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National Healthcare Decision Day is forthcoming. Here’s an easy and free way to commemorate the occasion: openly discussing how we want to be cared for at the end of our lives. Join Renown Health’s experts at a workshop about making decisions about an advance directive. Among the random national holidays, this one has significance: April 16 is National Healthcare Decision Day. And experts agree that the best time to discuss your views about end-of-life care and to learn what choices are available is before a life-limiting illness or crisis occurs. By preparing in advance, you can help reduce the doubt and anxiety related to decision making for your family if you cannot speak for yourself. “Completing your advance directive is a gift you give your family,” says Mary-Ann Brown, RN, MSN, director of Palliative Care. “The stress associated with these difficult decisions is decreased if everyone knows what is important to you and what you want the end of life.” What Are Advance Directives? An advance directive is a document that states your choices about medical treatment and names another person to make medical decisions on your behalf if you are unable to. This document allows you to make legally valid decisions about future medical care. Find more information about advance directives and the form online. The Conversation The first step in completing an Advance Directive is to think about what’s important to you and talk to your loved ones. The Conversation Project provides helpful tools to guide you and your family through this challenging topic. Getting this information together will help you fill out and complete your advance directives. Some things to consider and discuss with your family include: When you think about the last phase of your life, what’s most important to you? Who do you want involved in your care? Who should make decisions on your behalf if you’re not able to? Where do you want or not want to receive care? Are there specific treatments you would or would not want? Complete Your Advance Directive Planning In order to complete an advance directive, you will need either two witnesses or a notary to sign the form. Be sure to note restrictions on the witness process. When an advance directive is complete, you should keep the original. Copies should be given to your agent named in the form, your family, your doctor(s) and the location that you receive care. Renown Health offers four advance directive workshops every month to cover the details of filling out this document. A healthcare team is available to answer questions and work through the process with you. A notary is also present to finalize the process, which means you can complete your advanced directives during this workshop. Find the workshop by calling 775-982-RSVP for more information. Advance Care Planning Workshop April 17, 1-2:30 p.m. | Free Join Renown Health’s experts for a workshop about making decisions regarding end-of-life care. You will learn how to fill out an advance directive, receive one-on-one assistance and have your documents signed by a notary. Workshops are typically held several times each month. To RSVP, call 775-982-7787

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Becoming a caregiver or playing a more active role in another’s healthcare is a big responsibility. At some point, almost all adults will support an aging parent or a loved one in need. Keeping track of their needs and wellbeing, while also prioritizing your own can become overwhelming. It’s important to know: you are not alone, and help is available. Read on for 11 tips to help you manage your time, your own wellbeing and your loved one’s care. Self-care comes first. When your main priority is the person in your life who needs care, it’s easy for your own needs to take the backseat. Give yourself time each day to focus on your personal wellbeing. It’s hard to give a loved one the care they need if your own needs are not met. Prioritize the Activities of Daily Living (ADL). Make a note of what ADLs your loved one can do alone, what they need help with and what activities require the most help. This will help you work through the day with them, as well as plan out how the day’s activities will go. Do a home safety audit. Do showers, bathtubs and steps have safety grab bars? Look around the house for additional tripping hazards, like rugs or electrical cords. If your loved one struggles with day-to-day navigation of the home, consider scheduling an occupational therapy appointment. This type of therapy helps a person develop or maintain the motions required to accomplish daily tasks. You might also qualify for a referral to in-home healthcare, such as Home Care. Have the hard conversation. The best time to discuss views about end of life care and to learn what choices are available is before a life-limiting illness or crisis occurs. With advance care planning, you can help reduce the doubt and anxiety related to decision making at the end of life. Completing an Advance Directive is a great tool to sort out all these decisions before they’re needed. Attend a free workshop to learn more and complete this important document. Identify when you need respite. Respite care involves receiving a short-term break from caregiving. Organizing in-home care for your loved one will allow you to step away and tend to your needs. By identifying what kind of respite care you are seeking, you can find the right person to provide you with that much-needed break. Don’t wait until you feel overwhelmed, plan ahead. Write down insurance contact information. Have a direct connection to the right insurance professional for support and advice. If your loved one is eligible Medicare, this is a good opportunity to review their current selections and if they would benefit from a Medicare Advantage Plan or Medicare Supplement Insurance. Seeking out expert advice or information on Medicare options is a great way to navigate this. Consider calling a broker, or attend a free educational seminar with Senior Care Plus. Gather legal and financial information. Make a list of all existing legal documents and financial accounts that your loved one has. These might include a will, advance directive, power of attorney, bank accounts or investment accounts. If you have questions about how to manage them, or need assistance in setting up additional framework, reach out to a lawyer, legal service, financial adviser or bank representative. Create an inventory of medical information. Identify where all of your loved one’s medical records are, as well as a list of providers or healthcare practices where they have received care. Consider if you should have your loved one give you Proxy Access in MyChart, which allows you to access all the features in MyChart on their behalf, including viewing upcoming appointments, viewing test results and emailing a doctor on their behalf. Make a list of what others can do. Think about all the little (and big) things that need to happen, and write down tasks that others could take care of you. When someone says “let me know what I can do” you’ll be ready with a pre-written list of items they may be able to assist with. Tasks could include tackling around-the-house repairs, scheduling lawn work, helping to walk the dog, taking a car for an oil change and cleaning. Find programs and events for social enjoyment. If and when possible, seek an activity outside of the home. Look for community centers that have programs for seniors, recreational activities or meals that you can patriciate in together. If leaving the home is not an option, arrange for visits or in-home activities, such as movie nights, card games or time to visit with family. Research long-term options. If you will be considering a nursing home or assisted living, make a list of amenities that you and the person you are caring for would like. Take this list with you when visiting potential locations to make sure you don’t forget to ask about each item.

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Medical emergencies like strokes and heart attacks still happen, even in a pandemic. That’s why Renown Health is always ready to provide emergency care to patients in need, and being admitted at Renown does not put patients at risk of getting COVID-19. When to Get Emergency Care Resources like Renown Virtual Visits have allowed us to stay home while making routine visits with our primary care physician. But, if you are feeling any of the following symptoms, please call 911 or have someone you know take you to the emergency room. Symptoms that may require emergency care: Heart attack Stroke symptoms Difficulty breathing Chest pain Seizure Sudden loss of consciousness Severe abdominal pain Serious allergic reaction Fighting the Good Fight for Our Patients Renown Health provides a clean and safe environment 365 days of the year, 24 hours a day. Alongside regular sanitation practices, Renown is dedicated to protecting patients from infectious disease while providing emergency care. Staff, Care Providers and Visitors Wear Masks Every staff member, care provider and visitor is wearing a mask. Additionally, providers are following guidelines from the Centers for Disease Control (CDC) on wearing protective equipment, such as masks and gloves. Respiratory Illness Screenings for Everyone Care providers and staff members are participating in respiratory illness screenings. Therefore, any care provider or staff member with a fever, cough, difficulty breathing or severe respiratory illness is not on a Renown campus. Visitor Restrictions are in Place Visitor restrictions are in place to prevent the spread of infectious disease by practicing physical distance. Because of these restrictions, Renown is only allowing one visitor per patient for with extenuating circumstances. Staying healthy and safe means caring for yourself in emergency situations, too. Please do not hesitate to call 911 when you or a loved one are in need of emergency medical care. Virtually Visit a Renown Urgent Care Login to MyChart to “get in line” for a virtual urgent care visit between 8:30 a.m. to 10:30 p.m. Monday-Friday and 9:30 a.m. to 4:30 p.m. Saturday and Sunday. Login to MyChart

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There are many lenses through which to view health. As you would expect, medical providers typically focus on the health of individual patients. For example, doctors consider a person’s symptoms, their current lifestyle, their past medical history, and their family’s history to diagnose medical conditions and recommend treatments. The Public Health Perspective Public health professionals look beyond the health of an individual and instead focus on the health of an entire community or population of people. They strive to achieve “the greatest good for the greatest number.” As the CEO of a health system, I feel fortunate to have education and training in both medicine and public health. As Renown Health’s leader, it is my responsibility to care for the people and communities we serve. That involves bringing world-class staff and innovative medical care to northern Nevada. We also focus on prevention by looking for ways to improve health outside of our facilities. That means partnering with local organizations to address the social, economic, and environmental factors that shape our health. Or working with local government to create policies that help to prevent disease and injury. In order to make a genuine and long-lasting impact on health, we must foster a community that helps our neighbors live well. Public health is especially important during times of crisis, such as the COVID-19 pandemic that we’re experiencing now. During these times, health systems must be able to swiftly shift focus from prioritizing the needs of individual patients to considering what is best for our local population. For example, we may need to temporarily limit hospital visitors or educate the public about how to socially distance in order to stop the spread of disease. Being prepared to make this shift and having strong relationships with our local health department and community organizations help us better serve the public. In both good times and bad, I am thankful that my public health background provides me with the perspective to look beyond our health system and embrace the health our community.

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Eating healthy is a daily challenge for many, but for those with cancer it is an even harder struggle. A cancer diagnosis not only impacts those diagnosed, but family members and friends too. One key area of concern is making sure your loved one stays well by eating healthy food every day. Here are some essential cancer nutrition tips from Renown Health registered dietitians Jessica Blauenstein and Amy Laster. Help to Prepare Meals and Snacks for Daily Cancer Nutrition Make it grab and go. Easy-to-make meals help reduce the burden of having to cook and prepare food. Having easy to grab snacks on the counter or in the fridge can help ensure your loved one has access to those nutrients when needed. Sit outside of the kitchen. This allows your loved one to avoid cooking smells which can make them feel sick as a side effect of cancer treatments. Also try serving them cold foods such as sandwiches, cheese and crackers, or shakes which have a mild scent. Try drinkable meals. Some people with cancer find it easier to sip their calories over the course of 30 minutes to an hour. Consider smoothies or supplemental shakes such as Ensure Enlive or Boost Plus as snacks not meal replacements. A great foundation for a smoothie is a protein source (Greek yogurt, protein powder, nut butters or milk) with a carbohydrate (fruits, juice or berries). Add other ingredients as desired, such as spinach, kale, and ground flaxseed or chia seeds to give it more vitamins, minerals, and fiber. Snack Ideas for Those Undergoing Cancer Treatment The following ideas are both quick and easy to make for your loved one. Chicken or tuna salad with whole grain crackers or as a sandwich on whole grain bread Greek yogurt mixed with cereal, fruit and/or nuts Cottage cheese with banana, cinnamon and/or peanut butter Favorite fruit with 100% natural peanut or almond butter spread - Try peanut butter with bananas, apples, or even celery Their favorite veggies dipped in a salad dressing of your choice - For example, carrots with hummus or ranch dressing Cheese and whole grain crackers - Add tomato slices with a dash of oregano on top for more flavor Eggs scrambled with cheese, vegetables and/or salsa Peanut butter and jelly sandwich on whole grain bread A baked sweet potato with some favorite toppings Hard boiled eggs and/or egg salad with whole grain crackers, or as a sandwich on whole grain bread Oatmeal or cream of wheat prepared with milk, fruit and/or nuts Sometimes your loved one may not feel like eating or refuse to eat. If treatment side effects are impacting your loved one’s ability to eat, please visit the websites below containing recipes tailored to treat side effects. Cook for Your Life ELLICSR Of course you may also consult a registered dietitian and/or the patients care team, if you have more cancer nutrition concerns. No Appetite? Assisting with Cancer Taste Changes Taste changes are common during cancer treatment. Patients experiencing these changes may not feel like eating, which can negatively impact their nutrition. Help your loved one overcome taste changes with these cancer nutrition strategies: Metallic or bitter taste in food - add something sweet such as maple syrup, honey or jelly. You may also try adding fat, such as a nut butter, avocado or regular butter. Pickles or vinegar could help with this too. A taste like cardboard - try adding salt and extra flavor to foods with seasonings and spices. Some examples are onion, garlic, chili powder, basil, oregano, rosemary, tarragon, barbecue sauce, mustard, ketchup, or mint. Lemon juice, citrus, vinegar, or pickles may also help with this as well Food tastes too sweet - try adding six drops of lemon or lime juice. Add small amounts until the sweetness is gone. Very salty taste - try adding ¼ teaspoon of lemon juice. Try plastic utensils instead of metal, especially if your loved one is struggling with foods tasting metallic. Dipping small bites of food into either lemon juice or vinegar can have a “palate cleansing” feel and may improve taste perception. This helps avoid getting tired of the flavor after a few bites. Try marinating food or meats in sweet fruit juices, salad dressings, or sweet-and-sour sauce. Other “palate cleansing” foods are lime juice, orange juice, mangos, lemongrass, parsley, cilantro, mint, ginger, basil, and pickled foods. Use aroma to make foods appealing, avoiding any smells that may cause nausea. In particular, cinnamon, nutmeg, cloves, coriander, cumin, ginger, and black pepper can add an aromatic flavor. Also include herbs such as oregano, rosemary and thyme. Think texture. Consider trying wafers, crunchy nut butters, carrots, celery, cucumbers, chips, rice crispies, corn flakes, crackers, panko crumbs, nuts, or seeds if you are able to chew and swallow them safely. Remember that patience with your loved one's changing appetite and tastes can be the strongest form of support you can provide. Nutrition Tips for Cancer Survivorship and Beyond If eating large meals is difficult for your loved one, encourage them to snack throughout the day. Aim for 4-6 snacks or small meals per day. Focus on consuming 2-3 protein-rich foods each day such as lean animal meats, fish, eggs, soy or a protein supplement with 20-30 grams of protein per serving. Eat a variety of brightly colored fruits and veggies. Aim to make half of each meal fruits and vegetables. Eat less than 18 oz. (cooked weight) of red meat per week. Limit cold cuts, bacon, sausage, and hot dogs. Avoid excess salt and saturated fats. Cut back on simple carbs. (i.e. desserts, candies, white bread/pastas, french fries, packaged foods, chips) Drink in moderation- if at all- one drink per day for women, two for men. Get enough vitamin D (through diet and/or supplement) Avoid tobacco of any kind. Keep a healthy weight and stay up on exercise. Other Ways to Help a Loved One with Cancer Assist with Chores Allow your loved one to relax as you help take care of chores around the house, such as cleaning, cooking and grocery shopping. This may reduce overall stress and can be helpful for those that get tired after their treatments. Physical activity can still be beneficial, so be sure to do an activity together that they enjoy and is approved by their doctor. Be Patient It can be very difficult to see a loved one go through cancer treatment. Remember to be patient with your loved one. There may be things we want them to do or eat that we know would be good for them, however, meet your loved one with grace and understanding. It is ultimately their decision on what to do, just be there to support and assist them as they go through this challenging time. Additionally, Renown hosts free “Eating Well After Cancer Treatment” nutrition classes for cancer survivors.  Our next cancer nutrition class series starts Thursday, June 3, 2021, and will be hosted virtually. It is open to anyone in the community. For more information or to register please click here.

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We get it – the entire world has been overwhelmed with COVID-19 vaccine information, questions and celebrations around vaccines developed to combat COVID-19 induring the past several months. It’s hard to know where to start in digesting all this news and information. But one thing is clear: healthcare experts agree that the authorized COVID-19 vaccines are safe, effective and recommended to help end this pandemic. If you are passionate about stepping up in your community to encourage the vaccination efforts, we’re offering a few ideas on how you can be an ambassador. Find the Facts Content on the vaccine is abundant, but and there’s a few resources that we can all rely on to help digest the information: The Centers for Disease Control (CDC) updates its website content around the vaccine regularly, and also offerings information in Spanish. Health departments across the U.S. are leading the way in distribution logistics planning, and partnering with other providers, like such as hospitals and pharmacies, to distribute give people doses. Their websites are great resources to understand options where you live. Locally, check out washoecounty.gov/health/programs-and-services/environmental-health/covid-19-guidance for vaccine updates in Washoe County. Many providers like Renown Health and other providers are sharing content around their recommendations for the vaccine. Get answers about the vaccine types from one of our pharmacists, read common concerns addressed by experts and view videos from many doctors and other specialists on our YouTube Channel.

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