Pressure Ulcer Awareness - Pressure Injury Prevention Points and Nutrition Intervention

The National Pressure Ulcer Advisory Panel (NPUAP) serves as the authoritative voice for improved patient outcomes in pressure injury prevention and treatment through public policy, education, and research. The objective of STOP logo 2017 World Wide Pressure Injury Prevention Day is to increase national awareness for pressure injury prevention and to educate the public on this topic. NPUAP has developed an extensive media materials package appropriate for all healthcare settings and organizations.

It is important to identify individuals who are prone to pressure injuries. I have a son with cerebral palsy. He is in a wheelchair and lacks movement without assistance. He receives a body check twice a day, but even with my constant supervision, an ulcer can creep up quickly. My son's feet had become swollen and hot. The doctor placed him on antibiotics, but his left foot continued to get worse. A few days later, I took a photo of my son's wound and showed it to the doctor. The doctor immediately contacted a wound care nurse and his ankle was diagnosed as a stage II pressure ulcer. The wound healed eventually. It took about 6 weeks. Be your family and/or friend's advocate.

Skin Care

1. Inspect all of the skin upon admission as soon as possible (but within 8 hours).
2.  Inspect the skin at least daily for signs of pressure injury, especially nonblanchable erythema.
3. Assess pressure points, such as the sacrum, coccyx, buttocks, heels, ischium, trochanters, elbows, and beneath medical devices.

4.  When inspecting darkly pigmented skin, look for changes in skin tone, skin temperature, and tissue consistency compared to adjacent skin. Moistening the skin assists in identifying changes in color.

5. Cleanse the skin promptly after episodes of incontinence.

6. Use skin cleansers that are pH balanced for the skin. 
7. Use skin moisturizers daily on dry skin.

8.  Avoid positioning an individual on an area of erythema or pressure injury.

Nutrition
1.  Consider hospitalized individuals to be at risk for undernutrition and malnutrition from their illness or being NPO for diagnostic testing.

2.  Use a valid and reliable screening tool to determine the risk of malnutrition, such as the Mini Nutritional Assessment.

3.  Refer all individuals at risk for pressure injury from malnutrition to a registered dietitian/nutritionist. 

4. Assist the individual at mealtimes to increase oral intake. 

5.  Encourage all individuals at risk for pressure injury to consume adequate fluids and a balanced diet.

6.  Assess weight changes over time.

7.  Assess the adequacy of oral, enteral and parenteral intake.

8. Provide nutritional supplements between meals and with oral medications, unless contraindicated.

Repositioning and Mobilization
1. Turn and reposition all individuals at risk for pressure injury, unless contraindicated due to medical conditions or medical treatments. 

2.  Choose a frequency for turning based on the support surface in use, the tolerance of skin for pressure and the individual’s preferences.

3.  Consider lengthening the turning schedule during the night to allow for uninterrupted sleep.

4.  Turn the individual into a 30-degree side-lying position, and use your hand to determine if the sacrum is off the bed

5.  Avoid positioning the individual on body areas with pressure injury.

6. Ensure that the heels are free from the bed.

7.  Consider the level of immobility, exposure to shear, skin moisture, perfusion, body size, and weight of the individual when choosing a support surface.

8. Continue to reposition an individual when placed on any support surface.

9.  Use a breathable incontinence pad when using microclimate management surfaces.

10.  Use a pressure-redistributing chair cushion for individuals sitting in chairs or wheelchairs.

11. Reposition weak or immobile individuals in chairs hourly.

12.  If the individual cannot be moved or is positioned with the head of the bed elevated over 30°, place a polyurethane foam dressing on the sacrum.

13.  Use heel offloading devices or polyurethane foam dressings on individuals at high-risk for heel ulcers

14,  Place thin foam or breathable dressings under medical devices.

Education
1. Teach the individual and family about risk for pressure injury

2.  Engage individual and family in risk reduction interventions

Staging Pressure Injury

A pressure injury is localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other devices. The injury can present as intact skin or an open ulcer and may be painful. The injury occurs as a result of intense and/or prolonged pressure or pressure in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion, co-morbidities and condition of the soft tissue.

Stage 1 Pressure Injury: Non-blanchable erythema of intact skin. Intact skin with a localized area of non-blanchable erythema, which may appear differently in darkly pigmented skin. The presence of blanchable erythema or changes in sensation, temperature, or firmness may precede visual changes. Color changes do not include purple or maroon discoloration; these may indicate deep tissue pressure injury.

Stage 2 Pressure Injury: Partial-thickness skin loss with exposed dermis. Partial-thickness loss of skin with exposed dermis. The wound bed is viable, pink or red, moist, and may also present as an intact or ruptured serum-filled blister. Adipose (fat) is not visible and deeper tissues are not visible. Granulation tissue, slough and eschar are not present. These injuries commonly result from adverse microclimate and shear in the skin over the pelvis and shear in the heel.  This stage should not be used to describe moisture associated skin damage (MASD) including incontinence associated dermatitis (IAD), intertriginous dermatitis (ITD), medical adhesive related skin injury (MARSI), or traumatic wounds (skin tears, burns, abrasions).

Stage 3 Pressure Injury: Full-thickness skin loss. Full-thickness loss of skin, in which adipose (fat) is visible in the ulcer and granulation tissue and epibole (rolled wound edges) are often present. Slough and/or eschar may be visible. The depth of tissue damage varies by anatomical location; areas of significant adiposity can develop deep wounds.  Undermining and tunneling may occur. Fascia, muscle, tendon, ligament, cartilage and/or bone are not exposed. If slough or eschar obscures the extent of tissue loss this is an Unstageable Pressure Injury.

Stage 4 Pressure Injury: Full-thickness skin and tissue loss. Full-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage or bone in the ulcer. Slough and/or eschar may be visible. Epibole (rolled edges), undermining and/or tunneling often occur. Depth varies by anatomical location. If slough or eschar obscures the extent of tissue loss this is an Unstageable Pressure Injury.

Unstageable Pressure Injury: Obscured full-thickness skin and tissue loss. Full-thickness skin and tissue loss in which the extent of tissue damage within the ulcer cannot be confirmed because it is obscured by slough or eschar.  If slough or eschar is removed, a Stage 3 or Stage 4 pressure injury will be revealed. Stable eschar (i.e. dry, adherent, intact without erythema or fluctuance) on the heel or ischemic limb should not be softened or removed.

Deep Tissue Pressure Injury: Persistent non-blanchable deep red, maroon or purple discoloration. Intact or non-intact skin with a localized area of persistent non-blanchable deep red, maroon, purple discoloration or epidermal separation revealing a dark wound bed or blood-filled blister. Pain and temperature changes often precede skin color changes. Discoloration may appear differently in darkly pigmented skin.  This injury results from intense and/or prolonged pressure and shear forces at the bone-muscle interface.  The wound may evolve rapidly to reveal the actual extent of tissue injury, or may resolve without tissue loss. If necrotic tissue, subcutaneous tissue, granulation tissue, fascia, muscle, or other underlying structures are visible, this indicates a full-thickness pressure injury (Unstageable, Stage 3, or Stage 4).

References
1. The National Pressure Ulcer Advisory Panel - NPUAP - Resources

World Diabetes Day - The Family and Diabetes

World Diabetes Day was created in 1991 by the International Diabetes Federation and the World Health Organization. World Diabetes Day became an official United Nations Day in 2007. The campaign draws attention to the issues of importance to the diabetes world and keeps diabetes in the public spotlight. 

World Diabetes Day (WDD) is celebrated every year on November 14th. The World Diabetes Day campaign is led by the International Diabetes Federation (IDF) and its association members. It joins millions of people worldwide in diabetes advocacy and awareness.

The Family and Diabetes

To mark diabetes awareness month and World Diabetes Day on November 14, the International Diabetes Federation (IDF) is urging families to learn more about the warning signs of diabetes. New research from IDF has discovered that parents would struggle to spot this serious life-long disease in their own children. Despite the majority of people surveyed having a family member with diabetes, alarming four-in-five parents would have trouble recognizing the warning signs. One-in-three wouldn’t spot them at all.

The findings underline the need for education and awareness to help people spot the diabetes warning signs early.

The warning signs can include excessive thirst, frequent urination, a lack of energy, blurred vision, slow-healing wounds, and numbness in the feet and/or hands.

This November, IDF is urging people to test their diabetes knowledge and learn more. IDF has made an awareness assessment available online at http://discoverdiabetes.idf.org/

Meet Toby Smithson, RDN, LDN, CDE

Toby Smithson is a Registered Dietitian, a Certified Diabetes Educator, a national spokesperson for the American Dietetic Association, and holds a certification in adult weight management. Toby was diagnosed with Type 1 diabetes in October 1968 and has managed diabetes personally every single day since with no hint of complications. Toby founded DiabetesEveryDay to share her insights into successful diabetes self-management.

DiabetesEveryDay.com members enjoy 24/7 access to weekly menu selections, recipes (developed by dietitians for heart health and carbohydrate management), grocery lists, and a unique library of video clips featuring Toby Smithson. New content is added weekly, Toby draws upon her own extraordinary diabetes management success to make this overwhelming responsibility for self-care both understandable and practical. She explores not only the nuts and bolts…. medical issues, food, and physical activity…. but also everyday lifestyle, emotional challenges, stress, and life-changing motivation; the real keys to success. To learn more, visit DiabetesEveryDay.com

Blue Circle Dance

About 500 employees, families, and friends of Novo Nordisk from all around the world filmed themselves while dancing to 'Move your feet' by Junior Senior. The idea is to generate awareness for diabetes on World Diabetes Day on 14 November.

National Hunger & Homeless Awareness Week

This is National Hunger and Homeless Awareness Week. How You Can Help... 

I've heard about Chicken Soup for the Soul but have not read any books. I browsed the site and was fascinated and inspired by the stories. I came across one specific story devoted to Hunger and how a group sold pizza for $1.00 to raise money for the hungry.

New York City's Biggest Pizza Party
Helps Feed The Hungry


National Hunger & Homeless Awareness Week 

No one should worry about whether they will have food on their plates or a roof over their heads. But the reality is that hunger and homelessness are widespread problems that affect far too many people. Many Americans live on the edge, forced to choose between basic necessities like purchasing food, paying rent, or going to the doctor.

Needed items and services might include:

• Clothing. The lack of clean, well-fitting clothes and shoes causes great hardship beyond exposure to the elements—it hurts one's self-image and chance to get ahead. People experiencing homelessness must travel light, with few opportunities to safely store or adequately clean what they can't carry. In job interviews, a poorly dressed person has little chance for success. Give your clean clothes to those who could use them. Before you give your clothes or start a clothing drive, talk to your local shelter and find out what items they need. Most have limited storage space and can't use winter clothes in summer or vice versa. Some serve only a specific group of people. Please clean the clothes before you donate them.

• In-kind services and materials. Service providers may use copying, printing, food, transportation, marketing assistance, computer equipment and assistance, electrical work, building materials, plumbing, etc.

• Household goods or other items. Service providers may need kitchen utensils, furniture, books, toys, games, stuffed animals, dolls, diapers, etc.

• Books. People experiencing homelessness may have limited access to a library and find that there is little for them to do when spending a night at a shelter. Find out if your local shelter would appreciate donations of books. Consider organizing a book drive to create a small library at the shelter if there is not one already.

• Computers. Many non-profit organizations need help purchasing expensive but essential equipment such as computers. A local shelter or service provider might greatly appreciate the donation if you have a machine you no longer need. Shelter guests might also enjoy donating devices for their use, although you should check if a shelter would have space to set up public computers.

• Homeless "survival kits." Create and distribute kits that include cups, pots, pans, soap, shampoo, toothpaste, toothbrushes, and cosmetics. (Try coordinating this through a group that gives out meals from a van, for example.)  During cold weather, organize drives for blankets, coats, hats, scarves, mittens, socks, etc.

• Phone calls. Help people experiencing homelessness contact loved ones by offering the opportunity to make free long-distance calls on holidays. Donate to or organize a cell phone drive for the homeless.

• Job opportunities. Encourage your company, school, or place of worship to hire people experiencing homelessness (if they are not already working). Most unemployed, homeless adults desperately want to work but need an employer to give them a chance.

• Support for a homeless person or family. As people move out of a shelter or transitional housing program, consider raising money to contribute for a security deposit or assist by contributing household goods, babysitting, or moral support. See if your local shelter has a partnering program.

   

National Hunger & Homeless Awareness Week

Chicken Soup for the Soul

National Indian Pudding Day

Indian Pudding

Modified from @AFamilyFeast

Prep Time: 20 mins
Cook Time: 1 hour 30 mins
Total Time: 1 hour 50 minutes
Yield: 10 servings

INGREDIENTS

2 eggs
4 cups 2% milk
½ cup cornmeal
2 tablespoons unsalted butter
½ cup molasses
¼ cup maple syrup
¼ cup brown sugar
1/2 teaspoon salt
½ teaspoon cinnamon
½ teaspoon dry ginger
¼ teaspoon allspice
pinch of nutmeg
1/2 cup golden raisins
½ teaspoon vanilla extract
Spray pan with nonstick cooking spray
1/4 cup Vanilla ice cream per serving 

INSTRUCTIONS

1. Preheat oven to 325 degrees.
2. Beat eggs in a small bowl and set aside.
3. In a 6-quart pot, heat milk to hot, do not boil. Slowly add in cornmeal and whisk continually until all of the cornmeal is added. Cook for 10 minutes on a low simmer, stirring occasionally. Be careful that it does not stick and burn to the bottom of the pan.
4. Remove from heat and add all other ingredients except the beaten eggs. Mix to combine.
5. Temper the eggs by slowly adding some of the hot pudding a little at a time to the eggs, stirring as you go (about a cup total). Then add the egg mixture to the pot and stir.
6. Pour mixture into a 6-cup casserole dish and place the casserole dish in a water bath. Bake for about one hour and 30 minutes.
7. The pudding should be set up and somewhat firm. If the center is a bit loose, that is okay.
8. Let the pudding rest for 15 minutes, then serve hot with a scoop of vanilla ice cream.

National Deviled Egg Day - Recipes

The traditional deviled eggs are hard-boiled, shelled, cut in half, and the egg yolk removed. The yolk is mixed with other ingredients, such as mayonnaise and mustard, and placed in the hard-boiled egg white. Deviled eggs are customarily served cold as a side dish, appetizer, or main course. 

Recipes
The following recipes are modified for low cholesterol and variety.

Egg Whites with Tomatoes,
Parsley and Bulgur

Serves 2

Ingredients

2 Eggs, hard-boiled, yolks removed
4 Tablespoons Diced Tomatoes, Parsley, and Bulgur, prepared
Directions

Fill egg whites with diced tomatoes, parsley, and bulgur. Serve

Nutrition Information

Egg Whites filled with Diced Tomatoes,
Zucchini and Feta Cheese

Ingredients
1 Egg White, cut in half
1/2 cup Diced Tomatoes
1/3 cup Diced Zucchini
1/3 ounce Feta Cheese
Directions
Fill egg whites with ingredients. Serve

Resources and References
1. Wikipedia: Deviled Egg  This article is licensed under the GNU Free Documentation License
2. Consumer Reports, Deviled Eggs are a Healthier Snack

Nutrient Analysis Services
Ensure accurate nutritional analysis for your recipes utilizing an extensive research database and over 35 years of experience. A valuable service for Media, Cookbook Publishers, Writers, Chefs, Recipe Websites, and the Recipe Blogger. Your readers will benefit from the Nutrition information and a Registered Dietitian. Contact: Sandra Frank, Ed.D, RDN, FAND at recipenews@gmail.com or call 954-294-6300

New Food Trends for Halloween and Trick-or-Treat for UNICEF

"For generations, kids have toted UNICEF's collection boxes door to door on Halloween, calling out "Trick-or-Treat for UNICEF!" They have raised over $170 million since 1950 to help children worldwide - funds enabling UNICEF to save and improve children's lives by providing health care, improved nutrition, clean water, education, and more."

Resource
1. UNICEF, Trick-or-Treat for UNICEF

National Bologna Day

Aside from pork, bologna can alternatively be made out of chicken, turkey, beef, venison, a combination, or soy protein. Typical seasoning for bologna includes black pepper, nutmeg, allspice, celery seed, coriander, and like mortadella, myrtle berries give it its distinctive flavor, U.S. Government regulations require American bologna to be finely ground and without visible pieces of fat.

Resources

Bologna sausage, Wikipedia   

Sausages and Food Safety, USDA  

Tricky Treats, Halloween Story from the CDC

Tricky Treats is part of the Centers for Disease Control,

animated Eagle Book Series.

The Eagle Books consists of four books that are brought to life by wise animal characters, Mr. Eagle and Miss Rabbit, and a clever trickster, Coyote, who engage Rain that Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about traditional ways of being healthy. Animated versions of the four books bring the characters to life. Narrated by author Georgia Perez and voiced by children and adults from the Standing Rock Sioux tribal nation, the animated versions provide an interactive tool to engage children in activities and discussions about healthy eating, and the joy of being active while looking to traditional ways to stay healthy and prevent type 2 diabetes.

Shrimp Bisque, Lighterside

Shrimp Bisque

Yields: Make 3 cups
Servings: 6 (3/4 cup)
Makes 3 cups

Ingredients
1 small onion, chopped
1 tablespoon olive oil
2 garlic cloves, minced
1 tablespoon all-purpose flour
1 cup water
1/2 cup light whipping cream
1 tablespoon chili powder
2 teaspoons sodium-free chicken bouillon granules
1/2 teaspoon ground cumin
1/2 teaspoon ground coriander
1/2 pound uncooked medium shrimp, peeled and deveined,
   washed and drained
1/2 cup low-fat sour cream
Fresh cilantro, optional


Directions

1. In a small saucepan, saute onion in oil until tender. Add garlic; cook 1 minute longer. 
2. Stir in flour until blended. Stir in the water, cream, chili powder, bouillon, cumin, and coriander; bring to a boil. Reduce heat; cover and simmer for 5 minutes.
3. Cut shrimp into bite-size pieces; add to soup. 
4. Simmer for 5 minutes longer or until shrimp turns pink.
5. Gradually stir 1/2 cup hot soup into sour cream; return all to the pan, stirring constantly. 
6. Heat through (do not boil). Garnish with cilantro, if desired.

 

National School Lunch Week

"In the long view, no nation is healthier than its children, or more prosperous than its farmers." - President Harry Truman, on signing the 1946 National School Lunch Act. Through the Years The National School Lunch Program was created in 1946 when President Truman signed the National School Lunch Act into law. The National School Lunch Program is a federal nutrition assistance program. Through the years, the program has expanded to include the School Breakfast Program, Snack Program, Child and Adult Care Feeding Program, and the Summer Food Service Program. In 1962, Congress designated the week beginning on the second Sunday in October each year as "National School Lunch Week." The video below looks at the school lunch program from the late 1930s to the present day and includes President Obama signing the Healthy, Hunger-Free Kids Act. One can see from the photographs some of the changes in the foods provided. There is an increase in whole grains, fruits, vegetables, lean protein, and low-fat dairy. (Part of the video has clips from a film produced by the USDA in the mid-60s.) School Lunch Resources  Organizations, Associations, and Programs School Nutrition Association “Celebrate NSLW. School Lunch invites creative and fun new menu items while appealing to students in all grade levels. The School Nutrition Association is a national, nonprofit professional organization.  Mission. To advance good nutrition for all children. National Farm to School Month Farm to School is broadly defined as any program that connects schools (K-12) and local farms with the goal of serving healthy meals in school cafeterias, improving student nutrition, providing agriculture, health, nutrition education, and supporting local and regional farmers. Farm to School programs exist in all 50 states, but since Farm to School is a grassroots movement, programs are as diverse as the communities they serve. About the Farm to Preschool program at UEPI, Occidental College The National School Lunch Program (NSLP) is a federally assisted meal program operating in public and nonprofit private schools and residential childcare institutions. It provides nutritionally balanced, low-cost, or free lunches to children each school day. The program was established under the National School Lunch Act, signed by President Harry Truman in 1946. Kids Eat Right Kids Eat Right is your source for scientifically-based health and nutrition information you can trust to help your child grow healthy. As a parent or caretaker, you need reliable resources, and you can find them here, backed by the expertise of nutrition professionals. Team Nutrition. Campaign launched by USDA's Food and Nutrition Service (FNS) to encourage and teach children, parents, and caregivers to eat healthy and be physically active every day.  Choose MyPlate. The website features practical information and tips to help Americans build healthier diets. Elmo Doesn't Fear School Lunch Elmo joins White House, Chef Sam Kass in the White House kitchen to talk about the importance of healthy and delicious school meals.  We Can. The We Can! GO, SLOW, and WHOA Foods fact sheet (pdf) can be posted on the refrigerator or used when grocery shopping. The We Can! Parent Tips - Snack (pdf) 100 Calories or Less tip sheet can help consumers choose vegetables, whole grains, and fat-free or low-fat (1 percent) milk for healthier snacks. Healthy Children The American Academy of Pediatrics (AAP) and its member pediatricians dedicate their efforts and resources to the health, safety, and well-being of infants, children, adolescents, and young adults. Healthy Children - Nutrition; Food Allergies in Children Action for Healthy Kids: we believe there are ways to reduce and prevent childhood obesity and undernourishment. Learn how Action for Healthy Kids is working with schools, families, and communities to help our kids learn to be healthier and be ready to learn. National Dairy Council® (NDC), Child Nutrition Fuel Up sponsored by National Dairy Council and the NFL, in collaboration with United States Department of Agriculture (USDA). Fuel Up is an in-school program that encourages the availability and consumption of nutrient-rich foods, along with daily physical activity. Fruits and Veggies   Tom Vilsack, Secretary of Agriculture, stated: “National School Lunch Week reminds us how important it is that our children be healthy and active, that they do not go hungry, and that they have access to nutritious meals." 

World Arthritis Day - Cooking Tips for People with Arthritis

Arthritis is not a single disease; it is an informal way of referring to joint pain or disease. There are more than 100 different types of arthritis and related conditions. People of all ages, sexes, and races can and do have arthritis, and it is the leading cause of disability in America. More than 50 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people age.

Common arthritis joint symptoms include swelling, pain, stiffness, and decreased range of motion. Arthritis can cause permanent joint changes. These changes, such as knobby finger joints, may be visible, but the damage can often be seen on an X-ray.

Osteoarthritis is the most common type of arthritis. Over time, joints can lose strength, and pain may become chronic. Risk factors include excess weight, family history, age, and previous injury.

When the joint symptoms of osteoarthritis can be managed by:

• balancing activity with rest
• using hot and cold therapies
• regular physical activity
• maintaining a healthy weight
• strengthening the muscles around the joint for added support
• using assistive devices
• taking over-the-counter (OTC) pain relievers or anti-inflammatory medicines
• avoiding excessive repetitive movements

If joint symptoms are severe, causing limited mobility and affecting the quality of life, some of the above management strategies may be helpful, but joint replacement may be necessary.

Osteoarthritis can be prevented by staying active, maintaining a healthy weight, and avoiding injury and repetitive movements.

Cooking Tips for People with Arthritis

Cooking can be difficult for people with arthritis, physical limitations, pain, and fatigue. Here are some meal-prep strategies to help you fuel your body with nutritious and delicious food, even when arthritis has left you feeling tired and in pain.

1. Use Ergonomic Cooking Tools. Arthritis pain, especially affecting the hands, fingers, wrists, elbows, and shoulders, can make simple cooking tasks more difficult. Lightweight cooking tools which have easy grips and non-slip handles are very helpful for people with arthritis. There are many design selections for cooking tools and kitchen aids. Spatulas, spoons, ladles, whisks and other cooking tools which feel comfortable in your hand can improve manual dexterity, reduce pain, and compensate for swollen and deformed joints.

2. Use tools for chopping and stirring.  Actions that force you to exert a lot of pressure on your joints in the hands and wrists can be painful, which is why chopping, cutting, and stirring are perhaps the hardest kitchen tasks for those with arthritis. Food processors help people with arthritis who have difficulty with manual cooking tasks like chopping, cutting, and slicing. The food processor will automatically chop, shred, or slice after you load it. Choose a food processor which is manageable.

3. Get help with jars. Jars can be a pain to open. Flat, rubber grips may make it a little easier but still require some effort. You can also try a mounted under-cabinet opener, and there are even electric jar openers. For hard-to-pop-open plastic containers, like yogurt use an inexpensive ring on your thumb and place the ring under the edge to lift it up.

4. Rocker Knife or Specialty Knives Simplify Cutting. Rocker knives are an example of a specialty cooking tool. The two-handled design puts strength and controls back into cutting and chopping. The rocker blade design has the motion built right in.

5. Lighten your load. Use lighter-weight pots and pans. This also goes for plates, prep bowls, cookware, and storage containers. Be extra careful with large pots of food. Pots and pans can be heavy, clumsy, and hard to manage for people with painful, arthritic joints. Using a pot or pan with two handles distributes the weight evenly between your hands and wrists.

6. Pull Up a Stool. Sit on a chair to do all the chopping and prep work. Work at your kitchen table, or sit there if you have stools under the counter. If you are standing, use an anti-fatigue kitchen mat. Non-trip mats can take some of the stress off your legs and feet.

7. Store Foods Conveniently. Make sure you have food storage containers that are easy for you to open and easy for you to stack. Whether you choose plastic storage containers with easy-open lids or Ziploc bags, make sure they are convenient for you.

8. Make Kitchen Shelves Accessible. Your kitchen shelves should be easily accessible so that you don't strain your muscles and hurt painful joints when trying to reach dishes, cookware, or food. Have your most commonly used items closest to where you use them. Make sure kitchen items are not stacked precariously so that they can fall as you reach for them. Set up your kitchen with safety in mind and convenience too.

9. Invest in a slow or instant cooker. One-pot meals are the way to go to simplify your prep and cleanup. Slow cookers and Instant Pots make it easy to throw the ingredients in and forget about them until they’re ready.

10. Get help from the grocery store. Grocery shopping doesn’t have to be difficult as it used to be. Home delivery or pickup services take this task off your shoulders. If you do venture to the store, take advantage of any assistance the store can give you. Shop for precut veggies in both the fresh and frozen sections, ask the butcher and fishmonger to cut up meat and debone fish or buy precooked foods like a roast chicken to doctor up at home.

11. Delegate. A good manager knows what tasks to hand off to others. If you find something really painful, ask your partner or kids to help.

12. Simplify cleanup. Use the dishwasher. You can also prepare ahead of time for less mess by placing liners in your slow cooker, aluminum foil in your roasting pans, and parchment paper on your cookie sheets.

13. Planned Leftovers. Make extra food and plan for leftovers. By doubling your recipe, you can create planned leftovers which you can freeze and have available for another day.

Take steps to avoid foodborne illness

People who take arthritis medications that suppress the immune system are particularly vulnerable to E. coli, hepatitis C, and other food-related illnesses. Stay apprised of food recalls, and remember to thoroughly wash fruits and vegetables.

Resources
1. Arthritis Foundation, Arthritis Diet
2. Nutrition and Rheumatoid Arthritis, by Kristine Duncan, RDN. TodaysDietitian
3. Rheumatoid Arthritis: Cooking Made Easier, Everyday Health.

Home Food Safety When the Power Goes Out

Be Prepared

Stock up on non-perishable foods that don't require refrigeration, and choose single-serve sizes if available to avoid the need for refrigeration of unused portions. Consider these easy, healthy, shelf-stable foods: 

Summary

 More information can be found at Home Food Safety.