1. Scherpenberg, Scott BSN, RN

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Q: Many of my patients are moving south for the winter to escape the cold, but I want to ease their transition and make sure they care for themselves properly while they're away. How can I help make their winter away a health success?


A: You and your snowbird patients share the same goals for their migration south: you both want it to be an enjoyable experience for them. Your role in preparing them for it ideally begins a few months in advance.


One of the first steps your patients should take before heading south is to establish an intermediate physician in that area who is familiar with whatever illnesses or limitations they have. Having established a local physician to use prior to the trip is crucial in the event of an emergency or should a more minor medical issue arise during the transition. Likewise, if your patients are receiving home healthcare at home and will also require it in the new location, they need to coordinate those logistics beforehand. In most cases, the agency they currently use can assist in arranging the transfer.


Also critical to a smooth transition is transferring their prescription drugs. Remind them to notify their local pharmacist ahead of time when and where they will be in a different part of the country so that their prescriptions are transferred BEFORE they arrive. Similarly, they will need to transfer all of their data to their home pharmacy when they fly back in the spring. A common problem snowbird patients run into in a new location is prescription delays because they didn't transfer the information beforehand. Another potential headache is dealing with the surprise that their insurance or prescription drug plan isn't friendly to the new area and may not extend to that particular state. This could be an absolute deal breaker for the move, so stress to them how essential it is to investigate this during the initial planning stages.


An appropriate housing choice is also crucial to a successful move. In this case, effective planning means selecting a home that meets their health needs. Although the move isn't permanent and their time there may only be for a few months, they need to confirm that their home is adaptable to their needs ahead of time. For example, if their permanent home is one level because it's unsafe for them to use stairs, their winter home must also be one level. Additionally, take the time to review with them the essential modifications and items they must have in their winter home. If they require common additions like a chair or grab bars in the shower, remind them to have these in place by the time they arrive or make sure to pack them. An accident can easily occur from just one negligent detail, and you can step in to help them to avoid this.


Regarding their health, remind them that as carefree and exciting as the new environment may seem, their health issues will not disappear and will likely worsen if they don't attend to them as they do at home. Relay to them the importance of continuing their daily health regimen, from taking their medications to performing essential physical therapy exercises. By this point, they should already have a good knowledge base from everything you've taught them and the good habits they've formed, but they need to understand how crucial it is that they ease sensibly into both their new routine and climate.


The patient may underestimate the drastic effect a completely different climate and lifestyle can have on their health if they aren't aware of the potential pitfalls. In certain destinations where activities like golf, tennis, and hiking are a huge draw for many seniors, it's absolutely crucial that they heed the medical advice from their clinicians and make all of the recommended modifications so that they can safely enjoy themselves. After all, it's very likely that they're replacing a daily lifestyle consisting of indoor sedentary activities and temperatures in the 20s to 40s with an alluringly active one with summer-like temperatures. This dichotomy can be a recipe for disaster and often leads to unexpected health conditions and emergencies. Their bodies won't respond well to a sudden daily routine of golf in the sun and heat, and they risk throwing off their entire body mechanic, increasing the likelihood of a fall or dislocated hip. Unfortunately, a sudden change in routine also causes snowbirds to encounter more severe health problems like a cardiac event or stroke. Seniors have thin skin that can cause them to lose more perspiration, heat up, and even burn more easily. Seniors are extremely prone to dehydration, especially in a desert destination, so emphasize the importance of drinking water constantly-even before they feel thirsty because thirst can indicate that they're already dehydrated. In these circumstances, a relaxed, dismissive attitude can promote risk.


Similar to activity, dietary habits also require a premeditated and healthy approach. A break in routine with a diet over the course of 3 to 5 months can wreak havoc on the body of a senior who is used to eating only certain foods. It's easy to slip into vacation mode and feel tempted by the ease of eating out rather than cooking, but at home, patients are better able to eat healthfully because they can control their own ingredients. If the patient is on a low sodium diet, for instance, they likely know how to prepare a healthy meal for themselves, whereas in restaurants they could jeopardize their health by eating meals often doused in salt.


Like any nurse, you care about the welfare of your patients even when they're far from home and no longer in your care. Your responsibility to them extends beyond the current care because you always have their best interests at heart. Show them this by taking the time to review essential information with them to ensure that they have a happy and successful time in their winter home.