 years old.

Cold Vs. Flu

Signs and SymptomsColdInfluenza (Flu)
Symptom onsetGradualAbrupt
FeverRareCommon; lasts 3-4 days
AchesSlightCommon; often severe
ChillsUncommonFairly common
Fatigue, weaknessSometimesUsual
SneezingCommonSometimes
Chest discomfort, coughMild to moderate; hacking coughCommon; can be severe
Stuffy noseCommonSometimes
Sore throatCommonSometimes
HeadacheRareCommon

Emergency Warning Signs of Flu Complications

People experiencing these warning signs should obtain medical care right away.

In Children

  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Ribs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
  • Not alert of interacting when awake
  • Seizures
  • Fever above 104 degrees Fahrenheit that is not controlled by fever-reducing medicine
  • Worsening of chronic medical conditions

In Adults

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

These lists are not all inclusive. Please consult your medical provider for any other symptom that is severe or concerning.

To learn more, please visit https://www.cdc.gov/flu/symptoms/symptoms.htm.

Flu and People 65 Years and Older

December 5, 2022

People 65 years and older are at higher risk of developing serious flu complications compared with young, healthy adults. This increased risk is due in part to changes in immune defenses with increasing age. While flu seasons vary in severity, during most seasons, people 65 years and older bear the greatest burden of severe flu disease. In recent years, for example, it’s estimated that between 70 percent and 85 percent of seasonal flu-related deaths have occurred in people 65 years and older, and between 50 percent and 70 percent of seasonal flu-related hospitalizations have occurred among people in this age group.

A Flu Vaccine is the Best Protection Against Flu

Flu vaccination has many benefits. It has been shown to reduce the risk of getting sick with flu and also to reduce the risk of more serious flu outcomes that can result in hospitalization or even death. Although immune responses to vaccination may lower in older people, studies have consistently found that flu vaccination has been effective in reducing the risk of medical visits and hospitalizations in older people. Higher dose and adjuvanted flu vaccines are potentially more effective than standard dose of unadjuvanted flu vaccines for people in this age group and are therefore recommended preferentially over a regular dose flu vaccine.

The best way to protect against flu and its potentially serious complications is with a flu vaccine.  Flu vaccines are updated each season because flu viruses are constantly changing. Also, immunity wanes over time. Annual vaccination helps to ensure the best possible protection against flu. A flu vaccine protects against the flu viruses that research indicates will be most common during the upcoming season. (More information about this season’s exact vaccine composition is available at Vaccine Virus Selection.) Flu vaccines for the 2022-2023 flu season have been updated from last season’s vaccine to better match circulating viruses. Immunity from vaccination fully sets in after about two weeks.

Flu vaccination is especially important for people 65 years and older because they are at higher risk of developing serious flu complications. Three specific flu vaccines are preferentially recommended for people 65 years and older over other flu vaccines. People 65 and older should get a higher dose or adjuvanted flu vaccine, including: Fluzone High-Dose QuadrivalentFlublok Quadrivalent, or Fluad Quadrivalent vaccine. These vaccines are preferred for people 65 years and older because a review of existing studies suggested that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines.

When should I get vaccinated?

For most people who need only one dose of flu vaccine for the season, September and October are generally good times to be vaccinated against flu. Ideally, everyone should be vaccinated by the end of October. Additional considerations concerning the timing of vaccination for certain groups of people include:

  • Most adults, especially those 65 years and older, and pregnant people in the first or second trimester should generally not get vaccinated early (in July or August) because protection may decrease over time. However, early vaccination can be considered for any person who is unable to return at a later time to be vaccinated.
  • Some children need two doses of flu vaccine. For those children it is recommended to get the first dose as soon as vaccine is available, because the second dose needs to be given at least four weeks after the first. Vaccination during July and August also can be considered for children who need only one dose.
  • Vaccination during July and August also can be considered for people who are in the third trimester of pregnancy during those months, because this can help protect their infants for the first few months after birth (when they are too young to be vaccinated).

Specific Flu Shots for People 65 and Older

For the 2022-2023 season, CDC and ACIP preferentially recommend the use of higher-dose flu vaccines (Fluzone High-Dose Quadrivalent inactivated influenza vaccine and Flublok Quadrivalent flu vaccine) or adjuvanted flu vaccine (Fluad Quadrivalent vaccine) over standard-dose unadjuvanted flu vaccines for people 65 years and older. This recommendation is based on a review of available studies which suggests that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines. More information is available at Flu Vaccines Worked Better than Initially Estimated this Past Season & CDC’s Advisory Council Recommends Specific Flu Vaccines for Seniors. If one of these vaccines is not available at the time of administration, people in this age group should get a standard-dose unadjuvanted inactivated flu vaccine instead. There are other flu vaccines approved for use in people 65 years and older. People 65 years and older should not get a nasal spray vaccine. More information about preferentially recommended flu vaccines is below:

Symptoms and Treatment

Because you are at higher risk of developing serious flu complications, if you get flu symptoms, call your health care provider right away. There are antiviral drugs that can treat flu illness and prevent serious flu complications. CDC recommends prompt treatment with a flu antiviral medication for people who have flu or suspected flu infection and who are at higher risk of serious flu complications.

Symptoms:
Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. Some people may also have vomiting and diarrhea, though this is more common in children than in adults. People may be infected with flu and have respiratory symptoms without a fever.


Treatment:

  • Influenza antiviral drugs are medicines that fight against flu by keeping flu viruses from making more viruses in your body.
  • Antiviral drugs can make your flu illness milder and make you feel better faster. They may also prevent serious health problems that can result from flu illness.
  • Treatment with an influenza antiviral drug should begin as soon as possible because these medications work best when started early (within 48 hours after symptoms start).
  • You need a prescription from a health care provider for an influenza antiviral medication.
  • There are four FDA-approved flu antiviral drugs recommended by CDC this season that can be used to treat the flu.

Other Preventive Actions

In addition to getting a flu shot, people 65 years and older should take the same everyday preventive actions CDC recommends for everyone, including avoiding people who are sick, covering coughs, and washing hands often.

To learn more, please visit https://www.cdc.gov/flu/highrisk/65over.htm.

Similarities and Differences between Flu and COVID-19

November 28, 2022

What is the difference between Influenza (Flu) and COVID-19?

Influenza (flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a coronavirus (SARS-CoV-2) first identified in 2019. Flu is caused by infection with a flu virus (influenza viruses).

From what we know, COVID-19 spreads more easily than flu. Efforts to maximize the proportion of people in the United States who are up to date with their COVID-19 vaccines remain critical to reducing the risk of severe COVID-19 illness and death. More information is available about COVID-19 vaccines and how well they work.

Compared with flu, COVID-19 can cause more severe illness in some people. Compared to people with flu, people infected with COVID-19 may take longer to show symptoms and may be contagious for longer periods of time.

You cannot tell the difference between flu and COVID-19 by the symptoms alone because they have some of the same signs and symptoms.  Specific testing is needed to tell what the illness is and to confirm a diagnosis. Having a medical professional administer a specific test that detects both flu and COVID-19 allows you to get diagnosed and treated for the specific virus you have more quickly. Getting treated early for COVID-19 and flu can reduce your risk of getting very sick. Testing can also reveal if someone has both flu and COVID-19 at the same time, although this is uncommon. People with flu and COVID-19 at the same time can have more severe disease than people with either flu or COVID-19 alone. Additionally, some people with COVID-19 may also be affected by post-COVID conditions (also known as long COVID).

We are learning more everyday about COVID-19 and the virus that causes it. This page compares COVID-19 and flu, given the best available information to date.

Similarities:

Both COVID-19 and flu can have varying degrees of symptoms, ranging from no symptoms (asymptomatic) to severe symptoms. Common symptoms that COVID-19 and flu share include:

  • Fever or feeling feverish/having chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue (tiredness)
  • Sore throat
  • Runny or stuffy nose
  • Muscle pain or body aches
  • Headache
  • Vomiting
  • Diarrhea (more frequent in children with flu, but can occur in any age with COVID-19)
  • Change in or loss of taste or smell, although this is more frequent with COVID-19.

Differences:

If a person has COVID-19, they could be contagious for a longer time than if they have flu.
Flu

  • People with flu virus infection are potentially contagious for about one day before they show symptoms. However, it is believed that flu is spread mainly by people who are symptomatic with flu virus infection.
  • Older children and adults with flu appear to be most contagious during the first 3-4 days of their illness, but some people might remain contagious for slightly longer periods.
  • Infants and people with weakened immune systems can be contagious for even longer.

COVID-19

  • On average, people can begin spreading the virus that causes COVID-19 2-3 days before their symptoms begin, but infectiousness peaks one day before their symptoms begin.
  • People can also spread the virus that causes COVID-19 without experiencing any symptoms.
  • On average, people are considered contagious for about eight days after their symptoms began.

To learn more, please visit https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm.

CDC Reports Early Increases in Seasonal Flu Activity

November 14, 2022

CDC’s first full FluView report of the 2022-2023 flu season shows that while flu activity is relatively low overall, there are early increases happening in most of the country. Flu activity is highest and increasing the most in the southeast and south-central parts of the United States. This increased activity could signal an early start to flu season. CDC recommends that everyone 6 months and older get vaccinated each year, ideally by the end of October, but vaccination should continue as long as flu viruses may circulate. For people who live in a community where flu activity has already begun, there’s still time to be vaccinated. Most of the time flu activity peaks between December and February, although significant activity can last as late as May.

This week’s FluView report shows that the percentage of respiratory specimens testing positive for flu nationally has reach 3.3%. The percent positive ranges from about 10% in HHS Region 4 (the southeast of the country) to 0.2% in the northwestern part of the country. In Region 6 (the south-central part of the country) 5% of specimens tested positive for flu, followed by Region 9 (the south-west of the country and Hawaii and Guam) at 4%.

The report also shows data from the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) which tracks the percentage of people visiting outpatient health care providers or emergency departments for respiratory illness. Respiratory illness, also referred to as influenza-like illness (ILI), is defined as fever or couth or sore throat. ILI is already slightly above the national baseline of 2.5%. National and regional baselines indicate a statistically significant increase above the average percent of patient visits for ILI during weeks of low flu activity in previous seasons. This is a high level of ILI for this time of year and the first time that ILI has been above baseline at this time of year since the 2009 H1N1 flu pandemic.

It’s important to note that ILINet monitors symptoms of respiratory disease, not laboratory-confirmed flu, and will therefore capture respiratory illness visits due to infection with pathogens that can present with similar symptoms, including flu, the virus that causes COVID-19, and RSV. Other respiratory viruses are circulating at elevated levels in the United States at this time; therefore, it is important to evaluate data from ILINet and other symptom-based data in the context of other sources of surveillance data to obtain a complete and accurate picture of flu and other respiratory virus activity.

While the timing and severity of the upcoming flu season cannot be predicted, the United States has experienced little flu for the past two seasons. Reduced population immunity, particularly among young children who may never have had flu exposure or been vaccinated, could bring about a robust return of flu. CDC is particularly concerned about drops in flu vaccine coverage in the past two years among higher risk groups, including children and pregnant people. ILI visits at this time are highest among children 0-4 years, followed by people 5-24 years. Often flu activity first increases in children and then spreads to older age groups.

This week, CDC also reported three new pediatric deaths for the prior (2021-2022) flu season, bringing the season total to 43 pediatric deaths. This report further underscores the importance of vaccination among children. During most years, about 80% of pediatric flu deaths happen in children who have not been fully vaccinated.

More than 105 million doses of flu vaccine have been distributed in the United States at this time. You can find a flu vaccine by visiting vaccines.gov and entering your zip code.

To learn more, please visit https://www.cdc.gov/flu/spotlights/2022-2023/early-flu-activity.htm

Flu Season

November 4, 2022

What’s New for 2022-2023

A few things are different for the 2022-2023 influenza (flu) season, including:

  • The composition of flu vaccines has been updated.
  • For the 2022-2023 flu season, there are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccineFlublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine.
  • The recommended timing of vaccination is similar to last season. For most people who need only one dose for the season, September and October are generally good times to get vaccinated. Vaccination in July and August is not recommended for most adults but can be considered for some groups. While ideally it’s recommended to get vaccinated by the end of October, it’s important to know that vaccination after October can still provide protection during the peak of flu season.
  • The age indication for the cell culture-based inactivated flu vaccine, Flucelvax Quadrivalent (ccIIV4), changed from 2 years and older to 6 months and older.
  • Pre-filled Afluria Quadrivalent flu shots for children are not expected to be available this season. However, children can receive this vaccine from a multidose vial at the recommended dose.

To learn more, please visit https://www.cdc.gov/flu/season/faq-flu-season-2022-2023.htm.

COVID-19 Testing: Types of Tests

October 4, 2022

Viral tests look for a current infection with SARS-CoV-2, the virus that causes COVID-19, by testing specimens from your nose or mouth. There are two main types of viral tests: nucleic acid amplification tests (NAATs) and antigen tests. In certain circumstances, one test type may be recommended over the other. All tests should be performed following FDA’s requirements.

  • NAATs, such as PCR-based tests, are most often performed in a laboratory. They are typically the most reliable tests for people with or without symptoms. These tests detect viral genetic material, which may stay in your body for up to 90 days after you test positive. Therefore, you should not use a NAAT if you have tested positive in the last 90 days.
  • Antigen tests* are rapid tests which produce results in 15-30 minutes. They are less reliable than NAATs, especially for people who do not have symptoms. A single, negative antigen test result does not rule out infection.  To best detect infection, a negative antigen test should be repeated at least 48 hours apart (known as serial testing). Sometimes a follow-up NAAT may be recommended to confirm an antigen test result.

*Self-tests, or at-home tests, are usually antigen tests that can be taken anywhere without having to go to a specific testing site. Follow FDA and manufacturer’s instructions, including for the number of times you may need to test. Multiple negative test results increase the confidence that you are not infected with the virus that causes COVID-19.

  • You can order free self-test kits at COVIDtests.gov or purchase tests online, in pharmacies, and retail stores.
  • You can also visit FDA’s website to see a list of authorized tests.
  • As noted in the labeling for authorized over-the-counter antigen tests: Negative results should be treated as presumptive (meaning that they are preliminary results). Negative results do not rule out SARS-CoV-2 infection and should not be used as the sole basis for treatment or patient management decisions, including infection control decisions. Please see FDA guidance on the use of at-home COVID-19 antigen tests.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html#types-of-tests

What to Expect at Your Appointment to Get Vaccinated for COVID-19

September 26, 2022

Everyone 6 Months and Older Should Get a COVID-19 Vaccine

COVID-19 vaccination has many benefits and is an important tool to help protect you from severe illness, hospitalization, and death.

Even if you or your child have had COVID-19, you should still get yourself or your child vaccinated.

  • Getting a COVID-19 vaccine after having COVID-19 provides added protection against the virus that causes COVID-19.
  • People who already had COVID-19 and do not get vaccinated after their recovery are more likely to get COVID-19 again than those who get vaccinated after their recovery.
  • If you were given monoclonal antibodies or convalescent plasma while sick with COVID-19 you do not need to wait to get vaccinated.

Before the Vaccination

If you do not regularly take over-the-counter medications, you should not take them before you get a COVID-19 vaccination.

It is not known how over-the-counter (OTC) medicines, such as ibuprofen, aspirin, or acetaminophen, might affect how well the vaccine works. You may be able to take these types of medications to reduce fever or pain after you get your vaccine to relieve any pain or discomfort resulting from possible side effects.

Get a COVID-19 vaccine with your routine medical procedures and screenings

You can combine most procedures, screenings, and vaccinations at the same appointment when you get your COVID-19 vaccination. Talk to your healthcare provider if you have questions.

Children, teens, and adults may get a COVID-19 vaccine and other vaccines, including a flu vaccine, at the same time.

Preparing children and teens for vaccination

If you are getting your child or teen vaccinated learn how you can support them and talk to them about what to expect. The experience of getting a COVID-19 vaccine will be very similar to that of getting routine vaccines.

Requesting accommodations at COVID-19 vaccination sites

If you have allergies related to vaccines

Talk to your doctor if you:

  • have had a severe allergic reaction to a previous dose to learn if you should get a different type of COVID-19 vaccine,
  • are allergic to polyethylene glycol (PEG) and you should not get Pfizer-BioNTech or Moderna COVID-19 vaccine,
  • are allergic to polysorbate and you should not get Novavax or J&J/Janssen COVID-19 vaccine
  • if you are allergic to other types of vaccines or injectable medications for other diseases.
  • If you had an immediate allergic reaction (a reaction that started within 4 hours of getting vaccinated) to a COVID-19 vaccine, but the reaction was not considered severe by a medical professional, you can receive another dose of the same vaccine under certain conditions. Your doctor may refer you to an allergy and immunology specialist for more care or advice.
  • If you have had an immediate allergic reaction—even if it was not severe—to a vaccine or injectable therapy for another disease, you should discuss this with your doctor to determine which COVID-19 vaccine is best for you.

If you have allergies not related to vaccines

You should get vaccinated if you have allergies that are not related to vaccines or injectable medications such as food, pet, venom, environmental, or latex allergies. People with a history of allergies to medications taken by mouth or a family history of severe allergic reactions can also get vaccinated.

At the Vaccination Site

  • You should receive a paper or electronic version of a fact sheet that tells you more about the COVID-19 vaccine you or your child received. Each approved and authorized COVID-19 vaccine has its own fact sheet that contains information to help you understand the risks and benefits of that vaccine.
  • There is no charge for your COVID-19 vaccine. Your COVID-19 vaccine is free. COVID-19 vaccines are paid for with taxpayer dollars and are given free of charge to all people living in the United States, regardless of health insurance or immigration status. If anyone asks you to pay for a COVID-19 vaccine, it’s a scam.

After Getting a COVID-19 Vaccine

  • Stay on site to be monitored for at least 15 minutes.
  • Make sure your vaccination provider updates your vaccination card (or gives you one if this is your first dose).
  • Stay up to date with the recommended COVID-19 vaccines and boosters.
  • You may experience side effects after getting a COVID-19 vaccine.
  • Adverse effects (serious safety problems) and severe allergic reactions are rare.
  • To report any side effects, you can sign up for v-safe. V-safe is a smartphone-based tool that provides quick and confidential health check-ins via text messages and web surveys so you can quickly and easily share with CDC how you or your dependent feel after getting a COVID-19 vaccine.

Watch Video: Use v-safe to tell CDC how you’re feeling after COVID-19 vaccination [00:00:34]

Your CDC COVID-19 Vaccination Card

Keep your CDC COVID-19 vaccination card for proof of vaccination. Consider taking a picture of your card after each of your COVID-19 vaccination appointments as a backup copy.

  • Bring your card to your appointment whenever you get a primary series dose or booster so that your provider can fill in information about your shot.
  • If your vaccine card is full, your vaccine provider can give you another card.
  • If you did not receive a CDC COVID-19 vaccination card at your first appointment, contact the vaccination provider site where you got your first shot to find out how you can get a vaccination card. You can also contact your state health department to get a copy of your vaccination record.
  • Some vaccination providers and health departments may offer you access to a QR code or digital copy of your COVID-19 vaccination card in addition to giving you a physical CDC COVID-19 vaccination card. Contact your vaccination provider or local health department to learn if a digital copy of your card is available to you.
  • If you were vaccinated abroad there are ways you can update your U.S. vaccination record.
  • To report suspicious activity involving fake CDC COVID-19 vaccination cards, please visit Fraud Alert: COVID-19 Scams or call 1-800-HHS-TIPS.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect.html.

Pre-Exposure Prophylaxis with Evusheld

September 16, 2022

What You Need To Know

  • In addition to following the recommended COVID-19 vaccination schedule, tixagevimab/cilgavimab (Evusheld), a combination of two monoclonal antibodies, should be administered to people who are moderately or severely immunocompromised every 6 months for pre-exposure prophylaxis to supplement vaccine protection. Per the product EUA, Evusheld can be given at least 2 weeks after COVID-19 vaccine. People may initiate Evusheld at any time after this interval, including between doses in the primary series and between any primary and booster doses.
  • This medication can provide protection for those not expected to mount an adequate immune response following vaccination, including those who are immunocompromised due to a medical condition or immunosuppressive medication, or for those individuals for whom COVID-19 vaccination is not recommended due to a history of severe adverse reaction to COVID-19 vaccination.
  • Evusheld is administered by intramuscular injection by a healthcare provider at an office or healthcare facility.
  • Current locations of EVUSHELD distribution can be found here.

The current treatment guidelines [5.4 MB, 456 pages] on the use of Evusheld as pre-exposure prophylaxis:

  • Tixagevimab 300 mg plus cilgavimab 300 mg (Evusheld) administered as two 3-mL intramuscular (IM) injections for adults and adolescents (aged ≥12 years and weighing ≥40 kg) who do not have SARS-CoV-2 infection, who have not been recently exposed to an individual with SARS-CoV-2 infection AND who:
    • Are moderately to severely immunocompromised or
    • Are not able to be fully vaccinated with any available COVID-19 vaccines due to history of severe adverse reactions
  • Tixagevimab plus cilgavimab should be repeated every 6 months.
  • Individuals who received tixagevimab 150 mg plus cilgavimab 150 mg should be given a second dose as soon as possible.
    • If the initial dose was administered ≤3 months prior, the second dose should be tixagevimab 150 mg plus cilgavimab 150 mg.
    • If the initial dose was administered >3 months prior, the second dose should be tixagevimab 300 mg plus cilgavimab 300 mg.
  • Individuals should be clinically monitored after injections and observed for at least 1 hour.
  • Evusheld is contraindicated in individuals with previous severe hypersensitivity reactions, including anaphylaxis, to Evusheld.
  • There is not currently sufficient evidence to recommend either for or against the use of SARS-CoV-2 serologic testing to assess for immunity or guide clinical decisions about using Evusheld for pre-exposure prophylaxis. For more information, see NIH’s COVID-19 Treatment Guidelines.

Evusheld and timing with COVID-19 vaccination

  • Evusheld may be given at least 2 weeks after any COVID-19 vaccine.
  • After this interval, Evusheld may be initiated at any time between primary series and booster doses.
  • COVID-19 vaccines may be administered at any time after Evusheld administration.
  • Use of monoclonal antibodies is not a substitute for COVID-19 vaccination.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/pre-exposure-prophylaxis.html.

Ending COVID-19 Isolation

September 12, 2022
  • Updated guidance reflects new recommendations for isolation and precautions for people with COVID-19.
  • Removed Assessment for Duration of Isolation and Key Findings From Transmission Literature sections so page provides most current information.

Key Points

  • People who are infected but asymptomatic or people with mild COVID-19 should isolate through at least day 5 (day 0 is the day symptoms appeared or the date the specimen was collected for the positive test for people who are asymptomatic). They should wear a mask through day 10. A test-based strategy may be used to remove a mask sooner.
  • People with moderate or severe COVID-19 should isolate through at least day 10. Those with severe COVID-19 may remain infectious beyond 10 days and may need to extend isolation for up to 20 days.
  • People who are moderately or severely immunocompromised should isolate through at least day 20. Use of serial testing and consultation with an infectious disease specialist is recommended in these patients prior to ending isolation.

Recommendation for Ending Isolation

For people who are mildly ill with SARS-COV-2 infection and not moderately or severely immunocompromised:

  • Isolation can be discontinued at least 5 days after symptom onset (day 0 is the day symptoms appeared, and day 1 is the next full day thereafter) if fever has resolved for at least 24 hours (without taking fever-reducing medications) and other symptoms are improving.
  • Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation​.
  • high-quality mask should be worn around others at home and in public through day 10. A test-based strategy may be used to remove a mask sooner.
  • If symptoms recur or worsen, the isolation period should restart at day 0.
  • People who cannot wear a mask, including children < 2 years of age and people of any age with certain disabilities, should isolate for 10 days.
  • In certain high-risk congregate settings that have high risk of secondary transmission, CDC recommends a 10-day isolation period for residents.

For people who test positive, are asymptomatic (never develop symptoms) and not moderately or severely immunocompromised:

  • Isolation can be discontinued at least 5 days after the first positive viral test (day 0 is the date the specimen was collected for the positive test, and day 1 is the next full day thereafter).
  • high-quality mask should be worn around others at home and in public through day 10. A test-based strategy may be used to remove a mask sooner.
  • If a person develops symptoms within 10 days of testing positive, their 5-day isolation period should start over (day 0 changes to the first day of symptoms).
  • People who cannot wear a mask, including children < 2 years of age and people of any age with certain disabilities, should isolate for 10 days.
  • In certain high-risk congregate settings that have high risk of secondary transmission, CDC recommends a 10-day isolation period for residents.

For people who are moderately ill and not moderately or severely immunocompromised:

  • Isolation and precautions can be discontinued 10 days after symptom onset (day 0 is the day symptoms appeared, and day 1 is the next full day thereafter).

For people who are severely ill and not moderately or severely immunocompromised:

  • Isolation should continue for at least 10 days after symptom onset (day 0 is the day symptoms appeared, and day 1 is the next full day thereafter).
  • Some people with severe illness (e.g., requiring hospitalization, intensive care, or ventilation support) may remain infectious beyond 10 days. This may warrant extending the duration of isolation and precautions for up to 20 days after symptom onset (with day 0 being the day symptoms appeared) and after resolution of fever for at least 24 hours (without the taking fever-reducing medications) and improvement of other symptoms.
  • Serial testing prior to ending isolation can be considered in consultation with infectious disease experts.

For people who are moderately or severely immunocompromised (regardless of COVID-19 symptoms or severity):

  • Moderately or severely immunocompromised patients may remain infectious beyond 20 days. For these people, CDC recommends an isolation period of at least 20 days, and ending isolation in conjunction with serial testing and consultation with an infectious disease specialist to determine the appropriate duration of isolation and precautions.
  • The criteria for serial testing to end isolation are:
    • Results are negative from at least two consecutive respiratory specimens collected ≥ 24 hours apart (total of two negative specimens) tested using an antigen test or nucleic acid amplification test.
    • Also, if a moderately or severely immunocompromised patient with COVID-19 was symptomatic, there should be resolution of fever for at least 24 hours (without the taking fever-reducing medication) and improvement of other symptoms. Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation​.
    • Re-testing for SARS-CoV-2 infection is suggested if symptoms worsen or return after ending isolation and precautions.
  • If a patient has persistently positive nucleic acid amplification tests beyond 30 days, additional testing could include molecular studies (e.g., genomic sequencing) or viral culture, in consultation with an infectious disease specialist.
  • For the purposes of this guidance, moderate to severely immunocompromising conditions include, but might not be limited to, those defined in the interim clinical considerations for people with moderate to severe immunocompromise due to a medical condition or receipt of immunosuppressive medications or treatments.
    • Other factors, such as end-stage renal disease, likely pose a lower degree of immunocompromise, and there might not be a need to follow the recommendations for those with moderate to severe immunocompromise.
    • Ultimately, the degree of immunocompromise for the patient is determined by the treating provider, and preventive actions should be tailored to each patient and situation.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html.

Success Story: Clara Quisinberry

September 6, 2022

Greenville Nursing and Rehabilitation is so excited to share resident Clara Quisinberry’s Success Story!

Ms. Quisinberry admitted to Greenville Nursing and Rehabilitation on June 23rd due to an infection after a recent back surgery. Upon admission, Clara was unable to transfer from her bed, take any steps, complete independent activities of daily living, and couldn’t walk without extensive assistance. Clara was incredibly determined to heal and was motivated to participate in physical and occupational therapy. With a lot of commitment and hard work, Clara was able to regain the ability to transfer, walk with a walker, become independent with self care, and manage stairs and standing again with only minimal assistance!

Clara stated that she really enjoyed participating in her daily therapy, otherwise she knew she would not be strong enough to go home and perform her daily tasks without “a lot” of help. Clara also stated that she enjoyed attending activities, especially BINGO and socializing with her fellow residents. Congratulations to Clara and her Care Team on their success!

CDC Recommends the First Updated COVID-19 Booster

September 2, 2022

Effective September 1st, 2022, CDC Director Rochelle P. Walensky, M.D., M.P.H., endorsed the CDC Advisory Committee on Immunization Practices’ (ACIP) recommendations for use of updated COVID-19 boosters from Pfizer-BioNTech for people ages 12 years and older and from Moderna for people ages 18 years and older.

Updated COVID-19 boosters add Omicron BA.4 and BA.5 spike protein components to the current vaccine composition, helping to restore protection that has waned since previous vaccination by targeting variants that are more transmissible and immune-evading.

In the coming weeks, CDC also expects to recommend updated COVID-19 boosters for other pediatric groups, per the discussion and evaluation of the data by ACIP on Sept. 1, 2022. When data are available and FDA authorizes these other types of COVID-19 boosters, CDC will quickly move to help make them available in the United States.

The Food and Drug Administration’s (FDA) authorization of updated COVID-19 boosters, and CDC’s recommendation for use, are critical next steps forward in our country’s vaccination program—a program that has helped provide increased protection against COVID-19 disease and death.

The following is attributable to Dr. Walensky:

“The updated COVID-19 boosters are formulated to better protect against the most recently circulating COVID-19 variant. They can help restore protection that has waned since previous vaccination and were designed to provide broader protection against newer variants. This recommendation followed a comprehensive scientific evaluation and robust scientific discussion. If you are eligible, there is no bad time to get your COVID-19 booster and I strongly encourage you to receive it.”


U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC works 24/7 protecting America’s health, safety and security. Whether disease start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

To learn more, please visit https://www.cdc.gov/media/releases/2022/s0901-covid-19-booster.html

Novavax COVID-19, Adjuvanted Vaccine: Overview and Safety

August 26, 2022

GENERAL INFORMATION

Manufacturer: Novavax, Inc.

Number of Shots: 2 doses in the primary series, given 3–8 weeks apart.

People who are moderately or severely immunocompromised should also receive 2 doses, given 3 weeks apart (a 3rd primary dose is not currently authorized).

Booster Shot:  Novavax COVID-19 vaccine is not authorized for use as a booster dose.

Type of Vaccine: Protein subunit

How Given: Shot in the muscle of the upper arm

Does NOT Contain: Eggs, preservatives, latex, metals
See full list of ingredients

Name: NVX-CoV2373

SAFETY DATA SUMMARY

  • COVID-19 vaccines have undergone—and continue to undergo—the most intensive safety monitoring in U.S. history. Side effects that happen within 7 days of getting vaccinated are common but are mostly mild and only last a few days. Some people have reactions that affect their ability to do daily activities.
  • Side effects throughout the body (such as fever, chills, tiredness, and headache) are more common after the second dose of the vaccine.
  • Severe allergic reactions to vaccines are rare but can happen. Cases of myocarditis and pericarditis have been reported in people who received Novavax COVID-19 vaccine.

Learn more about vaccine safety monitoring after a vaccine is authorized or approved for use.

HOW WELL THE VACCINE WORKS

  • Vaccines reduce the risk of COVID-19, including the risk of severe illness and death among people who are fully vaccinated.
  • COVID-19 vaccines are effective. Clinical trials demonstrate that Novavax COVID-19 reduces the risk of COVID-19, including the risk of severe illness and death. However, studies from other COVID-19 vaccines have shown that protection declines over time especially with the Omicron variant.
  • All FDA-approved or authorized COVID-19 vaccines provide substantial protection against COVID-19 hospitalization and death.
  • CDC will continue to provide updates as we learn more.

Learn about Novavax’s clinical trial information for people 18 years and older.

NOVAVAX COVID-19 VACCINE INGREDIENTS

COVID-19 vaccine ingredients are considered safe for most people. Nearly all of the ingredients in COVID-19 vaccines are ingredients found in many foods—fats, sugar, and salts. The Novavax COVID-19 vaccine also includes harmless pieces (proteins) of the virus that causes COVID-19; they are pieces of what is often called the spike protein.  After vaccination, the body creates an immune response to these protein pieces. This response helps protect you from getting sick with COVID-19 in the future. After the body produces an immune response, it discards all the vaccine ingredients, just as it would discard any substance that cells no longer need. This process is a part of normal body functioning.

All COVID-19 vaccines are manufactured with as few ingredients as possible and with very small amounts of each ingredient. Each ingredient in the vaccine serves a specific purpose as seen in the table below.

Type of IngredientIngredientPurpose
ProteinSARS-CoV-2 recombinant spike proteinCauses an immune response that helps protect the body from getting sick with COVID-19 in the future.
Lipids (fats)Cholesterol PhosphatidylcholineWork together to help the recombinant spike protein enter cells
AdjuvantFraction-A and Fraction-C of Quillaja saponaria Molina extract.Facilitates activation of the cells of the innate immune system.
Salts, sugar, and acidDisodium hydrogen phosphate heptahydrate Disodium hydrogen phosphate dihydrate Polysorbate-80 Potassium chloride (common food salt) Potassium dihydrogen phosphate (common food salt) Sodium chloride (basic table salt) Sodium dihydrogen phosphate monohydrate Sodium hydroxide or hydrochloric acid WaterWork together to help keep the vaccine molecules stable while the vaccine is manufactured, shipped, and stored until it is ready to be given to a vaccine recipient.

The vaccine may also contain very small amounts of ingredients from the manufacturing stage, which can be found in the EUA Fact Sheet.

INGREDIENTS THAT ARE NOT USED IN COVID-19 VACCINES

The above table lists ALL ingredients in the Novavax COVID-19 vaccine. There are NO ingredients in this vaccine beyond what is listed in the table. The Novavax COVID-19 vaccine has:

  • No preservatives such as thimerosal or mercury or any other preservatives.
  • No antibiotics such as sulfonamide or any other antibiotics.
  • No medicines or therapeutics such as ivermectin or any other medications.
  • No tissues such as aborted fetal cells, gelatin, or any materials from any animal.
  • No food proteins such as eggs or egg products, gluten, peanuts, tree nuts, nut products, or any nut byproducts (COVID-19 vaccines are not manufactured in facilities that produce food products).
  • No metals such as iron, nickel, cobalt, titanium, rare earth alloys, or any manufactured products like microelectronics, electrodes, carbon nanotubes or other nanostructures, or nanowire semiconductors.
  • No latex. The vial stoppers used to hold the vaccine also do not contain latex.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/novavax.html.

Understanding Exposure Risks

August 22, 2022


Learning about how COVID-19 spreads and the factors that can increase or decrease that risk can help you make informed choices.

The questions below are written in past tense to help you assess the likelihood that you were infected when you were around a person with COVID-19. If multiple factors below indicate higher transmission risk, you should follow the steps for what to do if you are exposed.

You can also ask yourself the same questions, but about future interactions with others, to help you decide what prevention actions to take. If multiple factors below indicate higher transmission risk, you should consider adding more prevention actions.

Factors that lower or increase risk of transmission

Length of time: How long were you with the infected person?

Longer exposure time increases the risk of transmission (for example, contact longer than 15 minutes is more likely to result in transmission than two minutes of contact).

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Cough or heavy breathing: Was the infected person coughing, singing, shouting, or breathing heavily?

Activities like coughing, singing, shouting, or breathing heavily due to exertion increase the risk of transmission.

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Symptoms: Did the infected person have symptoms at the time?

Being around people who are symptomatic increases the risk of transmission.

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Masks: Were you or the infected person or both wearing a respirator (for example, N95) or high-quality mask?

If one person was wearing a mask, the risk of transmission is decreased, and if both people were wearing masks, the risk is substantially decreased. Risk is also lower if the mask or respirator is a type that offers greater protection.

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Ventilation and filtration: How well-ventilated was the space?

More outdoor air can decrease the risk of transmission. Being outside would be lower exposure risk than being indoors, even with good ventilation and filtration; both of those options would be lower risk than being indoors with poor ventilation or filtration. See the Interactive Home Ventilation Tool.

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Distance: How close was the infected person to you?

Being closer to someone who is infected with COVID-19 increases the risk of transmission. Crowded settings can raise your likelihood of being close to someone with COVID-19.

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To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/your-health/risks-exposure.htm

Selected Adverse Events Reported after COVID-19 Vaccination

August 12, 2022

What You Need to Know

The benefits of COVID-19 vaccination continue to outweigh any potential risks.

CDC is providing timely updates on the following adverse events of interest:

  • Anaphylaxis after COVID-19 vaccination is rare and has occurred at a rate of approximately 5 cases per one million vaccine doses administered. Anaphylaxis, a severe type of allergic reaction, can occur after any kind of vaccination. If it happens, healthcare providers can effectively and immediately treat the reaction. Learn more about COVID-19 vaccines and allergic reactions, including anaphylaxis.

CDC scientists have conducted detailed reviews of cases of anaphylaxis and made the information available to healthcare providers and the public:

A review of reports indicates a causal relationship between the J&J/Janssen COVID-19 vaccine and TTS. CDC scientists have conducted detailed reviews of TTS cases and made the information available to healthcare providers and the public:

Based on a recent analysis of data from the Vaccine Safety Datalink, the rate of GBS within the first 21 days following J&J/Janssen COVID-19 vaccination was found to be 21 times higher than after Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines). After the first 42 days, the rate of GBS was 11 times higher following J&J/Janssen COVID-19 vaccination. The analysis found no increased risk of GBS after Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines). CDC and FDA will continue to monitor for and evaluate reports of GBS occurring after COVID-19 vaccination and will share more information as it becomes available.

  • Myocarditis and pericarditis after COVID-19 vaccination are rare. Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the outer lining of the heart. Most patients with myocarditis or pericarditis after COVID-19 vaccination responded well to medicine and rest and felt better quickly. Most cases have been reported after receiving Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines), particularly in male adolescents and young adults.

review of vaccine safety data in VAERS from December 2020–August 2021 found a small but increased risk of myocarditis after mRNA COVID-19 vaccines. Over 350 million mRNA vaccines were given during the study period and CDC scientists found that rates of myocarditis were highest following the second dose of an mRNA vaccine among males in the following age groups:

  • 12–15 years (70.7 cases per one million doses of Pfizer-BioNTech)
  • 16–17 years (105.9 cases per one million doses of Pfizer-BioNTech)
  • 18–24 years (52.4 cases and 56.3 cases per million doses of Pfizer-BioNTech and Moderna, respectively)

Multiple studies and reviews of data from vaccine safety monitoring systems continue to show that vaccines are safe. As a result, the agency will refocus enhanced surveillance and safety monitoring efforts toward children and adolescents.

As of July 28, 2022, there have been 1,010 preliminary reports in VAERS among people younger than age 18 years under review for potential cases of myocarditis and pericarditis. Of these, 258 remain under review. Through confirmation of symptoms and diagnostics by provider interview or review of medical records, 665 reports have been verified to meet CDC’s working case definition for myocarditis. See below for counts of verified reports of myocarditis by age group.

5-11 years: 22 verified reports of myocarditis after 20,404,074 doses administered

12-15 years: 346 verified reports of myocarditis after 24,198,309 doses administered

16-17 years: 297 verified reports of myocarditis after 13,326,016 doses administered

As the COVID-19 vaccines are authorized for younger children, CDC and FDA will continue to monitor for and evaluate reports of myocarditis and pericarditis after COVID-19 vaccination and will share more information as it becomes available. Learn more about myocarditis and pericarditis, including clinical considerations, after mRNA COVID-19 vaccination.

  • Reports of death after COVID-19 vaccination are rare. FDA requires healthcare providers to report any death after COVID-19 vaccination to VAERS, even if it’s unclear whether the vaccine was the cause. Reports of adverse events to VAERS following vaccination, including deaths, do not necessarily mean that a vaccine caused a health problem. More than 603 million doses of COVID-19 vaccines were administered in the United States from December 14, 2020, through July 27, 2022. During this time, VAERS received 15,700 preliminary reports of death (0.0026%) among people who received a COVID-19 vaccine. CDC and FDA clinicians review reports of death to VAERS including death certificates, autopsy, and medical records.

Continued monitoring has identified nine deaths causally associated with J&J/Janssen COVID-19 vaccination. CDC and FDA continue to review reports of death following COVID-19 vaccination and update information as it becomes available.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html

Success Story: Don Harper

August 5, 2022

Greenville Nursing and Rehabilitation is excited to share resident Don Harper’s Success Story!

Don Harper was admitted to Greenville Nursing and Rehabilitation on April 28th, 2022 after a fall left him with a fracture on his right leg with severe muscle weakness. When Mr. Harper started therapy, he required a lot of assistance. He needed help transferring in and out of bed, help transfer from sitting to standing, and he was not able to walk. Even completing regular daily tasks independently were difficult. With extreme motivation and participation, Mr. Harper was able to complete the sitting to standing transfer with minimal assistances, walk again with a rolling walker and with help from family, he could transfer in and out of bed again! He has become much more independent with daily tasks and continues to improve each day on his healing journey as he returns home. Mr. Harper said he enjoyed the “comradery” being at Greenville Nursing and Rehabilitation and enjoyed going to therapy and socializing. Congratulations to Mr. Harper and his Care Team on their success!

Understanding Protein Subunit COVID-19 Vaccines

July 26, 2022

The Novavax COVID-19 vaccine is a protein subunit COVID-19 vaccine that is authorized for use in the United States under Emergency Use Authorization. Learn more about Novavax COVID-19 vaccine, including who can get it, doses, and ingredients.

How Protein Subunit COVID-19 Vaccines Work

Protein subunit vaccines contain pieces (proteins) of the virus that causes COVID-19. These virus pieces are the spike protein. The vaccine also contains another ingredient called an adjuvant that helps the immune system respond to that spike protein in the future. Once the immune system knows how to respond to the spike protein, the immune system will be able to respond quickly to the actual virus spike protein and protect you against COVID-19.

  1. First, protein subunit COVID-19 vaccines are given in the upper arm muscle. After vaccination, nearby cells pick up these proteins.
  2. Next, our immune system recognizes that these proteins do not belong there. Another ingredient in the vaccine, the adjuvant, helps our immune system to produce antibodies and activate other immune cells to fight off what it thinks is an infection. This is what your body might do if you got sick with COVID-19.
  3. At the end of the process, our bodies have learned how to help protect against future infection with the virus that causes COVID-19. The benefit is that people get this protection from a vaccine, without ever having to risk the potentially serious consequences of getting sick with COVID-19. Many side effects from getting the vaccine are normal signs the body is building protection.

Facts About Protein Subunit COVID-19 Vaccines

Protein subunit COVID-19 vaccines cannot cause COVID-19 or other illnesses.

  • Protein subunit COVID-19 vaccines do not use any live virus.
  • Protein subunit COVID-19 vaccines cannot cause infection with the virus that causes COVID-19 or other viruses.

They do not affect or interact with our DNA.

  • The protein pieces do not enter the nucleus of the cell where our DNA (genetic material) is located, so they cannot change or influence our genes.

Protein Subunit COVID-19 Vaccines Have Been Rigorously Evaluated for Safety

COVID-19 vaccines are safe and effective.

Protein subunit COVID-19 vaccines have been held to the same rigorous safety and effectiveness standards as all other types of vaccines in the United States. The only COVID-19 vaccines the Food and Drug Administration (FDA) makes available for use in the United States (by approval or emergency use authorization) are those that meet these standards.

Protein Subunit Vaccines Have Been Used for Years

More than 30 years ago, a hepatitis B vaccine became the first protein subunit vaccine to be approved for use in people in the United States. Another example of other protein subunit vaccines used in the United States today include acellular pertussis (whooping cough) vaccines.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/proteinsubunit.html

Success Story: Dorothy DeArmond

July 13, 2022

Greenville Nursing and Rehabilitation is proud to recognize resident Dorothy DeArmond’s Success Story!

Mrs. DeArmond admitted to Greenville Nursing and Rehabilitation Center on May 20, 2022 with a complaint of generalized weakness after a recent hospital stay. She worked hard with our occupational and physical therapy team, strengthening her endurance, walking, and regaining the ability to be independent in caring for herself again. Dorothy was determined to return home independently with only minimal assistance from her family members. Mrs. DeArmond loved talking to everyone and enjoyed participating in her therapy. After only a short couple of weeks, she was able to complete her goals and return home with her family! Dorothy says, “I will miss everyone here at Greenville Nursing and Rehab”. Congratulations to Dorothy and her Care Team on their success!

COVID-19 After Vaccination: Possible Breakthrough Infection

July 12, 2022

COVID-19 vaccines help protect against severe illness, hospitalization and death. COVID-19 vaccines also help protect against infection. People who are vaccinated may still get COVID-19. When people who have been vaccinated get COVID-19, they are much less likely to experience severe symptoms than people who are unvaccinated.

To get the best protection against COVID-19, especially against severe illness and hospitalization, stay up to date on your COVID-19 vaccines.

When someone who is vaccinated with either a primary series or a primary series plus a booster dose gets infected with the virus that causes COVID-19, it is referred to as a “vaccine breakthrough infection.”

When people who are vaccinated get COVID-19 get a breakthrough infection, they are much less likely to experience severe symptoms than people who are unvaccinated.

People who get vaccine breakthrough infections can spread COVID-19 to other people. When a community reports more COVID-19 infections, that means more virus is circulating. When more virus is circulating, more breakthrough infections will occur even when vaccination rates are high. Even if you are vaccinated, if you live in a county with a high COVID-19 Community Level, you and others in your community, whether vaccinated or not, should take more steps to protect yourself and others, like wearing a mask in indoor public places.

CDC monitors reported vaccine breakthrough infections to better understand patterns of COVID-19 among people who are vaccinated and unvaccinated. The latest rates of COVID-19 cases and deaths by vaccination status are available on the CDC COVID Data Tracker.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/why-measure-effectiveness/breakthrough-cases.html

Visiting Older Adults in Residential Communities

July 1, 2022

Residential communities for older adults may combine nursing, assisted living, and independent living lifestyles. Each community may face different risks and decide to put in place less restrictive or more restrictive protocols.

To help protect friends and family members who live in these communities, get vaccinated. CDC has also issued updated recommendations for visitations at post-acute facilities. These recommendations align with the Centers for Medicare and Medicaid Services (CMS)external iconexternal icon guidance for visitations under various circumstances.

Learn more about the risks among people who live in nursing homes or long-term care facilities and about CDC’s guidance for preventing the spread COVID-19 infection in nursing homes.

There is no way to ensure you have zero risk of getting the virus that causes COVID-19.  So, it is important to understand the risks and know how to reduce your risk as much as possible if or when you do resume some activitiesrun errands, and attend events and gatherings.

While it is generally safest to implement universal use of source control for everyone in a healthcare setting, the following allowances could be considered for individuals who are up to date with all recommended COVID-19 vaccine doses (who do not otherwise meet the criteria described above) in healthcare facilities located in counties with low to moderate community transmission. These individuals might choose to continue using source control if they or someone in their household is immunocompromised or at increased risk for severe disease, or if someone in their household is not up to date with all recommended COVID-19 vaccine doses.

  • HCP who are up to date with all recommended COVID-19 vaccine doses:
    • Could choose not to wear source control or physically distance when they are in well-defined areas that are restricted from patient access (e.g., staff meeting rooms, kitchen).
      • They should wear source control when they are in areas of the healthcare facility where they could encounter patients (e.g., hospital cafeteria, common halls/corridors).
  • Patient Visitation:
    • Indoor visitation (in single-person rooms; in multi-person rooms, when roommates are not present; or in designated visitation areas when others are not present): The safest practice is for patients and visitors to wear source control and physically distance, particularly if either of them are at risk for severe disease or are unvaccinated.
      • If the patient and all their visitor(s) are up to date with all recommended COVID-19 vaccine doses, they can choose not to wear source control and to have physical contact.
      • Visitors should wear source control when around other residents or HCP, regardless of vaccination status.
    • Outdoor Visitation: Patients and their visitors should follow the source control and physical distancing recommendations for outdoor settings described on the page addressing Your Guide to Masks.
  • Residents who are up to date with all recommended COVID-19 vaccine doses in Nursing Homes in Areas of Low to Moderate Transmission:
    • Nursing homes are healthcare settings, but they also serve as a home for long-stay residents and quality of life should be balanced with risks for transmission. In light of this, consideration could be given to allowing residents who are up to date with all recommended COVID-19 vaccine doses to not use source control when in communal areas of the facility; however, residents at increased risk for severe disease should still consider continuing to practice physical distancing and use of source control

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html.

From the Desk of the CEO: Celebrating National Nursing Assistants Week

June 21, 2022

“I entered skilled nursing as a Certified Nursing Assistant (CNA). During this role, I developed love and compassion for the elderly. It gave me an opportunity to learn who each of these people were, hear their stories, and listen to the words of wisdom they often imparted to me. They encouraged me to continue to grow and make a difference in long-term care. As I continued in my healthcare journey, there were various leaders who believed in me and continued to provide opportunities and experiences. I continued to grow from one role to the next all while expanding my education of the field. I am thankful for each role that I’ve held through the years. Each member of the nursing team is important and needed, but the role of a CNA is invaluable. They are the backbone of the long-term care industry. They are often the unsung heroes that become more like family to a Resident than a caregiver. We honor and give gratitude to those CNA’s that answer the call every single day and make unmeasurable impact.”

CEO, Bernie McGuinness

Understanding mRNA COVID-19 Vaccines

June 20, 2022

The Pfizer-BioNTech and Moderna COVID-19 vaccines are messenger RNA vaccines, also called mRNA vaccines. Learn more about Pfizer-BioNTech and Moderna COVID-19 vaccines, including who can get them, doses, and ingredients.

How mRNA COVID-19 Vaccines Work

To trigger an immune response, many vaccines put a weakened or inactivated germ into our bodies. Not mRNA vaccines. Instead, mRNA vaccines use mRNA created in a laboratory to teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what helps protect us from getting sick from that germ in the future.

  1. First, mRNA COVID-19 vaccines are given in the upper arm muscle. After vaccination, the mRNA will enter the muscle cells. Once inside, they use the cells’ machinery to produce a harmless piece of what is called the spike protein. The spike protein is found on the surface of the virus that causes COVID-19. After the protein piece is made, our cells break down the mRNA and remove it.
  2. Next, our cells display the spike protein piece on their surface. Our immune system recognizes that the protein does not belong there. This triggers our immune system to produce antibodies and activate other immune cells to fight off what it thinks is an infection. This is what your body might do if you got sick with COVID-19.
  3. At the end of the process, our bodies have learned how to help protect against future infection with the virus that causes COVID-19. The benefit is that people get this protection from a vaccine, without ever having to risk the potentially serious consequences of getting sick with COVID-19. Any side effects from getting the vaccine are normal signs the body is building protection.

mRNA COVID-19 Vaccines Have Been Rigorously Evaluated for Safety

COVID-19 vaccines are safe and effective.

mRNA COVID-19 vaccines have been held to the same rigorous safety and effectiveness standards as all other types of vaccines in the United States. The only COVID-19 vaccines the Food and Drug Administration (FDA) makes available for use in the United States (by approval or emergency use authorization) are those that meet these standards.

While COVID-19 vaccines were developed rapidly, all steps have been taken to ensure their safety and effectiveness.

mRNA Vaccines Are Newly Available to the Public, but Have Been Studied for Decades

Researchers have been studying and working with mRNA vaccines for decades. Interest has grown in these vaccines because they can be developed in a laboratory using readily available materials. This means vaccines can be developed and produced in large quantities faster than with other methods for making vaccines.

mRNA vaccines have been studied before for flu, Zika, rabies, and cytomegalovirus (CMV). As soon as the necessary information about the virus that causes COVID-19 was available, scientists began designing the mRNA instructions for cells to build the unique spike protein into an mRNA vaccine.

Future mRNA vaccine technology may allow for one vaccine to provide protection against multiple diseases, thus decreasing the number of shots needed for protection against common vaccine-preventable diseases.

Beyond vaccines, cancer research has used mRNA to trigger the immune system to target specific cancer cells.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html

COVID-19 Vaccines are Free to the Public

June 13, 2022

What You Need to Know

  • COVID-19 vaccines are available for everyone ages 5 years and older at no cost.
  • Vaccines were paid for with taxpayer dollars and will be given free of charge to all people living in the United States, regardless of insurance or immigration status.
  • COVID-19 vaccination is an important tool to help stop the pandemic.
  • CDC recommends you get a COVID-19 vaccine as soon as you can.

Be Aware of Scams

If anyone asks you to pay for access to a COVID-19 vaccine, you can bet it’s a scam. Don’t share your personal or financial information if someone calls, texts, or emails you promising access to a vaccine for an extra fee.

COVID-19 vaccination providers cannot:

  • Charge you for a vaccine
  • Charge you directly for any administration fees, copays, or coinsurance
  • Deny vaccination to anyone who does not have health insurance coverage, is underinsured, or is out of network
  • Charge an office visit or other fee to the recipient if the only service provided is a COVID-19 vaccination
  • Require additional services in order for a person to receive a COVID-19 vaccine; however, additional healthcare services can be provided at the same time and billed as appropriate

COVID-19 vaccination providers can:

  • Seek appropriate reimbursement from the recipient’s plan or program (e.g., private health insurance, Medicare, Medicaid) for a vaccine administration fee
    • However, providers cannot charge the vaccine recipient the balance of the bill.

Anyone in the United States Can Get Vaccinated

The federal government is providing vaccines free of charge to everyone 5 years and older living in the United States, regardless of their immigration or health insurance status.

CDC does not require U.S. citizenship for individuals to receive a COVID-19 vaccine. Jurisdictions (state, tribal, local, and territorial) cannot add U.S. citizenship requirements or require U.S. citizenship verification as a requirement for vaccination.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/no-cost.html

Success Story: Penny Anderson

June 2, 2022

Greenville Nursing and Rehabilitation is excited to share resident Penny Anderson’s Success Story!

Ms. Penny Anderson was admitted to Greenville Nursing and Rehabilitation after a fracture of her left leg, which left her unable to return home. Upon admission, she was dependent with her transferring and needed a lot of assistances with completing her daily care task. Ms. Anderson enjoyed taking part in therapy and enjoyed being around other rehabilitation residents. Her husband and daughters were incredibly supportive with her therapy and participated in caregiver training to be able to help her with tasks and transferring once she returned home. Ms. Anderson, after a lot of hard work and determination, was recently able to discharge back to her home with her husband. We gave her a “Red Carpet” farewell. Congratulations to Ms. Anderson and her Care Team on their success!

Telehealth and Telemedicine during COVID-19

May 31, 2022

KEY POINTS

  • In 2020, countries reported on average, about half of essential health services were disrupted -WHO “pulse survey“external icon
  • Pursue telehealth as an alternative to face-to-face healthcare services, commonly used pre-pandemic, to:
    • Reduce unnecessary exposure to COVID-19,
    • Help mitigate the spread of the virus, and
    • Reduce surges in hospitals and clinics.

This guidance document is developed to encourage healthcare providers to explore ways of meeting the essential healthcare needs of the community using innovative telehealth modalities and technologies; and expand the use of telehealth in the care of patients, and telemedicine in the care of COVID-19 and other non-COVID-19 patients.

WHAT IS TELEHEALTH?

Telehealth is remote patient care and monitoring. It allows direct transmission of a patient’s clinical measurements from a distance to their healthcare provider and may or may not be in real timeThe telehealth session may also be facilitated by a Healthcare Professional (to other healthcare professionals), Village Health Volunteer -VHV, a Community Health Worker -CHW visiting the patient, or by the patient him/her-self, a parent or a legal guardian. Telehealth can be any combination of healthcare services including telemedicine. Some healthcare specialties default to “referring to all of such services” as telehealth. “TeleCOVID-19” care is Telemedicine.

Examples of Telehealth Care include:

  • Screening for COVID-19, testing recommendations, and guidance on isolation or quarantine
  • General health care (i.e. wellness visits, blood pressure control, advice about certain non-emergency illnesses, like common rashes)
  • Non-emergency follow-up clinics
  • Prescriptions for medication
  • Nutrition counseling
  • Mental health counseling
  • Physical therapy exercise
  • Teleradiology
  • Tele-intensive care (in infectious disease hospitalizations)
  • Telemedicine

Telehealth  decreases contact with healthcare facilities, other patients, and healthcare staff in order to reduce the risk of COVID-19 spread in the community.

Generally, Telehealth Modalities include:  

  • Synchronous: Real-time telephone or live audio-video interaction, typically with a patient, using a smartphone, tablet, or computer.
    • For example: In some cases, peripheral medical equipment (e.g., digital stethoscopes, otoscopes, ultrasounds) can be used by another health care provider (e.g., nurse, medical assistant) physically with the patient, while the consulting medical provider conducts a remote evaluation.
  • Asynchronous:The provider and patient communication does not happen in real time.

For example, “store and forward” technology allows messages, images, or data to be collected at one point in time and interpreted or responded to later. Patient portals can facilitate this type of communication between provider and patient through secure messaging. Other examples of telehealth modalities developed/used by American College of Obstetricians and Gynecologistsexternal icon include:

  1. Live, two-way (or real-time) synchronous audio and video allows specialists, local physicians, and patients to see and hear each other in real-time to discuss conditions e.g. via phone or computer (also defined above).
  2. Store-and-forward, also referred to as “asynchronous telemedicine,” sends medical imaging such as X-rays, photos, ultrasound recordings, or other static and video medical imaging to remote specialists for analysis and future consultation (also defined above).
  3. Remote patient monitoring collects personal health and medical data from a patient in one location and electronically transmits the data to a physician in a different location for use in care and related support.
  4. mHealth is a general term for self-managed patient care using mobile phones or other wireless technology and does not necessarily involve monitoring by a physician. It is most commonly used to deliver or reinforce patient education about preventive care and provide medication reminders, appointment reminders, and other essential self-care steps that patients should undertake to maintain their optimal obstetric health.

WHAT IS TELEMEDICINE?

Telemedicine is the use of electronic information and telecommunication technology to get needed health care while practicing physical distancing.  This encourages meaningful use of patient health measures to help guide the engagement of patient in care.

Telemedicine goals for Developing Countries should includeexternal icon, but not be limited to:

  • Remote diagnosing and teleconsulting* system. Data (including signals and images) are locally (patient-side) acquired and stored, and then forwarded to the main hospital, where physicians can analyze those data. The remote (physician-side) hospital will then send back the diagnosis.
  • Remote diagnosis performed with patient assisted by nurses. If no physician is in the neighborhood: such a situation typically occurs in rural locations of developing countries, and in some cases a preliminary diagnosis is locally performed by the aid of a decision support system (DSS).
  • Remote monitoring system. The patient is monitored in the remote location, his/her signals are continuously acquired, forwarded to the main hospital, and possibly, locally analyzed by a DSS. Alarms are remotely detected and transmitted back to the patient-side. The monitoring system can be managed and locally controlled by a physician or by a nurse.
  • Remote intervention system. The patient enters the operating room, the intervention is performed through a local (patient-side) robot that is remotely controlled by a physician in the main hospital. The remote intervention requires that some local assistance is performed by a physician or by a nurse.
  • Remote education (e-learning) system. Students or caregivers (mostly physicians, nurses, and technicians) attend classes taught from remote academic institutions, and possibly by a bi-directional communication interact with the teacher by making up questions. Remote education can be locally assisted by a local tutor, during and/or after the classes.

*Note: Teleconsulting, i.e., expert second opinion, is performed among physicians, where a non-specialist physician requires a remote consultation with one or more specialist physicians: typically, such a situation occurs in emergency centers of rural locations or in minor hospitals of developed countries, or in any location of developing countries.

POTENTIAL LIMITATIONS OF TELEHEALTH

Adaptations to telehealth may need to be considered in certain situations where in-person visits are more appropriate such as:

  • Due to urgency, a person’s underlying health conditions, or the fact that a physical exam or laboratory testing is needed for medical decision making.
  • If sensitive topics need to be addressed, especially if there is patient discomfort or concern for privacy.
  • Limited access to technological devices (e.g., phones, tablets, computers) or connectivity. This may be especially true for those living in rural settings.
  • When healthcare workers or patients may be less comfortable with using the technology, and may prefer an in-person visit.
  • When virtual visits are not readily accepted in lieu of in-person visits by healthcare workers or patients.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/telehealth-covid19-nonUS.html

COVID-19 Vaccine Access in Long-Term Care Settings

May 20, 2022

The federal government is committed to ensuring that residents and staff in long-term care (LTC) settings, such as nursing homes, assisted living, residential care communities, group homes and senior housing, have access to COVID-19 vaccines to receive primary series and booster shots. For additional examples of LTC settings, see COVID-19 Vaccine Access in Long-Term Care Settingsexternal icon.

The goal is to continue to protect those who are disproportionately affected by COVID-19—especially residents of LTC settings. All LTC settings that request assistance accessing COVID-19 vaccines for their residents and staff will receive the support they need.

Many LTC providers have already identified strategies and partnerships to obtain and administer COVID-19 vaccines for residents and staff. These include:

Long-term care providers are encouraged to consider the option that works best for their residents and staff when coordinating access to COVID-19 vaccines, either in the local community or on-site. Additional details on these options are available on the pages linked below.https://www.cdc.gov/vaccines/covid-19/long-term-care/pharmacy-partnerships/administrators-managers.htmlhttps://www.cdc.gov/vaccines/covid-19/long-term-care/pharmacy-partnerships/jurisdictions.html

Additional Information COVID-19 Vaccination Recommendations

COVID-19 vaccination is recommended for all people ages 5 years and older in the United States for the prevention of COVID-19. COVID-19 vaccines currently approved or authorized by FDA are highly effective in preventing serious outcomes of COVID-19, including severe disease, hospitalization, and death. Efforts to maximize the proportion of people in the United States who are fully vaccinated against COVID-19 remain critical to ending the COVID-19 pandemic. At present, people with moderately to severely compromised immune systems should receive an additional dose of mRNA COVID-19 vaccine after the initial 2 doses.

CDC now recommends that certain people receive a COVID-19 booster shot. For more information, visit Who is Eligible For a COVID-19 Vaccine Booster Shot?

In addition, COVID-19 vaccines may now be administered along with other vaccines. This includes simultaneous administration of the COVID-19 vaccine and other vaccines such as the flu vaccine on the same day, as well as coadministration within 14 days. For more information, see Interim Clinical Considerations for Use of COVID-19 Vaccines.

To learn more, please visit https://www.cdc.gov/vaccines/covid-19/long-term-care/pharmacy-partnerships.html.

National Nurses Week: The History of Florence Nightingale

May 12, 2022

During National Nurses Week, take time to celebrate the founder of modern nursing, Florence Nightingale! Her endeavors to improve the aspect of healthcare has greatly shaped the quality of care by nurses in the 19th and 20th centuries. 

Currently, there are nurses all around the world putting their lives on the line to help stop the spread of COVID-19. It’s clear that Florence Nightingale’s impact on healthcare also helped pave the way for modern-day nurses and healthcare professionals to follow suit.

“With nurses around the world on the front lines of a global pandemic, it’s a poignant time to reflect on how Nightingale’s legacy laid the groundwork for their heroic work in hospitals today.” Says Greta Westwood, CEO of the Florence Nightingale Foundation. “She never took no for an answer – anything was possible.”

Also known as “The Lady with the Lamp”, Florence Nightingale started her nursing career in London, and later became appointed as the head nurse of the 1854 Crimean War. Nightingale’s passion and determination set her apart from others and got her the famous nickname “Lady with the Lamp” for checking on her patients via lamplight during the war. Not only did she care for her patients’ health, but she also often wrote letters to soldiers’ loved ones on their behalf.

The “Angel of the Crimea” made it her goal to lower death rates by improving hygiene practices in hospitals. She created numerous patient services that improved each patient’s quality of care while admitted in the hospital. She oversaw “invalid’s kitchen” where she set out food plans for patients that had dietary requirements. She also secured a laundry area so patients could have clean bed sheets and towels.

After the Crimean War, Nightingale wrote a book called Matters Affecting the Health, Efficiency and Hospital Administration of the British Army to share her observations and experiences while tending wounded soldiers. In 1857, the War Office’s administrative department was completely reconstruction due to Nightingale’s book and her experiences during the Crimean War, reforming several military hospitals that were under very poor conditions. (History.com Editors 2009)

In August of 1910, Nightingale became ill and was battling with heart failure. She died a week later at her home in London, bringing her life to an end at 90 years old. (History.com Editors 2009) Two years after her death, the Florence Nightingale Medal was created by the International Committee of the Red Cross, dedicated to be given to exceptional nurses every 2 years. In 1965, International Nurses Day was also created, residing on Nightingale’s birthday to continue celebrating her accomplishments. (Alexander 2018)

Despite her unexpected death, her legacy continues to live on at the Florence Nightingale Museum, which is located at the exact same spot of the original Nightingale Training School for Nurses. The museum holds over 2,000 artifacts to memorialize the mother of modern nursing. (History.com Editors 2009)

Florence Nightingale’s legacy is important to note during significant time for nurses courageously fighting on the frontlines during the pandemic. Notes Westwood, “Florence would be so proud of what nurses have managed to achieve during the pandemic.” (Haynes 2020)

References:

https://time.com/5835150/florence-nightingale-legacy-nurses/

http://history.com/topics/womens-history/florence-nightingale-1https://www.womenshistory.org/education-resources/biographies/florence-nightingale

National Nurses Week 2022: Month Long Discounts and Freebies

May 10, 2022


We are preparing for an amazing celebration of National Nurses Week this year! Many companies are showing their gratitude for nurses and healthcare workers by offering awesome deals and freebies during Nurses Week and throughout the year. Whether you are a healthcare worker looking for a good deal or you’re shopping for a healthcare hero in your life, check out these great deals valid for the entire month of May for Nurses Week 2022!

Food & Drinks

  • Mrs. Fields – Take a look online at this sweet selection of cookies in the Heroes Collection of cookie tins, which honors healthcare workers.
  • Outback Steakhouse – Grab a hot meal and a big thank you! Show your industry identification to get 10% off your bill. The discount is not available via ordering online.
  • Texas de Brazil – Enjoy a night or lunch out with a delicious selection of steaks (salads too!) and save 15% with a valid badge or ID.

Retail

  • Amazon – Curl up with a selection of four free medical drama books, specially curated to celebrate nurses.
  • Adidas – Receive 30% off in-store and on the Adidas website, and 20% off at factory outlet stores, when you verify your status as a nurse with ID.me.
  • All Seasons Uniforms – Spruce up your closet with 20% off all medical apparel, such as scrubs, lab coats, and cleanroom clothing. Use discount code NURSE20.
  • ASICS – Medical professionals and first responders, including nurses, physicians, police officers, and firefighters, can enjoy 40% off ASICS products. When you verify your healthcare worker status using SheerID, you will receive a on-time-use promo code.
  • Brooklyn Bedding – Don’t snooze on this offer. Get 25% off and free shipping on your entire order of mattresses, pillows, sheets, and/or foundations. Verify your eligibility via ID.me during checkout.
  • Lenovo – Need to upgrade your technology? Take an extra 5% off products sitewide, excluding doorbuster deals and select clearance products. Verify your healthcare worker status with ID.me during checkout.
  • L.L. Bean – Enjoy 15% off one purchase after verifying your employment status through SheerID. This discount is valid on merchandise purchases are llbean.com, retail stores, or by phone.
  • Lululemon – Receive 15% off in-store or online purchases.
  • Nike – All medical professionals and first responders in the US are eligible for a 10% discount. Verify your profession as a nurse with SheerID to get a one-time-use promo code.
  • Purple – Take 10% off any order purchased at purple.com or Purple retail showrooms, after verifying employment status through SheerID. Click on the “Verify Eligibility” button to start the process. Once approved, you will receive a single-use promotional code to use at checkout.
  • Ring – Stay safe with a 20% discount savings on select Ring Doorbell products.
  • Rothy’s – Enjoy some cool comfort with 20% off a pair of washable shoes. Verify your nurse status and claim the savings at online checkout.
  • Under Armour – Take advantage of 20% off at UA.com and in UA Brand House stores. Choose the Military and First Responder Discount at checkout, and then verify your status as a nurse with ID.me.
  • Verizon – You and your loved ones can get a Start Unlimited plan (with unlimited talk, text, and data) from $30 per line with four lines. That’s an offer the whole family can enjoy!
  • Vineyard Vines – Save 15% on all apparel with a verified medical ID.

Travel

  • Budget – Available through the ID.me shop, Budget is offering a discount of up to 25% for nurses. Create an ID.me account or sign in to enjoy this offer.
  • Enterprise Rent-a-Car – Similar to the Budget discount, nurses, military members, and teachers can take up to 25% off their rental car costs with Enterprise. An ID.me account is required to access this discount.
  • National – Rounding out the trio of rental car companies’ offers for nurses through ID.me, National “lets you choose any car in the aisle and go” with up to 25% off.

In addition to this month’s discounts and freebies, Majestic Care is proud to partner with Panda Perks to give our Care Team members 24/7 access to discounts and perks on the brands you love! Give us a call to learn more

Long COVID or Post-COVID Conditions

May 9, 2022

Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as post-COVID conditions (PCC) or long COVID.

People call post-COVID conditions by many names, including: long COVID, long-haul COVID, post-acute COVID-19, post-acute sequelae of SARS CoV-2 infection (PASC), long-term effects of COVID, and chronic COVID.

WHAT YOU NEED TO KNOW

  • Post-COVID conditions can include a wide range of ongoing health problems; these conditions can last weeks, months, or years.
  • Post-COVID conditions are found more often in people who had severe COVID-19 illness, but anyone who has been infected with the virus that causes COVID-19 can experience post-COVID conditions, even people who had mild illness or no symptoms from COVID-19.
  • People who are not vaccinated against COVID-19 and become infected may also be at higher risk of developing post-COVID conditions compared to people who were vaccinated and had breakthrough infections.
  • There is no single test for post-COVID conditions. While most people with post-COVID conditions have evidence of infection or COVID-19 illness, in some cases, a person with post-COVID conditions may not have tested positive for the virus or known they were infected.
  • CDC and partners are working to understand more about who experiences post-COVID conditions and why, including whether groups disproportionately impacted by COVID-19 are at higher risk.

ABOUT LONG COVID OR POST-COVID CONDITIONS

Post-COVID conditions are a wide range of new, returning, or ongoing health problems that people experience after first being infected with the virus that causes COVID-19. Most people with COVID-19 get better within a few days to a few weeks after infection, so at least four weeks after infection is the start of when post-COVID conditions could first be identified. Anyone who was infected can experience post-COVID conditions. Most people with post-COVID conditions experienced symptoms days after their SARS CoV-2 infection when they knew they had COVID-19, but some people with post-COVID conditions did not notice when they first had an infection.

There is no test to diagnose post-COVID conditions, and people may have a wide variety of symptoms that could come from other health problems. This can make it difficult for healthcare providers to recognize post-COVID conditions. Your healthcare provider considers a diagnosis of post-COVID conditions based on your health history, including if you had a diagnosis of COVID-19 either by a positive test or by symptoms or exposure, as well as doing a health examination.

SYMPTOMS

People with post-COVID conditions can have a wide range of symptoms that can last more than four weeks or even months after infection. Sometimes the symptoms can even go away or come back again.

Post-COVID conditions may not affect everyone the same way. People with post-COVID conditions may experience health problems from different types and combinations of symptoms happening over different lengths of time. Most patients’ symptoms slowly improve with time. However, for some people, post-COVID conditions may last months, and potentially years, after COVID-19 illness and may sometimes result in disability.

People who experience post-COVID conditions most commonly report:

GENERAL SYMPTOMS

  • Tiredness or fatigue that interferes with daily life
  • Symptoms that get worse after physical or mental effort (also known as “post-exertional malaise”)
  • Fever

RESPIRATORY AND HEART SYMPTOMS

  • Difficulty breathing or shortness of breath
  • Cough
  • Chest pain
  • Fast-beating or pounding heart (also known as heart palpitations)

NEUROLOGICAL SYMPTOMS

  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
  • Headache
  • Sleep problems
  • Dizziness when you stand up (lightheadedness)
  • Pins-and-needles feelings
  • Change in smell or taste
  • Depression or anxiety

DIGESTIVE SYMPTOMS

  • Diarrhea
  • Stomach pain

OTHER SYMPTOMS

  • Joint or muscle pain
  • Rash
  • Changes in menstrual cycles

SYMPTOMS THAT ARE HARD TO EXPLAIN AND MANAGE

People with post-COVID conditions may develop or continue to have symptoms that are hard to explain and manage. Clinical evaluations and results of routine blood tests, chest x-rays, and electrocardiograms may be normal. The symptoms are similar to those reported by people with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) and other poorly understood chronic illnesses that may occur after other infections. People with these unexplained symptoms may be misunderstood by their healthcare providers, which can result in a long time for them to get a diagnosis and receive appropriate care or treatment. Review these tips to help prepare for a healthcare provider appointment for post-COVID conditions.

HEALTH CONDITIONS

Some people, especially those who had severe COVID-19, experience multiorgan effects or autoimmune conditions with symptoms lasting weeks or months after COVID-19 illness. Multiorgan effects can involve many body systems, including the heart, lung, kidney, skin, and brain. As a result of these effects, people who have had COVID-19 may be more likely to develop new health conditions such as diabetes, heart conditions, or neurological conditions compared with people who have not had COVID-19.

PEOPLE EXPERIENCING ANY SEVERE ILLNESS MAY DEVELOP HEALTH PROBLEMS

PICS refers to the health effects that may begin when a person is in an intensive care unit (ICU), and which may persist after a person returns home. These effects can include muscle weakness, problems with thinking and judgment, and symptoms of post-traumatic stress disorder (PTSD). PTSDexternal icon involves long-term reactions to a very stressful event. For people who experience PICS following a COVID-19 diagnosis, it is difficult to determine whether these health problems are caused by a severe illness, the virus itself, or a combination of both.

PEOPLE MORE LIKELY TO DEVELOP LONG COVID

Researchers are working to understand which people or groups of people are more likely to have post-COVID conditions, and why. Studies have shown that some groups of people may be affected more by post-COVID conditions. These are examples and not a comprehensive list of people or groups who might be more at risk than other groups for developing post-COVID conditions:

  • People who have experienced more severe COVID-19 illness, especially those who were hospitalized or needed intensive care.
  • People who had underlying health conditions prior to COVID-19.
  • People who did not get a COVID-19 vaccine.
  • People who experience multisystem inflammatory syndrome (MIS) during or after COVID-19 illness.
  • Some people affected by health inequities including people from racial or ethnic minority groups and people with disabilities.

HEALTH INEQUITIES MAY AFFECT POPULATIONS AT RISK FOR LONG COVID

Some people are at increased risk of getting sick from COVID-19 because of where they live or work, or because they can’t get health care. Health inequities may put some people from racial or ethnic minority groups and some people with disabilities at greater risk for developing post-COVID conditions. Scientists are researching some of those factors that may place these communities at higher risk of both getting infected or developing post-COVID conditions.

PREVENTING LONG COVID

Research suggests that people who are vaccinated but experience a breakthrough infection are less likely to report post-COVID conditions, compared to people who are unvaccinated.

Learn more about protecting yourself and others from COVID-19.

LIVING WITH LONG COVID

However, people experiencing post-COVID conditions can seek care from a healthcare provider to come up with a personal medical management plan that can help improve their symptoms and quality of life. Review these tips to help prepare for a healthcare provider appointment for post-COVID conditions. In addition, there are many support groups being organized that can help patients and their caregivers.

Although post-COVID conditions appear to be less common in children and adolescents than in adults, long-term effects after COVID-19 do occur in children and adolescents.

CDC is working to:

  • Better identify the most frequent symptoms and diagnoses experienced by patients with post-COVID conditions.
  • Better understand how many people are affected by post-COVID conditions, and how often people who are infected with COVID-19 develop post-COVID conditions afterwards.
  • Better understand risk factors, including which groups might be more at risk, and if different groups experience different symptoms.
  • Help understand how post-COVID conditions limit or restrict people’s daily activity.
  • Help identify groups that have been more affected by post-COVID conditions, lack access to care and treatment for post-COVID conditions, or experience stigma.
  • Better understand the role vaccination plays in preventing post-COVID conditions.
  • Collaborate with professional medical groups to develop and offer clinical guidance and other educational materials for healthcare providers, patients, and the public.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/whats-new-all.html.

Success Story: Sandra Guy

May 5, 2022

Greenville Nursing and Rehabilitation is proud to shine the spotlight on resident Sandra Guy’s Success Story!

Mrs. Sandra Guy was admitted to Greenville Nursing and Rehabilitation after a fracture to her right leg, which left her unable to return home. Upon admission, she was unable to bear any weight on her leg or complete her daily care tasks independently. She needed maximum assistances with transferring and walking. During her stay, Mrs. Guy and her husband, Charlie, celebrated their 55th wedding anniversary. On March 9th, our community provided a second wedding ceremony with a preacher, decorations, and a wedding cake for the couple. Employees and fellow residents attended Ms. and Mr. Guy’s beautiful renewal ceremony that was later featured in the local newspaper and in McKnight’s Long-Term Care Newsletter!

With a lot of hard work in therapy, Mrs. Guy was recently able to discharge back home with her husband. Congratulations to Sandra and her Care Team on their success!

COVID-19 Treatments and Medications

May 2, 2022

For people who are more likely to get very sick from COVID-19 infection, medications are available that can reduce your chances of severe illness and death. Other medications can help reduce symptoms and help you manage your illness.

Here’s what you need to know.

Treating COVID-19

If you test positive and are more likely to get very sick from COVID-19, treatments are availableexternal iconexternal icon that can reduce your chances of being hospitalized or dying from the disease. Medications to treat COVID-19 must be prescribed by a healthcare provider and started as soon as possible after diagnosis to be effective. Contact a healthcare provider right away to determine if you are eligible for treatment, even if your symptoms are mild right now.

Don’t delay: Treatment must be started within days after you first develop symptoms to be effective.

People who are more likely to get very sick include older adults (ages 50 years or more, with risk increasing with older age), people who are unvaccinated, and people with certain medical conditions, such as a weakened immune system. Being vaccinated makes you much less likely to get very sick. Still, some vaccinated people, especially those ages 65 years or older or who have other risk factors for severe disease, may benefit from treatment if they get COVID-19. A healthcare provider will help decide which treatment, if any, is right for you.

The FDA has issued emergency use authorizations (EUA) for certain antiviral medications and monoclonal antibodies to treat mild to moderate COVID-19 in people who are more likely to get very sick.

  • Antiviral treatmentsexternal icon target specific parts of the virus to stop it from multiplying in the body, helping to prevent severe illness and death.
  • Monoclonal antibodiesexternal icon help the immune system recognize and respond more effectively to the virus. They may be more or less effective against different variants of the virus that causes COVID-19.

The National Institutes of Health (NIH) provides COVID-19 Treatment Guidelinesexternal icon for healthcare providers to help them work with their patients and determine the best treatment options for them. Several options are available for treating COVID-19 at home or in an outpatient setting. They include:

  • Nirmatrelvir with ritonavir (Paxlovid)external icon is an investigational antiviral treatment used in adults and children ages 12 years and older. It is taken at home by mouth (orally). It should be started as soon as possible and must begin within 5 days of when your symptoms start.
  • Remdesivir (Veklury)external icon is an antiviral treatment used in adults and children. Treatment requires intravenous (IV) infusions at a healthcare facility for 3 consecutive days. It should be started as soon as possible and must begin within 7 days of when your symptoms start.
  • Bebtelovimabexternal icon is an investigational monoclonal antibody treatment used in adults and children ages 12 years and older. A healthcare provider gives bebtelovimab as a single IV injection. It should be started as soon as possible and must begin within 7 days of when your symptoms start.
  • Molnupiravir (Lagevrio)external icon is an investigational antiviral treatment used in adults ages 18 years and older. It is taken at home by mouth (orally). It should be started as soon as possible and must begin within 5 days of when your symptoms start.

Some treatments might have side effects or interact with other medications you are taking. To find out if medications to treat COVID-19 are right for you, you have options:

If you are hospitalized, your healthcare provider might use other types of treatments, depending on how sick you are. These could include medications to treat the virus, reduce an overactive immune response, or treat COVID-19 complications.

Managing COVID-19 Symptoms

Most people with COVID-19 have mild illness and can recover at home. If you are worried about your symptoms, the Coronavirus Self-Checker can assist in the decision to seek care. You can treat symptoms with over-the-counter medicines, such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil), to help you feel better. Learn more about what to do if you are sick.

Preventing COVID-19

COVID-19 vaccines available in the United States effectively protect people from getting seriously ill, being hospitalized, and even dying—especially people who are boosted. As with vaccines for other diseases, you are protected best when you stay up to date. CDC recommends that everyone who is eligible stay up to date on their COVID-19 vaccines, including people with weakened immune systems.

Preventive Medications

The FDA has issued an EUA for tixagevimab plus cilgavimab (Evusheld)external icon, an investigational medicine used in adults and children ages 12 years and older. Evusheld consists of 2 monoclonal antibodies provided together to help prevent infection with the virus that causes COVID-19. A healthcare provider gives Evusheld as 2 separate consecutive intramuscular (IM) injections at a doctor’s office or healthcare facility. If you are moderately or severely immunocompromised or severely allergic to COVID-19 vaccines, you may be eligible for Evusheld. Talk to a healthcare provider to determine if this option is right for you.

The right medications for COVID-19 can help. People have been seriously harmed and even died after taking products not approved for use to treat or prevent COVID-19, even products approved or prescribed for other uses. Talk to a healthcare provider about taking medications to treat COVID-19.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html

How CDC Determines the Level for COVID-19 Travel Health Notices

April 25, 2022


CDC uses Travel Health Notices (THNs) to alert travelers and other audiences to health threats around the world and advise on how to protect themselves.

On April 18, 2022, CDC updated its COVID-19 THN system. Level 4 will no longer be based on COVID-19 incidence or case count alone. It will be reserved for special circumstances, such as rapidly escalating case trajectory or extremely high case counts, emergence of a new variant of concern, and healthcare infrastructure collapse. Levels 3, 2, and 1 will still be primarily determined by 28-day incidence or case counts as outlined below.

COVID-19 Travel Recommendations can be found in two places:

The 4-level system categorizes international destinations into the following levels:

Level 4: Special Circumstances / Do Not Travel

  • Do not travel to this destination.
  • If you must travel, make sure you are up to date with your COVID-19 vaccines before your trip.

Level 3: High Level Of COVID-19

  • Make sure you are up to date with your COVID-19 vaccines before traveling to this destination.
  • If you are not up to date with your vaccines, avoid travel to this destination.
  • If you have a weakened immune system or are more likely to get very sick from COVID-19, even if you are up to date with your COVID-19 vaccines, talk with your clinician about your risk and consider delaying travel to this destination.

Level 2: Moderate Level Of COVID-19

  • Make sure you are up to date with your COVID-19 vaccines before traveling to this destination.
  • If you have a weakened immune system or are more likely to get very sick from COVID-19, even if you are up to date with your COVID-19 vaccines, talk to your clinician about what additional precautions may be needed before, during, and after travel to this destination.

Level 1: Low Level of COVID-19

  • Make sure you are up to date with your COVID-19 vaccines before traveling to this destination.

Level Unknown: Unknown Level of COVID-19

  • Make sure you are up to date with your COVID-19 vaccines before traveling to this destination.
  • If you are not up to date with your vaccines, avoid travel to this destination.
  • If you have a weakened immune system or are more likely to get very sick from COVID-19, even if you are up to date with your COVID-19 vaccines, talk with your clinician about your risk, and consider delaying travel to this destination.

Travel Health Notice Thresholds

CDC reviews case data reported to the World Health Organizationexternal icon to determine a destination’s COVID-19 THN level.

Level 4 Travel Health Notices

Level 4 will be reserved for special circumstances, such as rapidly escalating case trajectory or extremely high case counts, emergence of a new variant of concern, and healthcare infrastructure collapse. Other factors that may be considered include information such as vaccination rate and hospitalization rate. CDC works with country authorities through CDC country or regional offices to gather additional data as appropriate.

Level 1-3 Travel Health Notices are determined as follows:

Primary criteria for destinations with populations over 100,000

  1. Incidence rate (cumulative new cases over the past 28 days per 100,000 population)
  2. New case trajectory (Have daily new cases increased, decreased, or remained stable over the past 28 days?)

Primary criteria for destinations with populations of 100,000 or less

  1. COVID-19 case counts* (cumulative new cases over past 28 days)
  2. New case trajectory (Have daily new cases increased, decreased, or remained stable over the past 28 days?)

*CDC does not count identified imported cases (i.e., cases in travelers who were exposed in another country) against a destination’s total.

Secondary Criteria for Determining Travel Health Notice Levels

Reported case counts and incidence rates depend on testing capacity. CDC assesses testing capacity using two secondary criteria metrics: population testing rate and test-to-case ratio. The population testing rate is the number of tests conducted per 100,000 people over 28 days. The test-to-case ratio is the number of tests conducted for each case reported during the same 28-day period. Testing data are obtained from multiple sources, including Our World in Dataexternal iconFoundation for Innovative Diagnosticsexternal icon, and country ministries of health.

Travel Health Notice levels 1 through 3 for destinations with a population more than 100,000 people. Levels are based on combined 1) incidence rate (primary criteria) and 2) testing data (secondary criteria)

This image has an empty alt attribute; its file name is Infographic-COVID1.png

*Incidence rate is the primary criteria for destinations with a population more than 100,000 people. Testing data are the secondary criteria and that data includes both the testing rate (column 1) and test-to-case ratio (column 2). The resulting THN levels are shown in rows 3–11 of columns 3–5.

Travel Health Notice levels 1 through 3 for destinations with a population of 100,000 people or fewer. Levels are based on combined 1) case count (primary criteria) and 2) testing data (secondary criteria) *

This image has an empty alt attribute; its file name is Infographic-COVID2.png

*Case count is the primary criteria for destinations with a population fewer than or equal to 100,000 people. Testing data are the secondary criteria and that data includes both the testing rate (column 1) and test-to-case ratio (column 2). The resulting THN levels are shown in rows 3–11 of columns 3–5.

Population testing rates of more than 1,500 tests per 100,000 people over 28 days are considered sufficient to provide an accurate representation of COVID-19 in the destination. Rates less than or equal to 1,500 tests per 100,000 people over 28 days may signify concerns that testing is insufficient and may not provide an accurate representation of the incidence rate in the destination. The cutoffs for evaluating population testing ratesexternal icon have been adapted from the WHO guidelines.

The WHO determined a test-to-case ratio greater than or equal to 10 as the minimum indicator of sufficient surveillance capacity. A test-to-case ratio of less than 10 tests per case might indicate restrictive testing, or that only symptomatic people are being tested and undercounting the incidence rate (primary criteria). The preferred level is a test-to-case ratio of more than 30. The cutoffs for evaluating test-to-case ratios pdf icon[PDF – 18 pages]external icon have been adapted from the WHO guidelines.

When both the population testing rates and test-to-case ratios are high, CDC has confidence in a destination’s reported incidence. If either the population testing rate or test-to-case ratio is low, CDC has less confidence that the reported incidence accurately depicts the COVID-19 situation in the destination. In this situation, CDC adjusts a destination’s THN level as shown in the tables above. Countries with low incidence and testing rates are classified as unknown as well as countries that report data infrequently.

Level Unknown Travel Health Notices are determined as follows:

If a destination has insufficient data to make a THN level determination, its THN level is designated as “unknown”. Insufficient data means that the destination does not provide data or that the provided data are non-representative of the COVID-19 situation in the destination, making an accurate THN level determination difficult. This situation includes destinations with low COVID-19 incidence and low reported COVID-19 testing levels.

Raising a Travel Health Notice

CDC raises a destination’s THN level when the incidence rate (or case count) and testing metrics meet the THN threshold for a higher level and remain at that level for 14 consecutive days. The THN level may be raised before 14 days if there is a large increase in COVID-19 cases reported.

Lowering a Travel Health Notice

CDC lowers a destination’s THN level when the incidence rate (or case count) and testing metrics meet the THN threshold for a lower level and remain at that level for 28 consecutive days. Vaccination coverage rates and case trajectory will be considered when determining if the THN level can be lowered before 28 days.

For more information, visit How CDC Determines the Level for COVID-19 Travel Health Notices | CDC

Testing Strategies for COVID-19

April 18, 2022

Diagnostic Testing

Diagnostic testing is intended to identify current infection in individuals and should be performed on anyone that has signs and symptoms consistent with COVID-19 and/or following recent known or suspected exposure to SARS-CoV-2.

Examples of diagnostic testing include:

  • Testing anyone with symptoms consistent with COVID-19
  • Testing vaccinated and unvaccinated people who were exposed to someone with a confirmed or suspected case of COVID-19

Screening Testing

Screening tests are intended to identify people with COVID-19 who are asymptomatic and do not have known, suspected, or reported exposure to SARS-CoV-2. Screening helps to identify unknown cases so that measures can be taken to prevent further transmission.

Examples of screening include testing:

  • Employees in a workplace setting
  • Students, faculty, and staff in a school setting
  • A person before or after travel
  • Someone at home who does not have symptoms associated with COVID-19 and no known exposures to someone with COVID-19

Public Health Surveillance Testing

Public health surveillance is the ongoing, systematic collection, analysis, and interpretation of health-related data essential to the planning, implementation, and evaluation of public health practice. See CDC’s Introduction to Public Health Surveillance.

Public health surveillance testing is intended to monitor community- or population-level outbreaks of disease, or to characterize the incidence and prevalence of disease. Surveillance testing is performed on de-identified specimens, and thus, results are not linked to individual people. Public health surveillance testing results cannot be used for individual decision-making.

Public health surveillance testing may sample a certain percentage of a specific population to monitor for increasing or decreasing prevalence, or to determine the population effect from community interventions such as social distancing. An example of public health surveillance testing is when a state public health department develops a plan to randomly select and sample a percentage of all people in a city on a rolling basis to assess local infection rates and trends.

Regulatory Requirements for Diagnostic, Screening, and Public Health Surveillance Testing

Any laboratory or testing site that performs diagnostic or screening testing must have a Clinical Laboratory Improvement Amendments (CLIA) certificate and meet all applicable CLIA requirements. For more information, see the Centers for Medicare & Medicaid Services CLIA websiteexternal icon. Tests used for SARS-CoV-2 diagnostic or screening testing must have received an Emergency Use Authorization from the U.S. Food and Drug Administration (FDA) or be offered under the policies in FDA’s Policy for COVID-19 Testsexternal icon.

Tests used for SARS-CoV-2 public health surveillance on de-identified human specimens do not need to meet FDA and CLIA requirements for diagnostic and screening testing.

Reporting Diagnostic, Screening, and Public Health Surveillance Testing Results

Both diagnostic and screening testing results should be reported to the people whose specimens were tested and/or to their healthcare providers.

In addition, laboratories that perform diagnostic and screening testing must report positive diagnostic and screening test results to the local, state, tribal, or territory health department in accordance with Public Law 116-136, § 18115(a), the Coronavirus Aid, Relief, and Economic Security (CARES) Act. As of April 4, 2022, laboratories are no longer required to report negative results for non-NAAT tests (rapid or antigen test results). The Department of Health and Human Services published guidance on COVID-19 Pandemic Response, Laboratory Data Reporting: CARES Act Section 18115pdf iconexternal icon that specifies what data, in addition to test results, laboratories and testing sites should collect and electronically report.

Public health surveillance testing results cannot be reported directly to the people whose specimens have been tested and are not reported to their healthcare providers. Public health surveillance testing results (test results that are de-identified) can be reported in aggregate to local, state, tribal, or territory health departments upon request. Results from testing that is performed outside of a CLIA-certified facility or without an FDA-authorized test can only be reported to a health department if those results are used strictly for public health surveillance purposes, and not used for individual decision making.

Summary of Testing for COVID-19

 DiagnosticScreeningPublic Health Surveillance
SymptomaticYesNoN/A
Unvaccinated or vaccinated with known or suspected exposureYesNoN/A
Unvaccinated and Asymptomatic without Known or Reported Suspected ExposureNoYesN/A
Characterize Incidence and Prevalence in the CommunityN/AN/AYes
Testing of Personally Identifiable SpecimensYesYesNo
Results may be Returned to IndividualsYesYesNo
Results Returned in Aggregate to Requesting InstitutionNoNoYes
Results Reported to State Public Health DepartmentsYesYesIf requested
Testing can be Performed in CLIA-Certified LaboratoryYesYesYes
Testing can be Performed in a Non-CLIA-Certified LaboratoryNoNoYes
Test System Must be FDA Authorized or be Offered under the Policies in FDA’s GuidanceYesYesNo

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/sars-cov2-testing-strategies.html

COVID-19 Orders, Laws, and Regulations

April 11, 2022

To help prevent the spread of COVID-19 and help our country cope during the pandemic, CDC has occasionally issued legally binding orders and regulations.

People must wear face masks in indoor areas of public transportation traveling into, within, or out of the United States and indoors at U.S. transportation hubs, including airports.

Air passengers, 2 years or older, traveling to the United States from another country must present a negative COVID-19 test result or documentation of recovery from COVID-19 before boarding their flights. Regardless of vaccination status, passengers ages 2 or older are required to present a negative COVID-19 viral test result from a sample taken no more than 1 day before travel. Alternatively, passengers may present documentation showing that they tested positive for COVID-19 on a sample taken within the past 90 days and have been cleared to travel (documentation of recovery).

CDC issued an Order to implement the President’s direction on safe resumption of global travel during the COVID-19 pandemic and provided guidance to airlines, other aircraft operators, and passengers in Technical Instructions and Frequently Asked Questions.

All non-U.S.-citizen, non-immigrants, with limited exceptions, traveling to the United States by air must be fully vaccinated and show proof of vaccination.

CDC issued an Order on October 25, 2021 requiring airlines and other aircraft operators to collect contact information for passengers before they board a flight to the United States from a foreign country. The purpose of collecting this information is to identify and locate passengers who may have been exposed to a person with a communicable disease for public health follow-up. Airlines will retain the information for 30 days and transmit the information to CDC upon request for contact tracing and public health follow-up to keep people safe.

Following a public health determination, the CDC Director is terminating the Order under 42 U.S.C. §§ 265, 268 and 42 C.F.R. § 71.40 suspending the right to introduce certain persons into the United States. The implementation of the termination of the Order will be on May 23, 2022.

CDC considered multiple factors in its public health assessment and finds that, at this time, the available COVID-19 mitigation tools, as well as the fact that 97% of the U.S. population lives in a county identified as having “low” COVID-19 Community Level, will sufficiently mitigate the COVID-19 risk for U.S. communities and make an order under 42 U.S.C. §§ 265, 268 and 42 C.F.R. § 71.40 no longer necessary. This Termination will be implemented on May 23, 2022, to enable the Department of Homeland Security (DHS) to implement appropriate COVID-19 mitigation protocols, such as scaling up a program to provide COVID-19 vaccinations to migrants, and prepare for full resumption of regular migration processing under Title 8 authorities.

The initial CDC Order Suspending Introduction of Certain Persons from Countries where a Communicable Disease Exists was issued on 3/20/2020 pdf icon[2.1 MB, 43 pages], extended on 4/22/2020external icon and extended and amended on 5/19/2020 pdf icon[136 KB, 12 pages]. The Order was replaced with the Order Suspending the Right to Introduce Certain Persons from Countries Where a Quarantinable Communicable Disease Exists on 10/16/2020external icon and replaced again on 8/2/2021 pdf icon[296 KB, 24 pages]. This Order and accompanying public health determination terminate all previous orders.

During the COVID-19 pandemic, CDC issued an order suspending the right to introduce certain noncitizens attempting to enter the U.S. from Canada or Mexico (regardless of country of origin) at or between ports of entry. CDC has terminated the Order with respect to unaccompanied noncitizen children.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/cdcresponse/laws-regulations.html.

Success Story: Exie Gilland

April 8, 2022

Greenville Nursing & Rehabilitation is thrilled to shine the spotlight on resident Exie Gilland’s Success Story!

Ms. Exie Gilland was admitted to Greenville Nursing and Rehabilitation after a recent hospitalization left her too weak to return home alone. Upon admission, she was unable to complete her daily care tasks independently and needed help transferring and walking more than a few feet. Being a retired nurse, Ms. Gilland know that hard work with physical and occupational therapy would help her regain the strength she needed to return to living at home. Within just a couple of weeks, Ms. Gilland was back to being independent enough to discharge home with help from her daughter and grandson nearby. Congratulations to Exie and her Care Team on their success!

CDC Expands Eligibility for COVID-19 Booster Shots

April 6, 2022

On October 21, 2021, CDC Director Rochelle P. Walensky, M.D., M.P.H., endorsed the CDC Advisory Committee on Immunization Practices’ (ACIP) recommendation for a booster shot of COVID-19 vaccine in certain populations. The FDA’s authorization and CDC’s recommendation for use are important steps forward as we work to stay ahead of the virus and keep Americans safe.

For individuals who received a Pfizer-BioNTech or Moderna COVID-19 vaccine, the following groups are eligible for a booster shot at 6 months or more after their initial series:

  • 65 years and older
  • Age 18+ who live in long-term care settings
  • Age 18+ who have underlying medical conditions
  • Age 18+ who work or live in high-risk settings

For the nearly 15 million people who got the Johnson & Johnson COVID-19 vaccine, booster shots are also recommended for those who are 18 and older and who were vaccinated two or more months ago.

There are now booster recommendations for all three available COVID-19 vaccines in the United States. Eligible individuals may choose which vaccine they receive as a booster dose. Some people may have a preference for the vaccine type that they originally received, and others may prefer to get a different booster. CDC’s recommendations now allow for this type of mix and match dosing for booster shots.

Millions of people are newly eligible to receive a booster shot and will benefit from additional protection. However, today’s action should not distract from the critical work of ensuring that unvaccinated people take the first step and get an initial COVID-19 vaccine. More than 65 million American remain unvaccinated, leaving themselves- and their children, families, loved ones, and communities- vulnerable.

Available data right now show that all three of the COVID-19 vaccines approved or authorized in the United States continue to be highly effective in reducing risk of severe disease, hospitalization, and death, even against the widely circulating Delta variant. Vaccination remains the best way to protect yourself and reduce the spread of the virus and help prevent new variants from emerging.

The following is attributable to Dr. Walensky:

“These recommendations are another example of our fundamental commitment to protect as many people as possible from COVID-19. The evidence shows that all three COVID-19 vaccines authorized in the United States are safe- as demonstrated by the over 400 million vaccine doses already given. An, they are all highly effective in reducing the risk of severe disease, hospitalization, and death, even in the midst of the widely circulating Delta variant.”

To learn more, visit https://www.cdc.gov/media/releases/2021/p1021-covid-booster.html

Post-COVID Conditions

March 29, 2022



Although most people with COVID-19 get better within weeks of illness, some people experience post-COVID conditions. Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19. Even people who did not have COVID-19 symptoms in the days or weeks after they were infected can have post-COVID conditions. These conditions can present as different types and combinations of health problems for different lengths of time.

These post-COVID conditions may also be known as long COVID, long-haul COVID, post-acute COVID-19, long-term effects of COVID, or chronic COVID. CDC and experts around the world are working to learn more about short- and long-term health effects associated with COVID-19, who gets them, and why.

Types of Post-COVID Conditions

New or Ongoing Symptoms

Some people experience a range of new or ongoing symptoms that can last weeks or months after first being infected with the virus that causes COVID-19. Unlike some of the other types of post-COVID conditions that tend only to occur in people who have had severe illness, these symptoms can happen to anyone who has had COVID-19, even if the illness was mild, or if they had no initial symptoms. People commonly report experiencing different combinations of the following symptoms:

  • Difficulty breathing or shortness of breath
  • Tiredness or fatigue
  • Symptoms that get worse after physical or mental activities (also known as post-exertional malaise)
  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”
  • Cough
  • Chest or stomach pain
  • Headache
  • Fast-beating or pound heart (also known as heart palpitations)
  • Joint or muscle pain
  • Pins-and-needles feeling
  • Diarrhea
  • Sleep problems
  • Fever
  • Dizziness on standing (lightheadedness)
  • Rash
  • Mood changes
  • Change in smell or taste
  • Changes in menstrual period cycles

Multiorgan Effects of COVID-19

Some people who had severe illness with COVID-19 experience multiorgan effects or autoimmune conditions over a longer time with symptoms lasting weeks or months after COVID-19 illness. Multiorgan effects can affect many, if not all, body systems, including heart, lung, kidney, skin, and brain functions. Autoimmune conditions happen when you immune system attacks healthy cells in your body by mistake, causing inflammation (swelling) or tissue damage in the affected parts of the body.

While it is very rare, some people, mostly children, experience multisystem inflammatory syndrome (MIS) during or immediately after a COVID-19 infection. MIS is a condition where different body parts can become inflamed. MIS can lead to post-COVID conditions if a person continues to experience multiorgan effects or other symptoms.

Effects of COVID-19 Illness or Hospitalization

Hospitalizations and severe illness for lung-related diseases, including COVID-19, can cause health effects like severe weakness and exhaustion during the recovery period.

Effects of hospitalization can also include post-intensive care syndrome (PICS), which refers to health effects that begin when a person is in intensive care unit (ICU) and can remain after a person returns home. These effects can include severe weakness, problems with thinking and judgement, and post-traumatic stress disorder (PTSD). PTSD involves long-term reactions to a very stressful event.

Some symptoms that can occur after hospitalization are similar to some of the symptoms that people with initially mild or no symptoms may experience many weeks after COVID-19. It can be difficult to know whether they are caused by the effects of hospitalization, the long-term effects of the virus, or a combination of both. These conditions might also be complicated by other effects related to the COVID-19 pandemic, including mental health effects from isolation, negative economic situations, and lack of access to healthcare for managing underlying conditions. These factors have affected both people who have experienced COVID-19 and those who have not.

Prevention

The best way to prevent post-COVID conditions is to prevent COVID-19 illness. For people who are eligible, getting vaccinated against COVID-19 as soon as you can is the best way to prevent getting COVID-19 and can also help protect those around you.

Stopping a pandemic takes all the tools in our toolbox:

  • Get vaccinated and stay up to date on your COVID-19 vaccines.
  • Know when to wear a well-fitted mask to help protect yourself and others.
  • Avoid crowds and poorly ventilated indoor spaces.
  • Test to prevent spread to others.
  • Stay 6 feet apart from others who don’t live with you.
  • Wash you hands often with soap and water. Use hand sanitizer if soap and water aren’t available.

If you are NOT yet fully vaccinated, prevent long-term complications by protecting yourself and others from COVID-19.

Although media articles have reported that some people with post-COVID conditions say their symptoms improved after being vaccinated, studies are needed to determine the effects of vaccination on post-COVID symptoms.

What CDC is Doing

CDC continues to work to identify how common post-COVID conditions are, who is most likely to get them, and why some symptoms eventually improve for some people and may last longer for other people. Rapid and multi-year studies are underway to further investigate post-COVID conditions in more detail. These studies will help us better understand post-COVID conditions and how to treat patients with these longer-term effects.

For more information, please visit https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html.

FAQs about Medical Consent and Booster Doses for Long-term Care Residents

March 18, 2022

A resource for Providers Participating in the CDC COVID-19 Vaccination Program, Long-term Care Residents & Their Families

In response to inquiries about medical consent surrounding the administration of a booster shot of Pfizer-BioNTech COVID-19 vaccine to residents in long-term care (LTC) settings at least five months after their Pfizer-BioNTech primary series, the Centers for Disease Control and Prevention (CDC) has developed the following responses to frequently asked questions (FAQs).

These FAQs are intended to clarify that medical consent is not required by federal law for COVID-19 vaccination in the United States.

Providers enrolled in the CDC COVID-19 Vaccination Program, including those administering vaccines to residents in LTC settings, are required by the CDC Provider Agreement to follow applicable state and territorial laws on medical consent. Providers should consult their legal counsel on such requirements.

Frequently Asked Questions

Is medical consent required for LTC residents to receive a booster shot of the Pfizer-BioNTech COVID-19 vaccine?

Medical consent is not required by federal law for COVID-19 vaccination in the United States.

COVID-19 vaccine providers should consult with their own legal counsel for state or territorial requirements related to consent; compliance with all applicable state and territorial laws is required under the CDC Provider Agreement.

The COVID-19 Provider Agreement contains the following requirements:

  • Before administering a COVID-19 vaccine with Emergency Use Authorization (EUA), the provider must provide the approved EUA fact sheet (or Vaccine Information Sheet, as applicable) to each vaccine recipient, the adult caregiver accompanying the recipient (as applicable), or other legal representative (as applicable). The fact sheet/information sheet explains risks and benefits of the particular COVID-19 vaccine and what to expect but is not a consent document.

Is consent required for the booster shot if consent was previously given for the Pfizer-BioNTech primary series?

Explaining the risks and benefits of any treatment to a patient – in a way that they understand – is the standard of care.

Providers should consult with their legal counsel to determine whether previous medical consent obtained from a resident or their representative is legally sufficient under the applicable laws of the state or territory for purposes of administration of a booster dose of Pfizer-BioNTech COVID-19 vaccine.

Is consent for a booster shot of the Pfizer-BioNTech COVID-19 vaccine required if the vaccine is being administered by a different provider?

Providers should consult with their legal counsel to determine whether consent for the Pfizer-BioNTech primary series previously obtained from an LTC resident or their guardian by a different provider is sufficient, or if consent should be obtained prior to administration of the booster shot of Pfizer-BioNTech vaccine, in accordance with any applicable laws of the state or territory.

Does CDC have a consent form that should be used to receive a COVID-19 vaccine?

No. Since applicable medical consent laws are a matter of state, tribal, or territorial law, providers are advised to consult with their legal counsel to assure compliance with the scope of those consent laws.

A written form is not needed if state law allows for oral consent and the organization/provider does not otherwise require it.

Your COVID-19 Vaccination

March 15, 2022
  • COVID-19 vaccines are safe and effective.
  • Everyone 5 years and older is now eligible to get a free COVID-19 vaccination.
  • Learn about different vaccines available.
  • Search vaccines.gov, text your zip code to 438829, or call 1-800-232-0233 to find COVID-19 vaccine locations near you.

Find a COVID-19 Vaccine

How do I get a COVID-19 Vaccine?

When You Get the Vaccine

What are the possible side effects?

Do I need a booster shot?

Register for v-safe

Vaccine Information for Specific Groups of People

What if I’m at risk for severe illness?

Can my child get vaccinated?

What if I’m pregnant or breastfeeding?

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/your-vaccination.html.

Success Story: Betty Adams

March 9, 2022

Greenville Nursing and Rehabilitation is proud to recognize resident Betty Adams’s Success Story!

Betty Adams was admitted to Greenville Nursing and Rehabilitation Center after a right hip fracture. During her stay, Occupational and Physical Therapy started to identify Betty’s unique needs and specialized treatment plans efficiently and effectively to successfully transition back home where she lives independently. When Ms. Adams admitted, she needed maximum assistances with her daily activities of living along with requiring assistances for transfer and assistances when walking with a walker. She showed great progress and motivation to return home. When Ms. Adams discharged to home, she was able to complete her daily activities of bathing/dressing and toileting with modified independence and supervision for transferring and walking using a walker. Congratulations to Betty and her Care Team on their success!

Families and COVID-19

March 4, 2022

As more people are getting vaccinated and resuming activities they did before the pandemic, parents and caregivers are making hard decisions on how to protect their families. Not everyone is able to get vaccinated, so you may be confused about how to keep your family safe, especially if your family has vaccinated and unvaccinated members. Below are some things to consider when planning outings with your family.

What is Your Family’s Vaccination Status?

  • Everyone 5 years and older should get a COVID-19 vaccination to help protect against COVID-19.
  • People who are not up to date on their COVID-19 vaccines and children under 5 years old who are not able to get a COVID-19 vaccine should continue taking steps to prevent getting sick.
  • Everyone ages 2 years and older should properly wear a well-fitting mask indoors in public in areas where the COVID-19 Community Level is high, regardless of vaccination status.
  • In general, people do not need to wear masks when outdoors.
  • If you are sick and need to be around others, or are caring for someone who has COVID-19, wear a mask.
  • If the COVID-19 Community Level where you live is
    • Low
      • Wear a mask based on your personal preference, informed by your personal level of risk.
    • Medium
      • If you are at risk for severe illness, talk to your healthcare provider about wearing masks indoors in public.
      • If you live with or will gather with someone at risk for severe illness, wear a mask when indoors with them.
    • High
      • If you are 2 or older, wear a well-fitting mask indoors in public, regardless of vaccination status or individual risk (including in K-12 schools and other community settings).
  • If you are at risk for severe illness, wear a mask or respirator that provides you with greater protection.

Do You Have Family Member with Medical Conditions or a Weakened Immune System?

  • People with certain underlying medical conditions are at increased risk for severe illness from COVID-19.
  • People who have a condition or are taking medications that weaken their immune system may not be fully protected even if they are up to date with their COVID-19 vaccines. They should talk to their healthcare provider about what precautions may be needed.
  • If you are at increased risk for severe illness, or live with or spend time with someone at higher risk, speak to your healthcare provider about wearing a mask at medium COVID-19 Community Levels.

Where is Your Family Going?

  • Outdoor activities and settings are safer than indoor ones.
  • Avoid places that are poorly ventilated.
  • If someone in your family is younger than 2 years old or cannot wear a mask, limit visits with people who are not vaccinated or whose vaccination status is unknown and keep distance between your child and other people in public.

Regardless of which safer activities your family chooses, remember to protects yourself and others.

What are the Number of COVID-19 Cases and Vaccinated People in Your Community or the Community You are Visiting?

  • Use CDC Data Tracker to learn about the situation in your community.
  • If your community has a high number of COVID-19 cases or a low number of vaccinated people, consider choosing safer activities.

How to Talk to People Who Care for or Spend Time with Your Family Member

Learn how to talk to professional caregivers, extended family members, family friends, teachers, or other people your loved one spends time with about how to keep your loved one safe from COVID-19.

  • Check that your child’s school, childcare program, your family member’s adult care program, or other caregivers are taking the necessary steps to protect your loved ones in their care.
  • Tell them to encourage your family member to weak a mask indoors in public during times when the COVID-19 Community Level is high.
    • Caregivers can help model mask-wearing for children who are too young to get vaccinated.
  • Let caregivers know, as appropriate, if your loved one or someone they live with has an underlying medical condition or a weakened immune system.
  • Pack an extra mask in your child’s backpack. If your child is old enough, ask if your child can bring hand sanitizer from home to use when they cannot wash their hands with soap and water.

Helping Your Family Member Cope

As families participate in more activities, children or other family members may worry about themselves, their family, and friends getting sick with COVID-19. They may feel anxious about going to school, childcare, or normal activities like grocery shopping or gatherings. Parents, family members, and other trusted adults can help your loved one make sense of what they hear.

  • Make yourself available to listen and talk. Let your family member know they can come to you when they have questions.
  • Reassure your child or family member that they are safe.
  • Let them know it is okay if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.
  • Answer questions honestly and share facts about COVID-19 in a way that your family members can understand.
  • Teach children and other family members everyday actions to reduce the spread of germs.
    • Parents and caregivers can help by modeling these behaviors themselves.
  • Discuss with your family member any actions or routines that may be taken at school, childcare, adult care, or other activities to help protect them and others.
  • Take steps to protect you and your family’s mental health.
    • Try to keep up with regular routines.
    • Find safe ways to keep your family connected with friends and other family members.
    • Teach your family healthy coping skills by modeling them yourself. Take breaks, get plenty of sleep, exercise, and eat well.

Success Story: Aline Cartwright

March 3, 2022

Greenville Nursing & Rehab is excited to share resident Aline Cartwright’s Success Story!

Aline Cartwright was admitted to Greenville Nursing and Rehabilitation Center on November 24, 2021 under the care of Dr. Mahesh Moolani. During the course of her stay, Speech Therapy was initiated to efficiently and effectively identify Aline’s unique needs and tailor specialized treatment plans to successfully transition to the next level of care.

Our therapy team provided skilled interventions to address the adaptation, compensation, and restoration potential of Ms. Cartwright and coordinated with the interdisciplinary team to ensure appropriate clinical care areas were addressed. On January 26, 2022, Aline was successfully discharged to long-term care. Congratulations to Aline and her Care Team on their success!

COVID-19 & People with Certain Medical Conditions

March 2, 2022

If you test positive for COVID-19 and have one or more health conditions that increase your risk of becoming very sick, treatment may be available. Contact a health professional right away after a positive test to determine if you may be eligible, even if your symptoms are mild right now. Don’t delay: Treatment must be started within the first few days to be effective.

What You Need to Know

  • A person with any of the medical conditions listed below is more likely to get very sick with COVID-19.
  • Staying up to date with COVID-19 vaccines (getting primary series and booster) and following preventive measures for COVID-19 are important. This is especially important if you are older or have severe health conditions or more than one health condition, including those on the list below.
  • Approved and authorized COVID-19 vaccines (primary series and booster) are safe and effective.
  • Some immunocompromised people, or people with weakened immune systems, may be eligible for a COVID-19 additional primary shot.
  • The list below does not include all possible conditions that put you at higher risk of severe illness from COVID-19. If you have a condition not included on this list, talk to your healthcare professional about how best to manage your condition and protect yourself from COVID-19.

Overview

Based on current evidence, a person with any of the conditions listed below is more likely to get very sick with COVID-19. This means that a person with one or more of these conditions and who gets very sick with COVID-19 more likely to:

  • Be hospitalized
  • Need intensive care
  • Require a ventilator to help them breathe
  • Die

In addition:

Staying up to date with COVID-19 vaccines (getting primary series and booster) and following preventive measures for COVID-19 are important. This is especially important if you are older or have severe health conditions or more than one health condition, including those on this list. Learn more about how CDC develops COVID-19 vaccination recommendations. If you have a medical condition, learn more about Actions You Can Take.

Medical Conditions

  • The conditions on this list are in alphabetical order. They are not in order of risk.
  • CDC completed a review for each medical condition on this list. This was done to ensure that these conditions met criteria for inclusion on this list. CDC conducts ongoing reviews of additional underlying conditions. If other medical conditions have enough evidence, they might be added to this list.
  • Because we are learning more about COVID-19 every day, this list does not include all medical conditions that place a person at higher risk of severe illness from COVID-19. Rare medical conditions, including many conditions that mostly affect children, may not be included on the list below. We will update the list as we learn more.
  • A person with a condition that is not listed may still be at greater risk of getting very sick from COVID-19 than other people who do not have the condition. It is important that you talk with your healthcare professional about your risk.

Cancer

Having cancer can make you more likely to get very sick from COVID-19. Treatments for many types of cancer can weaken your body’s ability to fight off disease. At this time, based on available studies, having a history of cancer may increase your risk.

Get more information:

Chronic Kidney Disease

Having chronic kidney disease of any stage can make you more likely to get very sick from COVID-19.

Get more information:

Chronic Liver Disease

Having chronic liver disease can make you more likely to get very sick from COVID-19. Chronic liver disease can include alcohol-related liver disease, non-alcoholic fatty liver disease, autoimmune hepatitis, and cirrhosis (or scarring of the liver).

Get more information:

Chronic Lung Diseases

Having a chronic lung disease can make you more likely to get very sick from COVID-19. Chronic lung diseases can include:

  • Asthma, if it’s moderate to severe
  • Bronchiectasis (thickening of the lungs’ airways)
  • Bronchopulmonary dysplasia (chronic lung disease affecting newborns)
  • Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis
  • Having damaged or scarred lung tissue known as interstitial lung disease (including idiopathic pulmonary fibrosis)
  • Pulmonary embolism (blood clot in the lungs)
  • Pulmonary hypertension (high blood pressure in the lungs)

Get more information:

Cystic Fibrosis

Having cystic fibrosis, with or without lung or other solid organ transplant (like kidney, liver, intestines, heart, and pancreas) can make you more likely to get very sick from COVID-19.

Get more information:

Dementia or Other Neurological Conditions

Having neurological conditions, such as dementia, can make you more likely to get very sick from COVID-19.

Get more information:

Diabetes (Type 1 or 2)

Having either type 1 or type 2 diabetes can make you more likely to get very sick from COVID-19.

Get more information:

Disabilities

People with some types of disabilities may be more likely to get very sick from COVID-19 because of underlying medical conditions, living in congregate settings, or systemic health and social inequities, including:

Get more information:

Heart Conditions

Having heart conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure (hypertension) can make you more likely to get very sick from COVID-19.

Get more information:

HIV Infection

Having HIV (Human Immunodeficiency Virus) can make you more likely to get very sick from COVID-19.

Get more information:

Immunocompromised State (Weakened Immune System)

Some people are immunocompromised or have a weakened immune system. For example, people on chemotherapy or who have had solid organ transplant, like a kidney transplant or heart transplant. Being immunocompromised can make you more likely to get very sick from COVID-19. Many conditions and treatments can cause a person to be immunocompromised or have a weakened immune system. For example, some people inherit problems with their immune system. Once example is called Primary immunodeficiency. Other people have to use certain types of medicines for a long time, like corticosteroids, that weaken their immune system. Such long-term uses can lead to secondary or acquired immunodeficiency.

People who are immunocompromised or are taking medicines that weaken their immune system may not be protected even if they are up to date on their vaccines. They should continue to take all precautions recommended for people who are not vaccinated, including wearing a well-fitting mask, until advised otherwise by their healthcare professionals.

After completing the primary series, some moderately or severely immunocompromised people should get an additional primary shot.

Everyone 12 years and older, including immunocompromised people, should get a booster shot. If you are eligible for an additional primary shot, you should get this dose first before you get a booster shot.

Get more information:

Mental Health Conditions

Having mood disorders, including depression, and schizophrenia spectrum disorders can make you more likely to get very sick from COVID-19.

Get more information:

Overweight and Obesity

Overweight, obesity, or severe obesity, can make you more likely to get very sick from COVID-19. The risk of severe COVID-19 illness increases sharply with higher BMI.

Get more information:

Physical Inactivity

People who do little or no physical activity, or exercise, are more likely to get very sick from COVID-19 than those who are physically active. Being physically active (or exercising regularly) is important to being healthy. Get more information on physical activity and health, physical activity recommendations, how to become more active, and how to create activity-friendly communities:

Pregnancy

Pregnant and recently pregnant people (for at least 42 days following end of pregnancy) are most likely to get very sick from COVID-19 compared with non-pregnant people.

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Sickle Cell Disease or Thalassemia

Having hemoglobin blood disorders like sick cell disease (SCD) or thalassemia can make you more likely to get very sick from COVID-19.

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Smoking, Current or Former

Being a current or former cigarette smoker can make you more likely to get very sick from COVID-19. If you currently smoke, quit. If you used to smoke, don’t start again. If you’ve never smoked, don’t smart.

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Solid Organ or Blood Stem Cell Transplant

Having a solid organ or blood stem cell transplant, which includes marrow transplants, can make you more likely to get very sick from COVID-19.

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Stroke or Cerebrovascular Disease

Having cerebrovascular disease, which affects blood flow to the brain, can make you more likely to get very sick from COVID-19.

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Substance Use Disorders

Having a substance use disorder (such as alcohol, opioid, or cocaine use disorder) can make you more likely to get very sick from COVID-19.

Get more information:

Tuberculosis

Having tuberculosis can make you more likely to get very sick from COVID-19.

Get more information:

Actions You Can Take

It is important to protect yourself and others by taking preventive measures against COVID-19:

  • Stay up to date with your COVID-19 vaccines
  • Wear a well-fitting mask
  • Avoid crowds and poorly ventilated spaces
  • Test to prevent the spread to others
  • Wash your hands often
  • Cover coughs and sneezes
  • Monitor your health daily

Seek Care When Needed

  • Call your healthcare professionals if you have any concerns about your medical conditions or if you get sick and think that you may have COVID-19. Discuss steps you can take to manage your health and risks. If you need emergency help, call 911 right away.
  • Do not delay getting care for your medical condition because of COVID-19. Emergency departments, urgent care, clinics, and your healthcare professionals have infection prevention plans to help protect you from getting COVID-19 if you need care.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

Success Story: Jerry Rose

February 28, 2022

Greenville Nursing and Rehabilitation is proud to recognize Jerry Rose’s Success Story.

Jerry Rose admitted to Greenville Nursing and Rehabilitation Center on September 16, 2019, under the care of Dr. Mahesh Moolani.  During her course of the stay, Occupational Therapy was initiated on January 3, 2022, to efficiently and effectively identify Jerry Rose’s unique needs and tailor specialized treatment plans to successfully transition her to her prior level of function. The therapy team provided skilled interventions to address the adaptation, compensation, and restoration potential of Jerry Rose and coordinated with the interdisciplinary team to ensure appropriate clinical care areas were addressed.  Jerry Rose, after demonstrating great progress and participation, successfully discharged from skilled Occupational Therapy on January 27, 2022, to long term care. Congratulations to Jerry and her Care Team on their success!

COVID-19 Antigen Testing in Long-Term Care Facilities

February 18, 2022

Summary of Changes

This document is intended to assist long-term care facility (LTCF) providers and state and local public health departments with interpretation of and response to results of antigen tests used to diagnose new SARS-CoV-2 infections in the following circumstances:

  • Testing of symptomatic residents and healthcare personnel (HCP),
  • Testing of asymptomatic residents and HCP in facilities as part of a SARS-CoV-2 outbreak response or following close contact with someone with SARS-CoV-2 infection, and
  • Testing of asymptomatic HCP as part of expanded screening testing in facilities without a SARS-CoV-2 outbreak.

Information on the role of testing in determining the length of work restriction  for HCP with SARS-CoV-2 infection or exposure to SARS-CoV-2 is available here: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html.

Information on the role of testing in mitigating staff shortages is available here: https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html

Testing Symptomatic Residents or HCP

  • If an antigen test is positive, confirmatory testing is generally not necessary.  The symptomatic individual should be classified as having SARS-CoV-2 infection.
    • If the resident or healthcare worker is the first positive case of SARS-CoV-2 within the facility (i.e., an index case), an outbreak response might be indicated.
  • If an antigen test is negative, confirmatory testing1 with a nucleic acid amplification test (NAAT) should be performed as soon as possible (within 1 to 2 days of the antigen test).  Residents should be kept on Transmission-Based Precautions and HCP should remain excluded from work until NAAT results return.
    • If the confirmatory NAAT is negative:
      • If not in an outbreak facility and no known close contact with someone with SARS-CoV-2 infection, residents and HCP may be treated as not SARS-CoV-2 infected or exposed; further management will depend on the suspected etiology of their symptoms.
  • If the confirmatory NAAT is positive:
    • If the resident or healthcare worker is the first positive case of SARS-CoV-2 within the facility (i.e., an index case), an outbreak response might be indicated.

Some antigen platforms have higher sensitivity when testing people soon after symptom onset (e.g., within 5 days). Clinical discretion may be used when determining if people who test negative should be retested with NAAT. Confirmatory testing may not be necessary if the individual has a low likelihood of SARS-CoV-2 infection. Factors that might indicate a lower likelihood of infection include: low to moderate levels of community transmission, no known or suspected close contact with someone with SARS-CoV-2 infection, and/or the person is up to date with COVID-19 vaccination.

Asymptomatic residents or HCP in LTCF tested as part of an outbreak response or following close contact with someone with SARS-CoV-2 infection

  • If an antigen test is positive, confirmatory NAAT should generally be performed2.
    • Residents should be placed on Transmission-based Precautions in a single room or, if single rooms are not available, remain in their current room pending results of confirmatory testing. They should not be transferred to a COVID-19 unit or placed in another shared room with new roommates. HCP should be excluded from work.
  • If an antigen test is negative OR if the antigen test is positive but the confirmatory NAAT (performed within 1 to 2 days of the antigen test) is negative:
    • Residents and HCP may be treated as not SARS-CoV-2 infected; however, because of their potential exposure (in an outbreak facility or have had close contact) residents and HCP should be managed as described in current guidance for long-term care infection control and HCP return to work.
  • Note: In general, asymptomatic people who have recovered from SARS-CoV-2 infection in the past 3 months should not be tested for SARS-CoV-2.

In situations where the pre-test probability is higher (e.g., facility with a large outbreak, a person who is a close contact of someone with SARS-CoV-2 infection and is not up to date with all recommended COVID-19 vaccine doses), the antigen positive test might not require confirmation and the individual should be treated as infected with SARS-CoV-2.

Asymptomatic HCP as part of expanded screening testing in LTCF without an outbreak 

  • If an antigen test is positive, perform confirmatory NAAT as soon as possible (within 1 to 2 days of the antigen test). Asymptomatic HCP who are antigen test positive should be excluded from work but initiation of an outbreak response, including facility-wide testing, can be delayed until confirmatory test results are available.
    • If the confirmatory NAAT is negative, the antigen test should be considered a false positive and the HCP may return to work.
  • If an antigen test is negative, allow HCP to continue to work following all routine recommended infection control practices.

Note: In general, asymptomatic HCP who have recovered from SARS-CoV-2 infection in the past 3 months should not be tested for SARS-CoV-2.

For more information, please visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/nursing-homes-antigen-testing.html.

Handwashing

February 11, 2022

Wash hands with soap and water for at least 20 seconds. Use the cleanest water possible, for example, from an improved source. *If soap and water are not available use an alcohol-based hand rub that contains at least 60% alcohol.

Handwashing Solution

Make a Handwashing Solution

Remember, only use chlorine-based handwashing solutions when soap and water or alcohol-based hand rub are not available.

Making Handwashing Solution from 5% Liquid Bleach

Use the MILD chlorine water to wash hands. Make new mild chlorine water every day.

  1. Mix 14 tablespoons (1 Cup plus ¾ Cup) of 5% bleach into 20 liters (5 gallons plus 4½ Cups) of clear water. Stir well.
    Label plastic bucket for handwashing only / MILD 05%. Do not drink or use for cooking.
  2. Make sure the bucket is covered. Use the MILD chlorine water to wash hands.

Making Handwashing Solution from HTH Chlorine Powder

Use the MILD chlorine water to wash hands. Make new mild chlorine water every day.

  1. Mix 1 tablespoon of HTH chlorine powder into 20 liters (5 gallons plus 4½ Cups) of water every day. Stir well. Label plastic bucket for handwashing only /MILD 05%. Do not drink or use for cooking.
  2. Stir well and wait 30 minutes.
  3. Use the MILD chlorine water to wash hands.

To learn more, please visit: https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/handwashing.html

Self-Testing

February 4, 2022

What You Need to Know

  • Testing is critically important to help reduce the spread of COVID-19.
  • COVID-19 self-tests can be taken at home or anywhere, are easy to use, and produce rapid results.
  • Self-tests (also referred to as at-home tests or over-the-counter (OTC) tests) are one of many risk-reduction measures, along with vaccinationmasking, and physical distancing, that protect you and others by reducing the chances of spreading  COVID-19.
  • Free self-tests can be ordered at COVIDtests.gov.
  • You can use COVID-19 self-tests regardless of vaccination status or whether or not you have symptoms.
  • Consider using a COVID-19 self-test before joining indoor gatherings with others who are not in your household. This is especially important before gathering with individuals at risk of severe diseaseolder individuals, those who are immunocompromised, or unvaccinated people, including children who cannot get vaccinated yet.
  • To obtain accurate results, follow all of the manufacturer’s instructions for performing the self-test.
  • If you test positive, you should isolate and wear a well-fitting mask if you must be around others, inform your healthcare provider, and inform any close contacts. If you are a healthcare provider, follow CDC guidance for healthcare providers.
  • A negative self-test result means that the test did not detect the virus that causes but it does not rule out a COVID-19 infection. A single negative self-test result may not reliable, especially if you have symptoms associated with COVID-19.
  • If your result is negative, repeating the self-test within a few days, with at least 24 hours between tests, will increase the confidence that you are not infected with the virus causing COVID-19.

What is a Self-Test?

Self-tests for COVID-19 are those that can be performed on yourself at home or anywhere. Sometimes a self-test is also called a “home test,” an “at-home test,” or an “over-the-counter (OTC) test.” Self-testing offers fast results. Self-tests are one of several options for testing for the virus that causes COVID-19 and may be more convenient than laboratory-based tests and point-of-care tests.

Visit FDA’s website for a list of authorized tests. Some self-tests may have age limitations for self-collection or collection by an adult for a child.

As of January 2022, self-tests are used to detect current infection. No self-tests are available to detect antibodies to the virus, which would suggest previous infection.

When to Consider Self-Testing

Self-tests may be used if you have COVID-19 symptoms or have been in close contact or potentially in close contact with an individual with COVID-19.

Even if you don’t have symptoms and have not been in close contact with an individual with COVID-19, using a self-test before gathering indoors with others can give you information about the risk of spreading COVID-19. This is especially important before gathering with individuals at risk of severe diseaseolder individuals,  those who are immunocompromised, or unvaccinated people, including children who cannot get vaccinated yet.

Specifically, the best timing when using a self-test is:

  • If you have COVID-19 symptoms, use a self-test immediately
  • If you were a close contact of someone with COVID-19, self-test after at least 5 days, plus a second test in 1 or 2 days if your first test is negative (See Serial Testing, below)
  • If you are testing before a gathering, test immediately before the gathering (or as close in time to the event as possible)

How to Get a Self-Test

Self-tests can be purchased online or in pharmacies and retail stores. Private health insurance will reimburse the cost of purchasing self-tests.

Self-tests can be purchased online or in pharmacies and retail stores. They are also available at no cost through some local health departments, Federally Qualified Health Centers (FQHC), or by ordering at COVIDtests.gov

For a list of authorized self-tests, see FDA EUA Testsexternal icon. Some tests may have age limitations for self-collection or collection by an adult for a child. If you are unable to obtain a self-test, but have symptoms of COVID-19 or have been exposed, stay away from others as much as possible and follow CDC recommendations for What to Do If You Are Sick. You may also consider visiting a community testing site. Call your local health department for additional testing options.

How to Use a Self-Test

Read the complete manufacturer’s instructions for use before using the test. Talk to a healthcare provider if you have questions about the test or your results.

Prepare to Collect a Specimen

  • Wash your hands with soap and water for at least 20 seconds.
  • Open the box and follow the instructions included with the COVID-19 self-test to collect your own nasal specimen.
  • If you do not collect the specimens as directed, your test results may be incorrect.

Collect a Specimen and Perform the Self-Test

Follow the manufacturer’s instructions exactly and perform the steps in the order that they are listed. The manufacturer may also provide other resources, such as quick reference guides or instructional videos, to help you perform the test correctly.

Most COVID-19 self-tests require the collection of a nasal specimen (see the Additional Print Resources section below).

Once collected, use the specimen as described in the instructions to complete the self-test.

If Your Test Result is Positive

You should isolate according to CDC recommendations  and wear a well-fitting mask if you must be around other people. Report your positive result to your healthcare provider. It is particularly important to seek medical care and possible treatment if you have an underlying medical condition that increases your risks from COVID-19. If your illness becomes severe, seek medical attention. If you have an emergency warning sign (including trouble breathing), seek emergency medical care immediately. To avoid spreading the virus to others, follow CDC recommendations.

Tell your close contacts that they may have been exposed to the virus that causes COVID-19. A person with COVID-19 can begin spreading the virus starting 48 hours (or 2 days) before they have any symptoms or test positive. By informing your close contacts that they may have been exposed, you are helping to protect everyone.

If you think your positive test result may be incorrect, contact a healthcare provider to determine whether additional testing is necessary.

If Your Test Result is Negative

A negative test result means that the virus that causes COVID-19 was not detected in your specimen, and you may have a lower risk of transmitting the disease to others. If you took the test while you had symptoms and followed all instructions carefully, a negative result means your current illness may not be COVID-19, though it does not rule out COVID-19 infection.

It is also possible for a test to give a negative result in some people who have COVID-19. This is called a false negative. You could also test negative if the specimen was collected too early in your infection. In this case, you could test positive later during your illness. You should consider serial testing (see below).

Even if you receive a negative result, you should continue to practice preventative measures, such as being up to date on your COVID-19 vaccination, wearing a mask indoors, and physical distancing to reduce the risk of spreading COVID-19.

If Your Result Shows Invalid or Error

Sometimes invalid results or an error can occur on the self-test device. Invalid results or an error can occur for many reasons. Your specimen may not have been collected correctly, or the test may have malfunctioned.

Invalid test results are rare but can occur. If the self-test shows an invalid result or a test error, the test did not work properly. If this happens, a new test is needed to get an accurate result. Refer to the manufacturer’s instructions in the package insert and contact the manufacturer for assistance, consider taking another self-test, or contact a healthcare provider for additional help.

Serial Testing (Repeat Testing)

Serial testing is when a person tests multiple times for COVID-19, or on a routine basis, such as every few days. Some self-tests are designed to be used in a series. By testing more frequently, you may be able to detect COVID-19 more quickly and could reduce the spread of infection. Some self-tests include instructions for performing serial testing, including the number of days between tests, and may include more than one test in the package.

If your self-test is negative, you should follow the manufacturer’s instructions for serial testing, if applicable. Manufacturer’s instructions are included in the test box and are also available on the FDA website. The instructions may recommend you test again within 2 or 3 days. Contact a healthcare provider if you have any questions about your test results or serial testing. You may also use the COVID-19 Viral Testing Tool to help you determine the next steps after testing.

If you think your negative test result may be incorrect, contact a healthcare provider to determine whether additional testing is necessary.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/testing/self-testing.html

Preparing for Your COVID-19 Vaccine

January 28, 2022

COVID-19 vaccines are effective at protecting you from getting sick even if you have had COVID-19. Vaccination is an important tool to help us get back to normal. This information will help you prepare for your COVID-19 vaccination.

Learn more about the different types of COVID-19 vaccines and how they work.

Learn more about the benefits of getting a COVID-19 vaccination.

Plan and Prepare for Your COVID-19 Vaccination

Who should Get a COVID-19 Vaccine?

  • COVID-19 vaccination is recommended for everyone ages 5 years and older
  • Moderately or severely immunocompromised people who are ages 5 years and older and received a Pfizer-BioNTech primary vaccine series or ages 18 years and older received a Moderna primary vaccine series should receive an additional primary dose of the same vaccine at least 28 days after their second one
  • Everyone ages 12 years and older who is fully vaccinated against COVID-19 should get a booster shot. Learn more about booster shots

Get Vaccinated Even If You Had COVID-19 and Think You Have Natural Immunity

You should get a COVID-19 vaccine even if you already had COVID-19.

Getting sick with COVID-19 offers some protection from future illness with COVID-19, sometimes called “natural immunity”. The level of protection people get from having COVID-19 may vary depending on how mild or severe their illness was, the time since their infection, and their age; and no currently available test can reliably determine if you are protected after a COVID-19 infection.

All COVID-19 vaccines currently available in the United States are effective at preventing COVID-19. Getting a COVID-19 vaccine gives most people a high level of protection against COVID-19, even in people who have already been sick with COVID-19.

Emerging evidence shows that getting a COVID-19 vaccine after you recover from COVID-19 infection provides added protection to your immune system. One study showed that, for people who already had COVID-19, those who do not get vaccinated after their recovery are more than 2 times as likely to get COVID-19 again than those who get fully vaccinated after their recovery.

People Who Should Wait to Get Vaccination

If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma while sick with COVID-19, you should wait 90 days before getting a COVID-19 vaccine. If you received monoclonal antibodies or convalescent plasma after you were exposed to someone with COVID-19 to prevent you from getting sick, you should wait 30 days before getting a COVID-19 vaccine. Talk to your healthcare professional if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.

If you or your child have a history of multisystem inflammatory syndrome in adults or children, consider delaying vaccination until you have recovered from being sick and for 90 days after the date of diagnosis of MIS-A or MIS-C. Learn more about the clinical considerations for people with a history of MIS-A or MIS-C.

Considerations for Taking Medication before Getting Vaccinated

For most people, it is not recommended to avoid, discontinue, or delay medications that you are routinely taking for prevention or treatment of other medical conditions around the time of COVID-19 vaccination.

If you are taking medications that suppress the immune system, you should talk to your healthcare provider about what is currently known and not known about the effectiveness of getting a COVID-19 vaccine. Ask about the best timing for receiving a vaccine. Learn about COVID-19 vaccines for moderately to severely immunocompromised people.

Most people who take medication can get a COVID-19 vaccine. Taking one of the following medications is not, on its own, a reason to avoid getting your COVID-19 vaccination:

  • Over-the-counter medications (non-prescription)
  • Non-steroidal anti-inflammatory drugs (NSAIDs) (naproxen, ibproufen, aspirin, etc.)
  • Acetaminophen (Tylenol, etc.)
  • Biologics or biologic response modifiers that treat autoimmune diseases
  • Chemotherapy or other cancer treatment medications
  • Antiviral medication
  • Antibiotics
  • Statins
  • Blood pressure medications/antihypertensives (amlodipine, lisinopril, etc.)
  • Diuretics
  • Thyroid medications
  • Antidepressants
  • Metformin
  • Diabetic medications
  • Insulin
  • Steroids (prednisone, etc.)

This is not a complete list. It is meant to provide some examples of common medications. Taking any of these medications will not make COVID-19 vaccination harmful or dangerous.

If you have questions about medications that you are taking, talk to your healthcare professional or vaccination providers.

For more information, please visit

visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/prepare-for-vaccination.html.

Success Story: Bonnie Lyon

January 26, 2022

Greenville Nursing and Rehabilitation is proud to recognize resident Bonnie Lyon’s Success Story!

Ms. Lyon was admitted to Greenville Nursing and Rehabilitation last month due to a right fractured hip. Bonnie participated in our Physical and Occupational therapy to increase her overall strength. Upon admission, Ms. Lyon required minimum assistances for all functional transfers and was only able to ambulate 10 feet with a rolling walker requiring Contact Guard Assistances. After demonstrating amazing progress and motivation, Bonnie was able to discharge home independently last week with recommendation for Home Health services! Congratulations to Bonnie and her Care Team for their success!

Staying Up to Date with Your Vaccinations

January 21, 2022

COVID-19 Vaccines

COVID-19 vaccines available in the United States are effective at protecting people from getting seriously ill, getting hospitalized, and even dying. As with vaccines for other diseases, people who are up to date are optimally protected. CDC recommends that everyone 5 years and older get their primary series of COVID-19 vaccines, and receive a booster dose when eligible.

When Are You Up to Date?

You are up to date with your COVID-19 vaccines when you have followed the current recommendations listed below. The recommendations will be different depending on your age, your health status, and when you first got vaccinated.

Many people who are immunocompromised may need an additional dose as part of their primary vaccine series.

Note that booster shots are not recommended for everyone at this time.

Pfizer-BioNTechModernaJohnson & Johnson’s Janssen
Primary Series
2 doses
Given 3 weeks (21 days) apart
Primary Series
2 doses
Given 4 weeks (28 days) apart
Primary Series
1 dose
Fully Vaccinated
2 weeks after final dose in primary series
Fully Vaccinated
2 weeks after final dose in primary series
Fully Vaccinated
2 weeks after 1st dose
Booster Dose
Everyone ages 12+ should get a booster dose at least 5 months after the last dose in their primary series
– Teens 12-17 should only get a Pfizer-BioNTech COVID-19 Vaccine booster
– Everyone 18+ should get a booster dose of either Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines)
Booster Dose
Everyone ages 18+ should get a booster dose of either Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines) at least 5 months after the last dose in their primary series
Booster Dose
Everyone ages 18+ should get a booster dose of Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines) at least 2 months after the first dose of J&J/Janssen COVID-19 Vaccine. You may get J&J/Janssen in some situations.
When Boosted
A person is considered “boosted” and up to date right after getting their booster dose.
When Boosted
A person is considered “boosted” and up to date right after getting their booster dose.
When Boosted
A person is considered “boosted” and up to date right after getting their booster dose.

If you have a severe allergic reaction after a previous dose or if you have a known (diagnosed) allergy to a COVID-19 vaccine ingredient, you should not get that vaccine. If you have been instructed not to get one type of COVID-19 vaccine, you may still be able to get another type.

CDC has updated its recommendations for COVID-19 vaccines with a preference for mRNA (Pfizer-BioNTech or Moderna) vaccines. Learn more about the updated guidance of the use of the Janssen (Johnson & Johnson) COVID-19 vaccine.

The primary series of these vaccinations include a third dose for people ages 18 years and older with moderate to severe immunocompromise. This third dose occurs 28 days after the second dose in the primary series.

You should get your second shot as close to the recommended 3-week or 4-week interval as possible. You should not get the second dose early.

To learn more information, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html.

Success Story: Glenda Cox

January 20, 2022

Glenda Cox admitted to Greenville Nursing and Rehabilitation in October of 2021. During the course of her stay, Occupational Therapy and Physical Therapy were initiated to efficiently and effectively identify Glenda’s unique needs and tailor specialized treatment plans to successfully transition to the next level of care.

The therapy team provided skilled interventions to address the adaptation, compensation, and restoration potential of Ms. Cox, and coordinated with the interdisciplinary team to ensure appropriate clinical care areas were addressed. On January 14th, Glenda was discharged back home to her family. Congratulations to Glenda and her Care Team on their success!

Contact Tracing

January 17, 2022

Contact tracing is key to slowing the spread of COVID-19 and helps protect you, your family, and your community.

Contact Tracing Slows The Spread Of COVID-19

Contact tracing helps protect you, your family, and your community by:

  • Helping people diagnosed with COVID-19 get referrals for services and resources they may need to safely isolate.
  • Notifying people who have come into close contact with someone diagnosed with COVID-19 and helping them determine what steps to take, depending on their vaccination status and history of prior infection with SARS-CoV-2 (the virus that causes COVID-19). Follow-up may include testing, quarantine, and wearing a well-fitted mask.
  • Discussions with public health workers are confidential. This means that your personal and medical information will be kept private and only shared with those who may need to know, like your healthcare provider.

If You Come Into Close Contact With Someone With COVID-19

  • A public health worker, other professional, or the person you came into close contact with may tell you that you are a close contact and have been exposed to COVID-19.
  • Follow recommendations for quarantine, testing, and wearing a well-fitted mask. Quarantine recommendations vary based on up-to-date COVID-19 vaccination status or history of prior COVID-19 infection in the past 90 days.
  • Monitor your symptoms. If you have an emergency warning sign (including trouble breathing), seek emergency medical care immediately.
  • If you develop symptoms, get tested immediately and isolate from others. If your test result is positive, follow recommendations to isolate.
  • If you need help, health department staff can provide information about the best time to get a vaccine and resources for COVID-19 testing in your area.

If You Are Waiting For A COVID-19 Test Result Or Diagnosed With COVID-19

If you are waiting for COVID-19 test resultsIf you are diagnosed with COVID-19 or have symptoms
Stay away from othersQuarantine:
– Stay away from others while waiting for your COVID-19 test result, especially people who are more likely to get sick from COVID-19, if possible.
– If you have come into close contact with someone with COVID-19, follow recommendations to quarantine and wear a well-fitted mask. Quarantine recommendations vary based on up-to-date vaccination status or history of prior COVID-19 infection in the past 90 days.
Isolate:
– Stay at home away from others (isolate), except to get medical care.
– Monitor your symptoms. If you have an emergency warning sign (including trouble breathing), seek emergency medical care immediately.
Stay in a separate room, away from other household members, if possible.
– Use a separate bathroom, if possible.
– Avoid contact with other household members and pets.
– Don’t share personal household items, like cups, towels, and utensils.
– Follow recommendations for isolation.
Think about your close contactsWhile you wait for your COVID-19 test result, think about anyone you have come into close contact with starting 2 days before your symptoms began (or two days before you test if you do not have symptoms). This information can help with contact tracing efforts and help slow the spread of COVID-19 in your community. Use this resource to help you think of people you may have been around while you may have had COVID-19.Tell your close contacts that you have COVID-19 right away so they can follow recommendations to quarantine, get tested, and wear a well-fitted mask, depending on their vaccination and booster status or history of prior infection.
– An infected person can spread COVID-19 starting 2 days before the person has any symptoms or tests positive. People who have COVID-19 don’t always have obvious symptoms.
– A person is still considered a close contact even if they were wearing a mask while they were less than six feet from someone with COVID-19 for a cumulative total of 15 minutes or more over a 24-hour period.
– You can call, text, or email your contacts. By letting your close contacts know they may have been exposed to COVID-19, you are helping to protect everyone.
– If you would like to stay anonymous, there is also an online tool that allows you to tell your contacts by sending out emails or text notifications anonymously.

Answer The Call

If a public health worker from the health department calls you, answer the call to help slow the spread of COVID-19 in your community.

  • Discussions with public health workers are confidential. This means that your personal and medical information will be kept private and only shared with those who may need to know, like your healthcare provider.
  • Your name will not be shared with those you came in contact with, even if they ask. The public health worker will only notify people you were in close contact with that they might have been exposed to COVID-19.
  • Public health workers may be able to connect you with other supportive services that can help you isolate or quarantine.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/contact-tracing.html.

Clinical Care Quick Reference for COVID-19

January 7, 2022

This quick reference highlights key COVID-19 Clinical Care information for healthcare providers and provides selected links to full guidance and research for easier CDC web navigation.

Caring for Patients

  • Signs and symptoms of COVID-19 can include fever, chills, cough, shortness of breath, fatigue, muscle aches, headache, loss of taste or smell, sore throat, nasal congestion or rhinorrhea, vomiting or diarrhea, and skin rashes.
  • Some patients with COVID-19 may progress or dyspnea and severe disease about one week after symptom onset.
  • Clinicians who wish to consider the use of therapeutics or other available investigational therapies should review the COVID-19 National Institutes of Health (NIH) Treatment Guidelines.

Ending Isolation

  • For most people with a current laboratory-confirmed SARS-CoV-2 infection, isolation and precautions can be discontinued 10 days after symptom onset and after resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms.
  • For adults who never develop symptoms, isolation and other precautions can be discontinued 10 days after the date of their first positive viral test.
  • Some severely immunocompromised persons with COVID-19 may remain infectious beyond 20 days after their symptoms began and require additional SARS-CoV-2 testing and consultation with infection disease specialists to determine the appropriate duration of isolation and precautions.

Reinfection

  • Confirmation of SARS-CoV-2 reinfection requires confirmation of initial infection and virus detection at two distinct time periods with genetic sequencing data that support reinfection.
  • A toolkit and criteria have been developed to support state and local health departments investigations of suspended cases of SARS-CoV-2 reinfection.

People at Increased Risk of Severe Illness

  • People of any with underlying medical conditions on CDC’s evidence-based list can be more likely to get severely ill from COVID-19.
  • Older adults are at highest risk for severe illness from COVID-19.
  • The risk of severe COVID-19 increases as the number of underlying medical conditions increases in a person.
  • Long-standing systemic health and social inequalities have put various groups of people at increased risk of getting sick and dying from COVID-19.
  • CDC highlights key findings from a large cross-sectional that examined risk factors and comorbidities associated with severe outcomes of COVID-19.

Multisystem Inflammatory Syndrome (MIS)

  • Multisystem inflammatory syndrome is a rare but serious complication associated with COVID-19 in which multiple organ systems become inflamed.
  • MIS can affect children and adolescents (MIS-C) and adults (MIS-A).
  • The MIS-C healthcare provider page provides information on clinical presentation, case definition of MIS-C, case report form (CRF), and more resources about MIS-C.
  • CDC has developed a MIS-A case definition for healthcare providers.

Post-COVID Conditions

  • Post-COVID conditions describe a range of new, returning, or ongoing health issues that persist four or more weeks after being infected with the virus that causes COVID-19, sometimes after initial symptom recovery.
  • New or ongoing symptoms can occur in people who have varying degrees of illness during acute infection, including patients who had mild or asymptomatic infections.
  • Medical and research communities are still learning about post-acute symptoms and clinical findings.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care-quick-reference.html.

Potential Rapid Increase of Omicron Variant Infections in the United States

December 30, 2021

The Centers for Disease Control and Prevention (CDC) has identified the potential for a rapid increase in infections of the new variant of SARS-CoV-2, the Omicron variant, in the United States. Plausible scenarios include steep epidemic trajectories that would require expedient public health action to prevent severe impacts on the health of individuals and the healthcare system. The CDC Center for Forecasting and Outbreak Analysis developed this finding as a synthesis of scenario models conducted by U.S. government, academic, and international partners. The models assess the range of plausible scenarios for the epidemic trajectory based on what is currently known about the Omicron variant. Recent case data of the Omicron variant from South Africa, Botswana, the United Kingdom, and elsewhere are consistent with the faster scenarios that were modeled.

Findings

Infections with the recently identified Omicron variant of SARS-CoV-2, the virus that causes COVID-19, are exponentially increasing in multiple countries. Increases in infections are most likely due to a combination of two factors: increased transmissibility and the ability of the variant to evade immunity conferred by past infection or vaccination (i.e., immune evasion). Though the precise contribution of each of the two factors remains unknown, a substantial degree of immune evasion is likely as has been demonstrated in early vitro studies.

CDC has collaborated with partners to model scenarios of the epidemic trajectory in the U.S. that simultaneously consider transmissibility and immune evasion. Results from scenario analysis indicate that current increases in Omicron cases are likely to lead to a national surge in the coming weeks with peak daily numbers of new infections that could exceed previous peaks; these scenarios may be realized as soon as January. In scenarios with lower immune evasion, a surge is still likely, but the peak could be lower and begin as late as April 2022. Projected large surges in cases indicate surges of hospital demand even if the severity is reduced, because of the large number of anticipated cases occurring in a short period of time.

Background

Since its identification in November 2021, the Omicron variant has been reported in South Africa, Botswana, and numerous countries where it is driving rapid epidemic growth. In the U.S., the variant has been found in the majority U.S. states. The Omicron variant is increasing in the percent of circulating SARS-CoV-2 viruses in the United States. S-gene Target Failure (STGF) is a market for identifying Omicron cases. Preliminary analysis of SGTF data from testing completed through a national chain of pharmacies also observes regional increases in this proxy measure of the Omicron variant. Modeling of both genomic surveillance and SGTF data predict that Omicron will become the most common variant nationally by December 25, 2021, with some regions exceeding this threshold earlier. Furthermore, multiple large clusters of Omicron variant cases have demonstrated the rapid spread of the virus. Upcoming holiday gatherings may further accelerate these trends.

The rapid growth rate in Omicron infections is believed to result from a combination of increased transmissibility and the ability to evade immunity conferred by past infection or vaccination (i.e., immune evasion). Data from laboratory experiments and epidemiologic investigations suggest a greater role for immune evasion than increased transmissibility; immunity conferred by prior infection or vaccination is likely to be reduced compared with Delta, but not completely overcome. Data also shows that vaccinated people who either receive a booster dose or who were also previously infected are likely to have stronger protection against Omicron.

The clinical severity profile of Omicron infection will strongly influence its impact on future U.S. hospitalizations and deaths. At present, early data suggest Omicron infection might be less severe than infection with prior variants; however, reliable data on clinical severity remains limited. Even if the proportion of infections associated with severe outcomes is lower than with previous variants, given the likely increase in number of infections, the absolute numbers of people with severe outcomes could be substantial. In addition, demand for ambulatory care, supportive care for treatment of mild cases, and infection control requirements, quarantining/isolation of exposed/infected workforce could also stress the healthcare system. These stresses likely will be in addition to the ongoing Delta variant infections and rising burden of illness caused by other respiratory pathogens, such as influenza, which have begun circulating at greater frequencies.

Analytic Approach

The modeled scenarios of the epidemic trajectory in the U.S. consider varying degrees of transmissibility and immune evasion: high transmissibility and low transmissibility together with high immune evasion and low immune evasion. Modeled scenarios with faster relative growth rates (of Omicron as compared to Delta) indicate that a large surge of infections could begin in the U.S. in early January 2022 and that the peak daily number of new infections could exceed previous peaks. With low immune evasion, the surge could be lower and occur as late as April 2022. Multiple modeling groups in the United States, as well as those from other countries’ public health agencies, have identified similar trends.

Recent case data of the Omicron variant from the United Kingdom and elsewhere are consistent with the faster growth scenarios which increase the plausibility of faster growth scenarios.

Scenario*Inherent transmissibility relative to DeltaImmune escape relative to all prior strains
Faster growth (Higher transmission**. Mid escape)1.5x43%
Slower growth (Higher transmission. Low escape)1.5x10%
Faster growth (Unchanged transmission. High escape)1.0x85%
Slower growth (Lower transmission. Mid escape)0.8x50%

*Parameters were chosen to span a range of apparent growth rate advantages for Omicron over Delta of ~2-3.5x in an environment where 75% of the population has immunity to infection due to vaccination or prior infection. **Relative to Delta

For more information, please visit https://www.cdc.gov/coronavirus/2019-ncov/science/forecasting/mathematical-modeling-outbreak.html.

Domestic Travel During COVID-19

December 23, 2021

What You Need to Know

  • Delay travel until you are fully vaccinated.
  • Check your destination’s COVID-19 situation before traveling. State, local, and territorial governments may have travel restrictions in place.
  • Wearing a mask over your nose and mouth is required in indoor areas of public transportation (including airplanes) and indoors in U.S. transportation hubs (including airports).
  • Do not travel if you have been exposed to COVID-19, you are sick, or if you test positive for COVID-19.
  • If you are not fully vaccinated and must travel, get tested both before and after your trip.

Before You Travel

Make sure to plan ahead:

  • Check the current COVID-19 situation at your destination.
  • Make sure you understand and follow all state, local, and territorial travel restrictions, including mask wearing, proof of vaccination, testing, or quarantine requirements.
    • For up-to-date information and travel guidance, check the state or territorial and local health department’s website where you are, along your route, and where you are going.
  • If traveling by air, check if your airline requires any testing, vaccination, or other documents.
  • Prepare to be flexible during your trip as restrictions and policies may change during your travel.

Do NOT Travel If…

  • You have been exposed to COVID-19 unless you are fully vaccinated or revered from COVID-19 in the past 90 days.
  • You are sick.
  • You tested positive for COVID-19 and haven’t ended isolation (even if you are fully vaccinated).
  • You are waiting for results of a COVID-19 test. If you test comes back positive while you are at your destination, you will need to isolate and postpone your return until it’s safe for you to end isolation. Your travel companions may need to self-quaranti

During Travel

Masks: Wearing a mask over your nose and mouth is required on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and while indoors at U.S. transportation hubs such as airports and train stations. Travelers are not required to wear a mask in outdoor areas of a conveyance (like an open deck area of a ferry or the uncovered top deck of a bus).

Protect Yourself and Others: Follow all state and local health recommendations and requirements at your destination, including wearing a mask and staying 6 feet (2 meters) apart from others. Travelers 2 years of age or older should wear masks in indoor public places if they are not fully vaccinated, if they are fully vaccinated and in an area with substantial or high COVID-19 transmission, or if they are fully vaccinated and with weakened immune systems.

  • If you are not fully vaccinated and aged 2 years or older, you should wear a mask in indoor public places.
  • In general, you do not need to wear a mask in outdoor settings.
    • In areas with high numbers of COVID-19 cases, consider wearing a mask in crowded outdoor settings and for activities with close contact with others who are not fully vaccinated.
  • Wash your hands often or use hand sanitizer (with at least 60% alcohol).

After Travel

  • ALL Travelers
    • Self-monitor for COVID-19 symptoms; isolate and get tested if you develop symptoms.
    • Follow all state and local recommendations or requirements after travel.
  • If you are NOT Fully Vaccinated
    • Self-quarantine and get tested after travel:
      • Get tested with a viral test 3-5 days after returning from travel.
        • Check for COVID-19 testing locations near you.
      • Stay home and self-quarantine for a full 7 days after travel, even if you test negative at 3-5 days.
      • If you don’t get tested, stay home and self-quarantine for 10 days after travel.

If Your Test is Positive

Isolate yourself to protect others from getting infected. Learn what to do and when it is safe to be around others.

If you Recently Recovered from COVID-19

You do NOT need to get tested or self-quarantine if you recovered from COVID-19 in the past 90 days. You should still follow all other travel recommendations. If you develop COVID-19 symptoms after travel, isolate and consult with a healthcare provider for testing recommendations.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-during-covid19.html.

COVID-19 Vaccines for Older Adults

December 16, 2021

The risk of severe illness from COVID-19 increases with age. Getting a COVID-19 vaccine is an important step in helping to prevent getting sick from COVID-19.

Tips on How to Get a COVID-19 Vaccine

  • Contact your state or local health department for more information.
  • Ask a family member or friend to help with scheduling an appointment.
  • Ask your doctor, pharmacist, or community health center if they provide vaccines.

Find a COVID-19 vaccine or booster: Search vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you.

What You Should Know about Vaccines

  • You can help protect yourself and the other people around you by getting vaccinated.
  • COVID-19 vaccines are safe and effective in preventing severe illness from COVID-19.
  • Depending on the kind of COVID-19 vaccine you get, you might need a second shot 3 or 4 weeks after your first shot.
  • The vaccines cannot make you sick with COVID-19.

You May Have Side Effects from the Vaccine

Some people have side effects after getting vaccinated. Common side effects include:

  • Pain, redness, or swelling where you get your shot
  • Tiredness
  • Headache
  • Muscle Pain
  • Chills
  • Fever
  • Nausea

These are normal signs that your body is building protection against COVID-19. Learn more about what to expect after getting your COVID-19 vaccine.

Booster Shots and Additional Doses

A booster shot is administered when a person has completed their initial vaccine series and protection against the virus has decreased over time. Booster shots are available to everyone ages 16 years and older who is fully vaccinated. Learn more about getting a COVID-19 vaccine booster shot.

An additional primary dose is administered when a person may not have built the same level of immunity to their initial vaccine series as someone who is not immunocompromised. Currently, moderately or severely immunocompromised people ages 18 years and older who completed their Moderna vaccine primary series should plan to get an additional primary dose 28 days after receiving their second shot. For people ages 12 years and older who completed their Pfizer-BioNTech vaccine primary series, they should also plan to get an additional primary dose 28 days after receiving their second shot.

Vaccination Card and Booster Shots

At your first vaccination appointment, you should have received a vaccination card that tells you what COVID-19 vaccine you received, the dates you received it, and where you received it. Bring this vaccination card to your booster dose vaccination appointment.

Safe, Easy, Free, and Nearby COVID-19 Vaccination

The federal government is providing the vaccine free of charge to all people living in the U.S., regardless of their immigration or health insurance status. To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/no-cost.html.

Omicron Variant: What You Need to Know

December 10, 2021

Emergence of Omicron

On November 24th, 2021, a new variant of SARS-CoV-2, B.1.1.529, was reported to the World Health Organization (WHO). This new variant was first detected in specimens collected on November 11, 2021, in Botswana and on November 14, 2021 in South Africa.

On November 26, 2021, WHO named the B.1.1.529 Omicron and classified it as a Variant of Concern (VOC). On November 30, 2021, the United States designated Omicron as a Variant of Concern, and on December 1, 2021, the first confirmed US case of Omicron was identified.

CDC had been collaborating with global public health and industry partners to learn about Omicron, as we continue to monitor its course. CDC has been using genomic surveillance throughout the course of the pandemic to track variants of SARS-CoV-2, the virus that causes COVID-19, and inform public health practice. We don’t yet know how easily it spreads, the severity of illness it causes, or how well available vaccines and medications work against it.

Despite the increased attention of Omicron, Delta continues to be the main variant circulating in the United States.

Where has Omicron been Detected in the United States

CDC is working with state and local public health officials to monitor the spread of Omicron. This map shows the states that have detected at least one case of COVID-19 illness caused by the Omicron variant. Omicron will be included in variant surveillance data on CDC’s COVID Data Tracker when it can be reliably estimated at a low frequency.

What We Know about Omicron

Infection and Spread

  • How easily does Omicron spread? The Omicron variant likely will spread more easily than the original SARS-CoV-2 virus and how easily Omicron spreads compared to Delta remains unknown. CDC expects that anyone with Omicron infection can spread the virus to others, even if they are vaccinated or don’t have symptoms.
  • Will Omicron cause more severe illness? More data are needed to know if Omicron infections, and especially reinfection and breakthrough infections in people who are fully vaccinated, cause more severe illness or death than infection with other variants.
  • Will vaccines work against Omicron? Current vaccines are expected to protect against severe illness, hospitalizations, and deaths due to infection with the Omicron variant. However, breakthrough infections in people who are fully vaccinated are likely to occur. With other variants, like Delta, vaccines have remained effective at preventing severe illness, hospitalization, and death. The recent emergence of Omicron further emphasizes the importance of vaccination and boosters.
  • Will treatments work against Omicron? Scientists are working to determine how well existing treatments for COVID-19 work. Based on the changed genetic make-up of Omicron, some treatments are likely to remain effective while others may be less effective.

We have the Tools to Fight Omicron

Vaccines remain the best public health measure to protect people from COVID-19, slow transmission, and reduce the likelihood of new variants emerging. COVID-19 vaccines are highly effective at preventing severe illness, hospitalizations, and death. Scientists are currently investigating Omicron, including how protected fully vaccinated people will be against infection, hospitalization, and death. CDC recommends that everyone 5 years and older protect themselves from COVID-19 by getting fully vaccinated. CDC recommends that everyone ages 18 years and older should get a booster shot at least two months after their initial J&J/Janssen vaccine or six months after completing their primary COVID-19 vaccination series of Pfizer-BioNTech or Moderna.

Masks offer protection against all variants. CDC continues to recommend wearing a mask in public indoor settings in areas of substantial or high community transmission, regardless of vaccination status. CDC provides advice about masks for people who want to learn more about what type of mask is right for them depending on their circumstances.

Tests can tell you if you are currently infected with COVID-19. Two types of tests are used to test for current infection: nucleic acid amplifications tests (NAATS) and antigen tests. NAAT and antigen tests can only tell you if you have a current infection. Individuals can use the COVID-19 Viral Testing Tool to help determine what kind of test to seek. Additional tests would be needed to determine if your infection was caused by Omicron. Visit your statetribal, local, or territorial health department’s website to look for the latest local information on testing.

Self-tests can be used at home or anywhere, are easy to use, and produce rapid results. If your self-test has a positive result, stay home or isolate for 10 days, wear a mask if you have contact with others, and call your healthcare provider. If you have any questions about your self-test result, call your healthcare provider or public health department.

Until we know more about the risk of Omicron, it is important to use all tools available to protect yourself and others.

What CDC is Doing to Learn about Omicron

Virus Characteristics

CDC scientists are working with partners to gather data and virus samples that can be studied to answer important questions about the Omicron variant. Scientific experiments have already started. CDC will provide updates as soon as possible.

Variant Surveillance

In the United States, CDC uses genomic surveillance to track variants of SARS-CoV-2, the virus that causes COVID-19 to more quickly identify and act upon these findings to best protect the public’s health. CDC established multiple ways to connect and share genomic sequence data being produced by CDC, public health laboratories, and commercial diagnostic laboratories within publicly accessible databases maintained by the National Center for Biotechnology Information (NCBI) and the Global Initiative on Sharing Avian Influenza Data (GISAID). If a variant is circulating at 0.1% frequency, there is a >99% chance that it will be detected in CDC’s national genomic surveillance.

For more information, please visit https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html.

Success Story: Delma Payton

December 6, 2021

Greenville Nursing and Rehabilitation is pleased to recognize resident Delma Payton’s Success Story!

Delma came to Greenville Nursing and Rehab in July with mobility limitations, which left her unable to stand, unable to reposition in bed, and unable to independently partake in self-care activities. Delma has worked diligently with our therapy team, and now is able to stand for up to 5 minutes! Delma is also now able to get dressed, get into bed, and reposition independently. She has also increased her ability to walk with her rolling walker from 25 feet to 125 with a stand-by assist from our Care Team. We appreciate Delma and her constant dedication to the personalized plan of care that our therapy team designed for her! Congratulations to Delma and her Care Team!

Improving Ventilation in Your Home

December 3, 2021

Staying home with only members of your household is the best way to keep SARS-CoV-2 (the virus that causes COVID-19) particles out of your home. However, if a visitor needs to be in your home, improving ventilation (airflow) can help prevent virus particles from accumulating in the air in your home. Good ventilation, along with other preventive actions, like staying 6 feet apart and wearing masks, can help prevent you from getting and spreading COVID-19.

Interactive Ventilation Tool

Use this tool to learn how you can decrease the level of COVID-19 virus particles during and after a guest visits your home. Get started.

Below are ways you can improve ventilation in your home. Use as many ways as you can (open windows, use air filters, and turn on fans) to help clear out virus particles in your home faster.

Bring as much fresh air into your home as possible. Bringing fresh, outdoor air into your home helps keep virus particles from accumulating inside.

  • If it’s safe to do so, open doors and windows as much as you can to bring in fresh, outdoor air. While it’s better to open them wide, even having a window cracked open slightly can help.
  • If you can, open multiple doors and windows to allow more fresh air to move inside.
  • Do not open windows and doors if doing so is unsafe for you or others (for example, presence of young children and pets, risk of falling, triggering asthma symptoms, high levels of outdoor pollution).
  • If opening windows or doors is unsafe, consider other approaches for reducing virus particles in the air, such as using air filtration and bathroom and stove exhaust fans.
  • Use fans to move virus particles in the air from inside your home to outside. Consider using a window exhaust fan if you have one. Be sure it is placed safely and securely in the window. Another option is to place a fan as close as possible to an open window or door, blowing outside. Don’t leave fans unattended with young children.

Filter the Air in Your Home

If your home has a central heating, ventilation, and air conditioning system, (HVAC, a system with air ducts that go throughout the home) that has a filter, do the following to help trap virus particles:

  • In home where the HVAC fan operation can be controlled by a thermostat, set the fan to the “on” position instead of “auto” when you have visitors. This allows the fan to run continuously, even if heating or air conditioning is not on.
  • Use pleated filters – they are more efficient than ordinary furnace filters and can be found in hardware stores. They should be installed initially within the HVAC system by a professional, if possible. If that is not possible, carefully follow manufacturer’s instructions to replace the filter yourself.
  • Make sure the filter fits properly in the unit.
  • Change your filter every three months or according to the manufacturer’s instructions.
  • Ideally, have the ventilation system inspected and adjusted by a professional every year to make sure it is operating efficiently.

Turn on the Exhaust Fan in Your Bathroom and Kitchen

Exhaust fans above your stovetop and in your bathroom that vent outdoors can help move air outside. Although some stove exhaust fans don’t send their air to the outside, they can still improve airflow and keep virus particles from being concentrated in one place.

  • Keep the exhaust fan turned on over your stovetop and in your bathroom if you have visitors in your home.
  • Keep the exhaust fans turned on for an hour after your visitors leave to help remove virus particles that might be in the air.

Use Fans to Improve Airflow

  • Place a fan as close as possible to an open window blowing outside. This helps get rid of virus particles in your home by blowing air outside. Even without an open window, fans can imrpove airflow.
  • Point fans away from people. Pointing fans toward people can possibly cause contaminated air to flow directly at them.
  • Use ceiling fans to help improve airflow in the home whether or not windows are open.

Limit the Number of Visitors in Your Home and the Time Spent Inside

The more people inside your home, and the longer they stay, the more virus particles can accumulate.

  • List the numbers of visitors in your home.
  • Try to gather in large rooms or areas where you can stay at least 6 feet apart.
  • Be sure that everyone wears a mask while visitors are in your home. This includes visitors as well as the people who usually live in your home.
  • Keep visits as short as possible.
  • Follow additional recommendations for hosting gatherings.

To learn more information and alternative methods for ventilating your home, please visit

https://www.cdc.gov/coronavirus/2019-ncov/community/ventilation.html.

Success Story: Phillip Buchanan

November 24, 2021

Greenville Nursing & Rehabilitation is proud to recognize resident Phillip Buchanan’s Success Story!

Anyone who visits our community is no stranger to Phillip Buchanan. He is often the first one in the lobby each day to greet visitors and our many Care Team members as they arrive for their shifts. Phillip has been a long-term resident for almost a year now. He enjoys making his rounds every day and visits often with us, as well as spending time going from room to room handing out snacks, and visiting with his fellow residents. Phillip always takes the time to brighten everyone’s day as part of his routine.

The thing he loves most about Greenville Nursing & Rehab is the people. Phillip said that we really make it feel like home here. Some of Phillip’s favorite activities are exercising, painting, reading the Harry Potter novel series, and decorating. We are proud to have our friend, Phillip Buchanan with us. We hope you all will stop by to meet him and visit with all of our residents soon!

Interim Infection Prevention and Control Recommends to Prevent SARS-CoV-2 Spread in Nursing Homes

November 22, 2021

Summary of Recent Changes

  • Updated outbreak response guidance to promote use of contact tracing approach. Alternative broad-based approaches to outbreak response at a facility-wide or unit level are also described.
  • Updated expanded screening testing recommendations for healthcare personnel (HCP).
  • Updated recommendations for quarantine of fully vaccinated residents.
  • Updated visitation guidance.

Key Points

  • Older adults living in congregate setting are at high risk of being affected by respiratory and other pathogens, such as SARS-CoV-2.
  • A strong infection prevention and control (IPC) program is critical to protect both residents and healthcare personnel (HCP).
  • Even as nursing homes resume normal practices, they must sustain core IPC practices and remain vigilant for SARS-CoV-2 infection among residents and HCP in order to prevent spread and protect residents and HCP from severe infections, hospitalizations, and death.

In general, healthcare facilities should continue to follow the IPC recommendations for unvaccinated individuals (e.g., use of Transmission-Based Precautions for those that have had close contact to someone with SARS-CoV-2 infection) when caring for fully vaccinated individuals with moderate to severe immunocompromise due to a medical condition or receipt of immunosuppressive medications or treatment.

Other factors, such as end-stage renal disease, likely pose a lower degree of immunocompromise and there might not be a need to follow the recommendations for those with moderate to severe immunocompromise. However, fully vaccinated people in this category should consider continuing to practice physical distancing and use of source control while in a healthcare facility.

Ultimately, the degree of immunocompromise for the patient is determined by the treating provider, and preventive actions are tailored to each individual and situation.

Infection Prevention and Control Program

Assign one or more individuals with training in infection control to provide on-site management of the IPC program.

  • This should be a full-time role for at least one person in facilities that have more than 100 residents or that provide on-site ventilator or hemodialysis services. Smaller facilities should consider staffing the IPC program based on the resident population are facility service needs identified in the IPC risk assessment.
  • CDC has created an online training course that can orient individuals to this role in nursing homes.

Provide supplies necessary to adhere to recommended IPC practices

  • Ensure HCP have access to all necessary supplies including alcohol-based hand sanitizer with 60-95% alcohol, personal protective equipment (PPE), and supplies for cleaning and disinfection.
    • Put FDA-approved alcohol-based hand sanitizer with 60-95% alcohol in every resident room (ideally both inside and outside of the room) and other resident care and common areas (e.g., outside dining hall, in therapy gym.)

Educate residents, HCP, and visitors about SARS-CoV-2, current precautions being taken in the facility, and actions they should take to protect themselves.

Vaccinations

Vaccinated residents and HCP against SARS-CoV-2

Source Control and Physical Distancing Measures

Refer to Interim Infection Control Recommendations for Healthcare Personnel During the COVID-19 Pandemic for details regarding source control and physical distancing measures recommended for vaccinated and unvaccinated HCP and residents.

Visitation

Have a plan for visitation

Additional information about visitation for nursing homes and intermediate care facilities for individuals with intellectual disabilities and psychiatric residential treatment facilities is available from CMS.

Personal Protective Equipment

Ensure proper use, handling and implementation of personal protective equipment

Testing

Create a plan for testing residents and HCP for SARS-CoV-2

  • Anyone with even mild symptoms of COVID-19, regardless of vaccination status, should receive a viral test as soon as possible.
  • Asymptomatic HCP with a higher-risk exposure and residents with close contact with someone with SARS-CoV-2 infection, regardless of vaccination status, should have a series of two viral tests for SARS-CoV-2 infection. In these situation, testing is recommended immediately (but not earlier than 2 days after exposure) and, if negative, again 5-7 days after the exposure. Criteria for use of post-exposure prophylaxis are described elsewhere.

Evaluating and Managing Personnel and Residents

Identify space in the facility that could be dedicated to monitor and care for residents with confirmed SARS-CoV-2 infection

  • Determine the location of the COVID-19 care unit and create a staffing plan.
  • The location of the COVID-19 care unit should ideally by physically separated from other rooms or units housing residents without confirmed SARS-CoV-2 infection. This could be a dedicated floor, unit, or wing in the facility or a group of rooms at the end of the unit that will be used to cohort residents with SARS-CoV-2 infection.
  • Identify HCP who will be assigned to work only on the COVID-19 care unit when it is in use. At a minimum, this should include the primary nursing assistants (NAs) and nurses assigned to care for these residents. If possible, HCP should avoid working on both the COVID-19 care unit and other units during the same shift.
    • To the extent possible, restrict access of ancillary personnel (e.g., dietary) to the unit.
    • Ideally, environmental services (EVS) staff should be dedicated to this unit, but to the extent possible, EVS staff should avoid working on both the COVID-19 care unit and other units during the same shift.
    • To the extent possible, HCP dedicated to the COVID-19 care unit (e.g., NA and nurses) will also be performing cleaning and disinfection of high-touch surfaces and shared equipment when in the room for resident care activities. HCP should bring an Environmental Protection Agency (EPA)- registered disinfectant (e.g., wipe) from List N into the room and wipe down high-touch surfaces (e.g., light switch, doorknob, bedside table) before leaving the room.

Manage Residents with Close Contact

Manage residents who had close contact with someone with SARS-CoV-2 infection

  • Unvaccinated residents who have had close contact with someone with SARS-CoV-2 infection should be placed in quarantine for 14 days after their exposure, even if viral testing is negative. HCP caring for them should use full PPE (gowns, gloves, eye protection, and N95 or higher-level respirator).
  • Fully vaccinated residents who have had close contact with someone with SARS-CoV-2 infection should wear source control and be tested as described in the testing section. Fully vaccinated residents and residents with SARS-CoV-2 infection in the last 90 days do not need to be quarantined, restricted to their room, or cared for by HCP using the full PPE recommended for the care of a resident with SARS-CoV-2 infection unless they develop symptoms of COVID-19, are diagnosed with SARS-CoV-2 infection, or the facility is directed to do so by the jurisdiction’s public health authority. Additional potential exceptions are described here.

Definitions:

Healthcare Personnel (HCP): HCP refers to all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances (e.g., blood, tissue, and specific body fluids); contaminated medical supplies, devices, and equipment; contaminated environmental surfaces; or contaminated air. HCP include, but are not limited to, emergency medical service personnel, nurses, nursing assistants, home healthcare personnel, physicians, technicians, therapists, phlebotomists, pharmacists, dental healthcare personnel, students and trainees, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care, but who could be exposed to infectious agents that can be transmitted in the healthcare setting (e.g., clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel).

Source Control: Use of well-fitting cloth masks, facemasks, or respirators to cover a person’s mouth and nose to prevent spread of respiratory secretions when they