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Compassionate Care Palliative and Supportive Care provides specialized medical care for serious illnesses and diseases, including advanced kidney failure or heart disease. Palliative Care helps to: Prevent and relieve suffering to help build the best possible quality of life. Add value to standard therapies by assisting with advanced illness planning and symptom management. Palliative & Supportive Care may be needed if: You've had multiple hospital admissions for severe illness. Severe pain, nausea, fatigue or other symptoms impacting quality of life and you are reconsidering treatment plans. Treatments are no longer working. You're feeling hapless or discouraged about the future due to your serious illness. Talk to your doctor to find out if palliative care is the right choice for you or your family member.   Your Care Team Your palliative care support team comprises doctors, nurses, chaplains, social workers and other specialists who work together with you to provide extra support. Your care team can help: Facilitate close communication between you and your physician team, as well as nurses and specialists. Offer medical assessments and symptom management to help reduce pain, nausea, fatigue, shortness of breath and anxiety. Improve the ability to tolerate medical treatments and fain the strength to live a productive daily life. Explain treatment options and the decision making process regarding care. Navigate the healthcare process. Lend emotional and spiritual support.

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When medical treatments no longer offer a cure, Hospice Care offers a special way to care for you and your family who are faced with a life-limiting illness. Serving Washoe, Lyon, Storey and Carson Counties, our team is available 24 hours a day, seven days a week.   Hospice staff receive special training to care for all types of physical and emotional symptoms that cause pain, discomfort and distress. When considering your options for end-of-life transition, our team is available to answer questions and discuss if Renown Hospice Care will meet your needs.  Your hospice care team includes Medical Director Registered Nurses Certified Nursing Aides Medical Social Workers Chaplains Registered Dietitians Trained Volunteers

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A wedding is a big day for the wedding couple, but it’s also special for loved ones. A patient at Renown, Ken, got to take part in his daughter’s special day as her wedding plans changed to accommodate his medical condition. Grab some tissues and read how Renown’s team of compassionate caregivers and chaplains planned a wedding in Fianna’s Healing Garden. Ken was hospitalized at Renown Regional Medical Center where he was battling a lung problem – which was unrelated to COVID-19 – and his condition worsened rapidly on Wednesday, Aug. 12. His family made the decision to transition him to palliative care, which helps patients near the end of their lives remain comfortable, while supporting their dignity and quality of life.  Ken’s medical condition altered wedding plans for his daughter, Chandra, and her fiancé, Tyler, who were planning to tie the knot later in 2020. Chandra wanted her father there, but knew he could not leave the hospital. That’s why Chandra’s sister, Heather, approached Ken’s care team with a request to have a small wedding ceremony at the hospital.  Planning the Wedding A member of Ken’s care team, Amy Heston, registered nurse (RN), began planning how the wedding could be held outdoors in Fianna's Healing Garden in the E. L. Wiegand Pavilion, which was donated by the E. L. Wiegand Foundation.   In 24 hours, Amy planned a wedding ceremony with the help of her colleague, Breyanna Aufiero, RN; the Renown Spiritual Care team; and nursing leaders on the coronary intensive care unit (ICU). Together, they decorated the aisle in the garden with flowers and battery-operated candles. They also made a sign for Ken’s hospital bed, which read, “Father of the Bride,” and crafted a bow tie for him to wear for the special occasion.  With visitor restrictions in place at the hospital due to coronavirus (COVID-19), having the wedding outside in the Healing Garden allowed for more members of Ken’s family to attend including his wife, Charlotte, and his dog, Bella.   Every step in planning the wedding required thoughtful and thorough care coordination so Ken could participate. His breathing was supported by oxygen and special arrangements were made to transport the oxygen tanks he needed to take part in his daughter’s wedding. Amy worked with respiratory technician, Kasey Benfield, and critical care technician, Ruben Duckworth, to ensure Ken’s oxygen needs were met using portable machines.  Celebrating Love and Life Together Ken’s team of caregivers bathed him and shaved his face so he could look and feel his best for the ceremony. They put on his bow tie, covered his bed in decorations and his favorite blue, flannel blanket, and wheeled his bed outside for the ceremony.  Renown associate chaplains Terri Domitrovich and Susan Palwick coordinated music and performed the ceremony for Chandra and Tyler on Thursday, Aug. 13, 2020. The bride and groom shared their first dance in the garden and Ken’s care team provided water and treats to give the family a full wedding experience.   Shortly after the ceremony, Ken passed away. This wedding provided Ken and his family meaningful memories for their big life-changing moments as they celebrated and said goodbye.  “Seeing Ken surrounded by family he never would have gotten to see again while in the hospital, watching him get to share a father-daughter dance with Chandra on her wedding day, and having him tell me that this day meant more to them than we would ever know were some of the most moving moments I’ve witnessed as a nurse,” Amy said. “I am so thankful for the team we have here. I know that this beautiful day wouldn’t have happened without the help of every single person who gave their time, money, creativity and passion to make it a day to remember.”

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In this article reprinted with permission from the Galena Times,  Dr. Max J Coppes, Physician-in-Chief, Renown Children’s Hospital, and Nell J. Redfield, Chair of Pediatrics, UNR Med, talk about adolescents vaping, and how an estimated additional 10 million teens are at risk to start using e-cigarettes. What are E-cigarettes? E-cigarettes are battery-operated devices heating a liquid (e-juice) into an aerosol to be inhaled. Breathing in this flavor vapor, which usually contains nicotine, anti-freeze or other cancer-causing chemicals is called ‘vaping.’  There are many forms of these electronic nicotine delivery devices - and they're not always obvious. They not only appear to be cigarettes, cigars, or pipes, but also pass for everyday items, such as flashlights, flash drives or pens.   The Effects of Vaping and E-cigarettes Regardless of the nicotine delivery, vaping is addictive and is quickly becoming a public health concern. Nicotine levels in e-cigarettes vary greatly, and they may also contain toxic chemicals. Currently there is a wide range of variability among vaping products. In other words - they deliver different ingredients, hardware, levels of nicotine, and possible toxic chemicals to the user. This makes it challenging to create an overall public health recommendation on their use. Nevertheless, there is no confusion about the harmful effects of the chemicals used in e-cigarettes to the young brain, which develops until age 25. Studies show e-cigarette use serves as an introductory product for teens to go on using ‘regular’ tobacco products. The American Academy of Pediatrics has several recommendations on their use. Such as increasing the minimum age to buy tobacco products, including e-cigarettes, to age 21 nationwide. (Update: nationwide the age as of January 2, 2020 is now 21.) A common misunderstanding with teenagers is the belief e-cigarettes are less harmful than other tobacco products. Moreover, there is a wide range of flavor choices, from mint, mango, crème brûlée to cucumber to attract users. As of September 6, 2019, The Centers for Disease Control and Prevention is reporting over 450 possible cases of lung illness associated with the use of e-cigarette products in 33 states.    What Should Parents Know about Vaping? Parents and teachers should know JUUL is a very popular e-cigarette among teenagers, capturing about 68% of the market. JUUL is sleek, small, hides easily, and resembles a flash drive. Surprisingly it charges in an USB port, and can also instantly be mistaken for a real flash drive. One JUUL cartridge contains twice the nicotine found in other e-cigarette cartridges. This roughly equals the amount of nicotine in an entire pack of cigarettes. To repeat, the use of JUUL in young people continues to grow, and this is why parents and teachers need to be aware. Be alert, teach, communicate, and talk to your child about the serious risks of smoking in all forms, whether at home or parties. Tell them how difficult it is to quit and why they should not start. Loving your children is caring; caring for their current and future health and well-being.

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November is National Alzheimer’s Disease Awareness Month. At Renown Health, we know that Alzheimer's safety for your loved one is a priority, as the symptoms can sometimes lead to unsafe situations. We asked Dr. Jonathan Artz – a neurology physician with Renown Health and an assistant professor of clinical neurology at the University of Nevada, Reno School of Medicine – for tips on keeping loved ones safe and secure.  According to the Alzheimer’s Association, Alzheimer’s disease affects safety in various ways, specifically due to body and brain adjustments. These changes can include: Judgment, including forgetfulness  Sense of place – getting lost on the way home  Behavior – being suspicious or fearful  Body difficulty – losing balance Sensing ability – noticeable sensitivity in hearing, seeing or temperature  Dr. Artz gives us four major tips to ensure your loved one’s safety as you both navigate this disease together.  Watch for Wandering  Those experiencing Alzheimer’s disease tend to wander and get lost. Try the following tips to reduce the risk of wandering:  Get your loved one an ID bracelet and have them wear it at all times. You can also enroll your loved one in “Wandering Support.”  Install door chimes so you know when exterior doors are open.  Ask neighbors to call you if they see your loved one out alone. Go with your loved one when they insist on leaving the house. Don’t argue or yell. Instead, use distraction or gentle hints to get them to return home.  Discourage Driving  Driving can be unsafe for someone with this disease. With this in mind, ask a doctor whether it’s safe for your loved one to drive. For example, on a case-by-case basis, there are certain situations where doctors are required to report individuals with particular cognitive impairments, wherein a form of a driving assessment will be recommended.  Limit access to the car. Keep the keys with you or lock them away.  Ask an authority figure, such as an insurance agent or a doctor, to tell them not to drive.  Adult-Proof Your Abode  A simple living space is a safe living space. This means reducing clutter and removing any issues that may pose a safety concern. You may also want to get advice from an occupational therapist (home safety expert). Keep in mind that some changes may not be needed right away. Focus on major safety concerns first.  Try the following tips:  Add lighting (or glow-in-the-dark tape) to brighten dark areas, including stairways and halls.  Use color contrast or texture indicators for dials, knobs and appliance controls.  Remind your loved one not to carry items while walking to avoid a fall.  Remove sharp objects from drawers and countertops.  Avoid using small throw rugs or doormats, as they are easy to trip on.  Move frequently used items so that they are easy to reach.  Lock away alcohol and tobacco products, as they are not recommended for dementia patients.  Install handrails in the shower, tub and near the toilet. Bathroom falls are especially common.  Adjust the setting on your hot water heater so water does not scald. Those with Alzheimer’s can lose their sensitivity to temperature.  Move and lock up hazardous chemicals and cleaning supplies, such as bleach and insecticides.  Disable and remove guns or any weapons. Supervise any medication taken by your loved one.  Promote a Positive & Healthy Lifestyle  Continually emphasize the strengths of your loved one by promoting participation in meaningful activities, wellness visits and healthy habits to help them improve their well-being. Here are some ways to keep them physically and mentally active:   Maintain regular vision and hearing screenings and make necessary adaptations.  Establish a routine for daily activities.  Encourage participation in self-care and leisure activities.  Work with your loved one’s doctor to establish a healthy diet.  Ensure proper hydration. It may help to set reminders for your loved one to drink fluids.  Encourage regular exercise. Exercise delivers oxygen to the brain, improving brain health. Promote good sleep habits. Good quality sleep can increase overall brain health and has been associated with improving memory, attention and concentration.  Resources and support are available with the Renown Memory Disorders Program. Providers within this program are specifically dedicated to treating several different memory-related disorders. Memory Disorders Resources & Support.

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According to the Centers for Disease Control (CDC), e-cigarette use isn’t just up among adults, but it has also tripled in usage for teens. Dr. Jose Cucalon Calderon, a Pediatrics Physician at Renown Health and an Assistant Professor of Pediatrics at the University of Nevada, Reno School of Medicine, provides helpful insight into e-cigarettes and the dangers it poses to kids and teens.   What Are E-Cigarettes? E-cigarettes are electronic nicotine delivery devices. e-cigarettes use liquid nicotine as an alternative to traditional smoked cigarettes. e-cigarettes contain nicotine which is an addictive substance with known toxic side effects that, when released in very high doses, that can have health consequences and causes addiction. Nicotine is described as “toxic,” but the most "toxic" part of e-cigarettes' is everything else within the E-juice. Nicotine mainly keeps people coming back for more. According to the CDC, e-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth use of other tobacco products, including cigarettes. In 2021, approximately 76% of students reported exposure to tobacco product marketing through traditional sources, and approximately 74% of students who used social media had seen e-cigarette–related content. What Does This Mean for the Health My Teen? We know that nicotine can affect brain development in kids and teens, so it is important to educate your teen on the risks of exposure. If you have young children in the home, it is important to be vigilant as well. One teaspoonful of liquid nicotine can be fatal for a young child. How Do I Monitor My Teen for E-Cigarette Use? Monitoring your children can be tricky for parents. E-cigarettes can be harder to detect, unlike traditional cigarettes that were easy to detect by smell and residual odor. E-cigarette use, or “vaping,” is often associated with a dry cough or chronic throat/mouth irritation. Overall, increasing research shows strong links between mental health conditions and posterior combustible tobacco use along with increased risk of marijuana use. Nicotine is addictive, but it does not cause altered mental status like the other drugs of abuse can. All parents are strongly encouraged to talk to their children about the potential dangers of e-cigarettes.   What are the health risks of vaping? Vaping devices have been on the market for a relatively short period of time, with evidence-based health effects and complications still being discovered. Vaping effects poses many harmful risks to children and teens. The risks of vaping include: Chest pain Difficulty breathing Dizziness Headaches Impaired response to infection in the airway Inflammatory problems of the airway Nausea Nicotine addiction Seizures Vomiting   For more information for both parents and teens about quitting smoking or vaping, you can click here. Parents can also use this tip sheet from the U.S. Surgeon General to talk to their child about vaping. The Substance Abuse and Mental Health Services Administration free national helpline number is 1-800-662-4357 (HELP). It is available 24/7, 365 days a year offering confidential treatment referral and information (in English and Spanish). If you or someone you know is facing a substance (or mental health) problem, please reach out to them.

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Being admitted to the hospital is never easy. Being admitted for a traumatic injury can be even harder. Whether it's learning how to walk again or powering through a new speech therapy routine, recovering from an injury that may affect the course of your life can be daunting.  But it doesn’t have to be, thanks to the Acute Care Rehab Therapy team at Renown Health.  The smiling faces of the Acute Care Rehab Therapy team at both Renown Regional Medical Center and Renown South Meadows Medical Center will make you see that there is a light at the end of the tunnel. Your dedicated physical therapists, occupational therapists and speech language pathologists are here to serve you and place you back on the right path to recovery and function.  The Role of Acute Inpatient Therapy  The Acute Care Rehab Therapy team comes in at a critical juncture in a patient’s care process after hospital admission. As one of the primary rehabilitation partners on a care team, these dedicated therapists are here to maximize every patient’s safe and independent living before they set off back home – all while reducing the risk of hospital readmission.  “As physical therapists, we address musculoskeletal deficits and assess a patient’s current function after acute injury or illness from their baseline and develop a plan for functional recovery,” said Kristie Eide-Hughes, Physical Therapist at Renown Regional. “We also use our clinical expertise to assist with the discharge process and make sure each patient has the best durable medical equipment the first time around, removing the guesswork.”   “On the occupational therapy side, we work with patients to facilitate their independence with basic life skills, such as dressing, bathing and using the restroom,” added Jeanne Clinesmith, Occupational Therapist at Renown Regional.  “In the pediatric setting, we help babies and kids get back to what they were doing before they came into the hospital,” continued Rhonda Yeager, Pediatric Occupational Therapist at Renown Regional. “In the NICU specifically, we support the development of babies, trying to prevent problems from worsening. It’s nice to be a source of positivity in an otherwise intimidating situation.”  The role of therapy in this setting reaches all ages, from babies in the neonatal intensive care unit (NICU) to adults approaching end-of-life care. Every therapeutic approach is tailored specifically to each patient.  “Therapy is more of a habilitative approach for infants in the NICU, while it is more of a rehabilitative approach for kids and adults following injury or illness,” said Sara Carolla, Physical Therapist at Renown Regional.   Each team member in the Acute Care Rehab Therapy department is dedicated to each patient, helping them make progress from start to finish and giving them the tools to succeed along the way.  “I enjoy the variety of the patients we get to see and the ability to see them make gains from the wonderful treatment they get in the hospital from my team,” said Kelly Schwarz, Occupational Therapist at Renown South Meadows.  “We provide education as each patient’s acute issues evolve,” added Nicole Leeton, Speech Language Pathologist at Renown Regional. “One of my favorite parts of my work is the patient and family education aspect, and that includes other healthcare provider education as well. It’s a moving picture.”  Moreover, every team member gives each patient tools to learn how to be themselves again and empowers them to continue striving for the best possible result of their therapy  “We get the opportunity to make a person’s bad experience in life better even by spending one session with them, giving them the keys to unlock something that they didn’t think they had the ability to do,” said Dana Robinson, Occupational Therapist at Renown Regional.  On the Road to Independence  Our dedicated therapists in the Acute Care Rehab Therapy team set the stage for a patient’s recovery process after trauma, showing them their potential for independence. With a multitude of patients coming into the hospital with many degrees of medical complexity, each day is different while the end goal is always the same: to optimize function as early as possible while overcoming any barriers and paving the way for a comfortable and effective quality of life.  “Early intervention is a big piece,” said Nicole Leeton. “Us seeing patients early can get them recovered and independent more quickly and help prevent future illness and injuries. For example, in speech therapy, getting in early and facilitating communication skills for patients with impaired speech can make a huge difference.”  Acute Care Rehab therapists dig deeply to see the whole picture of each patient’s situation to foster their independence – their history, social skills, support system and more.  “Sometimes, we are the difference between independence and dependence,” said Dana Robinson. “We are the eyes and ears because we have so much time with the patients. Our team is extremely collaborative and develops a great rapport with patients, so they feel comfortable telling us everything going on with them.”  “For kids, we teach parents ways they can help their kids by setting up their homes and the equipment they need to succeed,” added Rhonda Yeager.  According to the team, one of the biggest keys to independence is repetition. A continual flow of getting up and trying again is crucial for recovery.  “Repetition helps people regain their quality of life back sooner and control their recovery process,” said Megan Hough, Physical Therapist at Renown Health.  “Helping people continue to get stronger and more independent makes my job so rewarding,” added Sam Brown, Physical Therapist at Renown Regional.  Knowing that they have made a difference and help shape a patient’s overall development inspires each therapist to never give up, regardless of how difficult an injury presents. There is no set schedule for recovery, and the therapists are always in the patient’s corner.  “This team has the most passionate, caring and dedicated individuals that I know,” said Kendra Webber, Manager of Acute Inpatient Rehab Therapy Services at Renown Regional. They give 110 percent to every patient every time to ensure they have what they need to regain function and independence.”  “By tailoring therapy to the individual, the bounds are virtually limitless for what we can accomplish,” added Dana Robinson.  It Takes a Village  Since acute inpatient therapy is never a one-size-fits-all approach, it truly takes a village for this team to move the mountains they do for patients every day. These teams are fact-finding masters, gathering all the necessary information from the patient, their family and their care team to figure out their precise needs.  “We are a consistent presence for our patients, identifying a lot of different needs and meeting those needs to help patients grow in their treatment process,” said Kelly Schwarz. “By collaborating with each patient’s diverse care team, we are able to employ the clinical judgment to help patients overcome physical, emotional and environmental struggles and set them up with the proper resources once they leave our setting.”  “Our team has steady communication with physicians, nurses, acute care technicians, respiratory staff, physician assistants, case managers and more to ensure the best possible care,” added Jet Manzi, Physical Therapist at Renown Regional.  Constant communication and collaboration are also necessary beyond the acute treatment process. These skills are vital in order to facilitate discharge planning, and the Acute Care Rehab therapists are an essential resource in the discharge process alongside our Hospital Care Management team.  “Often times, a patient’s family needs a lot of guidance in helping their loved ones determine the next level, and we help them navigate those steps and the resources available to them,” said Mark Stumpf, Occupational Therapist at Renown Regional. “And it’s all a team effort.”  “Our therapists are the most committed, generous, hardworking people,” added Courtney Phillips-Shoda, Supervisor of Rehab Therapy Services at Renown Regional. “Despite being short-staffed, we come to work every single day and give everything to our patients. They are the priority.”  If you take away one thing, know this for certain: Renown’s Acute Care Rehab occupational, speech and physical therapists will always be there to help patients continue on a positive trajectory to physical, mental and emotional recovery.  “Whether you are a patient or a provider, if there is a problem, never hesitate to reach out to us,” said Nicole Leeton. “We are always receptive to anyone seeking our help.”  With the Acute Care Inpatient Therapy team on their side, a patient’s journey to recovery is only just beginning.

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COPD (chronic obstructive pulmonary disease) is a progressive lung condition often mistaken for typical aging signs, like shortness of breath and coughing. While smoking and pollution can contribute to its development, lifestyle changes and medications can help manage its progression. Diagnosis typically involves lung function tests, chest X-rays, or CT scans, with treatments available through a pulmonologist or primary care provider. Renown’s Pulmonary Rehabilitation Program offers insights into living with COPD. What is COPD? According to the COPD Foundation, it is an umbrella term used to describe progressive lung diseases including: Emphysema: Damage to the small air sacs in the lungs (alveoli). Chronic Bronchitis: Irritation and swelling of bronchial tubes, causing shortness of breath and coughing for long periods of time. Asthma (non-reversible): When asthma medications cannot reduce swelling in the airways. COPD Risk Factors Smoking is the most significant COPD risk factor, and the American Lung Association (ALA) says it accounts for nearly 90 percent of cases. If you are a smoker, it is essential to seek help and quit. Other COPD risk factors include: Air pollution Genetics Second-hand smoke Chemical, fumes or dust in the workplace How Can You Protect Yourself?  Stop smoking Renown Health provides support offering 4-week Smoking Cessation Virtual Classes, free of charge! Sign up today. Use natural cleaning products Many household chemicals, especially those containing bleach, can irritate the lungs – a condition called, chemical pneumonitis. Stay away from all types of smoke This includes smoke from fireplaces. Likewise, plan to stay indoors when it is smoky outside, or air quality is poor. Get active Of course, it’s never too late to start an exercise program. When exercising your heart pumps, circulating your blood and sending oxygen to every part of your body. Notably it strengthens your lungs, making it easier to breath. Talk to your doctor to see if you are healthy enough to begin exercising. Eat a healthy diet Surprisingly what you eat can affect your breathing. The American Lung Association encourages those with COPD to watch their sodium intake, eat smaller, more frequent meals (instead of three large ones), limit high fat foods and drink plenty of water. Avoid scented products Perfumes, aerosol sprays and plug-in air fresheners can trigger flare-ups. Get a flu shot Did you know chronic lung conditions, as well as, heart disease, cancer and diabetes, can be made even worse by the flu? Now is the time to get your flu shot for the season if you haven’t already. Renown’s Pulmonary Rehab staff is certified through the American Association for Cardiovascular and Pulmonary Rehabilitation (AACVPR).  Recently, Renown Regional Medical Center successfully completed a disease specific COPD certification survey by The Joint Commission. For two accreditation cycles in a row, the COPD Program has had zero findings during the rigorous survey.

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