Olympic athletes are typically seen as the epitome of human strength, flexibility, and performance. Did you know that there are also Senior Olympiads? The National Senior Games run from July 24th to August 4th this year!

We don’t have to be Olympiads to be our strongest as we age, though! Lower body strength is one of the largest predictors of how well we function as we age and whether we may need to live in a nursing home. Did you know the average 90-year-old man living at home can sit to stand from a normal height chair 7-12 times in 30 seconds WITHOUT using his arms to stand? 

Below is a chart on the average number of times a man or woman can sit to stand in 30 seconds in each half decade of life after 60 years old. What a great way to measure whether we are aging typically in our strength, even if we aren’t as strong as an Olympic athlete!

30-Second Chair Rise Norms by Age

So, how can we make sure we are maintaining optimal strength as we age?

1. Establish a baseline: At Functional Pathways, we offer a Senior Fit Test that establishes a baseline and allows for continued screening for declines using the 30-Second Chair rise as part of a holistic battery of tests that can help in identifying declines.
2. Ongoing Wellness: Participating in Wellness activities is a great way to stay strong as you age. The simple exercise of sitting to stand can be a great way to keep your lower body strong.
3. Therapy Intervention: When a decline is noted, reach out to an exercise specialist who can help you design a specific program to meet your strength, flexibility and functional needs.

We don’t have to be an Olympic Athlete to achieve a gold medal in aging. Reach out to the Clinical team at Functional Pathways for further assistance in helping you or your residents age with grace and dignity at Clinical@fprehab.com.

April is a BUSY month!! Lots to celebrate – Occupational Therapy Month, Earth Day, and National Walking Day, just to name a few. Information about OT Month was covered earlier, so let’s look at National Walking Day and explore ways to celebrate all month long!

National Walking Day is the first Wednesday in April every year, and it encourages Americans of all ages to get out, stretch their legs, and get their hearts pumping. The American Heart Association sponsors this day to help remind people about the benefits of taking a walk. Just because we missed the official day by the time of the posting of this article doesn’t mean we can’t celebrate!

By committing to walking at least 30 minutes each day, you can improve your mental and physical health. And remember, those 30 minutes do not have to be done all at once. Depending on your availability and your physical fitness, three smaller 10-minute walks throughout the day might be more appropriate. As always, check with your healthcare provider for specific recommendations.

Here are some tips for how to make walking more enjoyable:

• Wear comfortable clothes and supportive shoes.
• Walk with a friend or family member to help pass the time.
• Stretch prior to and after your walks to prevent injury and soreness.
• Drink plenty of water. You may even consider bringing a water bottle with you to ensure you stay hydrated.
• Choose different routes for your walks. Change things up with a variety of scenery, terrain, and elevation, if possible.

There are also plenty of easy ways to get in a few more steps each day. Maybe you don’t have 30 minutes to spare – it happens to the best of us! Instead, incorporate ways to get in more steps throughout your day. I promise they will add up over time!

Here are some tips for adding more steps into your day:

• Park further away. Instead of taking the spot closest to the entrance, park at the other end of the parking lot. The extra steps it takes to get into the building will certainly add up.
• Take the stairs. If you are able, take the stairs instead of the escalator or elevator when you have the chance. Not only will you be adding extra steps, but the elevation is also great for muscular strength and endurance.
• Walk while you talk. During your next phone call, try pacing around your office or home to get in a few extra steps. Take breaks as you need, but getting up to stretch your legs will certainly help you get through the day.

There are plenty of ways to celebrate National Walking Day all month long. Perhaps we can even turn these celebrations into some lifetime habits, too!

April is Occupational Therapy (OT) Month! We hear it all the time: “I am retired! I don’t have an occupation anymore, so why would I need OT?” Our residents might be retired, but OT is still beneficial.

Our residents may not have a 9-5 pm job that takes them out of the home anymore, but there are many daily activities that feed into vocational wellness that Occupational Therapy addresses every day.

One of the goals of OT is to promote independence in functional abilities. Here are just a few of the many ways our OTs and COTAs help residents every day:

• Fine Motor Skills – Maintain dexterity and improve grip strength. Make things like sewing, cleaning, or handwriting easier.
• Visual Assistance – Perform at the top of your abilities by learning about assistance for visual challenges.
• Environmental Modifications – Are our residents’ homes as safe as possible? What about when they travel to volunteer, participate in group activities, etc.? OT can help with environmental modifications to help our residents stay safe.
• Assistive Devices and Adaptive Equipment – Did you know simple devices exist, like grab bars and reacher tools, to help make tasks easier to complete? There are also more complex resources, such as voice-activated technology, to help with making lists, medication reminders, etc.

Of course, the list above is not all-encompassing of the scope and skill sets of our fantastic OTs and COTAs. If you are a PT/PTA/ST/DOR, find your OTs and COTAs and thank them for the work that they do every day. Their hard work is a huge part of what makes our teams successful in helping our residents return to or maintain the highest quality of life!

Thank you to all of our OTs and COTAs across the country!

Pressure injuries are important health issues and often one of the greatest challenges that healthcare constantly faces. Not only can treating pressure injuries be costly, but they can have a bigger negative impact on residents’ lives than you might think.

Pressure injuries are commonly seen in high-risk populations, such as the elderly, immobile residents, and those who are extremely ill. Preventing pressure ulcers can be difficult for caregivers and the healthcare industry. Prevention is not solely the responsibility of nursing; it falls on the entire interdisciplinary team. Providing optimal care and focusing the attention to prevention can save residents from unnecessary harm, hospital admissions, and potentially death.

Pressure injuries prevention:

• Assess skin thoroughly at admission.
• Assess pressure points, temperature, and skin beneath medical devices.
• Early identification for high-risk residents with comorbidities (such as diabetes and vascular problems).
• Clean skin promptly after incontinence episodes.
• Provide adequate nutrition/hydration (if not contraindicated).
• Implement a turn and reposition schedule.
• Refer resident to the dietician.
• Provide nutritional supplements as indicated.
• Provide pressure reducing devices (mattress, wheelchair cushion, etc.).

Benefits of preventing pressure injuries:

• Improve quality of life for residents.
• Decrease the risk of hospital admission.
• Prevents pain and infections.
• Improve Quality Measures.

Prevention of a pressure injury is a critical part of caring for a resident. For residents at risk, appropriate interventions need to be in place and communicated to the healthcare team and the caregiver. Treating a resident with a pressure injury requires a team approach to provide treatment that will maintain health and quality of life. No pressure, No injury.

Biting our nails, shopping daily on Amazon, prescribing treatment the same way we did 17 years ago….all three of these things are bad habits, but only one can affect the outcomes of our patients.

Therapists can agree that we all want to provide the highest quality of care, supported by the most current evidence. Yet, at times, it can be difficult to adapt our practice to new or different techniques. It takes, on average, 17 years for evidence to be translated into practice!

So why is it so hard to translate evidence into practice?

1. The complexity and expanse of our practice
2. Incomplete access to evidence
3. Difficulty interpreting evidence
4. TIME
5. HABITS

The Functional Pathways clinical team is here to help with the first four reasons! As part of each of our Core 4+ programs, we comb the intranet to include the current evidence, Clinical Practice Guidelines, and protocols from people much smarter than us. Outside of our clinical programs, we are here to find the most up-to-date and cutting-edge research and resources on any topic that you may need to support your patient outcomes.

Most importantly, our patients count on you to take this new information, form a new habit, and put it into practice!

How many of us have attended a CEU, thought the information was wonderful, but then did nothing with it (I am raising my hand too)? Here are a few steps to help you incorporate new clinical habits:

1. Write out a plan of what you want to change.
2. Start small (one new standardized test or treatment technique).
3. Set goals and mark progress towards them.
4. Realize that change causes discomfort. Changing means willing to be uncomfortable, which means a need for increased self-control, self-regulation and effort. Our brains reward us for routine and ease, so we have to work against our own brain.
5. Be willing to devote time and effort.
6. Create accountability through goal-setting with a buddy or support from clinical team.
7. Encourage curiosity.
8. Celebrate wins, even small ones.
9. Forgive yourself if you get off track, but set a plan to get back in motion.

If you want this level of support at your facility or community, reach out to the Functional Pathways clinical team at clinical@fprehab.com! Especially if you need help shopping on Amazon. We are really good at that!! 

Welcome to 2024! Well, a little late. Hard to believe the first full month of the new year is almost over!

Did you set a New Year’s resolution?  About 34% of people set them and only 8% of those 34% of people stick to them for the entire year. So maybe that is not the best way to make some personal or professional changes. 

Let’s think outside of the box. “New Year, New You” is often a phrase that is spoken, but how did we get here? What was the journey like? Did we learn from our mistakes and failures? I want to do something different this year. So here are some suggestions to make 2024 the best one yet:

• Create a 2024 bucket list – what would I like to do this year . . . . take a vacation and put my phone and computer away, volunteer, remodel my home or maybe reconnect with an old friend.
• Write a personal mission statement – we all have them for work, but what is my personal mission in life? Can anyone else interpret it from my actions?
• Choose a word or phrase for the year – maybe a word like gratitude, wellness, authentic, adventurous, or balance; maybe a phrase like “Be Kind,” “Lighten the Burden for Others,” “Focus on What’s Important,” “Have Character,” or “Take Action.”
• Mini goals – how about a 1-week challenge or a 1-month habit change to break up the year and find greater success one small step at a time.
• Healthy pleasures – get a massage, pedicure/manicure, play golf, take a hike, walk your dog, meditate, or read a book to take a moment to care for yourself.

That all being said, if you still wonder if you are lucky to have made it to 2024, think about what was posted by the Canadian Red Cross and author Mark Batterson:

• If you can read this, you are luckier than over one billion people who cannot read at all.
• If you woke up this morning with more health than illness, you are luckier than the million who will not survive the week.
• If you have never experienced the danger of battle, the loneliness of imprisonment, the agony of torture, or the pangs of starvation, you are luckier than 500 million people in the world.
• If you can attend any meeting you want — political, religious, social — you are luckier than 3 billion people in the world.
• If you have food in the refrigerator, clothes on your back, a roof over your head, and a place to sleep, you are richer than 75% of the world.
• If you have money in the bank, in your wallet, and spare change in a dish someplace, then you are among the top 8% of the world’s wealthy. 

Cheers to a fabulous 2024!

Too much, too many, and I’m salty about it…

I know what you’re thinking — there is a lot to be salty about, so which thing could this be? Well for today, or at least this moment, I am salty about QM, QRP, APU, VBP, 5-star, iQies…I think I got most of them. 

So, quality measures — we have been operating in and around them for some time. It’s not new; there are new measures, but that is to be expected. I’m just newly salty. 

Are QRPs QMs? Are VBPs QMs? There are QMs that aren’t 5-stars, there are 5-stars that aren’t from QMs, there are measures that are QMs, QRPs, and VBPs all at once….Which of these costs dollars vs. stars? Why am I losing the opportunity to get 66% of the 2% back? And from where? Or is it from when? Can I get an Amen? 

It is a struggle to keep all of these things straight, know what measure pulls from where, when they start to collect data (performance year) vs. when that data results in actual reimbursement (or not) (payment year), when they quit collecting data, when they freeze and thaw data, and what is reported where and for what audience. I have created spreadsheets, I have shamelessly borrowed infographs others created, I have read countless manuals and change logs, technical reports, technical user guides, reports user manuals, and just when it seems it is all becoming clear and the light bulb is brightening, another thing comes along and the process starts all over again. 

It’s what our industry does — changes, updates, corrects, and changes some more. If you work in the healthcare industry, you become accustomed to it. We wait every year for the proposed rules, final rules, and updated manuals to come out so we can start deciphering what it all means so that we can train our partners, staff, and others how to best navigate the updates all the while still providing excellent care and trying to put the resident at the center of all things. 

We have help along the way — there is power in networking and the community of others trying to break the code and understand the same things, and for that I am truly grateful. Shout out to ADVION, NARA, AAPACN, and others who make the process at least digestible.

I know (think) the intent is good: to provide care to our post-acute population. And not just to provide care, but quality care, so that’s a good thing right? 

Yes, it is a lot;  yes, it makes my face hurt; and yes, I get salty about it. But I also guess if this was easy anyone could do it, and if anyone could do it, everyone would do it, and if that happened, who would be left to make sure anyone is doing it well? 

I digress, and I think I have all of these things straight for now:  in my head, on my spreadsheets, in my copious cliff notes and in my dreams…

If you, too, suffer from saltiness around QMs, QRPs, VBPs or other acronyms, reach out — we can help!! Send an email to Clinical@fprehab.com and the team of clinical experts at Functional Pathways will be happy to assist.

Millions of people in the US are diagnosed with diabetes every year. Diabetes is a chronic health condition that affects how your body turns food into energy. The body breaks down most of our food into glucose (sugar) and releases it into the bloodstream. When your blood sugar increases, it alerts your pancreas to release insulin. Diabetes is a result of either not being able to produce enough insulin or not as well as it should.

Signs and Symptoms of Diabetes:

• Urinating often at night
• Losing weight without trying
• Presence of ketones in the urine
• Blurry vision
• Slow-healing sores
• Excessive thirst and hunger

Diabetes can lead to serious complications, such as heart disease, stroke, problems with feet (check them every day), chronic kidney disease, nerve damage, and diabetes-related ketoacidosis (life-threatening). Diabetes is the number one cause of lower limb amputation, kidney failure, and adult blindness.

Type 1 diabetes was once most commonly seen in children, teens, and young adults, but now it’s seen at any age. Once was considered insulin-dependent or juvenile diabetes, this form of diabetes is caused by autoimmune disease, in which your immune system attacks the body instead of protecting it.

Risk factors:

• Family history of type 1
• Age

Type 2 diabetes is often seen in people over age 45, but more children, teens, and young adults are diagnosed with it as time goes on. This type of diabetes doesn’t make insulin and can’t keep blood sugars at normal levels.

Risk Factors:

• Prediabetes
• Family history
• Physically inactive less than 3 times a week
• Race – African American, Hispanic, or Latino, American Indian, or Alaska Native.

Other forms of diabetes are gestational and prediabetes. Gestational is seen during pregnancy and is usually resolved after the baby is born. Prediabetes is high blood sugar, but not high enough to have type 2 diabetes. Without intervention, it will likely develop into type 2 diabetes.

Diabetes is determined by a simple blood test:                                                                                                

• A1C measures blood sugar level from the last 2-3 months.                                                              
• A fasting blood sugar test measures your blood sugar after not eating anything overnight.
• Glucose tolerance test measures blood sugar after drinking a liquid that contains glucose.                               
• Random blood sugar test measures your blood sugar at the time you are tested.

Managing your diabetes:

• Insulin (type 1)
• Monitoring your blood sugar (glucose) level
• Exercising
• Healthy eating
• Healthy weight

Although diabetes is manageable, it is a life-threatening disease. Therefore, it is important to monitor blood sugar levels, develop healthy eating habits, attend regular doctor visits, and adhere to your medication regimen.

Remember: Too much sugar can have you in a Not So Sweet situation.

“Art washes from the soul the dust of everyday life.”

— Pablo Picasso

What is art? Is it a famous painting hanging in a museum, song lyrics of your favorite song, or a hand-drawn card from a grandchild? Art is an expression that stimulates an individual’s thoughts, emotions, beliefs, or ideas through the senses – so, the famous painting, song lyrics, and hand-drawn card are ALL examples of art.

There are many health benefits to being artistically creative. Studies have shown that expression through art can help with depression, anxiety, and stress. In addition, it has also been linked to improving memory, reasoning, and resilience.

Don’t worry, you don’t have to be Picasso to reap the health benefits! It’s the ACT of creating art that is beneficial, not the artwork itself. There are many ways to get creative, such as through: poetry, painting, pottery, music, and dance, just to name a few.

Let’s look at some of the benefits of art:

• Relieves Anxiety and Stress – Engaging in artmaking can significantly reduce cortisol (“stress hormone”) levels in the body. Why? Creating art is like meditation – it forces the mind to slow down, focus on the details, and block out distractions. Painting, sculpting, drawing, and photography are relaxing and rewarding, and they can leave you feeling mentally clear and calm. Creating art provides a distraction, giving your brain a break from usual thoughts.
• Maintain Fine Motor Skills – Small muscles in the fingers, hands, and wrists are utilized during art creation. These motions, such as holding a paintbrush or pencil, molding clay, or writing poetry, are great for maintaining fine motor skills.
• Socialize and Connect – Art programs provide a community with an opportunity for attendees to share a similar purpose and commitment. You can connect with neighbors over your love of arts and crafts, or your interest in trying a new hobby. If group events don’t interest you, consider getting together with family or friends and work on something together! You get the same benefits, but in a more intimate setting.

Not an artist? That’s ok! Does the idea of a blank canvas intimidate you, but you still want to give art a try? Consider starting off with a paint-by-number or coloring book instead. These allow for creative choices on which colors to choose and allow for artistic independence while providing some guidance.

Art has a positive effect on both the brain and the body. You may find the addition of art into your routine can have a positive impact on your mental and physical health. For more information on the benefits of art or to learn more about therapy and how it can benefit you, please contact the Functional Pathways Therapy Team.

“Everything has its beauty, but not everyone sees it.” – Andy Warhol.