by Bobby Anderson, Staff Writer

Heisman Trophy winner Jason White and the Braum Family farm are arguably Tuttle’s two biggest claims to fame.
But this city in Grady County with a population of barely 6,000 is a test site for a new care model that promises to revolutionize elder care.
Tuttle Care Center is one of four nursing homes in the state involved in a 12-week evidence-based fall prevention study organized by the Fran and Earl Ziegler OU College of Nursing.
The study, entitled It’s Not OK to Fall, is led by Diana L. Studevant, PhD, GCNS-BC, APRN and Teri Round, BSN, MS, RN, BC-NE.
“We were tickled about all the things that would help the elderly not fall,” Childree said.
It has been estimated that one in three women and one in 12 men will sustain a hip fracture in their lifetime.
It has been reported that 86% of hip fractures occur in individuals aged 65 years and older.
More than 25,000 deaths in older adults were attributed to unintentional fall injuries in 2013.
Childree said much research has been done in the state of Wisconsin on preventing falls.
Wisconsin has one of the highest rates of death from unintentional falls in the nation. In fact, the death rate due to unintentional falls in Wisconsin is twice the national average.
That’s when the state decided to do something.
The Four P’s
Childree said the program includes following the Four P’s which includes position, personal needs, pain and placement.
Proper positioning of the resident reduces the need for them to try to reposition themselves on their own.
Meeting personal needs refers to asking whether the resident needs to toilet. Again, having someone there to help the resident meet a need helps reduce the potential for the resident to get themselves in a compromising position that may cause a fall.
Keeping a resident’s pain under control also allows them to rest comfortably.
And, finally, placement of a resident’s call light, reading glasses, walker, tissues and other necessary items is important to prevent residents from having to have to hunt them down.
There is a school of thought that still thinks falls are inevitable.
“I disagree,” Childree said. “The philosophy of this group is ‘what are we doing to cause them to fall.’”
That’s why Childree’s team has adopted a CSI-type approach when investigating falls. Asking questions of the resident involved in a fall is a good first step but also trying to gain as much information as possible including several photos of the area where the fall happens helps.
“We cause them to fall for some reason,” Childree said. “We want them to take a picture of the surroundings before anything is moved that way we can look at it just like an investigator does at a crime scene.”
Childree has a fall team that meets regularly to review all incident reports and decide what actions can be taken.
Childree said sleep is also a major component in falls risk. The traditional method of checking a resident every two hours to see if they are dry might be doing more harm than good.
“They’re not getting into that deep REM sleep so they did a study and that’s like torture,” Childree said. “That’s why you see a lot of nursing home residents that sleep during the day.”
Tuttle Care residents are also taking part in Tai Chi.
Scientific studies show that the practice of Tai Chi improves, and prevents, almost all chronic conditions including arthritis, heart disease and diabetes. In addition, it improves balance, immunity, and reduces stress. In fact, Tai Chi improves practically every aspect of health.
Kelli Brummer teaches Tai Chi at the Care Center weekly and works for the Oklahoma Healthy Aging Initiative, a statewide program through the Department of Geriatric Medicine at the OU Health Sciences Center. In addition to Tuttle she works with residents at Spanish Cover in Yukon and Cedar Creek in Norman.
“It’s been good,” Brummer said. “We’re having a great time at Spanish Cove. They do Tai Chi in the independent part anyway and we’ve had residents come over. It’s fun.”

Crowning jewel: St. Anthony Pavilion is set to open

by Jason Chandler, Staff Writer

St. Anthony Hospital is excited about its new four-story St. Anthony Hospital Pavilion. When it opens in late May or early June of this year, the 110,000-square-foot facility will grace Oklahoma as the hospital’s latest expansion on the Oklahoma City hospital’s midtown campus.
It consists of a new emergency room to replace the existing ER. There are two new intensive care units and an intermediate care unit.
The Pavillion represents the crowning point of the 2014 plan. In 2003, Saints made the decision to stay in midtown by investing $220 million to improving and modernizing its campus. The results have been spectacular, adding to the renaissance of downtown Oklahoma City with development and growth.
St. Anthony will have an additional helipad on top of the hospital, said Darla Wilson, RN, director of critical care services.
“One thing very nice about this is you have your emergency room on the very first floor and you have your intermediate care unit,” Wilson said. “And then the third floor is both transitional care and ICU and the fourth floor is all ICU.”
It is designed to expedite health care with the consumer in mind. She said the new addition will reach out to the community in a patient friendly manner that is designed in a way to meet the flow of patients’ needs and that of the nursing staff and physicians.
The nursing staff was instrumental in the design of the complex as well.
“What is really nice is we are increasing bed capacity for the intensive care unit,” Wilson said. “We will be at 36 beds (from 32), but we are also adding a 12-bed transitional care unit that will take ICU patients and overflow step down while waiting for placement.”
Nurses are excited to prepare for work in a brand new facility, Wilson added. She said they have known more beds were needed for patient care and Saints responded.
Every other room will have a lift for the patients to offer good support for the patients and it also makes work easier for the nursing staff when moving them. Enhancements will also benefit the families of patients.
A floor to ceiling window will help orient patients to know day from night even if they are not directly facing it.
“It gets that light into the room,” Wilson said.
Families will have more places to sit and relax in their loved one’s rooms. A longer bench designed for comfort will allow them to recline. All this is possible as the physicians and the nursing staff will be able to reach the patients when needed.
Wilson and her husband moved to Oklahoma City in 1988 and she has been employed at St. Anthony ever since then.
“It has changed so much in this area. And the hospital has changed and it’s just beautiful,” Wilson said. “I love the staff. They are a wonderful staff who care about their patients. They care that they are giving the best exceptional care. They truly have that desire.”
“I think that is what you want from your staff. That is what their heart felt desire is.”
Several things about the new ER make Courtney Myers happy as a registered nurse and, manager of the ER. It will not have two sides of an emergency room as is evident in the current ER.
“Currently we have 15 beds on one side and an additional eight beds. So trying to operate two ERs in conjunction with each other is difficult from a management perspective,” Myers said. “So now we will all be under one roof, so that’s really nice.”
Patients will enjoy a brand new and beautiful lobby. What is especially nice is there will be a private area designated for the mental health population, she said. It will be more therapeutic for the mental health patients to be in during their crisis.
“We looked nationwide at what the premier facilities were doing for mental health patients in ERs and that’s how we designed that area for them,” she said. The ER is designed to model a fishbowl, she said, for better monitoring of activity. As a result, the nurses are also excited about moving into the new building.
“We’ve all seen the healthplexes being built, so the staff is excited to move into a new building as well,” said Myers, who has been with Saints for 18 years.
“It’s amazing to me because this will be the third ER I have had some involvement with. We always had plans that we would outgrow the ER, so to see us outgrow what we thought we would outgrow is pretty amazing to me.”

Oklahoma Forestry Services announces the promotion of Andy James to assistant director and fire management chief. James will lead the state’s wildfire suppression and mitigation operations, as well as provide leadership for the division’s field operations based out of Tahlequah, Wilburton and Broken Bow.
“As the state’s lead agency for wildfire suppression, the role of fire chief is critical,” said Director of Oklahoma Forestry Services and State Forester Mark Goeller. “We are fortunate to have someone as knowledgeable and experienced as Andy ready to step into that role. He will do a phenomenal job.”
A 22-year veteran of Oklahoma Forestry Services, James previously served as the area forester for Community Fire Assistance programs, providing assistance to rural fire departments and communities. Prior to that he has served in a variety of positions including leading the Southeast Area operations located in Broken Bow, service forester in Wilburton and district forester in Jay. Wildland firefighting has been a big component of all of his positions with Oklahoma Forestry Services.
Throughout his forestry career James has focused on wildland fire suppression and management, not only in eastern Oklahoma, but across the state as a task force leader, division supervisor and operations chief for the OFS Interagency Type 2 Incident Management Team.
“I am excited about the opportunity to represent Oklahoma Forestry Services on a state and national level,” said Andy James. “We have made great strides as a wildfire agency over the last few years and I look forward to continuing those efforts.”
In addition to his duties with Oklahoma Forestry Services, Andy is a member of the Northern Rockies National Type 1 Incident Management Team, and is qualified as an operations section chief, type 2 and an operations section chief, type 1 (trainee). He is also a member of the Fuels Management Committee of the National Wildfire Coordinating Group and the Oklahoma Statewide Mutual Aid Working Group.

by Bobby Anderson, Staff Writer

For the better part of a decade Melissa Hill and Greg Bridges traveled Oklahoma trying to improve the health care landscape in our state.
They saw the good and often times the bad.
What they walked away with was a better understanding of what assistance seniors need to stay in and thrive in their own homes as long as possible.
And through that, Home Care Assistance was born in the metro.
IMPROVING HEALTH CARE
The group has cared for Oklahomans through Home Care Assistance for almost four years now.
Bridges – who brings more than 35 years of registered nursing experience to the company – worked with Hill consulting Medicare providers prior to opening Home Care Assistance.
“Quality improvement and patient safety initiatives,” Hill said of two things that occupied their time as they traveled. “We did a lot of work … particularly around the issue of readmissions. Why are people going back into the hospital and how many of those readmissions could have have been prevented?”
The answer to both questions could be found at home.
“It was very eye-opening for me personally to understand some of the risks or hazards of hospitalization and some of the safety issues that are prolific in the health system,” Hill said of her decade of process improvement. “We know people really want to avoid being institutionalized and the majority of people want to remain in their homes.”
HEALTH AT HOME
Typically, Home Care Assistance hires just one in 25 applicants – all home health aides and certified nursing assistants.
The focus is on activities of daily living – allowing clients to do as much as they possibly can on their own while also being there to help shore up any deficits.
“It’s A through Z, personal care, dressing …” Bridges said. “Statistically, 60 percent of people who come out of the hospital with strokes have depression. Having that relationship with a caregiver one-on-one and not feeling like they are a burden … can really lift someone out of that depression.
“It’s broad spectrum.”
Services range from personal care to medications reminders, running errands and light housekeeping.
“You want to maintain an optimal environment for them to thrive,” Bridges said.
Bridges noted that as health care moves more towards an in-home setting it’s important to understand that bringing someone into your home has legal ramifications.
The Oklahoma State Department of Health is cracking down on “rogue” caregivers who are unaffiliated with licensed agencies.
The reason is that these individuals often do not go through state and national background checks, carry workman’s compensation insurance or withhold required taxes.
Home Care Assistance leans heavily on Bridges’ three decades of experience ranging from the ICU into the home.
“With us you transfer that into the home and the practical things that keep a person safe,” Bridges said. “We try to focus on consistent assignments so the same caregiver and same team knows the patient’s idiosyncrasies. And we’re the owners and I’m the case manager so we know each client intimately and because of that we can intervene and tailor a plan of care.
“Watching a person that closely, supporting physical therapies and having that much feedback and intervention on a daily basis we really nip all sorts of stuff in the bud.”
Most clients who utilize Home Care Assistance are in their 70s or 80s – although Hill points out one client just turned 101 – and need assistance dealing with multiple chronic conditions. Heart and pulmonary issues are prevalent as are Alzheimer’s and dementia.
Following an acute medical issue is often when families realize not only the value but the need for assistance in the home.
“We wish more physicians understood the value of a non-medical home care service and where to find them,” Hill said. “It’s just not top-of-mind yet among health care professionals.”
That will be changing.
Through its Hospital Readmission Reduction Program, Medicare has been financially penalizing hospitals with high rates of Medicare readmissions and is extending the penalties to other settings of care such as skilled nursing facilities.
It’s estimated that in 2017 hospitals with relatively high readmission rates were penalized more than half a billion dollars.
That occured when Medicare patients were readmitted to the hospital within 30 days of discharge for the same diagnosis.
February is Heart Health Month, highlighting the leading cause of death for men and women.
Hill points out that the good news is heart disease is also one of the most preventable diseases. And heart disease can be managed at home.
“We see a lot of people coming out of the hospital after a heart incident or a stroke and that’s the perfect time to have in-home care services to help people recover,” Hill said. “That first 30 to 90 days after a hospital stay people are in a pretty vulnerable state.
“Our services are holistic.”
In late January, Home Care Assistance was honored by Home Care Pulse as a 2018 Best of Home Care aware winner in both provider and employer categories.
You can find out more at www.hospitaltohomecare.com.

Research from the Oklahoma Medical Research Foundation has identified new culprits that may be responsible for the development of arthritis.
The study found that growing older increases the production of a pair of inflammation-producing proteins. It suggests that targeting these inflammatory proteins might provide a path for future development of arthritis therapies.
The new findings, published in the Journal of Gerontology, provide a snapshot of age-related changes in a crucial area of soft tissue in the knee.
A team led by OMRF’s Tim Griffin, Ph.D., and Yao Fu, Ph.D., examined the knee joints of rats as they aged. In particular, the researchers studied the animals’ infrapatellar fat pad, the soft fatty tissue that lies beneath the kneecaps of both rodents and humans.
Scientists have known that these fat pads are a source of inflammation in osteoarthritic knees. And they’ve believed that this inflammation contributes to osteoarthritis, which occurs when cartilage breaks down and wears away.
“It’s actually the most common form of arthritis, often affecting the hips, hands and spine, in addition to the knees,” said Griffin. According to the Centers for Disease Control, an estimated 27 million Americans suffer from osteoarthritis.
Griffin and Fu wanted to look specifically at how aging affects inflammation in the fat pads. Griffin says he anticipated that as the animals grew older, the amount of inflammation produced by the fat pad and the size of the animals’ fat pads would increase.
“But our findings were not quite what we expected,” said Griffin. Specifically, the fat pads actually shrunk while producing higher levels of two inflammatory proteins.
“Our study suggests the fat pad is a contributor to a general increase in knee inflammation that occurs with age,” said Fu. This points toward future treatments to limit the inflammation, which might then prevent osteoarthritis from developing.
However, the researchers did find a benefit to aging in biological conditions that simulated an acute injury—such as a fall that causes damage to a joint. In this condition, the older fat pads decreased their production of leptin, a protein secreted by fat that also contributes to the break down of cartilage.
“We know there is acute inflammation that occurs after injury and can have long-term consequences,” said Griffin. “This study taught us that under certain conditions aging can actually limit the amount of leptin produced by the knee fat pad. This might help us develop new strategies to reduce post-traumatic osteoarthritis, a common cause of the disease in younger active adults.”
Janet Huebner, Ph.D., and Virginia Kraus, Ph.D., of Duke University also contributed to the research, which was supported by grants from the National Center for Research Resources (number RR018758), the National Institute of General Medical Sciences (number GM103441), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (number AR066828), and the Arthritis Foundation.

Photography and Text by Terry “Travels with Terry” Zinn  t4z@aol.com

An undiscovered intellectual and hands on treat is the Sam Nobel Museum of Natural History in Norman, Oklahoma.
Recently it was recognized for excellence by receiving the 2014 National Medal by the Institute of Museum and Library Services, the nation’s highest honor conferred on museums and libraries for services to their community. This honor was only awarded to five museums out of 17.500, and five libraries nationwide.
The honor was given in a ceremony at the White House where first Lady Michelle Obama said, “The work that you do in the summers and throughout the year is filling a crucial role n our country as we strive to give our young people a world-class education.”
Later O.U. President David L. Boren agreed, “This prestigious national award confirms that our museum is one of the most important university-based natural history museums in our nation and indeed in the world.”
As an example of the museums outreach is the ExplorOlogy program which involves promising students from schools across Oklahoma to get a hands on experience with experts in different scientific disciplines. One ExplorOlogy program took place in the high planes of Oklahoma in the Black Mesa area located in the states panhandle.
The Sam Noble Museum offers a variety of educational programming designed to engage and challenge students as they unlock the past, observe the present and consider the future though natural and cultural history. Jess Cole, head of education, says, “We are really fortunate to be a complement and supplement for Oklahoma schools with their science education.”
More information on the museum and their educational programs can be found at www.SamNobleMuseum.org. For your visit to the museum you may take in the “Be the Dinosaur!” exhibit running through June 12th, 2016. The exhibit is based on the fossils found in the Hell Creek Formations of Montana, North Dakota, South Dakota and Wyoming. You can guide a Tyrannosaurus Rex in a search for food or learn the behaviors of the Triceratops as it ambles through the Late Cretaceous from a video console. The highlight of a visit might be the video simulated pods which allow visitors to become dinosaurs.
Another attraction is the “Through the Eyes of the Lynx: Galileo and the Microscope” through August 31st. On March 10 at 7 pm, is the free “Galileo’s World Lecture Series and Sky Watch” hosted by the O.U. Observatory.
The museum is available for catered events and banquets.
Located at 2401 Chautauqua Avenue, the Sam Noble Museum is easily accessible near the O.U. Campus, and provides an educational and entertaining experience for all ages.

Mr. Terry Zinn – Travel Editor
Past President: International Food Wine and Travel Writers Association
http://realtraveladventures.com/author/zinn/
http://www.examiner.com/travel-in-oklahoma-city/terry-zinn
www.new.okveterannews.com – www.martinitravels.com