One of the hazards of providing home healthcare is the daily challenge of driving to and from the client’s home. In Winter, the streets may be snow-packed or icy. In Spring, roads may be flooded. Even under ideal conditions, driving can be challenging.

OSHA, the Occupational Safety and Health Administration, has published an overview of hazards in home healthcare at The article states that home healthcare workers “have little control over their work environment which may contain a number of safety hazards. These hazards include bloodborne pathogens and biological hazards, latex sensitivity, ergonomic hazards from patient lifting, violence, hostile animals and unhygienic and dangerous conditions. In addition, if their daily work schedule requires them to provide care for multiple patients, they face hazards on the road as they drive from home to home.”

The National Institute for Occupational Safety and Health has published six Fact Sheets to assist in reducing home healthcare workers’ risk for injury and illness. Publication Number 2012-122 focuses on preventing or reducing driving related injuries. The Fact Sheet addresses behaviors and conditions which contribute to car accidents. These include distracted driving, aggressive driving, failure to use a seatbelt, driving while tired or under the influence of drugs or alcohol, poor weather conditions, and poorly maintained vehicles.

What can you do to protect yourself? The OSHA Fact Sheet lists the following things employees should do to prevent driving-related injuries:

  • Use seatbelts.
  • Stop the vehicle before using a cell phone.
  • Avoid distracting activities such as eating, drinking, and adjusting radio and other controls while driving.
  • Avoid driving when over-tired.
  • Use detailed maps to determine your route before you leave, or use a GPS.
  • Have the vehicle checked and serviced regularly.
  • Keep the gas tank at least a quarter full.
  • Carry an emergency kit containing a flashlight, extra batteries, flares, a blanket, and bottled water.

—By Karen Centowski

To see a video about distracted driving, go to Distracted Driving Presentation at


If you love to cook, you are probably aware of the resurgence in popularity of cooking with a cast iron skillet or Dutch oven. You may have inherited a cast iron skillet from your grandmother, or you may have seen cast iron skillets at garage sales or estate sales or flea markets. Maybe your son was in Boy Scouts years ago, and his troop used a Dutch oven to cook over a campfire. Instead of buying a new cast iron skillet or Dutch oven, you could restore an old one.

Maybe you think that restoring your rusty cast iron skillet or Dutch oven is too difficult for you to attempt. Maybe you thought the rusty iron skillet you saw at a garage sale or estate sale or flea market was too damaged to be restored. You were wrong! With a few simple items and a little elbow grease, you can make these items as good as new.

To restore a cast iron skillet or Dutch oven, you will need a scouring pad (SOS pad) or fine steel wool, vegetable oil (e.g., Mazola oil), paper towels, warm water, dishwashing soap (e.g., Dawn), a soft towel, a large cookie sheet, aluminum foil, and an oven.

Below are the directions:

  1. Preheat oven to 350 degrees.
  2. Using a scouring pad or fine steel wool, scrub off rust from pan and lid,
  3. Wash in warm, soapy water.
  4. Dry thoroughly with a soft cloth towel.
  5. Coat inside and outside of pan and lid with vegetable oil (e.g., Mazola oil). Use a paper towel to spread oil around.
  6. Wipe off excess vegetable oil with a clean paper towel.
  7. Put aluminum foil on a cookie sheet and place on the bottom rack of an oven to catch drips.
  8. Place pan, upside down, on top rack of oven. Place lid, right side up, on top rack of oven.
  9. Bake at 350 degrees for one hour.
  10. Turn off oven. Let pan and lid cool in oven. Remove pan, lid, and cookie sheet.

Store Dutch oven with a folded paper towel between one side of pan and lid to allow air to circulate.

—By Karen Centowski

To see a video about how to restore a rusty cast iron skillet or Dutch oven, go to How To Restore Rusty Cast Iron Cookware at


In an article called “Top 5 Reasons Why Clients Choose A Home Care Provider,” Home Care Pulse described the results of a 2016 Home Care Benchmarking Study. According to an article at, each month the company conducted thousands of interviews with home care clients across the country. During these interviews, Home Care Pulse associates asked clients why they selected their provider over others. Their answers to the questions were recorded and analyzed and published as the 2016 Home Care Benchmarking Study.

Below are the results of the survey:

  1. Recommended by family and friends (34.3%)
  2. Reputation of company (25.4%)
  3. Recommended by referral source (22%)
  4. Consumer marketing of company (14.5%)
  5. Selected by case manager (government programs, hospital, etc.) (3.9%)

A report published on confirms that recommendations from family and friends remain the most important form of advertising. The report, RECOMMENDATIONS FROM FRIENDS REMAIN THE MOST CREDIBLE FORM OF ADVERTISING; BRANDED WEBSITES ARE THE SECOND-HIGHEST-RATED FORM, states that “eighty-three percent of online respondents in 60 countries say they trust the recommendations of friends and family.”

Twenty-five per cent of respondents said the reputation of the company was important. How can a person find out about the reputation of a company? Do some checking. Is the agency licensed by the State of Illinois? Is it approved for Medicare patients? Does it have contracts with the State of Illinois? Is it accredited by the Joint Commission? How long has it been in business?

Twenty-two percent of respondents said a referral source had recommended a home health provider. Referral sources include hospital discharge planners, doctors, nurses, and case managers. These individuals determine the level of care the patient will need after discharge and recommend agencies which provide these services.

Fourteen and one-half percent of the respondents said that they had selected a company because of consumer marketing. This includes ads in magazines, newspaper ads, TV ads, billboards, and the company’s website. Some consumers become aware of a company because of its participation at health fairs. Some respondents had heard a representative of a company speak at a senior citizen center,

Almost four percent of the respondents said that a case manager (government programs, hospital, etc.) had selected the home health provider.

If you or a friend or relative in the Chicago area is needing home health services, consider American Home Health. The agency is over twenty-five years old and has hundreds of employees. It is licensed by the State of Illinois and accredited by the Joint Commission. For more information about American Home Health, go to

—By Karen Centowski


Have you ever thought about the role railroads played in the settlement of the land in the Northern central part of the United States? This area, now known as the Midwest, includes Indiana, Iowa, Illinois, Michigan, Wisconsin, Minnesota, Ohio, and Missouri.

Before the railroads were built in the United States, the only practical way to travel and trade across long distances was along the nation’s natural waterways. In the Midwest, the Ohio River, Mississippi River, and the Great Lakes were vital waterways. Traders and settlers used canoes, boats, and barges on the streams and rivers. Rivers like the Ohio, which connected with the Mississippi River, were also essential in transporting goods produced in the fertile area surrounding the Ohio River.

A major change occurred in the 1800’s. Thousands of miles of railroad track were laid throughout the Midwest connecting rural areas with major metropolitan areas such as Chicago. Prior to 1840, Illinois had virtually no miles of railroad. However, forty years later the state had 8,000 miles of railroad. According to Railroads in the Midwest, Early Documents and Images (Knox College), “In the 1850’s more track was laid in the Midwest, east of the Mississippi, than in any other part of the country.” It was a time of rapid westward expansion.

Located at the intersection of river, lake, and railroad routes, Chicago became a hub of commerce. Trains carried coal to Chicago’s steel mills and cattle and hogs to Chicago’s stockyards. They also carried wheat, corn, passengers, and mail. Sears Roebuck and Company, a Chicago firm, even used trains to deliver some of its mail order products to customers.

Maps of the routes of these early Illinois railroads clearly show Chicago as the hub of the rail system in Illinois. The Chicago, Danville, and Vincennes Railroad Company, founded in 1870, served part of eastern Illinois and western Indiana. The Chicago, Burlington, and Quincy (CB&Q) ran fast mail trains from Chicago to areas west of Chicago. According to Railroads in the Midwest, Early Documents and Images (Knox College), “Begun in the 1870’s, the fast mail trains were mandated by the federal Post Office to deliver mail within a specified period of time. By 1900 the Burlington’s fast mail trains reached the Missouri River in just over nine hours.”

According to the same source, “From 1861-1890 the nation’s railroads grew more rapidly than at any other time. Just before the Civil War, the United States had about 30,600 miles of line; in 1890 steam railroad line measured almost 163,000 miles. The men who ran the railroads at this time were cognizant of their roles in the expansion of the American nation and the American economy even as it was being played out.”

—By Karen Centowski

To see a video called U.S. Railroad History Map 1830—1990’s You Tube, go to


In 2005-2006, a study was done to assess the status of home health care in New York City. According to, “A convenience sample of 1,561 home health aides, attendants, and personal care workers completed a risk assessment survey. Items addressed personal, patient, and home characteristics and health hazards. All activities had prior Institutional Review Board approval.”

The findings were presented in a report called “Home Health Care Patients and Safety Hazards in the Home.” The home health care workers reported the following:

  • Peeling paint (15 percent), irritating chemicals (17 percent)
  • Poor indoor air quality, cigarette smoke (30 percent)
  • Unsanitary conditions (12 percent) and unsafe conditions (6 percent) within the home
  • Vermin (23 percent), cockroaches (33 percent)
  • Aggressive pets (6 percent)
  • Clutter (17 percent)
  • Neighborhood violence/crime (11 percent)
  • Presence of guns in house (2 percent)
  • Signs of abuse of the client (12 percent)

If you are an American Home Health nurse, you may have encountered one or more of these in the home of a client. Be sure to report these issues to your supervisor.

If your client lives in an apartment complex or a multi-family house, eradicating cockroaches becomes a job for the professionals. American Home Health will contact the building management who will hire a pest control company to do the work. If one apartment has cockroaches, the adjoining apartment probably has cockroaches, too. Several units may need to be treated in order to eliminate the problem.

Bedbugs, small non-flying insects, may also be a problem. They feed by sucking blood from human and animals. They can live anywhere in the home, but they are most commonly found on beds, mattresses, box springs, and bed frames. They commonly bite the face, neck, hands, and arms of individuals while they are sleeping. Bedbugs can also live in carpets and bite the individual’s legs. Symptoms of bedbug bites are redness, itching, and swelling. A professional pest control company may be required to remove bedbugs from a home.

Remember that state law requires that most professionals in education, health care, law enforcement, and social work report suspected neglect or abuse. Registered nurses and licensed practical nurses are mandated reporters.

As an American Home Health nurse, you become an advocate for your clients. You help ensure that the clients receive not only professional nursing care but also live in safe home environments.

—By Karen Centowski