DHEC Observes National Alzheimer’s and Brain Awareness Month

June is Alzheimer’s and Brain Awareness Month, and DHEC recognizes the vital work that healthcare facilities, healthcare professionals, and caregivers do in providing treatment and improving the quality of life of those afflicted with brain trauma and disorders. There are currently over 95,000 people living with Alzheimer’s disease and other related dementias (ADRD) in South Carolina. According to the South Carolina Alzheimer’s Disease Registry, 25% of the ADRD population in the state resides in a long-term care facility (LTCF), including nursing homes and assisted living facilities, while the remaining 75% live independently or with loved ones in the community.

It comes as no surprise that COVID-19 has been an unexpected hurdle in providing special care to each resident or patient afflicted with these diseases. The risk for persons with Alzheimer’s disease and other dementias poses a unique challenge for caregivers, families, and facilities. Changes to routines, use of unfamiliar personal protective equipment (PPE), and disruption to daily schedules can lead to fear and anxiety resulting in increased depression and worsening behavioral changes, such as agitation, aggression, and wandering. While the Centers for Disease Control and Prevention (CDC) recommends specific guidance to facilities for infection control and prevention, it also recommends keeping environments and routines as consistent as possible for patients and residents suffering from ADRD and other brain disorders.

As facilities and caregivers continue to care for patients and residents, the following tips can help improve brain health for those afflicted with these diseases while preventing the spread of COVID-19:

  • Maintain the same environments and routines for the patients or residents while introducing frequent hand washing, social distancing, and use of cloth face coverings (if tolerated).
  • Introduce virtual games and activities for enrichment and memory care.
  • Use face coverings wisely. Face coverings should not be used for anyone with breathing issues or who is unconscious, incapacitated, or unable to remove the mask without assistance.
  • Keep staff consistent in memory care units at facilities.
  • Structured activities may need to occur in the resident’s or patient’s room, or be scheduled at staggered times throughout the day in order to maintain social distancing.
  • Provide safe ways to remain active, such as staff going on walks around the unit or outside with the patient or resident.
  • Limit the number of people in common areas while practicing social distancing.
  • Frequently clean often-touched surfaces, especially hallways and common areas.

Those suffering from ADRD may not be able to communicate that they are feeling ill. It is important to be informed and able to recognize symptoms in order to protect our most vulnerable from COVID-19. Early signs to recognize for a patient or resident who cannot communicate their symptoms are cough, shortness of breath, difficulty breathing, fatigue, or vomiting. Emergency warning signs are trouble breathing, new confusion, inability to wake or stay awake, and bluish lips or face.

Family and friends that would still like to visit loved ones in facilities are encouraged to use messaging systems such as emails, phone calls, cards and letters, recorded video messages, care packages, and even song and poem dedications through the facility intercom. The Centers for Medicare & Medicaid Services (CMS)’s Civil Monetary Penalty (CMP) Reinvestment Program is a great funding opportunity for facilities wishing to procure technical equipment for communication purposes. Nursing homes can also benefit from applying to CMS’ COVID-19 Communicative Technology grant that provides funding for residents to communicate with loved ones.

Lexington Medical Center (LMC) Extended Care recently took advantage of this COVID-19 grant opportunity and purchased two iPads and three iN2L tablets for the nursing home. Though the facility encourages families to make phone calls and chat with loved one outside of the facility’s windows, the technology procured through the grant allows more residents the opportunity to connect with loved ones and to do is in the most convenient, readily accessible, and intimate way. The facility already averages 700 calls per month, not including the calls made by residents with their personal devices. The use of the virtual technology for tele-videos, texts, calls, games, and a myriad of other activities connects loved ones together and helps augment the quality of life for these residents, especially those most vulnerable to brain dysfunction and memory loss.

“Without this COVID-19 communicative grant funding and the opportunity for communities to purchase needed devices, our residents might not have the opportunity to see their family nor would their family see them, which could be detrimental to everyone,” states Debbie Bouknight, Lexington’s Life Enrichment Director. “It is both heartwarming and sometimes heartwrenching, but so worth it to see the interactions happen. I feel we would see far more decline in our residents’ physical and emotional well-being if they did not have these video visit opportunities.

More ideas of how you can connect with loved ones during COVID-19 are available here.

DHEC would like to express its gratitude to all facility staff and loved ones keeping our Alzheimer’s and other dementias population healthy during COVID-19. Residents and patients suffering from these diseases are not just physically vulnerable during this pandemic, but they are also highly susceptible to mental anguish and confusion due to the necessary changes being made at facilities for infection control and prevention. We recognize the extraordinary cooperation between facility staff and families in ensuring excellent care for the quality of life of those afflicted with ADRD, as well as adapting to new forms of communication that keep loved ones both connected and safe.

Links

CDC – Considerations for Memory Care Units in Long-term Care Facilities

CDC – Supporting Your Loved One in a Long-Term Care Facility

USC, Arnold School of Public Health – Alzheimer’s Disease Registry

South Carolina Alzheimer’s Disease Report 2019: Annual Report

Alzheimer’s Association Facts Video

DHEC Recognizes National Nursing Assistants’ Week

In observance of the 43rd National Nursing Assistants’ Week 2020, DHEC would like to recognize and thank all of South Carolina’s nursing assistants for their hard work and dedication, especially during COVID-19. During the week of June 18-24, we celebrate nursing assistants and all they do for the community. The compassionate care nursing assistants demonstrate is essential to the well-being of our loved ones in nursing homes, hospitals, and other settings.

What Are Nursing Assistants?

Nursing assistants, or certified nurse aide (CNAs), ) are crucial for the successful operations of nursing homes and other long-term care settings; they provide nearly 80-90% of the direct patient care. Nursing assistants also work in hospitals, as well as in correctional institutions, hospice programs, and home care. Working under a licensed nurse’s supervision, a nursing assistant will provide basic care to patients or residents, often involving extensive daily contact. In order to become certified as a nursing assistant or nurse aide, one must successfully complete a state-approved training program and examination, , and be added to the state registry, which in South Carolina is maintained through the South Carolina Department of Health and Human Services (DHHS).

Duties of a nursing assistant:

  • Taking vital signs of patients
  • Listening to patients’ health concerns, record information, report information to nurses
  • Helping the patients dress
  • Bathing and cleaning patients
  • Serving meals to patients and helping them eat

It would come as no surprise that the extent of contact nursing assistants have with patients result in friendships; there is no limit to their commitment to the happiness and well-being of their patients.   

COVID-19

“During National Nursing Assistants’ Week, we should be mindful that what has historically been a difficult job, has become a true exercise in selflessness,” said Matt McCollum, Administrator for Ridgeway Manor Healthcare Center. “As we navigate through the changes that COVID-19 has brought upon our industry, our CNAs have been put in a position that they’ve not been tasked with before.”

During COVID-19, nursing assistants have shown great flexibility to the changes needed to keep patients and residents safe. Not only have South Carolina’s nursing assistants adapted well and continued to perform at high standards, but they have also taken on new challenges as routines and activities have come to a halt. Nursing assistants have creatively managed to keep residents active and in touch with loved ones and friends, while still following safe distancing measures and precautions.

 “These ladies and gentlemen have always done what is often a thankless job with compassion and care in their hearts, but now they are literally putting themselves in a position of potential jeopardy to provide that care to the most vulnerable Americans among us,” states McCollum. “They are truly the unsung heroes of this pandemic and no amount of thanks will ever be enough to express how blessed we all are to have them as our allies during these trying times.”

Join DHEC in thanking a CNA during the week of June 18-24. To all of South Carolina’s nursing assistants, we thank you and appreciate everything you have done for our loved ones. You are truly heroes!

June 19th is #WorldSickleCellDay

Today (June 19th) is World Sickle Cell Day!  Every year, the international health community recognizes Sickle Cell Disease (SCD) as a debilitating genetic disease that impacts families across the globe. Keeping individuals and communities informed about the struggles that come with daily management of SCD, can help raise awareness as well as debunk stereotypes and stigmas associated with persons who have SCD.   

SCD affects millions of people worldwide and is particularly common among people originating from sub-Saharan Africa, Saudi Arabia, India, South America and Central America, and Mediterranean countries, such as Turkey, Greece and Italy.

SCD affects approximately 100,000 Americans and occurs in about 1 out of every 365 African-American births. Individuals living with SCD suffer from both acute and chronic complications that require frequent contact with the medical system. These complications include acute sickle cell pain, fever, and acute chest syndrome (ACS), which is the term used for a number of different findings that includes chest pain, cough, fever, hypoxia and new lung infiltrates.

Here are some quick facts about SCD:

  • Sickle Cell Disease is a group of inherited red blood cell disorders. The red blood cells become hard and sticky and look like a C-shaped farm tool called a “sickle” and the cells die early, which causes a constant storage of red blood cells. Healthy red blood cells are round and move through small blood vessels to carry oxygen to all parts of the body.
  • To get SCD, the trait must be inherited from both parents who already have the SCD trait. People with the trait usually do not have any of the signs of the disease and live a normal life, but they can pass the trait to their children.
  • SCD is diagnosed with a simple blood test.  It is most often found at birth during routine newborn screening tests. Early diagnosis and treatment are important.
  • There are several treatment options available for individuals living with different complications of SCD, but the only cure for SCD is a bone marrow or stem cell transplant.  Transplants are very risky, and can have serious side effects, including death.  For the transplant to work, the bone marrow must be a close match (usually a brother or sister). 

SCD and COVID-19

Amid the COVID-19 pandemic, there is significant concern that the overlap of lung disease from COVID-19 with ACS may result in increased complications and amplification of healthcare utilization among individuals with SCD. Patients with SCD often have underlying cardiopulmonary co-morbidities that may predispose them to poor outcomes if they become infected with COVID-19. Source: hematology.org. 

Below are recommendations from the Sickle Cell Disease Association of America (SCDAA) for patients with SCD regarding COVID-19:

  • Patients and parents should be educated about COVID-19 signs and symptoms and the importance of physical distancing to limit chances of exposure and infection.
  • Patients and parents should receive counseling to continue to monitor for fever or other signs of infection. Call  hospital, doctor, or nurse first for advice on where to go for an evaluation.
  • Be sure that patients have an ample supply of all prescribed medication at home (including analgesics) to manage both acute and chronic pain.
  • Patients should adhere closely to the correct use of medications.

SCD Partnerships

DHEC is committed to educating the community and public about the availability of resources and services for individuals and families living with sickle cell disease.  DHEC’s Division of Children and Youth with Special Health Care Needs (CYSHCN), provides assistance to persons with sickle cell disease by covering services, such as, medical expenses, physician visits, durable medical equipment, medical supplies, and prescription drugs.  Assistance is offered to both children and adults who meet eligibility requirements. 

Additionally, CYSHCN engages with the four Sickle Community Based Organizations in the state — the James R. Clark Memorial Sickle Cell Foundation, – Louvenia D. Barksdale Sickle Cell Anemia Foundation, – Orangeburg Area Sickle Cell Foundation and – COBRA Human Services Agency Sickle Cell Program – to ensure persons living with SCD have access to community resources and support services. 

DHEC recognizes National #DamSafety Awareness Day

Sunday, May 31st is National #DamSafety Awareness Day. This day serves to encourage responsibility for dam safety, while promoting the benefits dams offer to communities. DHEC’s Dam Safety Program and their dedicated work on tools and initiatives help dam owners and the state’s dam safety program handle significant rainfall and other events that have the potential to impact dams.

DHEC’s Dam Safety Program has undergone a rebirth since October 2015’s historic floods.  Through the investments from the State Legislature, the Dam Safety Program has been able to add staff and improve its capabilities, including expanding education and outreach for dam owners. The Dam Safety team includes six Regional Dam Safety Engineers, as well as staff and engineers in the Bureau of Water, to work on permitting, inspections and increase interactions with dam owners.

Working with Dam Owners

Working with dam owners is one of the most important aspects of dam safety. When an issue arises at a dam that could lead to failure, one of the most critical tasks for the owner is to lower the water level. One tool commonly used to lower water levels is a temporary siphon. The size and number of siphons required depends on the size of the reservoir and target water level. DHEC Dam Safety has developed a video to help dam owners through installation.

Telecommuting

DHEC Dam Safety has continued (relatively) routine operations while teleworking. Each Thursday morning, program staff from across the state connect together on Teams to discuss the development of webinars, tackling a challenging aspect of a permit review, or prepping for hurricane season. 

Hurricane Season

As Hurricane Season approaches, summer thunderstorms in South Carolina can sit over a drainage basin for an extended period of time and drop 6-8” of rain in a matter of hours. When such an event is forecast or has occurred, dam owners should:

  • Evaluate the water level in the pond/lake and determine if water levels can be safely lowered to make room for incoming flows.
  • Coordinate with dam owners and/ or property owners downstream.
  • Routinely clear debris from spillways.
  • Review your Emergency Action Plan.
  • Keep alert. As the storm passes, watch for rising waters.
  • Report any immediate safety concerns to the DHEC Dam Safety Program’s 24/7 line at 803-898- 1939.

Interns

For over 10 years, DHEC’s Dam Safety Program has brought on interns to assist with development of Emergency Action Plans, data management, and mapping. Interns have been hired full-time to start careers with the Dam Safety Program here at DHEC and other have gone to work in the private sector at companies such as Trane and Dominion Energy.

Upcoming Webinars

DHEC Dam Safety has partnered with FEMA and Argonne National Laboratory on a series of webinars for dam owners, with a focus on the unique challenges faced by those dams owned by HOAs. Two webinars have been completed and the recordings posted to DHEC’s YouTube page. Additional presentations are scheduled for June 2 and July 7.

South Carolina Honors EMS Professionals on the Front Line of COVID-19

DHEC and SC EMS Association are proud to recognize our state’s emergency medical services (EMS) professionals during National EMS Week, which is May 17-20.

DHEC announced a new initiative that allows South Carolina emergency medical technicians (EMTs) to test patients for COVID-19. Following a recent pilot in April with Richland County EMS Community Paramedics, DHEC developed a training program to provide paramedics with guidance on how to collect COVID-19 specimens.

Due to the success of the pilot program, DHEC is rolling out the training to EMTs and paramedics across the state. As of today, the agency has trained more than 200 EMTs and paramedics in COVID-19 specimen collection. 

“DHEC would like to thank EMS workers for the sacrifices they make every day, especially during COVID-19,” said Rob Wronski, DHEC Bureau Director of Healthcare Professionals. “South Carolina’s EMS workers have done an absolutely incredible job of assisting patients suffering from the virus while carefully preventing the spread of COVID-19.”

In addition to responding to medical emergency calls day and night, South Carolina’s EMS professionals are a critical component of the state’s COVID-19 response. They work collaboratively with DHEC and other partners across the state to support community testing programs, universal testing in nursing homes, drive-through testing sites, and the transportation of patients.

“For many years, the South Carolina EMS Association has made purposeful movements to build cohesion of all Emergency Medical Service Professionals in our great state,” said William Tatum, the President Elect of the South Carolina EMS Association. “No matter the service, patch, or name on your ambulance, we are ONE for EMS in South Carolina. This wouldn’t have been possible without the strong relationship and mutual respect that is shared between DHEC and the members of the Association.”

South Carolina has 268 EMS agencies and 11,272 emergency personnel that includes first responders, EMTs, and paramedics. An EMS system involves a highly coordinated response for emergency medical care that relies on teamwork and camaraderie between multiple people and agencies.

“As COVID-19 emerged, the bonds established provided an information pathway and support system that continues to be beneficial to providers statewide. The future of EMS is bright in South Carolina because of the professionals that provide care to the sick and injured daily. Your hard work and dedication do not go unnoticed,” Tatum said.

During the COIVD-19 response, DHEC continues to work closely with the South Carolina EMS Association and EMS community partners by:

  • Creating 12 First Responder testing sites across all four regions of the state to allow for the rapid testing of SC First Responders suspected of having COVID-19
  • Assisting EMS workers with alternate transport destinations to allow EMTs from EMS Compact States to freely move in and out of South Carolina during support of interstate operations
  • Issuing protocols for conducting Point-of-Care Testing (POCT) for COVID-19 suspected patients that includes the use of tele-medicine
  • Expanding Scope of Practice to EMTs to collect specimens/support test sites across the state.
  • Approving the use of EMTs as temporary nurse aides at nursing homes.

More information regarding National EMS Week can be found here. For the latest information about COVID-19, click here. 

EMS workers help promote DHEC’s core value of Embracing Servicing and Service and Accessibility.