Information & Tips Archives - Page 2 of 10 - THE GRAND

COVID-19 Update April 24

April 24, 2020

Dear Families, Friends and Staff Members,

I want to generally update you as to the status of our facility.  We are doing our best to limit any fear of the unknown.  Please keep in mind, specific patient information cannot be shared in a public setting like this.  If in doubt or concerned for your loved one, call us.  We are happy to discuss your loved one and update you with specifics.  Rest assured we are still contacting family and friends directly with pertinent information whether there is an episodic event or general information to keep you updated.

This Coronavirus pandemic has changed our county, our state and the world.  There is no script or decision tree as new situations arise.  As we all learn and adapt each day, two things must remain constant.  First, our loved ones will remain our focus and their safety and well-being our singular goal.  Second is communication.  That being said, I want to share the following update:

Safety Measures:

As you know, we are still following all directives and guidelines released by local public health departments, the Ohio Department of Health, the CDC and other governmental agencies.  We are tracking and reacting to these updates daily.

For the safety, we are still restricting visitors, and monitoring temperatures, oxygen levels, respiratory symptoms and vital signs multiple times per day.  We practice social distancing by limiting group activities and communal dining amongst other things.  As needed, staff wears appropriate masks and other protective wear and takes all precautions to limit exposure.

Community and Family Thanks:

The amount of support and offers of assistance from our families and the local community have been amazing in this time of need.  We have had family members and local businesses make and/or donate protective equipment for our residents and staff.  We have seen people change their own businesses and repurpose to help support healthcare in general.  While this pandemic has brought a lot of heartache and tribulations to families and business alike, it has also been heartwarming to see overwhelming support from our communities and families.

Communication Options:

To reiterate, it is and will remain vitally important for family and friends to stay in touch with our residents.  They need to feel the love and support of their friends and relatives. We encourage you to reach out to our residents.  The telephone is still a viable option.  Additionally, The GRAND’s Facebook is set so you can leave a message for our residents at http://grandofdublin.wpengine.com/resident-messages/

To schedule a Skype video or group phone call, please call the facility at (614) 889-8585 and ask for the activity department, social work or email grand-family@grandofdublin.com for scheduling.

Please continue to stay in communication. The Grand of Dublin again wants to thank our staff for their continued dedication and compassion. We also want to thank our families and patients for their continued support.  We understand how hard this situation is on our staff, our family members and our loved ones.  Please continue to stay patient and stay safe.

We Are In This Together,

Blu Johnson
Administrator

COVID-19 Update April 22

April 22, 2020

To our families and friends,

Social distancing to help control the COVID-19 outbreak has affected all of us in many ways. While it’s the best thing we can do for our loved ones, we understand this is particularly hard for families of the people we serve.  Healthcare around the country is taking on a new shape.  It won’t be like this forever, but it will be forever changed.  In light of that, the one constant there is a need is to promote communication of our loved ones with their friends and families.

It is vitally important for family and friends to continue contact with our residents.  They need to feel the love and support of their friends and relatives. We encourage you to reach out to our residents, and we will be happy to help coordinate your communication with them in any way we can.  The telephone is still a viable option.  Additionally, The GRAND of Dublin has set up their Facebook so you can leave a message for our residents at http://grandofdublin.wpengine.com/resident-messages/

To schedule a Skype video or group phone call, please call the facility at (614) 889-8585 and ask for the activity department, social work or email grand-family@grandofdublin.com for scheduling.

Facility has increased daily monitoring to multiple daily temperatures and respiratory symptom checks for all staff members, our loved ones and essential visitors. We are still monitoring the latest information from local and state of Ohio Departments of Health, the CDC and the Centers for Medicare and Medicaid Services (CMS).  We are working on additional methods to communicate and keep everyone informed of any potential cases of COVID-19, while being respectful of all private health information.  If you have questions regarding your loved one’s that has not been addressed please reach out so we can discuss or a care conference can be set.

Again, I want to thank each of you for your cooperation and understanding during this trying time. Please reach out to the facility at (614) 889-8585 with further specific questions.  Please stay in touch and stay safe.  We will get through this together.

 

Sincerely,

Blu Johnson
Administrator
The GRAND of Dublin

COVID-19 Update April 7

April 7, 2020

Dear Families, Friends and Staff Members,

We hope this message finds everyone doing well, staying safe, and remaining in good health and spirits.  Everyone’s cooperation and embrace during this crisis has been exceptional.

We are asking for families to refrain from bringing in items to their loved ones. It is difficult, but another way that we are attempting to mitigate risk as we continue to learn more about the spread of this very serious virus. We are asking at this time, that this request also include mailed in items. The only items we are able to accept currently, are ESSENTIAL items. This would include items such as medications or incontinence supplies. Please understand, as soon as we are able to safely decrease restrictions, we happily do so!

I feel it is important to continue communications between our loved ones, family members, the community and medical professionals.  If you wish to be on our email distribution list, please reach out to The GRAND of Dublin at (614) 889-8585.

I will again direct you to our facility Facebook page.  The GRAND’s Facebook page is located at https://www.facebook.com/thegrandofdublin/ or by searching for The GRAND of Dublin on Facebook. At the facility’s page you can leave messages directly for our loved ones.  If you wish to leave a message, go to the following link and your message will be delivered. http://grandofdublin.wpengine.com/resident-messages/

To schedule a Skype video or group phone call, please call the facility at (614) 889-8585 and ask for the activity department, social work or email grand-family@grandofdublin.com for scheduling.

For safety, the facility continues to monitoring daily temperatures and respiratory symptoms of all staff members, our loved ones and essential visitors. We continue to monitor the latest information from local and state of Ohio Departments of Health, the CDC and the Centers for Medicare and Medicaid Services (CMS).  We remain in close contact with our medical doctors and have protocols in place for dealing with residents if they were to exhibit symptoms of the virus.

I want to thank each of you for your cooperation and understanding during this trying time. Please reach out to the facility at (614) 889-8585 with further specific questions.  Please stay in touch and stay safe.  We will get through this together.

Sincerely,

Blu Johnson
Administrator

COVID-19 Update – TRUMP DECLARES NATIONAL EMERGENCY

March 13, 2020

ATTENTION FAMILY AND VISITORS:

RE:    COVID-19 Update – TRUMP DECLARES NATIONAL EMERGENCY

Vrable Healthcare, Inc. and The GRAND of Dublin continue to work with all governmental bodies to limit the transmission of COVID-19.  President Trump recently declared a national emergency.  In his speech he called for skilled nursing facilities to suspend all visitations to nursing homes absent emergent / end-of-life circumstances.

Effective immediately, The GRAND of Dublin will be following governmental recommendations and temporarily halt visitation[1].

Again, we love to have visitors and family and understand spending time with family is of the utmost importance. Therefore, we are suggesting alternate means of communication.  Alternate means of communications can include Skype, Facetime, Facebook, etc.  The GRAND of Dublin will assist however they can to help accommodate this.

In the event of true end-of-life emergency, we will do our best to accommodate an emergent visit.  Outside activities and activities from outside vendors will also remain on hold.  We are asking families to cancel any outside appointments that are not medically necessary.

The health and safety of our residents and families continues to be our highest priority. Because the population we care for is especially vulnerable to potential infection, it is absolutely essential that we take these preventive steps.

The GRAND of Dublin and Vrable Healthcare will continue to follow governmental recommendations on additional prevention steps, including following handwashing and sanitation procedures.  Based on this, our process may be updated or changed at any time.  We thank you greatly for your consideration and for working with us to best limit risk to those we love.

Sincerely,

Blu Johnson,
Administrator

[1] Absent hospice or other emergent, end-of-life circumstances.

 

 

 

March 13, 2020

 

ATTENTION FAMILY AND VISITORS:

 

RE:    COVID-19 Update – TRUMP DECLARES NATIONAL EMERGENCY

 

Vrable Healthcare, Inc. and The GRAND of Dublin continue to work with all governmental bodies to limit the transmission of COVID-19.  President Trump recently declared a national emergency.  In his speech he called for skilled nursing facilities to suspend all visitations to nursing homes absent emergent / end-of-life circumstances.

 

Effective immediately, The GRAND of Dublin will be following governmental recommendations and temporarily halt visitation[1].

Again, we love to have visitors and family and understand spending time with family is of the utmost importance. Therefore, we are suggesting alternate means of communication.  Alternate means of communications can include Skype, Facetime, Facebook, etc.  The GRAND of Dublin will assist however they can to help accommodate this.

 

In the event of true end-of-life emergency, we will do our best to accommodate an emergent visit.  Outside activities and activities from outside vendors will also remain on hold.  We are asking families to cancel any outside appointments that are not medically necessary.

The health and safety of our residents and families continues to be our highest priority. Because the population we care for is especially vulnerable to potential infection, it is absolutely essential that we take these preventive steps.

The GRAND of Dublin and Vrable Healthcare will continue to follow governmental recommendations on additional prevention steps, including following handwashing and sanitation procedures.  Based on this, our process may be updated or changed at any time.  We thank you greatly for your consideration and for working with us to best limit risk to those we love.

 

Sincerely,

 

Blu Johnson,
Administrator

[1] Absent hospice or other emergent, end-of-life circumstances.

COVID-19 Update

March 12, 2020

ATTENTION FAMILY AND VISITORS:

RE:     COVID-19 Update

Vrable Healthcare, Inc. and The GRAND of Dublin are working in coordination with the Centers for Medicare and Medicaid Services (“CMS”), the Ohio Department of Health (“ODH”) and the Centers for Disease Control and Prevention (“CDC”) on limiting the transmission of COVID-19.

ODH recently released additional guidance on how skilled nursing facilities should continue to be proactive in limiting risk. The GRAND of Dublin has already begun screening visitors, staff and residents and taken other precautions outlined in the Joint Director’s Notice from ODH.

Effective immediately, The GRAND of Dublin will be following governmental recommendations and limiting the entrances of visitors to only the main, front entrance.  All visitors will be required to check-in and undertake screening and must clear the screening to be approved to visit.  Visitors must also present a valid government identification card and provide their name address and telephone number.

The GRAND of Dublin is limiting the number of visitors to one (1) visitor per resident, per day, absent emergent circumstances.  While we love to have visitors and family and understand spending time with family is of the utmost importance, we are suggesting alternate means of communication.  Alternate means of communications can include Skype, FaceTime, Facebook, etc.  The GRAND of Dublin will assist however they can to help accommodate this.  In the event of true emergency, we will do our best to accommodate an emergent visit.  At this time we will be eliminating outside activities and activities from outside vendors.  We also ask that you limit any outside appointments that are not medically necessary.

The health and safety of our residents and families are always our highest priority. Because the population we care for is especially vulnerable to potential infection, it is absolutely essential that we take these preventive steps.

The GRAND of Dublin and Vrable Healthcare continues to follow governmental recommendations on additional prevention steps, including following strict hand-washing and sanitation procedures.  Based on this, our process may be updated or changed at any time.  We thank you greatly for your consideration and for working with us to best limit risk to those we love.

Sincerely

 

Blu Johnson,

Administrator

Drug Class Series: Antiemetics

Drug Class Series: Antiemetics

Andrea Hartley, CPhT
Pharmacy Technician/Central Supply Manager
The GRAND of Dublin

Continuing the series of articles featuring common drug classes, this article is about antiemetics, or medications that treat or prevent nausea and vomiting.  The nausea and vomiting can be from any cause, including motion sickness, illness, drug side effects, and chemotherapy reactions.

Below I list some of the more common antiemetic medications and the most notable information about them.

dimenhydrinate (Dramamine); usually used for motion sickness; available OTC as an oral tablet and a prescription injection.

diphenhydramine (Benadryl); usually used for motion sickness, also commonly used as an antihistamine in preventing and treating allergic reactions as well as itching; available OTC as a tablet, capsule and liquid to be taken by mouth and as a prescription injection.

meclizine (Bonine); usually used for motion sickness and vertigo, also an antihistamine; available as OTC and prescription tablets.

promethazine (Phenergan); available in an oral tablet OTC and as a prescription in the form of a rectal suppository and injection.  Also an antihistamine used for minor allergies and used to relax patients in a clinical setting.

metoclopramide (Reglan); available in a regular and disintegrating oral tablet, liquid and injection; also used to treat gastroparesis and esophageal problems and usually used for nausea caused by these problems; available as prescription only.

ondansetron (Zofran);available as a regular oral tablet, an orally disintegrating tablet, an oral liquid and an injection; frequently used in pregnancy to treat nausea and nausea caused by radiation and chemotherapy treatment;  available as prescription only.

prochlorperazine (Compazine); technically an anti-psychotic but it is frequently used as an antiemetic.  It’s available as an oral tablet, rectal suppository and an injection and is prescription only.

scopolamine (Transderm Scop patch); used to prevent motion sickness, it’s available as a prescription only patch that’s worn behind the ear for three days at a time.

chlorpromazine; another one that’s technically an anti-psychotic but it is frequently used as an antiemetic.  It’s available as an oral tablet and injection and is prescription only.

Trimethobenzamide (Tigan); available as an oral capsule and an intramuscular injection.

I hoped this gave you a little information about these common drugs.  Next time I will be giving you information about a relatively new class of drugs:  antivirals.

The 5 Stages of Grief

The 5 Stages of Grief

Catherine Denlinger
Director of Social Services, MSW, LSW
THE GRAND of Dublin

Given the tragedies that happened over the weekend in El Paso and Dayton, I thought I would briefly talk to you about grief and how to cope with loss in general.

There are 5 stages of grief that one typically goes through and there is no timeline on each stage.  Everyone grieves at their own pace and on their own terms. The important thing to remember is that grieving is a natural and a necessary course of emotions that everyone goes through.

Grief Cycle

Below are the 5 stages of grief:

  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance

 

  1. Denial – Initially we are in shock that this happened. We are telling ourselves that this can’t be real.  I must be dreaming.  Please tell me I’m dreaming.  Numbness takes over our bodies and we seem to be frozen, unable to comprehend what’s happening.  This is a normal reaction to loss, tragedy, trauma, etc.
  1. Anger– We are annoyed easily, blame others, question our faith, and feel very negative about everything and everyone. The underlying feeling of anger is pain.  In order to grieve we need to feel angry.  It’s ok to be mad, to be upset, and to be furious.  We need to look for a reason.  Why did this happen?  Why did this happen to me, to us, to him, to her, to them?  Looking for an answer to explain what happened so that we can understand the why.  This is a normal reaction to loss, tragedy, trauma, etc.
  1. Bargaining – If only…What if…Please God…. This stage is when we try to come up with a plan to fix it.  Trying to figure out how we can give something of ourselves and in return we wake up and this was all just a bad dream.  This is when we are going through the guilt.  Why not me? It should have been me? Let me take his/her/their place.
  1. Depression – Emptiness. The loss is real and we feel it.  It’s the heaviness in our bodies and in our hearts.  This is one of the hardest stages to go through for many people.  The pain and loneliness can feel overwhelming.  This is most definitely when you need support from others.  You don’t have to go through this alone.
  1. Acceptance – We never forget, we find peace within ourselves. As hard as it is to do it is necessary.  We must try to live in a world without our loved one.  Things change, we change and we never replace.  We just learn to live with it day by day, month by month, and year by year.

In summary, be in shock, be mad, be a negotiator, be down and at some point…move forward.  It’s okay to experience these emotions.  It’s necessary to be able to move on, to have good days, to feel happy again, to experience pleasures, and to enjoy life.  If you find yourself unable to have these good feelings then please seek help.  There are many resources to help you with the grieving process. You are not alone.

If you’re ever in the situation that you need long term care, skilled care, any care in a Nursing Center and you are going through struggles in your life please reach out to your social worker.  We can help! We have resources to assist you with managing your feelings and improving your mood.  When in a Nursing Center and the social work administers a PHQ-9 mood assessment (discussed in a previous article) they are asking these questions for a reason.  When answering these mood questions and scoring a lot of points, take advantage of the question, “would you like to talk with someone about how you’ve been feeling?” “Would like to talk with a counselor or our physician?” “Would you like to talk with me about how you’ve been feeling?” Social workers in Nursing Centers are not grief counselors; however, we are trained to have the basic skills that are needed to provide support and encouragement to you.  We want to help you.   If you need help, we are here for you.

Drug Class Series: Antidepressants

Andrea Hartley, CPhT
Pharmacy Technician/Central Supply Manager
The GRAND of Dublin

Drug Class Series: Antidepressants

antidepressantsContinuing the series of articles featuring common drug classes, this article will be about antidepressants.

This class of medications is used to treat depression as well as anxiety and other psychiatric or sleep disorders as determined by a physician.  Nearly all antidepressants are taken orally and all require a doctor’s prescription.

There are 4 types of antidepressants within the class, based on how they work in the body:  SSRIs, Tricyclics, MAOIs and Atypical.  Side effects of medications within the same antidepressant group are very similar.

Below are the medications in the antidepressant class along with the most noteworthy facts about them.

SSRIs (selective serotonin reuptake inhibitors):

Paxil (paroxetine), Prozac (fluoxetine), Zoloft (sertraline), Serzone (nefazadone), Luvox (fluxoxamine), Celexa (citalopram), Lexapro (escitalopram), Pristiq (desvenlafaxine), Effexor (venlafaxine), Cymbalta (duloxetine).

SSRIs ease depression by increasing levels of serotonin in the brain. Serotonin is one of the chemical messengers (neurotransmitters) that carry signals between brain cells. SSRIs block the reabsorption (reuptake) of serotonin in the brain, making more serotonin available. SSRIs are called selective because they seem to primarily affect serotonin, not other neurotransmitters.  They are the most commonly prescribed type of antidepressant and generally cause the least amount of side effects.

Tricyclics (TCAs)

Anafranil (clomipramine) Elavil (amitriptyline) Norpramin (desipramine), Pamelor (nortriptyline), Sinequan (doxepin), Tofranil (imipramine), Vivactil (protriptyline),Asendin (amoxipine)

This type of antidepressant was discovered in the 1950s.  TCAs are named after their chemical structure, which contains 3 rings of atoms.  This type of antidepressant impacts several different neurotransmitters in order to change the brain and for that reason can cause many unwanted side effects.

MAOIs

Marplan (isoxarboxazid), Nardil (phenelzine), Emsam (selegiline), Parnate (Tranylcypromine)

MAOI stands for MonoAmine Oxidase Inhibitor.  This was the first variety of antidepressant developed.  They are effective, but are known for causing many side effects; frequently ones that are unsafe.

Atypical or Miscellaneous

Wellbutrin aka.  Forfivo, Budeprion, Aplenzin(bupropion), Viibryd (vilazodone),  Desyrel (trazodone),Trintellix (vortioxetine),  Remeron (mirtazapine), Serzone (nefazodone)

Medications are placed in this category because they don’t fit into the other groups.  This is because they treat depression in a completely different way or they combine multiple characteristics of other groups to work uniquely.  They are each unique medications that work in different ways from one another.

When you stay at The Grand, the knowledge of our doctors, nurse practitioners, nurses and pharmacy technician is at your disposal.  If you have a questions about your medications, just ask!

May is Older Americans Month, Focus on Aging!

May is Older Americans Month!

by Meghan Elliott, RN, Director of Nursing
and Sarah Schubert, LPN, MDS
The GRAND of Dublin

Older Americans Month, AgingAging is something no one can escape. While society frequently reinforces an anti-aging atmosphere, there are many reasons to celebrate and embrace the changes that occur throughout the aging process. Many physiological changes occur during this process, but very important mental aspects change as well. According to the World Health Organization, approximately 15% of those aged 60 or over suffer from dementia and depression; it is important to note that the majority of aging Americans do not. For those aged 65+, a lot of reflection tends to occur. These individuals look at their past and present relationships, and think about what they have accomplished or not accomplished throughout their life. This is a great time to interact with our “older” family members and friends as the insight they have is immeasurable.

Open a Dialogue and Ask Questions

This is also a critical time to focus on what that family member or friend may desire in terms of end of life care, or how they envision spending their final days, months, or years. Please take the time to ask your loved one their thoughts and feelings about alternate living arrangements, medical procedures they would want performed and those they would not. Also ask about a plan B, what if that preferred plan isn’t possible, then what? These questions are vital to the comfort and security our older population has when faced with a new or chronic health problem that requires treatment. These types of discussions are critical not only in a medical scenario, but they are also important ways to connect with that individual and appreciate their perspective on life. You may be incredibly surprised by the answers your loved ones will give you. Open, honest, frank discussions about life lessons, goals, failures and successes from the older population can mold and shape how WE live our lives. Those of us in healthcare want to take the time to thank our elderly population. You teach and guide us more than we could ever educate you. Happy Older Americans Month! Your wisdom is appreciated.

What is PHQ-9?

PHQ-9 – Patient Health Questionnaire Depression Module

Catherine Denlinger, DOSS, MSW, LSW
Director of Social Services
The GRAND of Dublin

PHQ-9 stands for Patient Health Questionnaire Depression Module.  It a screen used to assist with identifying a resident’s current and recent mood state and to help determine if any interventions or referrals need to occur.  The 9 stands for the 9 criteria derived from the DSM-IV (now DSM-V) which is a diagnostic manual for those in the mental health field.  The PHQ-9 is a mandatory interviewing tool for skilled nursing centers.  A social worker is usually the one that would be administering the PHQ-9.

The PHQ-9 is administered shortly upon admission and then several times thereafter if a resident is in a center for skilled services.   It is administered after 14 days, 30 days and so forth.  If a resident is receiving long term care, then the PHQ-9 is administered upon admission, quarterly and if there is a significant improvement or decline in a resident’s well-being.

A resident is asked is over the past 2 weeks, has he/she been bothered by any of the following problems.  There are 9 questions to be asked that are answered with a yes or no.  If a question is answered yes, then there is a follow-up question asking the frequency ranging from a 0 to a 3.

  • A 0 is never to 1 day
  • A 1 is 2-6 days (several days)
  • A 2 is 7-11 days (half or more of the days)
  • A 3 is 12-14 days (nearly every day)

The scoring ranges from 00 to 27.  The tally of the scores represents a resident’s tentative mood state for depressive signs/symptoms.

  • A score of 0-4 represents none to minimal depression
  • A score of 5-9 represents mild depression
  • A score of 10-14 represents moderate depression
  • A score of 15-19 represents moderately severe depression
  • A scored of 20 + represents severe depression

Below is the Resident Mood Interview (PHQ-9) found in the MDS Manual used by all skilled nursing centers:

PHQ-9

This questionnaire is a tool to assist with providing a holistic presentation of a resident in order to ensure the most appropriate plan of care.   Here at The GRAND, there are resources available to assist a resident with depression signs/symptoms during their stay with us such as scheduled activities, pet therapy, counseling services, a Medical Director to oversee any medication management needs and an ample amount of caring staff members to talk with.  The Grand has all private rooms for a resident’s comfort and privacy as well as multiple locations throughout the center to engage in socialization or to just have time for oneself.  We strive to make our residents stay both physically and mentally stimulating as well as to have the best possible outcome for their well-being.