Breath-by-Breath Care

OUR NON-INVASIVE VENTILATION PROGRAM

At Frontier Home Medical, our NIV program is built to be just that – a comprehensive therapy program. We provide equipment and expertise, but we go beyond that. Frontier focuses heavily on educating patients on respiratory impairment, therapy compliance and how home ventilation can improve our patients’ quality of life. Our goal is to hold ourselves to a higher standard of patient care. In doing so, we ensure every effort optimizes therapy quickly, maximizes benefit and lowers hospital readmissions.

We achieve our goal through: 

  • On-going patient education
  • Regularly scheduled follow-up visits with patients
  • Weekly compliance checks by experiences respiratory therapists
  • 24/7 on-call staff ensuring patients have the necessary support when needed

FIRST IMPRESSIONS

Introducing patients to NIV and their need for home ventilation begins during our initial interaction with the patient and continues with our initial face-to-face visit. At that time, we provide patients with a comprehensive guide to home ventilation therapy. The in-depth content covers specific respiratory disorders, the advantages and goals of using home ventilation therapy, maintenance of supplies, travel tips and compliance requirements. Patients are also provided with a step-by-step device manual with colorful pictures outlining assembly of their equipment, steps taken before starting therapy, stopping therapy and how to respond to alarms.

COMPLIANCE & FOLLOW UP

After the initial set-up is complete, our therapists—in combination with our PAP compliance specialist, monitor patients closely for subjective and objective improvements. We help patients understand that improving their overall well-being starts with consistent usage of their device. As therapists, we know that maximizing compliance starts with maximizing patient comfort. Thus, we make regularly scheduled follow-up visits with patients via telephone or face-to-face, which is a high priority to address any concerns patients may have with therapy settings or equipment-related issues. Our follow-up visits are done routinely—at 24 to 48 hours, seven days, one month, two months, three months post set-up, every 90 days and as needed thereafter, so as the ordering provider, you can rest assured knowing that your patient is adequately cared for. Upon completion of each 90-day visit, physicians and practitioners are provided with assessment notes and compliance reports on their patients. 

BIPAP VS. NIV

To any provider considering BiPAP (or BiLevel) therapy for home use, it is essential to know that a more reliable therapy option for your patient with chronic hypercapnia and/or respiratory failure is available. Standard BiPAP devices utilize fixed pressures to deliver a target tidal volume; however, the actual volume delivered can often be very inconsistent and is not guaranteed, potentially resulting in an exacerbation, hospitalization or both. This especially becomes true as patients’ conditions change over time. On the other hand, NIV guarantees either a set tidal volume or minute ventilation is delivered to the patient by utilizing a “pressure range” instead, ensuring that as patients’ ventilation needs change, they will continue to be met—guaranteed. 

DEDICATION TO CARE

Having worked in a variety of healthcare settings over the past decade, I believe that education is vital to providing the best care possible and ensuring the best quality of life. This has never been more true to me as of last year when my father underwent an emergent mitral valve repair that was close to being fatal. During his recovery, I witnessed firsthand the impact that in-depth patient education, as well as proper therapy management and support, can have on patient outcomes. My father is doing great and continues to thrive thanks to all of his providers who took the time to educate and support him to this day. Educating and supporting have become the foundation of our program here at Frontier. As providers, we make recommendations to our patients every day who trust us to ensure their well-being and I assume their trust in me as a personal responsibility. That’s why developing strong, trusting relationships is the foundation of everything I do, both professionally and personally. When it comes to NIV and the impact it can have on patients’ lives, such as being able to walk up a full flight of stairs for the first time in 7 years or being able to garden again without getting short of breath, my promise to every patient we care for or provider we work with is your support and clinical expertise is always just a phone call away. 

Written By:

Brandon Baker, BS, RRT

Brandon is Frontier’s Respiratory Disease Manager specializing primarily in Non-Invasive Ventilation. He previously worked in EMS as a paramedic for 10 years, as an adjunct EMS instructor for 2 years and a hospital respiratory therapist.

That’s A Diabetic Shoe

When your patients see our line of diabetic shoes, their first response is often, “Those look a lot different than what my grandparents wore. I’d wear those!”

Stylish & Well Constructed

Yes, they are indeed stylish and comfortable! Plus, there are shoes for every occasion. So, whether your patient wants casual, athletic, work boots, around-the-house or even a little dressy, all shoes have these key features for their diabetic foot health:

  • Seamless Lining
  • Padded Tongue
  • Extra Wide Toe Box
  • Lightweight Construction
  • Nonskid Sole
  • Firm Heel Counter

These features protect against foot ulcers and other ailments, critical issues for diabetic patients.

Custom Fit & Inserts

We custom fit the patient for their shoes that will accommodate deformities and protect, stabilize and give great comfort and support. Shoes come with three sets of inserts so that periodically throughout the year, the wearer can put in new to freshen and even bring the shoe back to its original fit.

Therapeutic footwear has come a long way from the days of the “old people shoe”—and with the added benefits of long-term foot health, patients truly value their diabetic shoes.

Written By:

Anne Seaman

Frontier Home Medical Sales Representative

Cozad, North Platte, McCook

Incontinence: Helping Patients Feel in Control

Studies show that fewer than half of those who experience incontinence voice their symptoms to their healthcare provider without first being asked. In the healthcare community, we can help patients to address concerns about incontinence.

WHAT ARE THE ROADBLOCKS?

For many, talking about incontinence unleashes a floodgate of fears like “I’m getting old,” “The next step is a long-term care facility” or “What if its cancer?” Embarrassment and shame add to the burden. Combine all that with a visit to a busy healthcare provider where the patient may be unenthusiastic about opening another can of worms and may not be able to explain what’s going on “down there” in the first place. What we now have is a stigma smothering a life.

WHAT STARTS WITH CONVERSATION?

The fact is that bringing the issue of incontinence to light can be as simple as asking questions:

Are you altering your schedule to accommodate for bathroom breaks?

Do you find yourself limiting your fluid intake to increase the time between bathroom breaks?

Are you skipping exercise or favorite pastimes due to a lack of control?

People have a certain willingness to tolerate general discomfort. Don’t let the “bother factor” be a roadblock to improving the lives of so many dealing with incontinence. Asking these questions opens the dialogue needed to find a solution. Help your patients focus on the problem and it can help them improve their quality of life. They can fully contribute back to their communities, back to their friends and loved ones and back to themselves.

HOW DO WE PROVIDE DIGNITY?

Once the diagnosis of incontinence has been determined, and a patient needs supplies such as pads or briefs, the concept of dignity must be a priority. The program provided at Frontier Home Medical begins with our certified continence coaches. Our friendly experts discreetly speak with people to determine the exact correct product for that individual. Absorbency, fit and proper usage all play a part in the success a patient has with controlling the problem. We offer many products like pads, briefs, wipes, gloves, perineal cleansers and disposable/washable under pads. The products are far more discreet than the adult diapers of the past and can be picked up in any of our store locations or shipped discreetly to their home or assisted living facility. Patients can enroll in a monthly resupply system so that they are never caught off guard by running out of the products they need.

When it comes to any medical condition, knowledge is the essential element of empowerment. Our patients have lives beyond their medical concerns. Great advice, emotional support and superior products and service are what they need to live life fully.

Written By:

Anne Seaman

Frontier Home Medical Sales Representative

Cozad, McCook, North Platte

Promoting Home Safety

We understand the importance of keeping loved ones home safe and sound – during the holidays and throughout the year. The prevalence of falls due to lack of bathroom and household safety is astounding.

One-fourth of Americans fall each year. Using products that promote independence and safety can greatly impact patients and loved ones. We need to work together to help assess daily living activities to determine what products patients need. Our staff will help and assist in finding the right products and properly fit them for comfort. Frontier offers many products that will prevent falls while promoting independence.

WHAT PRODUCTS DO WE OFFER THAT AID IN THE PREVENTION OF FALLS AND INCREASE INDEPENDENCE?

  • Shower chairs
  • Toilet seat risers
  • Grab bars
  • Grab bar installation
  • Rollators
  • Walkers
  • Detachable shower heads
  • Canes
  • Transport chairs
  • Hand-help shower heads
  • Non-slip bathmats
  • Suction cup shower head holders
  • Commodes
  • Reachers
  • Home exercise equipment
  • Pulse oximeters to assess oxygen levels at home

Simple changes can make the home a safer place for seniors and reduce the risk of injury. Many of these modifications are cost effective and straightforward. Staying safe is of the utmost importance, and in many instances, accidents can be prevented. We are here to help make these decisions and keep seniors at home!

Our name speaks to what our company stands for—Frontier Home Medical. Not only do our patients become part of our extended family, but you do too. We want to give you all a sincere thank you for all you are doing to help patients through a moment in history that will always be remembered.

Written By:

Kara Weier, BASc, AS

Frontier Home Medical Sales Representative

Lincoln and Omaha

STOP-BANG QUESTIONNAIRE

Diabetic Patients & the Power of Foot Care

We all know that patients with diabetes have an increased risk of having foot problems. This includes developing ulcers and other types of damage due to blood sugar levels affecting the nerves and vessels that go to the feet. Wearing specially designed shoes can help reduce that risk and promote healthy circulation.

AVOIDING FOOT COMPLICATION

Therapeutic shoes can stop complications before they start, including:

  • Neuropathy
  • Poor Circulation
  • Skin changes
  • Calluses
  • Foot ulcers
  • Amputations

Failure to perform recommended foot care and wearing inappropriate footwear can set diabetic patients up for foot ulcers. Ulcers are painful and potentially serious and can sometimes lead to amputation. Specially designed therapeutic footwear avoids the pitfalls of ill-fitting shoes, including things like pointed toes, flat soles, high heels, hard insoles, plastic or other non-breathable materials and shoes that do not adjust for fit.

Choosing the correct footwear for your diabetic patients can promote better foot care. Patients who get an evaluation by a foot doctor every year reduce their risk of getting a wound and then getting amputation by anywhere from 20% to 70%, according to the American Diabetic Association.

WHAT IS IT ABOUT THERAPEUTIC FOOTWEAR THAT SETS IT APART FROM ANY OTHER SHOE?

Firm Heel Counter:
Prevents slippage for stability and foot support

Padded Heel:
Reduces pressure points and provides support

Extra Width & Depth Design:
Provides a custom fit with insoles or pressure-free fit without insoles

Seamless Lining:
Soft material that shapes to the foot; no protruding stitching enhances comfort

Padded Tongue:
Helps to prevent friction and improves overall fit

Extra-Wide Toe Box:
Protection reduces risk of injury and offers support

Lightweight Construction:
Reduces daily fatigue

Non-Skid Sole:
Lightweight, long-wearing outsole increases traction and mobility

Customized Inserts:
Conforms to the bottom of the foot and provides custom support

Custom Modifications:
Fits each exact foot with custom support orthotics

INSURANCE COVERAGE

For patients with diabetes, the cost of therapeutic shoes and inserts may be covered by Medicare and supplementary insurance each year. Let us help your patients get the comfort and support they need and get them into a new pair of therapeutic shoes today!

Written By:

Kara Weier, BASc, AS

Frontier Home Medical Sales Representative

Omaha and Lincoln

AffloVest® Fitting Guide

The AffloVest® comes in 7 different sizes, from XXS to XXL(18″ to 65+”). It is fit using two measurements. Measure the patient with arms at his or her side and in a standing position, if possible. Measure around the largest part of the chest and abdomen, while the patient breathes normally. Use the larger of the two measurements to determine the correct size. Then refer to the Body Measurement Guide (see below) to choose the best size vest.

When fitting the patient with the vest, you will want to adjust the horizontal straps so the vest fits snugly, but without limiting the patient’s ability to take a deep breath. The top shoulder straps may also need to be adjusted so that the front oscillation motors sit on the upper chest, just below the collar bone. A 1-inch overlap of the vertical black seams on the front of the vest, as well as a 1- to 5-inch gap between the two sides of the vest, are acceptable for all sizes

Written By:

Joselin Lockard, RRT

Frontier Home Medical Sales Representative

Kearney and Grand Island

Incontinence 101

Identifying the type of bladder leakage is the first step to treating it. The sooner it is recognized, the sooner it can be addressed and improve quality of life. There are six basic types of urinary incontinence: stress, overflow, urge, functional, reflex and mixed.

Stress

This is the involuntary loss of small amounts of urine during a cough, laugh, sneeze, standing up or when any kind of movement can cause leakage. Common causes: urological procedures, pregnancy/childbirth, loss of muscle tone, prostate surgery, obesity, strenuous physical activities, etc.

Overflow

When a patient experiences leakage when his or her bladder is full, this is overflow incontinence. Leakage can be dribbling, frequency, urgency and/or bladder distention. Common causes: bladder injuries, nerve damage, any disease that causes urinary tract blockages, etc.

Urge

Inability to control urinating once one feels the need to void is called urge incontinence. Patients may feel the need to urinate but cannot wait to get to the bathroom. Common causes:   Alzheimer’s, Parkinson’s, enlarged prostate, urinary tract infections, hormonal changes, diabetes, etc.

Functional

This type of incontinence is due to a functional limitation (i.e., an inzability to move or move around in one’s environment). Common causes: immobility or cognitive impairment.

Reflex

Reflex incontinence is the frequent loss of urine with no warning. Common causes: spinal cord injuries, brain tumors, stroke and more.

Mixed

Mixed incontinence refers to a combination of incontinence forms, such as a mix of stress, urge and bowel incontinences.

In addition to the six types of urinary incontinence, bowel or fecal incontinence can be caused by childbirth, surgery, nerve damage, illness and more. There are protective hygiene products to address each type of incontinence, from light to heavy leakage. Addressing incontinence can lead to better control and a higher level of confidence for patients.

Written By:

Joselin Lockard, RRT

Frontier Home Medical Sales Representative

Kearney and Grand Island

Powerful Outcomes: Assigning Proper Mobility

Patient outcomes are the highest priority to find the best mobility solutions. As a full durable medical equipment provider, our team can address any mobility situation that comes our patient’s way.

THE PROGRESSION OF ASSISTIVE MOBILITY

To start, there are mobility aids such as canes and walkers to assist in the patient’s daily living activities within the home; due either to limitations or a mobility-related diagnosis. 

If neither a cane nor a walker is appropriate for the patient, we then look to a wheelchair that best suits their needs. We consider a wheelchair’s width, depth, height and any size restrictions due to the layout of the patient’s home. We find the best suitable size and type of wheelchair to allow for the patient’s safety and independence.

If a manual wheelchair has been trialed and failed, then we move to a Group 2 power wheelchair. We complete a trial to ensure the patient has both the physical and mental ability to safely and effectively use a power wheelchair to complete ADLs (Activities of Daily Living).

Should the patient meet the requirements for a power wheelchair, but a standard Group 2 does not meet all the patient’s needs due to diagnosis or impairment, then a Group 3 power wheelchair is recommended. A Group 3 power wheelchair will allow for any powered seating needed to allow the patient to independently reposition themselves as well as provide proper pressure relief as needed. Group 3s also allow for modifications as the patient’s needs may change as time goes on.

PROCESS FOR SUCCESS

Following this method for assistive mobility not only assures that we have the safest and most effective option for a patient, but also shows that providing proper equipment can reduce adverse outcomes and preventable medical complications. With proper care and follow-up, patient’s health and well-being are impacted; this, in turn, shapes the healthcare industry at large.

Written By:

Jesse Wellman

Frontier Home Medical Assistive Technology Professional

CSA 101

When it comes to any medical condition, knowledge is the essential element of empowerment. Our patients have lives beyond their medical concerns. Great advice, emotional support and superior products and service are what they need to live life fully. Causes for Central Sleep Apnea include:

Cheyne-Stokes Breathing

Most commonly associated with heart failure and strokes.

Drug-Induced Apnea

Certain medications, such as opioids, can cause a disruption in breathing.

High Altitude Periodic Breathing

A change in oxygen at high altitudes can cause one to increase and decrease breathing rate.

Treatment-Emergent CSA

Some patients with OSA develop CSA while being treated with a CPAP.

Medical Condition CSA

Several medical conditions may cause CSA with non Cheyne-Stokes types of breathing.

Idiopathic CSA

No known cause for the CSA breathing disorder; however this is uncommon.

DIAGNOSIS & TREATMENT

Diagnosis of CSA is done during a polysomnography (or sleep study). This can be a diagnostic, split-night or titration sleep study. CSA treatments include addressing the associated medical conditions, decreasing opioids, positive airway pressure machines (CPAP, BiPAP, ASV) and/or oxygen therapy.

Written By:

Joselin Lockard, RRT

Frontier Home Medical Sales Representative

Grand Island and Kearney

Health & Good Sleep

At Frontier Home Medical, we place considerable value on sleep therapy because of the profound effects we know that it can have on patients’ health. When left untreated, sleep apnea can increase the risk of high blood pressure, stroke, atrial fibrillation (AFib), diabetes, depression, memory loss and motor vehicle accidents due to falling asleep at the wheel. We hear the feedback from patients regarding how much better they feel after beginning their therapy. One of the most common comments we hear is “CPAP changed my life.”

Our experts work with patients every step of the way—including diagnostic testing, initial set up and training with a Respiratory Therapist, compliance monitoring and an efficient, easy-to-use resupply program. The human touch, combined with the latest technology, has helped our patients be successful with their sleep therapy and gives them the fighting chance they need to improve their health one sleep
at a time.

Written By:

Anne Seaman

Frontier Home Medical Sales Representative

Cozad, North Platte, McCook