Kristen Mauk

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About Kristen Mauk

President/CEO - Senior Care Central, LLC

Nurses Are….

This week we celebrate National Nurse’s Week beginning on May 6th and ending on May 12th (Florence Nightingale’s birthday). The profession of nursing has come far since its inception. When I went to nursing school in the late 1970’s, we were still wearing blue pin-striped uniforms and caps. There were striping and pinning ceremonies to mark milestones in the 4 year journey to the Bachelor of Science in Nursing degree, and it wasn’t until the early 1980’s when my nursing school started to eliminate those bulky caps that were so difficult to keep on our head. When the mandatory uniforms and nursing caps were no longer the symbol of the nurse, we had to develop other ways for patients and families to recognize us. I hope that we are now recognized for the knowledgeable care and comfort that we provide to others. It has been said that nurses are the backbone of the healthcare system.  I would suggest that we are that and much more:

Nurses are timeless. Florence Nightingale left the comforts of home care for the sick. Nurses are there for the beginnings and ends of countless lives. We hold the hands of the young, the old, and everyone in between. The shifts are long and if a patient needs us, we work overtime to finish the job. We might wear a uniform, scrubs, a lab coat, or a suit, but we transcend fashion to don whatever our patients need for safe, quality care.

Nurses are trusted. Gallup polls consistently show that the public trusts the ethics and honesty of nurses above even that of physicians, making us one of the most trustworthy professions in the eyes of the people.  Nurses adhere to the ANA Code of Ethics that emphasizes supporting patients’ autonomy and the concepts of beneficence, justice, fidelity, and veracity. All nurses receive education in ethics, with patient care at the center.

Nurses are inspiring.  How many people can say that their jobs changed a life? As a rehabilitation nurse, one woman who had experienced a stroke told me, “I had stroke and died three times. I was in ICU for weeks, but I didn’t feel alive until I came to rehab. Rehabilitation nurses helped me live again!” Yes, transforming lives is what nurses engage in daily. In fact, many of us can name that one nurse that we remember and would choose to have with us if we were sick or dying – that nurse who knows how to inspire and care.

Nurses are experts.  Nurses are expert caregivers, patient advocates, teachers, and researchers. We know the realm of health care better than anyone because we are the licensed professionals who are there 24/7. There are more nurses with advanced practice degrees and certifications than ever before. Nursing has evolved into a discipline with multiple specialties that support best practice in numerous areas that affect health and wellness. Nurses hold positions of leadership in government, the military, organizational systems, health care corporations, and major companies, all attesting to the value of our knowledge and education.

Nurses are still carriers of light. Florence Nightingale was known as “the lady with the lamp”. I always found that image inspiring. One of my favorite memories from my early career occurred while I was working the night shift on a geriatric unit. An elderly man couldn’t get the music he liked to play on the radio, so he asked for someone to sing some old hymns to him. I did so reluctantly at first, holding his hand and singing all the old songs of the faith that I could remember. The next day, I heard him excitedly telling his family members, “An angel came to my room and held my hand and sang to me last night!”  I was puzzled when later he didn’t seem to recognize me as the singing “angel”.  The following night, he died unexpectedly. Reflecting on that experience, I believe that higher powers were at work there. Maybe I was just the vessel through which a bit of healing flowed. Since then, I have seen countless similar examples of extraordinary happenings when caring nurses are involved.

Nurses do more than just enact art and science. Sometimes…our work is like a little piece of heaven.

 

By |2020-03-23T18:28:10-05:00March 25th, 2020|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Nurses Are….

Five tips for Grandparents to stay connected with family

bigstock-grandma-with-your-grandson-12149147

With the birth of my daughter’s second child, I began to reflect on the important role that grandparents can play in the lives of their grandchildren. Here are five essential tips for older adults who want to have a lasting influence in the lives of their children and grandchildren.

Visit often.  For those of us fortunate enough to live near our children and grandchildren, it is easy to see them often. Grandparents may even be the caregivers while parents are working. Visits don’t always have to be planned. Sometimes the best family time is a spontaneous invitation to dinner and a movie. However, sometimes distance can prevent regular visits. Some grandparents make it a goal to see their distant grandchildren once every 6 weeks or every few months. Be sure to take advantage of technology for your time together. Set a regular time to Skype or do Face-time. Don’t miss out on the subtle changes in those early years while babies are growing. Exchanging pictures may help, but they don’t replace the in-person experience. You may even think of relocating to be closer to family. For older grandchildren, be sure to have their cellphone number. Text them often and exchange pictures to stay involved in their lives and let them know you are available to them. Even small connections throughout the week (but without being annoying to teenagers of course) can make a difference in your relationship with your grandchildren.

Offer to help in practical ways. Working parents with young children will need a break at times. Ask how you can best help. Offer to keep the children for an overnight while mom and dad have a special dinner or weekend getaway. Many grandparents like to take their grandchildren on trips without the parents. Places like amusement parks, the zoo, or day trips to the water park or national forest all provide good diversion and quality time with Grandma and Grandpa while giving parents a rest. For even more quality time, take the older grandchildren on a cruise, camping in the mountains, or to a resort without their parents. For the mom with a newborn, take meals to the house (if you live close), do her grocery shopping or laundry, or send her a new bathrobe to show you are thinking of her. A favorite role model of mine sends the grandchildren a “baby shower in a box” with all sorts of goodies when she can’t be present due to distance or health concerns.

Plan special activities. Special activities need not be expensive. This could mean a trip to the park with Grandma or a special morning walk each week with Grandpa. My father used to take every grandson on a bow-hunting trip when they turned 12 years old. This was a rite of passage for every boy in the family. Grandpa would mount their first deer head for them and buy them a special hunting knife to commemorate the occasion. The girls in the family would take a trip to a Disney resort while the men were hunting. Grandchildren remember these events forever.

Attend special events. How fortunate are the kids whose grandparents are able to attend basketball and volleyball games, swimming tournaments, and Grandparent’s Day at school! Take advantage of being able to attend those dance recitals and school plays. If you live far, plan your visits to be able to attend some significant events like graduations, wedding showers, or school performances. This makes lasting memories with your family.

Be a constant in their lives. My parents divorced when I was 9 years old, and my paternal grandparents were the one constant in my life at that time. When a child’s world is jolted by change, grandparents can be that steadying influence that doesn’t change. They provide stability and security in an unsteady world for a child. The most important thing to remember is to be there. You don’t have to be the all-star parent or grandparent, but your children will remember that you were there for them when it counted the most.

By |2020-03-23T18:27:54-05:00March 24th, 2020|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Five tips for Grandparents to stay connected with family

A Mom for all Seasons

I have been fortunate to have a number of mothers in my life – by birth, marriage, or adoption. Each of these women has helped to shape my perspectives and  values in various ways during different seasons of life.  As Mother’s Day approaches, reflecting on the role that mothers play in our lives is a worthy exercise. So, here is my tribute to my mothers.

My first mother is the one who gave me life. I like to think of this as the Spring of my life. Mom Phyllis raised me until the age of 9 years. She tended to the scrapes and cuts, helped to mold my personality, hand-made my clothes, and made life an adventure, all whilst being the wife of a busy doctor who was studying to be a pediatric surgeon. Thank you, Mom, for treasuring my childhood.

bells

When my parents got divorced, a second mother entered the Summer of my life. Mom Kay took three confused and fragile children under her wings as a young step-mother in her early 20’s. She nurtured us as if we were her own. She helped me navigate the difficult teenage years and transition into young adulthood, listening to countless stories of puppy love, crushed hearts, and future dreams. Mom brought faith and light into a home that had been shattered by divorce. She has given me an example of a loving and faithful wife to my father for 45 years. Thank you, Mom, for preserving my spirit and encouraging my faith in God.

In college, I attended a little Baptist church where they had a program in which families could “adopt” a college student. Through a round-about way, I was adopted by Marvin and Patsy Bell. Grandma Bell, as my children later called her, saw me through my first 17-year  marriage, a painful divorce, and was a second mother to many other young women like me. She has been a faithful friend and mentor for more than 38 years. Ma Bell stood in the place of the mothers who couldn’t be with me during some of the coldest and darkest Winters of life. She attended countless school programs for my kids and never forgets a birthday to this day. Thank you, Ma, for giving me the example of the kind of Grandmother I want to be.

Lastly, when I remarried to my current husband, Jim, I gained a wonderful mother-in-law. Gracie is true to her name. She has a loving and nonjudgmental spirit. She always thinks the best of people and is kind and gentle.  In the Fall of my life, she embraced me as a daughter and is always ready to help in times of need.  Thank you, Mom Mauk, for showing me what unconditional love looks like.

All of us have mothers in our lives that we need to thank. So, this Mother’s Day, purpose to give a special blessing to those women who have so influenced your life. Without them, our days would be less rich and the journey much lonelier. Celebrate those who have traversed the seasons of life with you!

By |2020-03-18T12:16:10-05:00March 21st, 2020|Dr. Mauk's Boomer Blog, News Posts|Comments Off on A Mom for all Seasons

Diverticulosis and Diverticulitis Treatment

Colorful fresh group of vegetables and fruits

Background

Diverticulosis results from pouches that form in the wall of the colon (or large intestine). Diverticulitis is an inflammation or infection of these pouches. Diverticular disease is more common among older adults than younger people (Tursi, 2007). Sixty-five percent of older adults will develop diverticulosis by age 85 (Kennedy-Malone et al. 2004). The exact cause of diverticulosis is not known, but it is speculated that a diet low in fiber and high in refined foods causes the stool bulk to decrease, leading to increased colon transit time. Retention of undigested foods and bacteria results in a hard mass that can disrupt blood flow and lead to infection. The earlier the diagnosis and treatment, the better the outcomes will be; however, if complications such as bleeding increases the risk of less- than- optimal outcomes.

Warning Signs

Risk factors for diverticulosis include obesity, chronic constipation, and straining, irregular and uncoordinated bowel contractions, and weakness of bowel muscle due to aging. Other risk factors are directly related to the suspected cause of the condition. These include older than 40 years old of age, low-fiber diet, and the number of diverticula in the colon (Thomas, 2011). Diverticulosis may result in pain in the left lower quadrant (LLQ), can get worse after eating, and may improve after a bowel movement. Warning signs of diverticulitis include fever, increased white blood cell count, bleeding that is not associated with pain, increased heart rate, nausea, and vomiting.

Diagnosis

Evaluation of the abdomen may reveal tenderness in the LLQ and there may be rebound tenderness with involuntary guarding and rigidity. Bowel sounds may be initially hypoactive and can be hyperactive if the obstruction has passed. Stool may be positive for blood. The initial evaluation is abdominal Xx-ray films, followed by a barium enema, though a CT scan with oral contrast is more accurate in diagnosing this condition (Thomas, 2011). A complete blood count may be done to assess for infection.

Treatments

Diverticulosis is managed with a high-fiber diet or daily fiber supplementation with psyllium. Diverticulitis is treated with antibiotics, but in acute illness the person may require hospitalization for IV hydration, analgesics, bowel rest, and possible NG tube placement. Morphine sulfate should be avoided because it increases the intraluminal pressures within the colon, causing the symptoms to get worse (Thomas, 2011). Patients should learn about a proper diet, avoidance of constipation and straining during bowel movements, and when to seek medical care. The diet should include fresh fruits, vegetables, whole grains, and increased fluid intake, unless contraindicated. In extreme cases, either where the person has complications that do not resolve with medical management or has many repeated episodes, a colon resection may be needed. Patients will need to work closely with their primary care provider to manage any ongoing problems.

Adapted from Mauk, K. L., Hanson, P., & Hain, D. (2014). Review of the management of common illnesses, diseases, or health conditions. In K. L. Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Burlington, MA: Jones and Bartlett Publishers. Used with permission.

For more information on Diverticulosis, visit NDDIC at:
digestive.niddk.nih.gov/ddiseases/pubs/diverticulosis/

 

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By |2020-02-27T09:29:49-05:00March 2nd, 2020|News Posts|Comments Off on Diverticulosis and Diverticulitis Treatment

Guest Blog: What is Psoriasis?

Guest Blog: Lindsay Munden, DNP, RN, FNP-BC

Psoriasis

Psoriasis is a lifelong disease that causes scaling and inflammation of the skin. The condition starts beneath the skin’s surface and is triggered by an overactive immune system, which causes skin cells to be over-produced and accumulate on the skin’s surface faster than normal. This process is called cell turnover, and in psoriasis may take a few days instead of weeks. This causes the formation of thick, red, itchy, flaky patches with silvery scales known as plaques. While any part of your body can be affected, psoriasis most often occurs on the elbows, knees, scalp, back, face, palms, and feet.

Risks

According to the American Academy of Dermatology (2015) about 7.5 million people in the United States have psoriasis. Anyone can get the disease, but it occurs more often in adults.

  • Age: Adult men and women are affected equally. The two peak ages at onset are during the late teens to early 20s and in the late 50s to early 60s.
  • Genetics: Psoriasis has a strong genetic influence, with one-third of patients with psoriasis reporting having a family member with the disease.
  • Environmental Factors: Trauma to normal skin, repeated friction, infections, stress, fatigue, warm humid climates, changes in weather that dry the skin, and certain medications may trigger psoriasis flare-ups.

Causes

The primary cause of psoriasis remains unknown. Research has indicated that psoriasis is caused by genetic influences and a dysfunction of the immune system. Although, psoriasis plaques may look contagious, you cannot get the condition from someone that has the disease.

Symptoms

Symptoms can range from mild to severe and are often recurring. Itchy, red, inflamed and dry scaly plaques distributed symmetrically over areas of bony prominences such as the elbows and knees are characteristic of the disease. The joints, nails and scalp may also be affected. As with other chronic conditions, symptoms may flare or worsen for a few months and then subside for a period of time.

Diagnosis

Psoriasis may be hard to diagnose because it can be confused with other skin diseases. Usually your healthcare provider will make a diagnosis based on a thorough skin examination. Biopsy is seldom necessary because the clinical features of psoriasis are so distinctive. Plaque psoriasis is the most common form, but patients typically have one or more types.

Treatment

The goal of therapy is to control the symptoms and clear the plaque lesions.

For mild to moderate psoriasis, topical medications (those applied directly to the skin) and phototherapy (light therapy) are the mainstays of treatment.  For severe psoriasis, systemic treatments are recommended. Sometimes, combining topical, light and systemic treatments leads to the best results.

Topical Medication Options:

  • Topical steroids are widely used because they help reduce inflammation. Generally, a very potent topical corticosteroid preparation is applied two to three times daily for 2 weeks and then decreased to a lesser potency for maintenance therapy long term.
  • Coal tar works by causing the skin to shed dead cells from its top layer and slow down the growth of new skin cells. This effect decreases scaling and dryness. Coal tar is applied once or twice daily and is not well favored due to the potential for staining of the clothes and skin.
  • Anthralin works by slowing down the production of skin cells. This type of medication is applied to the skin for a prescribed period of time and then rinsed away, with increased increments until the skin is healed which may take a couple of weeks.
  • Topical immunomodulators are medications which work by decreasing the body’s immune system to help slow down the growth of the psoriasis plaques.
  • Vitamin D3 derivatives regulate cell growth and decrease lymphocyte (cells which play a role in the regulation of the immune system) activity. The medicine comes in a form of an ointment which is typically applied twice daily.

Phototherapy:

Phototherapy with ultraviolet-B (UVB) light is effective in the treatment of psoriasis lesions. This type of treatment reduces DNA synthesis of skin cells. Phototherapy can produce symptom-free periods of up to 2-4 months. UVB therapy units are often available at dermatologist offices and the use of commercial tanning beds (with both UVA and UVB lights) is not recommended. Dermatologists may recommend consistent light therapy 3-5 days a week for 2 to 3 months.

Systemic Medications:

Systemic therapy is reserved for patients that have severe or incapacitating disease. These medications are prescribed by expert specialists such as dermatologists or rheumatologists because they have a risk for serious side effects.

More Information:

National Psoriasis Foundation   www.psoriasis.org

National Institute of Arthritis and Musculoskeletal and Skin Diseases www.niams.nih.gov

American Academy of Dermatology https://www.aad.org/

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By |2020-02-27T09:28:57-05:00February 29th, 2020|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: What is Psoriasis?