Category Archives: Chronic Disease

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

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 Observes World TB Day, Recognizes Efforts of Those Who Work to End the Disease in SC

This World TB Day, DHEC joins local, state, national and global efforts to control and eliminate tuberculosis, as well as to celebrate the work people all over the world have done to address tuberculosis.

World TB Day is officially observed on March 24 of each year to commemorate the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacteria that causes TB.

Tuberculosis is a disease of the lungs that can be spread by coughing, sneezing or speaking. Signs and symptoms of TB disease include feelings of sickness or weakness, weight loss, fever and night sweats. The signs and symptoms of TB disease of the lungs also include coughing, chest pain and the coughing up of blood. The signs and symptoms of TB disease in other parts of the body depend on the area affected.

The 2020 World TB Day theme is ”It’s Time”. DHEC will take the time to recognize the amazing work of those in our TB division across the state. Our statewide theme is ”It’s time for us to speak out, step in, and stand up to end TB.”

In observance of the day, DHEC will celebrate with all TB staff on Friday, March 20. The two-hour celebration will include lectures by our state TB Clinician, Dr. Frank Ervin and Lowcountry’s TB Clinician, Dr. Susan Dorman. Awards will be given out in various categories, and staff will be recognized for their great achievements of continued reduction in our state case rate.

Visit the DHEC website for more information on our World TB Day activities.

A Look at Diabetes in South Carolina for American Diabetes Month

November is American Diabetes Month. Let’s use this month to understand one of South Carolina’s most prevalent chronic diseases. There are three types of diabetes: type 1, type 2, and gestational. Type 1 diabetes occurs when the body does not produce insulin. Type 2, the most common form of diabetes, occurs when the body does not use insulin properly. Gestational diabetes occurs in some pregnant women when hormones may block the mother’s insulin, causing insulin resistance.

Adults with diabetes in SC

Common Symptoms of Diabetes

  • Frequent urination
  • Feeling very thirsty
  • Extreme fatigue
  • Blurry vision
  • Weight loss (type 1)
  • Cuts/bruises that are slow to heal
  • Tingling, pain, or numbness in the hands/feet (type 2)
  • Feeling very hungry even though you have eaten

Diabetes can be very expensive to manage. Use these tips from the Centers for Disease Control and Prevention (CDC) to find ways to save on medicine. By successfully managing your diabetes, you could prevent other onset chronic diseases and health issues, such as kidney disease, heart disease, or vision impairment, and amputation.

Diabetes in South Carolina

According to the 2018 South Carolina Health Assessment:

  • The prevalence of adults in South Carolina diagnosed with prediabetes increased from 6.7% in 2011 to 9.4% in 2016 (Figure 6.3).
  • Although there was not a steady pattern in the percentage of adults with diabetes in South Carolina from 2011 to 2016, South Carolina’s diabetes rates were consistently higher than the United States (Figure 6.4).
  • Adults aged 65 or older experienced diabetes at the highest rate of other age demographics with 26.1%.
  • In 2016, the prevalence of diabetes was higher in non-Hispanic Blacks (16.9%) than in non-Hispanic Whites (11.7%), and higher in those with an annual household income of less than $25,000 than those with an annual household income of $50,000 or more (9.4%).

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What is Prediabetes?

Prediabetes in SC

Prediabetes, sometimes called “borderline diabetes,” is a condition that can lead to type 2 diabetes and heart disease. It occurs when your blood sugar (glucose) level is elevated, but not in the diabetes range yet. People with prediabetes are more likely to develop type 2 diabetes, heart disease, or experience a stroke. Your chances of having prediabetes increase if you:

  • Are 45 or older
  • Are Black, Hispanic/Latino, American Indian, Asian-American, or Pacific Islander
  • Have a parent, brother or sister with diabetes
  • Are overweight
  • Are physically inactive
  • Have high blood pressure or take medicine for high blood pressure
  • Have low HDL cholesterol and/or high triglycerides
  • Had diabetes during pregnancy
  • Have been diagnosed with Polycystic Ovary Syndrome

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Do you think you could have prediabetes? Take the risk test and find out. It only takes a few minutes and you can find the test online at https://www.cdc.gov/prediabetes/takethetest/.

There are ways to combat diabetes with lifestyle changes. By increasing physical activity, eating a balanced diet and quitting tobacco use, you may prevent your chances of getting diabetes. If your physician has diagnosed you with prediabetes, you can also enroll in a National Diabetes Prevention Program, which has shown to reduce your chances of developing diabetes by 58%. For more information and links to resources, visit https://www.scdhec.gov/health-professionals/clinical-guidance-resources/diabetes-data-and-reports.

DHEC Partners with LiveWell Greenville to Help Create Healthier Communities

DHEC collaborates with Trident United Way to embrace service, leadership and collaboration with Stronger Together Campaign

In our next installment of the DHEC Stronger Together video campaign, we take a look at our partnership with LiveWell Greenville. Stronger Together is a video series of testimonials from statewide partners of DHEC. In these inspirational testimonials, we intend to share stories to raise awareness about DHEC’s work in the community and illustrate our strategic plan. In addition, these spotlights will show out core values – Embracing Service, Inspiring Innovation, Promoting Teamwork and Pursing Excellence – in action.

We kicked off the campaign with our partnership with the South Carolina Restaurant and Lodging Association. We then met with Trident United Way in North Charleston. Now we head to the Upstate with LiveWell Greenville.

LiveWell Greenville is a network of more than 100 community organizations that work together to ensure access to healthy eating and active living. DHEC has been a member of this coalition since its inception.

In 2008, Piedmont Health Care Foundation, a non-profit foundation in partnership with the Health and Wellness Taskforce of Greenville Forward, commissioned a youth obesity study and employed Furman University’s Department of Health and Exercise Science to serve as the research base.

“The results of the study were informative,” said Lillie Hall, DHEC Upstate Public Health Region Community Systems Director and founding member of the original coalition. “The study found about 41 percent of the roughly 1,600 Greenville County School students measured were overweight or obese.”

So, the Foundation convened a coalition to develop policy, systems and environmental approaches to address childhood obesity in the county. Originally called the Childhood Obesity or CHO Taskforce, the group included: Piedmont Health Care Foundation, DHEC, Greenville Forward’s Health and Wellness Taskforce, Furman University, PRISMA Health (formerly Greenville Health System), local physicians and pediatricians, and the YMCA of Greenville. In 2011, the name became known as LiveWell Greenville.

Since then, LiveWell Greenville has improved the overall health and wellness in schools, communities, faith organizations and worksites. Jervelle Fort, DHEC Community Health Educator, is on LiveWell Greenville’s “At Worship” and “At Work” subcommittees.

As part of her role on the subcommittees, Fort provides support through the region’s community work plan to create and maintain a community that supports HEAL (healthy eating and active living) strategies and promotes PSE (policy, systems and environmental) change. She also supports the promotion of school and community gardens, updating and maintaining access to DHEC’s fruit and veggie outlet inventory, assisting community partners to implement HEAL and PSE strategies like developing breastfeeding promotion policies in local churches, coordinating resources for creating physical activity resources and creating healthier environments at worksites.

Executive Director of LiveWell Greenville Sally Wills said that partnering with DHEC allows the coalition to have a greater impact, and Fort agrees.

“Partnerships like this help to make the community and state stronger because it groups us together and makes us whole,” Fort said. “It makes us one.”

DHEC embraces service with the LiveWell Coalition and allows us to be part of “healthy people living in healthy communities.” Partnerships like these showcase the agency strategy of leadership and collaboration.

For previous Stronger Together videos