
	Health Care News from Perham Memorial Hospital and Home	Winter 2003

Metronome stimulates learning and development

Perham Memorial Hospital and Home Casey Moreno can't get enough of reading. Since the start of the school year, the 11 year old has read three American Girl books. To some, this may not seem like such a big deal. But to Casey's mother, Lisa, it is.

"Prior to participating in the Interactive Metronome^TM program at Perham Memorial Hospital, Casey didn't read much," Lisa stated. "We realized the reason was because she had difficulty understanding what she was reading. Since going through the program, Casey better comprehends what she's reading. The result; she's reading more."

Interactive Metronome (IM) is a technology designed to improve rhythm and timing for children and adults with cognitive difficulties, such as Attention Deficit Disorder and Attention Deficit Hyperactive Disorder.

The IM training system was originally developed by recording engineer Jim Cassily to help professional musicians improve their timing and rhythm.

"Research supports that by improving one's rhythm, timing, and sequencing – which is the basis for all the activities you do in a day – attention and learning are improved," says Denise Ristinen, an occupational therapist at Perham Memorial Hospital. "This can lead to improvements in concentration, motor planning, control of aggression, language processing, and reading."

How it works
A switch button, which is connected to the metronome, is strapped around the palm of the hand. Headphones deliver a computer-generated musical beat which the user tries to match by clapping or tapping another sensor with his foot.
The difference between these responses and the beat are measured in milliseconds. If the user is in sync with the beat, a pleasant noise is transmitted through the headphones. If he is off the beat, a clanging or buzzing noise lets the user know if he is ahead or behind the beat. A therapist also wears a set of headphones.

There are 14 movement patterns that the user trains with, including clapping, slapping the hip, tapping the sensor with toes and stepping backward with their heel.

"Like training wheels on a bicycle, the guide sounds instantaneously provide feedback on the accuracy of each movement and encourage improvement," says Ristinen. "You could consider the IM as advanced training for the brain. It appears to affect a core mental process and provides a noninvasive way to stimulate learning and performance."

Studies show IM performance correlates with academic achievement in areas such as mathematics, language, reading, and attention to task. In a clinical study, IM training produced significant gains in children with ADHD in the areas of concentration, motor planning, control of aggression, language processing, and reading. These findings are consistent with recent research on the growth of the brain that indicates that environmental influences, not just genetics, can facilitate brain development.

A physician referral is recommended for the purpose of insurance coverage.

The training is useful for children six and older, and involves 12 to 15 sessions, which are scheduled for an hour, three to five times a week.

Athletic Assistance
Athletes, especially golfers and football players, have found the training beneficial.

A study by the Central Michigan University psychology department found that golfers who underwent IM training improved shot accuracy by almost 20 percent compared to a control group.

Football players from St. Thomas Aquinas High School in Fort Lauderdale, Fla., completed the training after the 2000 season. In 2001, players had 24.2 percent fewer fumbles, 26 percent fewer penalties, scored 52 percent more points in the first half, and had 24.2 percent more third-down conversions.

"The Interactive Metronome program has made a difference in Casey's life," says Lisa. "By understanding what she's reading, reading has become fun for her, and isn't that wonderful?"

A Message
From The
CEO

You've likely heard in recent news the ongoing discussion we've had with the Elders' Home in New York Mills about a possible merger. Some have asked why PMHH would be interested? The simple answer is that New York Mills and the surrounding townships are a very big part of our service area. We need that community to stay strong and we need that nursing home to stay strong for our future success. Our board believes we would be much better off stepping in early and helping them out, than dealing with the ramifications of a declining service area if the Elders' Home would close and those employees would leave the area. In addition, many board members have expressed empathy for their situation, remembering that we were there as well, not quite 20 years ago. They believe our experience going from a financially struggling facility to a financially strong facility may benefit them.

Others have asked what went wrong? The honest answer is nothing went wrong; times have simply changed. The truth is the Elders' Home is admitting twice as many residents per year than they ever have before. However, nursing home residents no longer come to stay. They come for a quick recovery and go home. Some are admitted three or four times but all for very short stays. Just five years ago the average stay in a Minnesota nursing home was over three years. Today, it is less than three months! Couple that with all the alternatives growing around the state; assisted living, home care, adult foster care, congregate living, etc.

Most nursing homes in the state have seen declining occupancy and all have seen much shorter lengths of stay. The other reality is that there are very, very few free standing nursing homes that are not partnered with anyone. The financial outlook for nursing homes is so poor right now that it is nearly impossible to make it without sharing expenses with someone else. That's why most are part of a chain, partnered with other nursing homes, or affiliated with a hospital.

Another obvious question is how can we help? First, we would look at our group-purchasing program. Through our affiliation with MeritCare, we are part of a large purchasing group and get significant savings on medical supplies. We could immediately extend that to the Elders' Home. We also believe there are possible savings in overhead and support services if we are together. Refinancing of debt is another possible savings. Elders' Home currently does not have a strong enough balance sheet to refinance on their own. We will need to be creative, but we believe we can get to at least break even within three years.

Finally, I've been asked why the City of New York Mills and the Townships of Newton, Otto, Butler and Holmstead should financially support the Perham Hospital District? Many have noted that they get their health care elsewhere. The simple answer is that if that is the reason you are voting for the merger, don't. We're doing well today. The focus needs to be on the Elders' Home and their need for help. Joining the Perham Hospital District provides a vehicle to help us merge and assist the Elders' Home. It also brings in approximately $25,000 in tax revenue that can be put back into that building and help begin the process of turning things around. You should vote "yes" to keep senior care in the City of New York Mills. You should vote "yes" to keep 100 jobs in your community.

Perham Memorial Home continues journey toward culture change
Work taking place on building design and model of care

Work has begun on the physical redesign of the Perham Memorial Home. A committee consisting of employees, board members, residents, families and community members has been formed to work with the architects on the design for our new home.

It has been a challenging journey thus far. The committee has struggled with all the questions that those of us who have designed our own homes have had to deal with: how big should the living room be; do we really need that private dining room; will there be enough storage space; what kind of equipment will we need in the kitchen; and on and on. In addition, because it is a health care facility, regulations impact every aspect of the design.

One thing is for certain - everyone is excited about the prospect of having private rooms for our residents. The current plan includes 64 private living spaces and 32 companion rooms. This will certainly be one of the larger changes from our existing facility.

A second group of individuals has been meeting to develop our new model of care - resident-directed care - where care is determined by the needs, wants, and preferences of the resident - not the home.

Staff has toured a facility in northern Minnesota that has had great success using this model. One hundred percent of our staff will receive education over the next year called "Person First", an important piece of the model. Our plan is to have the new model of care in place prior to moving into the new facility to ease the transition for our residents.

This truly is a journey for all of us; one that is both challenging and exciting. Our goal from the beginning has been to involve as many people in the planning and development stages of the process as possible. With each new step, we try to bring in people who haven't been involved before, creating a real sense of ownership. Look for regular updates in Reflections to keep you informed of our progress. If you have questions, would like to know more about what we are doing, and/or would like to become involved, please call Marilyn Oelfke (346-1168) or Chuck Hofius (346-1133).

Health Clips

Sometimes antibiotics aren't the answer

Perham Memorial Hospital and Home It's winter and we're in the midst of the cough, cold and flu season, and it's important to be sensible with antibiotics. Though it is tempting to use antibiotics when you're stuck with a miserable cold, it can be dangerous. Antibiotics can treat most infections caused by bacteria, but not the common cold, most coughs or the flu, which are almost always caused by viruses.

Many people do not realize that if you have a virus, antibiotics will not cure your infection, stop the spread of illness to others or even make you feel better.

Antibiotic misuse can lead to the development of antibiotic-resistant bacteria, which are bacteria that have changed, and end up fighting against the antibiotics that are meant to kill them. This means that the antibiotics may not be effective when used to treat an infection in the future. Examples of antibiotic misuse include:

Demanding an antibiotic when your doctor says you don't need one – such as for a viral infection
Stopping the antibiotic when you feel better
Not finishing all of the antibiotics you were given
Saving some antibiotic to use for another illness
Sharing the antibiotic with someone else

Misusing antibiotics is a serious problem. People who misuse antibiotics require stronger, more expensive antibiotics, which may need to be given by vein (IV). Misuse may lead to the development of infections that are difficult to treat and may not be treatable in the future. When you have a virus, it's important to let it run its course.

It's also important to let your health care provider decide if an antibiotic is needed and to take the antibiotic exactly as prescribed. Remember to ease the symptoms of viral infections while they cure themselves. The next time you have a cold, instead of going to the doctor for a magic pill, drink plenty of fluids, take over-the-counter medication (follow doctor or package directions for dosage) and get plenty of rest.

Welcome

Dr. Vincent Pankonin

Perham Memorial Hospital welcomes Dr. Vincent Pankonin to its team of health care professionals. Originally from Sanborn, Minn., Dr. Pankonin has been practicing chiropractic care in Perham since 1993 as the owner of his own practice. In January, Dr. Pankonin joined the hospital.

As a doctor of chiropractic, Dr. Pankonin diagnoses and treats alignment and pain problems that affect the muscles, bones, and nerves of the body resulting from occupational stresses, sports injuries, and accidents. He also counsels patients on lifestyle habits such as nutrition and exercise. As a member of the PMHH staff, Dr. Pankonin has quick and easy access to radiology, lab, and other services for his patients.

Even though Dr. Pankonin is now a hospital employee, changes will be largely transparent for his clients. He still has the same client files with him and the same phone number (346-2330). The only change is his physical address.

To make an appointment with Dr. Pankonin, call Perham Memorial Chiropractic Center at 346-2330.

	Beat the winter blues - be a volunteer!

	Staying active is a great way to take the chill out of winter. Get involved as a volunteer at Perham Memorial Hospital and Home.

Just take a moment to print and fill out this coupon and send it to:
PMHH, Volunteer Services, 665 3rd St. SW, Perham, MN 56573

Name:_____________________ Phone number:____________

Address:___________________________________________

For information about how you can be a volunteer, please contact
PMHH Volunteer Services at (218) 346-4500 or
volunteer@pmhh.com.

NFP offers couples fertility options

Dr. Jeff Blickenstaff

Natural Family Planning (NFP) is a way for couples to avoid or achieve pregnancy according to an informed awareness of a woman's fertility. Family Practice Physician, Dr. Jeff Blickenstaff, is an advocate for Fertility Awareness/Natural Family Planning which includes various methods used to achieve or postpone pregnancies that do not involve drugs, devices or surgical procedures.

"The practice of NFP as only a tool in avoiding pregnancy is a myth," says Dr. Blickenstaff. "NFP looks at both the fertile and infertile times in a woman's cycle. NFP is also a means for couples to obtain pregnancy."

Because NFP is 100% natural, there are no health risks and because it teaches a woman to become aware of her normal fertility pattern, changes in the pattern can alert her to medical problems. Many couples using NFP experience an increase in intimacy in their relationship.

To make an appointment with Dr. Blickenstaff to discuss fertility options, call MeritCare Clinic Perham at 346-4040.

Perham Memorial Hospital and Home 665 3rd Street S.W. Perham, MN 56573 (218) 346-4500

Perham Memorial Hospital and Home, 665 3rd Street SW,
Perham, MN, 56573, (218) 346-4500

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