Tag Archives: UNMC College of Nursing in Omaha

Breaking the Silence of Osteoporosis

March 2, 2018 by

Underdiagnosed and undertreated, osteoporosis is a bone disease that often leads to severe and debilitating bone fractures. Roughly 35 million Americans are at risk of developing osteoporosis, and many who are living with the condition are unaware that they have it or that there are steps they could have taken to prevent it. Dr. Nancy Waltman and Dr. Laura Bilek are working to develop preventative measures while educating women on the risks of this prevalent and deadly condition.

Waltman, a professor in the University of Nebraska Medical Center College of Nursing, and Bilek, a physical therapist and an associate professor, are the lead investigators of a study titled “Bone-Loading Exercises Versus Risedronate on Bone Health in Post-Menopausal Women.” The study is part of a $3.2 million National Institutes of Health grant.

Waltman says that educating women about osteoporosis is an important step in treating it.

“It’s exciting when I meet women and talk about bones,” Waltman says. “[Osteoporosis] is very much a silent disease. People don’t talk about it, but they should be.”

Bilek and Waltman have screened thousands of women since 2015, and have recruited 220 of the 300 women needed for the study.

Bilek says that their ultimate goal is preventing bone loss in post-menopausal women.

“The most rapid bone loss occurs between the ages of 50 and 60; that’s who we seek out for the study,” Bilek says.

Bilek says that once a woman is chosen to participate in the study, they are put into one of three groups: the control group, which takes calcium and vitamin D; a second group that combines calcium, vitamin D, and exercise; or a third group that uses calcium, vitamin D, exercise, and the intake of bisphosphonates.

Bilek and Waltman say that ensuring the study was accessible to Spanish-speakers was important because the belief that osteoporosis mainly impacts Caucasian women is both common and false.

“A lot of Latina women don’t think they can have it [osteoporosis], but many Latina women don’t get enough calcium in their diet, putting them at greater risk,” Waltman says. “For our exercise program, we’ve partnered with the Kroc Center and have translators available.”

Another damaging rumor Bilek and Waltman are hoping to disprove is the “danger” of osteoporosis medications.

“The side effects reported in the media scared women away from taking the drugs,” Waltman says. “20-25 percent of women aren’t taking the medications they’re prescribed. It’s disappointing. Medication is very important in preventing fractures.”

Severe side effects have been reported from osteoporosis medications, but are incredibly rare, and Bilek and Waltman stress how dangerous osteoporosis can be if left untreated.

“About one in five people with hip fractures die within a year,” Bilek says. “I’m very passionate about this disease because maybe we can prevent that from happening.” 

They will have to wait for the end of the study before they can draw any conclusions, but Bilek says that (in general) they know that exercise is good.

“The question becomes how do we implement effective exercise for their bones?” Bilek says. “Over long term, how can they keep exercising when they have other priorities?”

No matter the results, Bilek and Waltman say that the study can benefit the women who choose to participate. It offers education, free medical tests such as a DXA scan (which measures bone density), and a role in breaking the silence that seems to surround osteoporosis.

For more information on the study or to inquire about participation, call 402-559-6584 or email hops@unmc.edu.

From left: a normal bone vs. an osteoporotic bone. When bones break, the problem is usually found in the inner bone. Osteoporosis causes the inner bone to become porous and spongy (resembling honeycomb).

This article was printed in the March/April 2018 edition of Omaha Magazine.

Geriatric Nurses

April 21, 2016 by
Photography by Bill Sitzmann

Some people just don’t get it when it comes to the health of older adults. Many believe that elderly people are always tired. But that’s a myth.

“It’s also not true that an older person doesn’t have a brain that works as well,” says Sara Wolfson, geriatric nurse practitioner for the University of Nebraska Medical Center (UNMC) Home Instead Center for Successful Aging.

Myths such as these lead to ageism that can affect how older adults are treated (or under-treated) for illnesses.

A geriatric nurse can sort it out. This registered nurse specialist has the skills to recognize what’s normal for older adults versus what’s abnormal.

Beth Culross

Beth Culross

“We are really focused on looking at the process of aging and how we can help older adults maintain their  health and prevent health problems as they age. What is normal at age 80 might not be normal for 40 or 50,” says Dr. Beth Culross, an R.N. with a Ph.D. in gerontology. She teaches undergraduate gerontology at the UNMC College of Nursing in Omaha.

Geriatric nurses often function as case managers who help patients live with chronic illnesses, giving them a greater chance of staying independent and active.

“With case management, there are a lot of phone calls, checking on them, answering questions about medication, seeing how a visit to the ER went,” Wolfson explains.

She says it’s important to keep older adults out of hospitals. “Being in the hospital weakens people. It takes longer to recover. Some get confused. Older people have less reserve when they get sick.”

Geriatric nurses can be found working in hospitals, clinics, physicians’ offices, long-term care facilities—and in patients’ homes.

Senior Assist, a home-visit program for patients ages 65 and older whose primary care physician is with Nebraska Medicine, is available at no cost through the Home Instead Center for Successful Aging. Home visits give the nurse a look at the person’s living environment, and consequently gives them a clue to what is going on with their physical and mental health. 

“One nurse went to the home of a patient who was constantly coming here because of congestion and found she wasn’t using her nebulizer,” says Wolfson. “Home visits give a heads-up if someone is having a problem.”

UNMC’s Home Instead Center for Successful Aging offers seniors a wellness center, outpatient clinic, assessment, and education in topics as diverse as fall prevention,  nutrition, arthritis, and tai chi. Nurses provide education as mandated by Medicare—information about medications, like blood thinners, or about general health and nutrition, like cutting back on sodium.

“We’re a center for people who are aging well and people who have a lot of chronic illnesses that need to be managed,” Wolfson says. “We take walk-in patients. They might have a cold, feel dizzy or tired.”

The center also provides dementia evaluation and diagnosis.

“We wouldn’t diagnose dementia on the fact that their memory is bad. It’s based on function. Are they still independent?  Taking medications?  Or are they not bathing? Are their clothes tattered?” says Wolfson, who points out that there are other geriatric clinics available in the area.

As people live longer and the number of people over age 65 increases, more nurses specializing in geriatrics are needed.

By 2030, one in five adults—88 million people—will be 65 or older, according to the U.S. Census. About 10,000 adults turn 65 every day.

Sara Wolfson

Sara Wolfson

“Most of the hospitals in the Omaha area have started recognizing this,” Culross says. “These hospitals have special designations around the need for care for older adults.”

There is a shortage of nurses in general and—because the number of aging adults is increasing—there is especially a need for certified geriatric nurses.

Almost half of all patients admitted to hospitals are over 65, but only 1 percent of registered nurses and 3 percent of advanced practice registered nurses are certified in geriatrics, reports the American Geriatric Society.

Adults over 65 account for nearly 26 percent of all physician visits, 47 percent of all hospital stays, 34 percent of all prescriptions, 34 percent of all physical therapy patients, and 90 percent of all nursing home stays, according to the Eldercare Workforce Alliance.

By 2030, 7.7 million people will have Alzheimer’s disease, up from 4.9 million in 2007.

“The fastest growing segment of the population in the United States are people 85 and over,” Culross says.

Recognizing what’s normal and what’s not for an aging adult is important for a geriatric nurse. So is listening. Allowing patients to talk about their experiences and life stories tells where they are now and how she can help, says Culross.

“I learn as much from my patients as they do from me. My husband tells me I’m really good at it because I like to talk.”