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Breast cancer is the leading cause of cancer deaths in women in the U.S. That’s why early detection is so important. Dr. George Krakora, a radiologist with Renown Institute for Cancer, explains what to watch for and how new technology can lead to early detection. Most women know the importance of breast health and staying current with annual breast exams, but may not know that both screening guidelines and technology is evolving. So we asked George Krakora, MD, a radiologist for the Renown Institute for Cancer, what every woman should know about breast cancer detection and which screening method is right for them. First off, when should women start getting breast exams? Generally, women should start getting breast exams using mammography or ultrasound after they turn 40 years old. But we also want women ages 18 to 39 to talk to their primary care provider and ask for what’s called a formal risk assessment to see if screening is needed sooner. And you want to make sure your care provider is giving you a breast exam starting at age 25. It’s also a good idea to be familiar with how your breasts look and feel so you can report any changes to your care provider. What are the risk factors for breast cancer? Are there any preventive steps women can take? There a few risk factors you can’t control, like your age, family history of breast or other cancers, and if you have dense breast tissue. Your risk for breast cancer increases as you get older, and most breast cancers are diagnosed after age 50. Knowing your family history is important because a history of cancer and shared lifestyle can raise your risk. Your breast density can also increase your risk: Women with high breast density are four-to-five times more likely to get breast cancer than women with low breast density. But the good news is there are quite a few things you can do to prevent breast cancer, like not smoking, watching your alcohol intake, and maintaining a healthy weight with good diet and exercise. There are a lot of newer screenings out today. What is the difference between 2-D and 3-D mammography? In a 2-D mammogram, the tech takes X-rays of the breast. These pictures can show the radiologist if there are any lumps or tumors you might not be able to feel. In 3-D mammography, the process is largely the same but more X-rays are taken and it takes a few seconds longer for each image. This kind of exam detects 41 percent more cancers and reduces the number of false-positive results given to patients. This improvement in technology is great for both patients and their care providers. 3-D mammography provides better images of the breast, which allow doctors to more clearly diagnose and avoid false positives, especially in women with dense breast tissue. And what about a whole breast ultrasound. What is that? A whole breast ultrasound uses sound waves to detect cancerous tumors in the breast without using any radiation — it’s an ultrasound just like pregnant women get to check up on their baby. And the exam only takes about 20 minutes. We recommend these exams for patients whose mammograms have shown that they have dense breast tissue. Dense breast tissue can make it harder for doctors to see any abnormalities, lumps or tumors in a mammogram, so this technology ensures better early detection.

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Not all memory loss is inevitable — there are several things you can do to keep your brain nimble at any age. Find out how brain exercises, a healthy diet and daily movement can improve your brain’s focus. A modest decline in memory is to be expected as we get older. We forget someone’s name but recall it later. We find the need to make lists to remember things more pressing. Manageable? Yes. But frustrating nonetheless. The good news is we don’t have to sit back and succumb to age-related memory loss. There are concrete things we can do at any age to keep our brains sharp, nimble and engaged. Five Simple Brain Exercises 1. Volunteer or participate in meaningful activities outside of work. This engages your brain and emotions in a healthy, positive way. 2. Engage in moderate, regular exercise to tone body and mind. Overall good health is critical to brain health. Even casual daily walking can boost your mental abilities. 3. Eat the rainbow. Choose to include plenty of colorful fruits and veggies and ease up on processed foods in your daily diet. The proper nutrients can improve circulation to your brain, which will amp up your cognitive abilities. Consult your doctor for the best diet and supplement choices for your specific health needs 4. Get a blood test to determine your body’s hormonal and nutrient levels. Specific hormones and nutrients can affect cognition. Be mindful of your cholesterol levels, and if you take cholesterol medications, such as statin drugs, be aware they can also affect your mental faculties. 5. Engage in brain activities like reading, crossword puzzles, Sudoku and Trivial Pursuit. These types of activities can improve your brain’s focus and concentration and — most important — test your memory and general knowledge. You derive more benefit by engaging in these activities consistently for short amounts of time, so make a weekly appointment with yourself to build brainpower.

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Award given to Truckee Meadows Health Communities, Renown Health & Washoe County Health District. Truckee Meadows Healthy Communities (TMHC), Renown Health and the Washoe County Health District received the BUILD Health Challenge® award, a $250,000 grant to support Caring For Reno’s Elders (C.A.R.E.) program. The award comes as a collaborative result of more than 30 local organizations submitting a proposal for the funding. Renown Health announced that the organization is matching the grant alongside other pledged funding from the community, bringing the current C.A.R.E. support to $580,000. Together the entities will focus on senior loneliness and the health issues it creates. The partners are honored that Truckee Meadows was selected as one of 18 communities to receive funding from BUILD in the 2019-2021 term. “C.A.R.E will be a community approach to enhance life quality for elders by reducing social isolation and loneliness, issues that seriously impact senior health,” said co-team leader Kindle Craig, Sr. Director Renown Institutes. “Loneliness is the root cause of many issues including suicide1 , chronic disease2 and a reduction in lifespan3 . Washoe County senior suicide rates are two and four times the national rate for those aged 65 and 85 years, respectively4 . That is unacceptable.” Sharon Zadra, TMHC executive director and co-team leader, said this project will tackle barriers to socialization such as access to affordable housing, transportation and healthcare.  “We’ll bring the entire community on-board, long-term, to increase social connectedness and reduce health and mortality issues associated with loneliness by starting a cross generational ‘Kindness Epidemic,’” Zadra said. The BUILD Health Challenge is a national program focused on bold, upstream, integrated, local and data driven projects that can improve community health. The award provides funding, capacity building support and access to a national peer-learning network to enhance collaborative partnerships locally to address our community’s most pressing health challenges. The C.A.R.E team expresses special thanks to the BUILD Health Challenge for its support of this initiative. “Loneliness and isolation in our senior population leads to declines in both mental and physical health, and increased mortality,” said Kevin Dick, Washoe County District Health Officer. “We are incredibly honored to join the BUILD cohort, teaming with TMHC and Renown Health to bring long-term solutions by building a cohesive social network to improve the health of our elders.”  The BUILD Health Challenge® is made possible with the support of: BlueCross BlueShield of South Carolina Foundation, the Blue Cross and Blue Shield of North Carolina Foundation, Blue Shield of California Foundation, Communities Foundation of Texas, de Beaumont Foundation, Episcopal Health Foundation, The Kresge Foundation, Methodist Healthcare Ministries of South Texas, Inc., New Jersey Health Initiatives, Robert Wood Johnson Foundation, and W.K. Kellogg Foundation. TMHC, Renown Health and WCHD have worked united for the last five years, rallying diverse partners and community leaders to influence and advocate for the region’s capacity to ensure a healthy community.

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According to the American Cancer Society, approximately 14,100 new cases of invasive cervical cancer will be diagnosed, and 4,280 women will die from cervical cancer. However, cervical cancer is preventable with regular screening tests and the HPV vaccine. It’s important to note that medical advances have allowed progress in diagnosing and treating cervical cancer. While it used to be one of the most common causes of cancer death for American women, the incidence of death has significantly declined. What to Know About the HPV Vaccine HPV vaccination is the best way to prevent cervical cancer and is recommended for all youth starting as early as age 9, or for teens and adults up to age 45 who didn’t start or finish the series. In Nevada, only 50.1% of teens ages 13-17 have been vaccinated for HPV.  There are 13 types of HPV, and the vaccine Gardasil 9 protects against 9 of those HPV strains, greatly reducing the incidence of cervical cancer among vaccinated individuals. What to Know About Cervical Cancer Screenings The CDC says the most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21. And there are two common tests that can detect early stages of cervical cancer (or precancer) and improve health outcomes. The pap test (or pap smear). This screening looks for precancers. Women should begin getting pap smears when they’re 21. The human papillomavirus (HPV) test looks for the virus that can cause these cell changes. Cervical Cancer Screening Schedule The American Cancer Society offers the following guidelines for screenings: All women should begin cervical cancer screening at 21. Women between 21 and 29 should have a pap test every three years. Beginning at 30, the preferred way to screen is with a pap test combined with an HPV test every five years. This is called co-testing and should continue until age 65. A pap test (or pap smear) is performed during a regular screening appointment to look for precancers, cell changes on the cervix that might become cervical cancer if they are not evaluated or appropriately treated. Typically outpatient procedures can reduce the risk of long-term health impacts that prevent pre-cancerous cells from becoming cancer cells. Women over 65 who have had regular screenings in the previous ten years should stop cervical cancer screening as long as they haven’t had any severe precancers found in the last 20 years. How to Get Screened Request an appointment with your primary care physician or OBGYN to schedule a screening.

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March is Colorectal Cancer Awareness Month, and we want you to receive the best preventative care possible. Early detection can help prevent serious illness, yet many people still choose to skip their annual exams and routine screenings. Bonnie Ferrara, MD, MPH, Section Chief for Primary Care at Renown Medical Group, further explains the importance of this simple, easy way to stay healthy. Why are annual exams so important? The benefits of early detection and prevention to save lives and reduce the impacts of disease have been proven. These exams are the perfect opportunity to get your health questions answered. “This is your chance to sit down with your provider and talk about your overall health and your family’s health history as well as your concerns for the future,” says Bonnie Ferrara, M.D., family medicine. “It’s the opportunity for your provider to talk with you about your lifestyle, tobacco use, exercise and alcohol use, all of which make a difference in your future longevity.” The annual wellness exam is also an ideal time for most adult patients to discuss health screenings. In addition, these visits are the perfect time to address issues that may not directly relate to a particular medical problem or immediate illness. A good rule of thumb is to schedule these appointments around your birthday each year to make sure you and your provider are both updated on your care. Why would you need an annual exam if you aren’t feeling sick? According to Dr. Ferrara, seeing your care provider when you aren’t sick is one of the best times. “It is better if you try to arrange this visit when you are not feeling ill,” she says. “It is an opportunity to talk about wellness. Not only how to contribute to your wellness but also the changes that you can make that will make huge dividends in the future for your wellness. In addition, it allows us to do some education about what to expect in the coming years as far as your health and lifestyle changes.” What can you expect at an annual exam? Annual exams usually check your: History – lifestyle behaviors, health concerns, vaccination status, family medical history Vitals – blood pressure, heart rate, respiration rate and temperature General appearance – your care provider can find out a lot about you just by watching and talking to you Dr. Ferrara adds, “If this is a Medicare annual wellness exam, it is an opportunity to talk to your provider about depression and dementia as well as be tested for those.” You can also leverage your annual exam to speak to your provider about managing your chronic health problems. "As a provider, these visits give us the opportunity to hear how the medications and lifestyle changes we have recommended are working and if you are having problems with these, we have the opportunity to make suggestions of how to do things better for the future," Dr. Ferrara.

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Virtual visits are basically secure, video conferencing visits with your health provider. Of course if you are sick, you want to avoid going outside of your house. With Renown Health’s virtual visit program, you can now see a provider from the comfort of your own home. As we work to keep all of our patients home and healthy, we’re here for any ongoing healthcare needs you have. There are two easy ways to access a virtual visit with Renown Health. If you need an urgent care visit, you can get in line using your MyChart account You can make a virtual visit with some Renown Health providers you see currently Virtual Urgent Care from a Renown Provider By using MyChart, you can now login and request to “Talk to a Doctor.” After filling in some information and confirming your healthcare concern, you will be put into a virtual line. The healthcare team will notify you by text or email when a provider is ready to talk to you virtually. Virtual urgent care visits are available for all ages. Get To Know MyChart Virtual urgent care visits are available for all ages, and can address: Common cold and cough symptoms Muscular, tendon or joint pains not caused by injury Allergy or sinus symptoms Pink eye Urinary discomfort Diarrhea without vomiting Rashes or skin sores Backache Nail problems Screening examination for sexually transmitted illness (without symptoms) Medication refills (not controlled substances) Symptoms for In-Person Urgent Care Visits Shortness of breath Chest pain Abdominal pain Numbness or weakness of any location that is new Traumatic injuries (including eye injuries or something in the eye) Severe pain of any other body location Dizziness or confusion Bleeding from any location High fever (greater than 102 degrees for all ages) Persistent vomiting Loss of vision Ear pain Substance abuse or psychiatric problems Virtual visits are open 9 a.m. through 6 p.m. Monday-Friday and 10 a.m. to 4 p.m. Saturday and Sunday for Nevada residents. Renown Provider Virtual Visits Many primary and specialty care appointments for adults and children are now available virtually. If you have a provider with Renown Medical Group, call 775-982-5000 to see if you can have a virtual appointment from the comfort of your home. MyChart Assistance If you need assistance with your MyChart account, please call 775-982-6686. For all other questions about scheduling and appointments, please call 775-982-5000.

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Flu shots don’t just protect those who get vaccinated; they guard everyone, including your family and the community. Renown Health experts help us understand why everyone, including children, pregnant women and the elderly, should get a flu shot. Ways to Schedule Your Flu Shot Call Us! 775-982-5000 Urgent Care Appointments Renown Pharmacy Vaccinations Make an Appointment via MyChart Need a Doctor? Find One Now Flu Shot Information Whitney Robinson, Renown Health Infection Prevention Expert Chills, body aches, fever and congestion; getting the flu isn’t fun. When you get a flu shot, you’re not just protecting yourself, you’re also helping reduce the total flu cases and hospitalizations. The ideal time to get your flu shot is September through October. This timing allows the vaccine to provide the strongest protection during the length of flu season. However, getting the vaccine later is better than not at all as it's still flu season well into spring. Flu Symptoms In general, influenza (flu) is worse than the common cold and shares symptoms with COVID-19, causing mild to severe illness, and at times can lead to death. Symptoms include: Fever or feeling feverish/chills (not everyone will have a fever) Cough and/or sore throat Runny or stuffy nose Headaches, muscle or body aches Fatigue (tiredness) Vomiting and diarrhea, though this is more common in children than adults Who Needs a Flu Shot? Almost everyone. The Centers for Disease Control and Prevention (CDC) considers it the first and most crucial step in protecting against the flu virus. Therefore, they recommend the yearly flu shot for those six months of age and older. Does the Flu Shot Help with COVID-19? The short answer is no. However, flu vaccines can reduce the risks of flu illness and hospitalization. Therefore, it is crucial for you to get your flu shot to not only protect yourself and the community, but also to help conserve vital, local healthcare resources. CDC Resource: Who Needs a Flu Vaccine and When Kids, the Elderly and Flu Shots  Vanessa Slots, M.D., Renown Medical Group The flu is not a passing cold. It is a serious illness that takes lives every year and it happens like clockwork. The onset of flu season is fall and lasts through winter into the spring months. This lung illness is caused by viruses, with yearly outbreaks occurring worldwide. No one is immune, and anyone can catch  to the flu. Flu Signs and Symptoms Quick onset of fever Headache Body aches and fatigue along with respiratory symptoms including cough Sore throat and nose Who's at Risk for the Flu? Children and the elderly are at greater risk of complications from the flu, specifically toddlers less than two years old. At this age, their immunity is still developing. Seniors over 65 are also at increased risk because their immune systems have weakened with age. The severity of a child’s symptoms depends on age and prior exposure to the virus. With young children, for example, the flu is more problematic since they cannot talk and communicate their symptoms. As a result, children often experience higher fevers, which can lead to seizures or convulsions. This can be coupled with issues such as nausea, vomiting, diarrhea and poor appetite, all of which put children at risk of dehydration and other complications that can require hospitalization. An average of 20,000 children are hospitalized for flu each year. Pre-Existing Health Issues Ongoing health conditions including asthma, heart conditions, diabetes and more can intensify flu symptoms. Still, many children without risk factors can experience severe flu complications. CDC Resource: Flu Information for Parents Pregnant Moms and Flu Shots Tamsen Carson, PAC, Surgical First Assistant, OB/GYN, Renown Medical Group “During pregnancy, your immune system wards off infection for your baby, leaving you more susceptible to infection and adverse health conditions,” Tamsen explains. She   highly recommends flu shots for ALL women during pregnancy. You must receive the injected vaccine versus the live vaccine, a nasal spray, which can cause the flu to occur. Passing Flu Immunity on to Your Baby Also, remember that you will also be able to pass the immunity onto your baby if you breastfeed, which will protect your baby from the flu. CDC Resource: Flu Safety and Pregnancy

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What is Proxy Access? Proxy access allows parents, legal guardians and caregivers to log into their personal MyChart account and connect to the health information of a patient they represent. As a proxy, you can view upcoming appointments, request appointments, view lab results, email a doctor on the patient’s behalf, view medications, request prescription refills and view health reminders. How Do I Establish Proxy Access? Login to your MyChart account with your username and password Go to the Profile menu at the top of the screen, then select Personalize From this screen you can see whose records you currently have access to Click Request Access to a minor’s chart Complete all of the fields When finished click Submit Request What if I Don’t Have a Renown MyChart Account? If you don’t have a Renown MyChart account, call 775-982-2781 and someone from the Renown Health MyChart team can help you set up proxy access. Keep in mind, the ability to request proxy access is only available on the MyChart website and not via the mobile app. However, the website can be accessed with your smartphone or tablet by using the web browser and going to mychart.renown.org.

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If you are approaching age 65, you may be starting to think about the government benefits you will soon qualify for. For example, your healthcare option to elect between Original Medicare or a Medicare Advantage plan. What’s the difference? Original Medicare comes in two parts: Part A and Part B. Part A covers a portion of hospitalization expenses, and Part B applies to doctor visits and medical expenses, such as lab tests and some preventative screenings. A Medicare Advantage plan, also known as Part C, is an “all-in-one” alternative to Original Medicare. These “bundled” plans include the benefits of Part A, Part B and Part D (prescription drugs). Some people choose a Medicare Advantage Plans over Original Medicare because these plans offer coverage like vision, hearing, dental and more. Saves You Money First and foremost, Medicare Advantage Plans save Medicare members money –and not just a little bit of money, but a lot of money. Original Medicare only pays 80% of the cost of medical care – the Medicare beneficiary is responsible for the other 20%. A Medicare Advantage Plan is different. The Medicare Beneficiary is only responsible for a small copay, typically less than 20% of a doctor visit or procedure. More importantly, Medicare Advantage Plans have a maximum out-of-pocket amount, meaning that once you reach the limit, the Plan pays 100% of all medical services. That alone can save thousands of dollars per year – particularly if there is a hospitalization involved. Dental, Vision and Hearing Coverage What sets Medicare Advantage plans apart is the additional benefits provided that Original Medicare doesn’t cover. These benefits include dental coverage, vision coverage, hearing exams and hearing aid coverage. None of these important health care benefits are included in Original Medicare. Also, most Medicare Advantage Plans include prescription drug coverage at no additional cost, while individuals with Original Medicare need to sign-up and pay extra for Part D prescription drug coverage. Medicare Advantage Plans offer more benefits than Original Medicare and they help members save on their health care costs. Focus on Accessibility, Wellness and Preventative Health Accessible healthcare coverage is key to staying on top of your health. To join a Medicare Advantage Plan you must have Part A and Part B coverage and live in the plan’s service area. It is important to remember that Original Medicare is only valid in the United States. Fortunately, many Medicare Advantage Plans offer worldwide emergency coverage. Another important healthcare consideration to keep in mind is Medicare Advantage Plans focus on your overall well-being. They offer preventative and wellness-related benefits at no cost to you. This includes important benefits like free over-the-counter medicines and free gym memberships. You won’t find those types of benefits with Original Medicare. Medicare Supplement Plans (Medigap) Some people confuse a Medicare Supplement Plan, also known as a Medigap Plan, with Medicare Advantage Plans. They are different and the biggest difference is Medicare Supplement plans come with ever-increasing premiums because they are based on your age. This means the cost of these plans increase every year. Plus, they don’t offer any supplemental benefit coverage like vision, dental or hearing. That’s not the case with a Medicare Advantage Plan. In many cases, there is no monthly premium and you receive all manner of supplemental benefits. These benefit-rich, zero-dollar premium Medicare Advantage plans are enticing people to say goodbye to pricy Medicare supplement plans and hello to Medicare Advantage Plans. Don’t worry, if you join a Medicare Advantage Plan for the first time and you aren’t happy with the plan, you’ll have special rights under federal law to buy a Medigap policy and a Medicare drug plan if you return to Original Medicare within 12 months of joining the Medicare Advantage Plan. The Flexibility to Change Your Mind A common misconception about Medicare Advantage Plans is that when you join, you are still on Medicare and are not giving up your Medicare coverage. Medicare Advantage Plans are considered “Medicare Part C.” This means they combine your Medicare Part A (hospital coverage), Part B (doctor’s coverage) and Part D (prescription drug coverage) into one convenient package that costs less and provides more. You can only join, switch or drop a Medicare Advantage Plan during the enrollment periods: Initial Enrollment Period: When you first become eligible for Medicare, you can sign up during your Initial Enrollment Period. For many, this is the seven-month period that begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. General Enrollment Period: If you have Part A coverage and you get Part B for the first time during this period (between January 1 - March 31 each year), you can also join a Medicare Advantage Plan. Your coverage may not start until July 1. Annual Election Period: Between October 15 and December 7, anyone with Medicare can join, switch or drop a Medicare Advantage Plan. Your coverage will begin on January 1 (as long as the plan receives your request by December 7). Medicare Advantage Plans have been around for more than 25 years and continue to grow in popularity. In some parts of the country, more than half of all Medicare beneficiaries are enrolled in a Medicare Advantage Plan. Only 40% are enrolled here in Nevada, but that number is growing every year.

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Did you know that members of Senior Care Plus, the largest Medicare Advantage Plan in northern Nevada, have access to an exclusive, senior-focused Renown Health primary care office right here in Reno? The facility – and the Medicare plan itself – are both designed with seniors in mind; this includes specialty staff, longer appointment times, on-site services, supportive furniture and more. 4 Benefits of an Exclusive Senior Care Plus Facility Centrally Located with Senior-Focused Staff The Senior Care Plus facility, located on Del Monte Lane, is only open to members of Senior Care Plus. This exclusive access means that the bilingual staff – including doctors, medical assistants, nurses and personal assistants – works daily with aging health needs. On-Site Services and Enrollment Specialists The Senior Care Plus providers understand that seniors often require complex care management and geriatric-focused services. That is why this location offers on-site lab draws, saving travel time and stress. Another essential service this location offers is longer appointment times, ensuring members don’t feel rushed when discussing their health needs with providers. Another perk of the Del Monte location – on-site enrollment specialists. Members, and potential members, can stop by this location on weekdays between 9 a.m. and 4 p.m. to have their SCP-related questions answered. Furniture Designed with Seniors in Mind Senior Care Plus makes a doctor visit as stress-free as possible. The office has furniture that makes each visit more comfortable for members. All of the office chairs have armrests, so seniors can easily get in and out of them. Also helpful are the exam room chairs with remote controls for reclining the chair and lifting the patient’s legs. This makes exams, such as a diabetic foot exam, less of a strain. Community Rooms Social connections are an important part of health. That is why the Del Monte Lane office has community rooms used for informative seminars and as a gathering place for members to mingle. The seminars focus on many interesting topics for older adults, such as diabetes, COPD, asthma, weight loss, nutrition, yoga and chair exercises.

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Millions suffer from urinary incontinence (urine leakage). Often people feel as if their bladders control their lives. But this doesn't have to be your story. Bladder control issues are treatable and you can take steps to help control your bladder. What is urinary incontinence? Men and women of all ages can have difficulty controlling their bladders. Urinary incontinence occurs when the muscles in the bladder that control the flow of urine contract or relax involuntarily. Is there more than one type of urinary incontinence? Yes, there are three main types: Stress incontinence is when the bladder leaks small amounts of urine as a result of physical stress or pressure on the muscles supporting the bladder caused by coughing, sneezing, laughing, lifting or any sudden physical exercise such as running or jumping. Urge incontinence is the inability to control a strong urge to go without advance warning, limiting the time needed to get to the bathroom. Overflow incontinence occurs when the bladder does not empty properly. As a result, over time, large quantities of urine are stored, causing the bladder to overflow (this is more common in men and is often the result of an enlarged prostate blocking the bladder opening). Are there any tests that can determine the cause and type of incontinence? Your doctor may have you track your fluid intake and output in a Bladder Diary. A urinalysis can be checked for infection, traces of blood, or other abnormalities. Blood tests can look for chemicals or substances that may relate to contributing causes. Other testing may be an ultrasound, cystogram or post voiding residual measurement. How is urinary incontinence treated? Exercises to strengthen the pelvic floor muscles or restrain the bladder to hold on for longer. Medication can relieve and control the troublesome symptoms. If there is an infection an antibiotic is used. Surgery can repair weakened muscles or remove blockage. Special products such as pants, pads, collection devices, and chair and bed protection may be needed if the problem cannot be controlled. How do you strengthen your pelvic floor muscles? To make your pelvic floor muscles stronger, alternate between squeezing and relaxing them. Following the steps below may help: Squeeze your muscles for one second and hold. Relax your muscles for two seconds. Each time you squeeze and relax, it counts as one set. Complete five sets. When you can do the exercises easily, increase to doing them 10 times per day. When that gets easy, try to squeeze and hold the muscles for three seconds and then relax the muscles for three seconds. As your pelvic muscles get stronger, you can progress to longer squeezes for about 10 seconds. Be sure to relax between squeezes so that your muscles can rest before squeezing again. You should do these exercises in three different positions. Do 10 sets lying down, 10 sitting and 10 standing. It is important that you develop the habit of doing the exercises every day. You may want to exercise just after you get up in the morning and right before you go to bed at night. What can I do to help control incontinence? Watch your weight, practice pelvic floor muscle exercises, eat plenty of fresh fruits, vegetables and fiber to prevent constipation. Most importantly, talk to your doctor regarding incontinence issues, don’t be embarrassed!

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According to the Centers for Disease Control and Prevention (CDC), one out of four adults aged 65 or older, fall each year. But less than half of those who fall talk to their healthcare provider about it. What’s more, among older adults, falls are the leading cause of both fatal and nonfatal injuries. Senior Care Plus, a Medicare Advantage Plan by Hometown Health, and Renown Health Nurse Educator, Nicholas Mannering, worked together to provide a list with simple tips to help you prevent falls.  1. Exercise Exercise strengthens both your muscles and bones and improves balance which is a key factor to preventing falls. The stronger you are, the less likely you are to fall. And, if you do fall, you are less likely to be injured.   2. Vision Check Vision is an import part of fall prevention, have your eyes check by an eye doctor at least once a year. Update your vision prescription and replace your eyeglasses as needed.   3. Install Safety Equipment in Your Bathroom Installing grab bars in your home bathroom provides a way for you to help yourself in and out of challenging situations. It also provides support if you suddenly feel week or unstable. Having a grab bar to lean on or hold onto when you feel yourself falling or slipping can help prevent falls. Rubber mats eliminate slick surfaces that increase your risk of falling.   4. Helpful Items in Your Bedroom A light within reaching distance is an important item to have in your bedroom. One reason adults fall is because they wander through a dark room, often to get to the bathroom at night, and can’t see where they are walking. Having a light within reach that is quick and easy to turn on before walking around a room can make it safer and decrease your risk of falling. Having a bedroom that is organized and furnished in a way that is easy to navigate is also important. If your bedroom is cluttered and hard to walk around without tripping or running into things, it might be worth reorganizing the area to define a clear walking path.   5. Helpful Items in Your Living Room Similar to your bedroom, your living room should have a light that is easily accessible. Sofas with armrests are helpful for support when getting up and sitting down. Avoiding clutter in your walkways, rugs that are not secured down and unstable furniture are important to consider when preventing falls.   6. Actions to Avoid in Your Home There are other ways to fall besides slipping or tripping while walking. Never stand on chairs, boxes or other unstable items in your home. Walkways should be tidy and free of objects that you could trip on. Spills should be cleaned up right away to prevent slipping.   7. Wear Appropriate Footwear Wearing shoes with non-slip soles and closed toes can help prevent you from falling.  Having shoes that fit properly, are made from hard rubber (like tennis shoes) and provide good support help prevent tripping and falling. Shoes with a collar that support the ankle and a well-padded tongue for the top of your foot can also help prevent injury to your feet.   8. Review Your Health & Medications at your Annual Health Check-Up It is important to review your health and medications with your healthcare provider so they can assess if you are at risk for falls. You should discuss your vision, heart health and blood pressure at your annual health check-up. These things can play a role in the risk of falling. Reviewing your current medications is also important. If medications are making you dizzy, talk to your provider about adjusting the dosage so you can feel more stable and balanced. When talking to your doctor about medications be sure to include your vitamins and supplements. Finally, Have your healthcare provider check your feet and discuss proper footwear yearly.   9. Avoid Smoking and Alcohol Balance is important in preventing falls. Alcohol consumption negatively affects balance and increases your risk for falls and fractures. It also increases your risk for cancer, liver damage, osteoporosis, high blood pressure and strokes. Smoking is connected to frailty in older adults. It prevents the development of muscle tissue and breaks down healthy muscle tissue due to the lack of oxygen in your body.

Read More About Your 9-Step Guide to Prevent Falls