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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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Winter skin alert – cold temperatures can put your skin into chaos. We asked for skin tips from Heidi Nicol, an esthetician with Renown Dermatology, Laser & Skin Care. She shares how to keep your skin glowing through the frosty months ahead. With the change from warm to cold weather, your skin can get stressed out. In fact, issues like flaky skin, irritation and chapped lips can be an everyday struggle. 5 Easy Winter Skincare Tips 1. Re-think your shower Few things feel better on a cold day than a long, hot shower. But hot showers can lead to dry skin because they strip your skin of its natural protective oils. Avoiding them altogether is best – choose a lukewarm, or warm, shower instead. If you have an occasional hot shower, the American Academy of Dermatology (AAD) suggests keeping it at five to ten minutes. Nicol recommends using a gentle cleanser and avoid using too much. Moisturizing after a shower or bath while your skin is still damp is also a must. Slathering on your favorite lotion helps your skin hold on to precious moisture. 2. Stay away from smoke and fire Although sitting close to a roaring fireplace can feel good, it is drying to your skin. Smoking and exposure to smoke also harms your skin. Smoking reduces healthy blood flow to the skin. This also causes your skin to wrinkle faster, making you looker older. Additionally your skin heals much slower if you smoke. 3. Consider a humidifier Cranking up the thermostat dries out indoor air. Skin is our largest organ, and in general, heat is very drying to your skin. To clarify, over time dry air degrades your skin’s natural moisture (lipid) barrier leading to flaking, peeling and cracking. Your skin can overcompensate for the dryness by producing even more oil. In other words it is possible for your skin to be both oily and dehydrated at the same time. Even oily skin needs a daily lightweight, non-pore clogging moisturizer. 4. Use SPF daily The sun’s rays damage your skin even on cloudy days. Sunlight contains UVB (burning) and UVA (aging) rays. Although UVB rays are less strong in the winter, the UVA rays are same strength all year. And snow can reflect almost 90% of UV radiation. With this in mind make sure you have suitable skin and eye protection when going outdoors. 5. Take care of your hands and feet Don’t forget your fingers and toes when moisturizing. These areas tend to be drier than other parts of the body. Gloves help to protect hands from winter weather and lock in moisture. Similarly, putting lotion on your feet before your socks will keep them your skin from flaking and cracking. Follow the tips above to make sure your skin is at its best, despite the winter weather. Renown Dermatology, Laser & Skin Care | 775-982-8255 Renown Dermatology, Laser & Skin Care offers a comprehensive range of treatments and products to address any skin care need. Visit our beautiful office in south Reno and browse our product lines. Experts are available to answer any questions concerning your skin care and health and wellness needs.

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Did you know that your makeup brushes are likely full of built-up dirt and bacteria? Using dirty makeup tools can lead to irritation, breakouts and even infections. The good news? It's completely preventable. An expert explains For anyone who regularly wears makeup, brushes are great tools for powdering, contouring and finishing touches. Unfortunately, these same brushes also harbor harmful bacteria that can clog pores and cause unwanted breakouts. “Brush hairs and sponges are porous, and hold on to oils, debris and bacteria,” says Heidi Nicole, medical esthetician with Renown Dermatology, Laser & Skin Care. “Also, if they are dirty, the application of makeup can be spotty and make blending more difficult." Most dermatologists suggest that you clean your makeup brushes at least once a week. Because they are used on your face, it makes sense to keep them as a clean as possible. In addition, your brushes will last longer if you stay on top of cleaning them. Six simple steps to integrate makeup brush care into your beauty routine: Wet your brush with lukewarm water. (Don’t soak your brushes, as water in the brush barrel can cause the hairs to fall out.) Place a drop of gentle cleanser or specialized brush cleaner in the palm of your hand. Gently massage the tips of the bristles on your palm. Rinse the bristles well. Blot with a clean towel and reshape the head. Let the bristles dry over the edge of a counter. Do not allow the bristles to dry on the towel, which could cause the brush to mildew. Store your brushes in a clean, dry place in between uses.

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As we begin to enjoy the springtime weather in northern Nevada, are you finding your skin less than tip-top shape? Here’s how to add moisture back in easy, natural ways. You don’t need to be a medical aesthetician: Dry, cold climates can often wreak havoc on your body’s largest organ — your skin. These tips from Renown Dermatology, Laser & Skin Care will quickly put moisture back and relieve dry, chapped skin. 11 Miraculous Moisturizing Tips Always wear broad-spectrum sunscreen, even during winter months. Don’t forget to use an SPF lip balm, too. Heaters dry out your skin. Use a humidifier to keep moisture in the air. (And try these simple tips to make sure you’re keeping that humidifier clean.) If your skin is dehydrated, try using a nighttime moisturizer during the day. Use a hydrating mask or moisturizing mask twice a week. Don’t forget your hands and feet. Apply a rich cream to the hands and feet at night and cover them with gloves and socks to restore moisture while you sleep. Drink plenty of water to stay hydrated. Try adding a hydrating serum to your morning and nighttime skincare routine to heal the skin. Use a gentle exfoliant to remove dry skin at least once a week, which helps your skin absorb your moisturizer. Apply body oil or lotion in the shower while your skin is still damp to trap moisture. Hot water dries out your skin, so turn down the temperature in the shower and bath.   A little pampering goes a long way, and Renown’s medical aestheticians are here to help. Trained in skincare and advanced therapies, our experts can transition your skin to look healthy, youthful and rejuvenated.

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August is National Make-a-Will month. We talked to Renown Health Foundation Planned Giving Officer, Abbey Stephenson, to learn more about wills, trusts, and estate plans and why you should feel motivated this month to get started. Did you know that 2/3 of Americans don't have a will or trust? If this is you, don’t worry, you’re not alone. Although there are laws in place to determine who inherits your assets if you die without a will or trust, having a will or trust ensures your assets go where you want them to go after you are gone. They can also help minimize disputes between family members and heirs about who gets what. In Nevada, the laws that govern who gets what if you die without a will or trust can be found in Chapter 134 of the Nevada Revised Statutes. There are other documents that people often prepare at the same time as their will or trust – like an advance health care directive and durable power of attorney for assets. These documents all together are called an estate plan. Although they have other purposes too (like nominating a guardian for a child, planning for disability or avoiding probate, which is a court process), wills and trusts are documents that say who will receive your assets after you are gone. The most common type of trust is often called a revocable living trust or a family trust. People who have a trust usually still have a will, although it is a shorter form of will called a pour-over will. It’s a good idea to talk to an estate planning attorney about whether or not a trust makes sense for your family or circumstances.  Now that you’re ready to get started, here are some mistakes to avoid: 1. Failing to plan Not setting aside the time to plan may be the biggest mistake. Failing to prioritize preparing or updating your estate plan means your last wishes and desires may not be fulfilled. The right documents memorialize what you would like to happen upon your disability and death so that other people can know and follow your wishes with respect to your care and your assets.  2. Failing to coordinate beneficiary designations Certain types of assets like life insurance and retirement accounts are not covered by your will or trust and need to be addressed separately. These types of assets are referred to as non-probate assets because they transfer under contract principles and don’t require court supervision or probate to be distributed to the named beneficiaries. By completing beneficiary designation forms provided by the retirement account custodian, insurance company or financial institution, you can direct your assets to one or more beneficiaries. 3. Failing to title your assets properly Asset titling refers to how you own your asset – such as in your individual name, jointly with someone else, or in a trust or entity. For example, assets titled for two people with a “right of survivorship” will automatically go to the surviving owner. Review your asset titling and make changes, if needed, to ensure your property and assets are passed down the way you intend. 4. Failing to include charities meaningful to you In addition to providing for family members and other important people in your life, you many also choose to give to charities meaningful to you in your estate plan. When you include a charity in your estate plan, that gift is called a planned gift and many charitable organizations, including Renown, recognize such donations through their legacy giving societies. As you prepare to make your own will or a more comprehensive estate plan, we recommend you consult with a lawyer. Here are some free resources that may be helpful too:  Renown Health Foundation is proud to sponsor the Family Estate Planning Series put on by PBS Reno and the Community Foundation of Northern Nevada. The free, 8-week course of 90-minute, in-depth workshops is a great place to learn much more and to help you get started in the planning process. The next course begins on September 7, 2022. More information can be found here. Renown Health offers periodic advance health care directive workshops where attendees can learn about, complete, and sign their directive. The next workshop is scheduled for September 14th. More information can be found here. The American College of Trust and Estate Counsel provides information on a number of commonly asked estate planning questions here. If you are interested in including a charitable gift to Renown in your estate plan, we would be happy to talk to you about how your gift will make a difference for our mission. Please contact Abbey Stephenson at abbey.stephenson@renown.org or visit renown.org/LegacyGiving to learn about Renown Health Foundation’s Legacy Giving Society and ways to give.

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You want to protect yourself and your family from the harmful rays of the sun — which are especially punishing at northern Nevada’s higher altitudes — but with so many options, how do you choose the right sunscreen? We asked our expert, Dr. Angela Walker, a dermatologist with Renown Medical Group, to shed some light on the subject. Sunscreen Application Dermatologists recommend a broad-spectrum sunscreen with a minimum SPF of 30, but keep in mind that no sunscreen protects against 100 percent of UV radiation and that reapplication is necessary. “No matter the SPF, sunscreen must be applied adequately and frequently, meaning a quarter-sized amount to cover the face and neck and a full shot glass amount for the body when wearing a bathing suit,” said Walker. “Reapplication should be every 80 minutes.” Why not use a high SPF, such as 70 or 100? According to the Skin Cancer Foundation, they don’t offer significantly more protection than SPF 30 and mislead people into thinking they have a higher level of protection. Here’s the breakdown: SPF 15 blocks 93 percent of UVB rays SPF 30 blocks 97 percent of UVB rays SPF 50 blocks 98 percent of UVB rays SPF 100 blocks 99 percent of UVB rays Do specific populations require a higher SPF? Walker explains that infants, seniors, and those with a history of skin cancer must take precautions against UV radiation, as their skin is vulnerable. Sunscreen should be an absolute priority before spending time outdoors and avoiding prolonged sun exposure, wearing a hat with wide brim (recommended 4-inch brim) and UPF (ultraviolet protection factor) clothing. Due to the sensitive nature of an infant’s skin, babies under six months should not spend time in the direct sun. For infants and toddlers six months and older, whose skin is thinner than adults, a sunscreen that contains zinc oxide or titanium dioxide (physical protectors) should be applied. Zinc and titanium are less likely to irritate because they do not penetrate the skin and instead sit on the surface and deflect UV radiation. Zinc oxide and titanium dioxide are vital ingredients to seek out in sunscreen due to their strong ability to deflect UV radiation. Sunscreen Terms Explained UVA = Long wave ultraviolet light. Penetrates deep into the dermis, the skin’s thickest layer, causing tissue damage that wrinkles and photo-aging and contributes to developing skin cancer. UVB = Short wave ultraviolet light. The biggest contributor to the development of skin cancer and are more prevalent during mid-day. SPF = Sun protection factor. Calculated by comparing the amount of time needed to burn sunscreen-protected skin vs. unprotected skin. So, SPF 15 means you can stay in the sun 15 times longer than you could without protection.

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Want to protect yourself from skin damage from the sun’s harmful rays? Dr. Angela Walker, dermatologist with Renown Medical Group, shares what you can do to prevent skin cancer. What can people do to prevent skin cancer while enjoying the outdoors? There are several steps you can take to protect your skin from the sun. “I caution all of my patients to avoid the sun during the hours of 10 a.m. until 2 p.m. when UV rays are strongest. I also encourage people to wear sleeves on cooler days. And don’t forget that we still need to wear sunscreen on cloudy days! UV rays can still cause sun damage on cloudy days. Preventing skin cancer also entails wearing sunscreen of at least SPF 30 everyday.  Are hats also a good idea for skin protection? Yes, of course! Choose a wide-brim hat that shades the face as well as the back of the neck for extra protection against UV rays. When it comes to identifying skin cancer, what should people watch for? We use easy-to-remember letters when checking for spots on the skin; it’s called the ABCDEs: How often should people go to a dermatologist for a full-body skin check? People with a family history of melanoma or who have already had skin cancer need to be screened at least once a year. Those who are younger and use sunscreen daily don’t need to be seen as regularly. Their primary care provider can do a yearly screening. And remember to do self-screening at home to keep an eye out for unusual looking spots. Is it best to visit a care provider with an expertise in skin with questions or concerns? Absolutely. As a dermatologist, I see a lot of people coming in with a changing mole or brown spot that looks irregular. I can assure them it’s benign or get them the treatment they need. We can even use photography to monitor skin spots and have the patient take photos at home. We also perform biopsies as needed.

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