What Is Long-Term Care?

Long-term care refers to a comprehensive range of medical, personal, and social services coordinated to meet the physical, social, and emotional needs of people who are chronically ill or disabled. A nursing home facility may be the best choice for people who require 24-hour medical care and supervision.

What Type of Care Do Nursing Homes Provide?

Nursing homes offer the most extensive care a person can get outside a hospital. Nursing homes offer help with custodial care -- like bathing, getting dressed, and eating -- as well as skilled care. Skilled nursing care is given by a registered nurse and includes medical monitoring and treatments.

How Can I Find the Right Nursing Home?

Finding the right nursing home takes time. It is important to begin the search for a suitable nursing home well in advance of seeking admission to the facility. There are often long waiting periods for available accommodations. Planning ahead also can make the transition of moving into a nursing home much easier.

About Nursing Homes

A nursing home, convalescent home, skilled nursing facility (SNF), care home, rest home or intermediate care provides a type of residential care. It is a place of residence for people who require continual nursing care and have significant difficulty coping with the required activities of daily living. Nursing aides and skilled nurses are usually available 24 hours a day.

Residents include the elderly and younger adults with physical or mental disabilities. Residents in a skilled nursing facility may also receive physical, occupational, and other rehabilitative therapies following an accident or illness. Some nursing homes assist people with special needs, such as Alzheimer patients.

Residents may have specific legal rights depending on the nation the facility is in.

Before the Industrial Revolution, elderly care was largely in the hands of the family who would support elderly relatives who could no longer do so themselves. Charitable institutions and parish poor relief were other sources of care.

Nursing homes offer the most extensive care a person can get outside a hospital. Nursing homes offer help with custodial care—like bathing, getting dressed, and eating—as well as skilled care given by a registered nurse and includes medical monitoring and treatments. Skilled care also includes services provided by specially trained professionals, such as physical, occupational, and respiratory therapists

Features included

  • 3 Chef-prepared meals daily and restaurant style dining
  • Dynamic calendar of activities, outings and Watercrest Institute classes
  • Salon and Spa Services on-site
  • Coastal Living design complete with pool, verandas, and outdoor living spaces
  • Spacious apartments with washer, dryer, and kitchenettes
  • 24-hour licensed staffing and world class personal care
  • Wellness programs
  • Pet friendly environment
  • A state-of-the-art wireless resident call system
  • Medication management available
  • Preventative health screenings
  • High apartment ceilings and spa showers
  • Transportation services seven days per week
  • Housekeeping services
  • Maintenance services
  • Utilities and cable included
  • Move-in coordination
  • Respite stay accommodations

Lumbar Radiculopathy (Sciatica)––Dr. Katharine Leppard

in Health & Fitness
Created: 01 June 2016

By Katharine Leppard, MD, Colorado Springs LIVING WELL Magazine

A lumbar radiculopathy is a pinched nerve in the low back. Typically, this causes low back and buttock pain, with pain radiating into one or both legs, which can be associated with numbness and weakness. A common lay term is sciatica. Leg pain can commonly be worse than low back pain. The pain is caused by compression of the nerves as they exit the spine.

The anatomy in the spine is beautiful and complex. The vertebrae are the bones in the spine. These are stacked on top of each other in a column. In between the bones is a structure called the disc. A spinal disc is a shock absorber pad or cushion between the bones. Between each bone, and next to the disc, a spinal nerve exits on both sides of the spine. These nerves can become pinched by a number of issues including a disc injury, by arthritic bone spurs, or a shift in the spine, which narrows the nerve canals. Central canal spinal stenosis is a narrowing of the main central canal in the spine. Typical symptoms for spinal stenosis include pain and numbness radiating into the legs with walking––commonly this improves when sitting down.

 

A spinal disc is built like a jelly doughnut. There is a tough outer wall called the annulus, and a watery jelly center called the nucleus. The jelly center of the disc in young people typically has a large amount of water. As we age, the jelly center of the disk dries––this is called degenerative disc disease. Any injury that compromises the outer wall of the disc––the annulus––will cause the center of the disc to dry earlier than expected. This is called degenerative disc disease. Sadly, this is not a reversible change.  I’ve seen advertisements for spinal decompression (spinal traction) where they claim that it will rehydrate a dried disc––this is not accurate. Once the outer walls of the disc are compromised, that disc cannot maintain the water inside it, and it will remain dehydrated.

Three types of injury can occur to a disc. The outer wall can tear, which is called an annular tear. The outer wall can bulge but remain intact, which is a disc bulge. The outer walls can tear and the jelly can come out of the disc, which is called a disc rupture or herniated disc. The term “slipped disc” is a misnomer, as the disc itself does not shift out of place. As we age, the spine also develops bone spurs around degenerative discs, and also in the joints of the spine called the facet joints. Age can also cause disc bulging and arthritis that combine to cause spinal stenosis.

Diagnosis of lumbar radiculopathy can be made based on history, physical examination, x-ray, MRI and EMG testing. MRI scans give the most detailed information about the cause of radiculopathy.

Treatment for radiculopathies falls into several main categories.

  1. Do nothing, often Mother Nature will resolve the problem. Please seek medical attention prior to doing nothing, there are very real risks of nerve damage and weakness if a serious condition is ignored. The longer there is pressure on a nerve, the greater the risk of permanent nerve damage. If someone develops sudden foot drop, which is weakness in raising the foot, this is a surgical emergency. They should be seen in the emergency room immediately, and typically requires surgery within 24 hours. Delay can lead to permanent foot drop.
  2. Surgery, the most extreme intervention, is done when there is significant pathology such as spinal cord compression, instability or severe nerve compression.
  3. Steroids, which reduce the swelling of a pinched nerve. These can be steroid pills or injections. Epidural injections are done into the spine under x-ray. There are potential side effects and risks of both the medication and injections. Cervical epidural injections have the remote risk of a spinal cord injury. How much steroids will help a patient is unknown.
  4. Traction, which temporarily opens the nerve canals one on the machine, temporarily relieving the pressure off the inflamed nerve, and allowing natural healing to occur. Traction and decompression are the same thing, and is covered by insurance if done through physical therapy. Traction for pinched nerves in the low back typically is not effective; traction is much more effective for a pinched nerve in the neck. Traction does not make disc protrusion smaller. The jelly center of the disc is 80% water, and through natural healing the body will reabsorb the extruded jelly of a disc rupture, and make disc ruptures smaller with time. Advertisements that show a reduction in the size of the disc herniation over time are demonstrating this natural healing––this is not an effect of traction.
  5. Hands on treatment with soft tissue work and gentle exercise to reduce muscle spasm and improve range of motion. High velocity spinal adjustments should be avoided in the presence of a truly pinched nerve. Adjustments can irritate or injure the pinched nerve, and make a small disc rupture into a large disc rupture, and can necessitate surgery.
  6. Being extremely careful with body mechanics can help to protect the disks.

Proper diagnosis is the first step towards appropriate treatment. Lumbar radiculopathies can be very painful and have the risk of permanent nerve damage if ignored. The majority of lumbar radiculopathies resolve without surgery. Please seek evaluation if you are experiencing pain, numbness or weakness.