Category Archives: Chronic Disease

DHEC Division One of Four Selected for Nationwide CDC Pilot for Cancer Survivorship

The Division of Cancer Prevention, located in the Bureau of Chronic Disease and Injury Prevention, was one of four awardees nationwide selected by the Centers for Disease Control and Prevention (CDC) to conduct a pilot project to address rural and urban disparities in cancer survivorship.

The pilot project, titled “Improving the Health and Wellness of Cancer Survivors in Rural Communities,” focused specifically on tele-mentoring strategies using Project ECHO (Extension for Community Healthcare Outcomes) to increase coordination and movement of knowledge between specialists and primary care providers. The internationally recognized Project ECHO offers a unique knowledge-sharing approach to create an online community that shares best-practices and case-based learning resources. This online model leverages technology to expand the reach and connectivity of providers in rural areas to subject-specific knowledge and specialists.

SC CCCP held monthly; one-hour Zoom sessions from October 2020 to February 2021. Topics included cancer pain management, sexuality and intimacy, and nutrition for cancer survivor patients. Each session was able to provide expert-delivered content that highlighted best-care practices and created a community of practice among oncologists, primary care providers, nurses, social workers, researchers, administrators, and other caregivers.

Over this ECHO series, the project reached 102 unique participants, with an average of 37 participants per session. Data from this pilot project was able to link providers in four rural counties with specialists in seven urban SC counties and four out-of-state sites. Providers who participated in the ECHO intervention reported up to 60% of their patient population reside in rural areas, which speaks to the intervention’s achievement in targeting rural patients for improved cancer care and outcomes.

“Residents in our rural counties often have less health care access including fewer health care workers, specialists such as cancer doctors, and transportation options,” said Sonya Younger, Comprehensive Cancer Control Program Director. “Rural residents are also more likely to be uninsured and to live farther away from health services. Through innovative telementoring, Project ECHO helped the Division of Cancer Prevention and Control increase rural provider workforce knowledge to provide best-practice, cancer specialty extended care.”

Visit the SC Cancer Alliance’s website to listen to the Cancer Survivorship Project ECHO recorded presentations at https://www.sccancer.org/events/cancer-survivorship-project-echo-recorded-presentations/ 

VIDEO INFORMATION 

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By utilizing the ECHO model to share knowledge and foster a clinical community, reaching widespread providers and other clinical professionals that service rural communities, the Division of Cancer Prevention and Control shows the core value of Inspiring Innovation and is an example of the agency strategies of Service and Accessibility and Education and Engagement.

Success was possible through the connectedness of the SC Cancer Division including Best Chance Network, Comprehensive Cancer Control, and Research and Planning program staff and its partners and providers, as well as virtual sessions and electronic communication, demonstrating DHEC’s core value of Promoting Teamwork

DHEC Observes National Alzheimer’s and Brain Awareness Month

June is Alzheimer’s and Brain Awareness Month

There are currently over 95,000 people living with Alzheimer’s disease in South Carolina, and over 25% of these persons reside in a long-term care facility, such as a nursing home.  

Long-term care facility residents and staff have represented about 40% of COVID-19 deaths in the United States. At the same time, the year-long visitation restrictions also took a tremendous toll on residents, family members, caregivers, and facility staff, especially with residents with Alzheimer’s disease or other dementia.  

“Ongoing changes and restrictions related to COVID-19 impacted our most vulnerable population,” said JoMonica Taylor, Director of Residential Facilities Division in the Bureau of Community Care. “Amidst staffing shortages, increase in infection rates and lockdowns, facility’s staff remained a physical, emotional, and spiritual support to the residents, especially those with Alzheimer’s and dementia.” 

DHEC worked with facilities over the past year to combat the spread of COVID-19 and find ways that facilities could still offer a connection between residents and loved ones, including tablets and other telecommunications, window visits, and isolation barrier visits.  

Long-term care facilities in South Carolina are now required to allow visitation at all times for all residents in accordance with DHEC guidelines, including indoor visits, outdoor visits, compassionate care visits, and window visits. With long-term care facilities reopened and widespread vaccine availability, DHEC leaders that oversee these facilities express their appreciation to facility staff.  

“DHEC would like to take this opportunity to express our appreciation to the facilities and their staff for their commitment to taking care of and keeping safe one of our most precious populations during this past year of uncertainty and change,” said Angie Smith, Director of the Bureau of Community Care. “DHEC stands along with the facilities and their staff and their commitment to the health, safety, and wellbeing of the Alzheimer’s and Dementia population.”  

As a reminder, DHEC continues to help administer CMS’s Civil Monetary Penalty (CMP) Reinvestment Program, which supports projects that benefit nursing home residents and improve their quality of life. Many of the projects are designed to help alleviate and comfort residents suffering with dementia.  

More information on the program and how entities can apply for funds to support an eligible project are available on DHEC’s website here.  

Lancaster County Goes Tobacco Free

DHEC’s Division of Tobacco Control and Prevention and the Midlands Community Systems team recently celebrated with community partners for Lancaster County going tobacco free. Congratulations and a big thank you to our community partners in Lancaster County, especially the Lancaster County Health and Wellness commission, for all they have done to protect residents from the harmful effects of secondhand smoke.  

In 2013, Lancaster became the first county in the state to ban indoor smoking at its public facilities and municipal government. Many other public agencies also adopted tobacco-free policies at that time. In 2019, three remaining public entities needed to adopt tobacco-free policies for the county to be considered fully tobacco-free – the first such county in South Carolina. 

The Division of Tobacco Control and Prevention and the Midlands Community Systems team were able to offer support and resources to help Lancaster County achieve this incredible milestone. By July 2020, the three remaining entities passed tobacco free polices.  

To celebrate and show our appreciation for all the hard work achieved by our partners, we provided tobacco free signs to all seven entities. A billboard on I-77 also recognized this accomplishment.  

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.