All posts by Angelo Antoline

Communicating with a Family Member in Critical Care

Sometimes it’s hard enough to say what we mean. So what do we do if we have a family member in critical care? Rest assured, communicating is an important part of the healing process for your loved one as well as your family.

Here are 5 tips to help you out:

  1. Even if your loved one is on a ventilator, he or she will most likely be able to hear you. Speak in a calm, clear manner in a normal tone of voice. There’s no need to speak loudly. Read your family member a favorite poem, book, or prayer. If the staff says it’s OK, you could even play some music.
  2. Use short, positive statements. Reassure your loved one that you’re there, and that everyone is taking good care of him or her. Help orient your family member to the surroundings by sharing the date, day of week and time of day. Help describe the noises in the room.
  3. It’s OK to acknowledge that your family member may be experiencing discomfort. You can help by explaining what is going on, “That tube is helping you breath.” Remind your loved one that this is just temporary and helping him or her to get better.
  4. Don’t ask questions that can’t be answered. Make it simple. Suggesting hand gestures to communicate may be helpful. For example, a thumbs up or thumbs could indicate pain level. A small dry erase board may also be helpful in communicating as well. You could write words that your family member could point to, or possibly your loved one can write a few words as well.
  5. Human touch goes a long way. Ask the hospital staff first, but holding a hand or touching your family member gently is a great way to express your love and concern.

If you’re unsure about the best way to communicate, don’t hesitate to ask a member of the hospital staff for help. If one way doesn’t seem to be working, there likely will be another way that can be more effective.

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6 Things to Expect When Your Loved One is in Critical Care

It’s difficult to imagine a loved one being ill or injured enough to require critical care. But being prepared for what to expect can help you manage the situation.
Here are 6 important things to know:

  1. You have an experienced team on your side. The hospital staff that’s caring for your loved one is highly trained and prepared to treat the sickest – and most medically complex – patients. From the physicians and nurses to the respiratory therapists and dietitians – they all are specially trained to care for your loved one.
  2. The tubes and equipment in a critical care unit can be intimidating. But, they all have a role and purpose in providing your loved one with the intensive healthcare that he or she needs. The healthcare team will be able to explain the role of any equipment to help you better understand what it happening.
  3. Information overload can – and most likely will – occur. Everything will be new to you from the equipment and noises to the procedures and health professionals. Take a deep breath. Once you get your bearings, think of how you can best keep track of information. Write in a notebook. Keep notes on your phone. Jot down items like key information, questions you want to ask, purpose of treatments, and names of hospital personnel.
  4. Expect peaks and valleys. Critical care can be a bumpy ride. Some days will be better than others. As much as possible, try to be patient and keep perspective.
  5. Talk to your loved one. Communicating with your loved one is important for not only him or her, but for your entire family. Often patients can hear while in critical care. Speak calmly and clearly, and make short, positive statements. Hold your loved ones hand or touch them gently if a member of the healthcare team says it’s OK.
  6. Take care of yourself. It may be a long road to your loved one’s recovery, so be sure to take time to do things like sleep, eat, and shower. Don’t be afraid to leave the room for a bit. The healthcare team will be there 24/7 to provide care.
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Advanced Care Hospital of Montana First in State to Earn National Accreditation

Advanced Care Hospital of Montana First in State to Earn National Accreditation

Bringing nationally recognized care to the local community


Advanced Care Hospital of Montana is the first hospital in the state to earn The Joint Commission’s disease-specific certification in Respiratory Failure. The hospital earned The Joint Commission’s Gold Seal of Approval for Respiratory Failure after a rigorous on-site review Oct. 14.

“This certification is significant,” says Judi Powers, Chief Executive Officer of Advanced Care Hospital of Montana, “because it means that we’re providing the highest level of respiratory failure care available in the nation right here to patients in our own community. It reflects our commitment to providing safe and effective care to our patients.”

Respiratory failure occurs when there isn’t enough oxygen passing from the lungs into the body’s bloodstream.

“Oxygen-rich blood is needed to help the body’s organs – such as the heart and brain – function properly,” explains Dr. Hector Stella, Medical Director of Advanced Care Hospital of Montana. “Respiratory failure also can occur if a patient’s lungs can’t remove carbon dioxide from the blood. Carbon dioxide is a waste gas that also can harm a body’s organs.”

Different types of diseases can cause respiratory failure, including lung diseases such as chronic obstructive pulmonary disease (COPD), pneumonia, or cystic fibrosis. Respiratory failure also can be caused by conditions that affect the nerves and muscles that control breathing such as stroke, spinal cord injuries, and muscular dystrophy.

Certification through The Joint Commission’s Disease-Specific Care Program is voluntary and addresses three main areas:

  • Compliance with consensus-based national standards
  • Effective use of evidence-based clinical practice guidelines to manage and optimize care; and
  • An organized approach to performance measurement and improvement activities.

“Through our services, we want to provide hope and quality of life to our community members who are experiencing these debilitating events,” Powers says. “This certification provides us with the framework to continue a culture of excellence for patients in our community.”

The hospital provides hundreds of patients throughout Montana every year with long-term acute and critical care services. These patients, who are recovering from serious illnesses or injuries, often need care for medically complex conditions such as trauma, infectious diseases, wound healing, cardiovascular disease, stroke, amputations, and respiratory failure.

The hospital, which is located at 3528 Gabel Road in Billings, Mont., features all private patient rooms, and an 8-bed high-observation critical care unit. All patient rooms include cardiac monitoring equipment and mechanical ventilators. The hospital also features a 4,000-square-foot therapy gym with private treatment rooms.

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Alzheimer’s and Brain Awareness Month

June is Alzheimer’s and Brain Awareness Month; our hospital is very passionate about mental well-being. Keeping our patients healthy and happy is a top priority. Alzheimer’s effects 5.4 million Americans and that number is continuing to grow. We invite you to visit our website and read up on what exactly Alzheimer’s Disease is, the facts, symptoms and prevention.  

What is Alzheimer’s?

Alzheimer’s is an advanced mental corrosion that can occur in mid or old age. The disease is caused due to widespread degeneration of the brain, this the most common form of dementia. This disease effects everyday tasks, memory, thinking and behavior.

The Facts:

• The majority of people with Alzheimer’s are 65 and older. But up there is about 5 percent of people with the disease have early onset Alzheimer’s which can start effecting those as young as 40.
• Head trauma has been linked to Alzheimer’s.
• Alzheimer’s worsens over time.
• Alzheimer’s has no current cure, but treatments for symptoms are available and research continues.


• lose items easily
• forgetting simple words or someone’s name
• forget about current discussions or occasions
• get lost in a familiar place
• forget schedules or anniversaries.
• repeating themselves, forgetting they had already stated something.
visuospatial skills:difficulties adjudicating distance or seeing objects
• orientation: becoming jumbled or losing track of the date.


• Get your blood pressure and cholesterol levels at a healthy number. Both high blood pressure and high total cholesterol are associated with an increased risk of Alzheimer’s
• Stay active
• Keep a healthy weight
• Be social and have intellectual activity
• Seek preventative care
• To avoid head trauma ALWAYS wear your seat belt and when participating in sports wear the proper safety equipment.

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For more information on Alzheimer’s click on the link below.

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Advanced Care Hospital of Montana celebrates Hospital Week

This week at Advanced Care Hospital of Montana, we’re celebrating Hospital Week and the great staff and patients that we interact with every day.

Advanced Care Hospital provides long-term acute and critical care to patients recovering from serious illnesses or injuries in Montana, Wyoming, and western South Dakota. We accepted our first patient in 2008, and now treat more than 400 patients every year (or more than 2,500 patients since opening).

Our patients often require additional critical care services for medically complex conditions such as trauma, infectious diseases, wound healing, cardiovascular disease, stroke, amputations and respiratory failure.

With that being said, many people still don’t have a good understanding of a how a long-term acute care hospital compares to a short-term acute care hospital. So, here is a brief explanation:

A short-term acute care hospital is where a patient goes when he or she is first ill or injured. These types of facilities accept emergencies, deliver babies, perform surgeries, and have a wide variety of diagnostic capabilities like MRI or CT scans. Patients typically stay about 3-5 days in these types of facilities.

Patients with medically complex conditions may be referred to a long-term acute care hospital like Advanced Care Hospital of Montana – which also is a certified acute care hospital – for continued care beyond their original hospital stay at the short-term acute care hospital. These patients are in the treatment mode of their illness, but they are still too sick to go home or receive a lower level of care. These patients require a physician to see them on a daily basis and 24/7 nursing care.

At Advanced Care Hospital of Montana our medical team is led by a full-time medical director and includes specially trained physicians, nurses, therapists, specialists, pharmacists, dieticians and other medical professionals. Members of our staff have voluntarily earned – and continue to maintain – advanced certifications so they can deliver exceptional care to our patients.

For their commitment and dedication, today and every day, we celebrate our staff!

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Welcome: Dr. Tom James

Advanced Care Hospital of Montana welcomes Dr. Tom James as our Director of Palliative Medicine.

Dr. James has been an active member of our medical staff since 2008 and is a board-certified family physician. In 2012, he received a Certificate of Added Qualification in Hospice and Palliative Medicine through the American Board of Family Medicine. As a specialist in palliative medicine, Dr. James will be developing the Palliative Medicine service line at the hospital and will be available for consultations on patients with serious illnesses requiring additional help with symptom management.

Dr. James is a graduate of Montana State University and the University of Tennessee School of Medicine. He completed his residency training in Tallahassee, Fla. Dr. James has lived and worked in Billings, Mont., for the past 20 years. He is on the active medical staff of St. Vincent Hospital as well as Billings Clinic.

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Employment Open House! Wednesday, March 16, 2016

On Wednesday, March 16, 2016, Advanced Care Hospital of Montana is hosting an Employment Open House.
The event will be from 4pm to 7pm at the hospital, located at 3528 Gable Road.
Stop by and tour our facility and find out about our exciting job opportunities in a variety of healthcare positions!

View open positions here.

We currently have openings for:
• RN’s
• LPN’s
• PCT/CNA’s (entry level and experienced)
• Respiratory Therapists
• Radiology Technologist
• Pharmacy Technician
• Case Manager
• Clinical Liaison

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Hospitalists Join Advanced Care Hospital of Montana

Hospitalists Join Advanced Care Hospital of Montana

JC Hospitalists, PLLC, recently joined Advanced Care Hospital of Montana to provide additional internal medicine services at the hospital. Advanced Care Hospital of Montana is a 40-bed freestanding facility providing long-term acute care and critical care services for patients recovering from serious illnesses or injuries. It is the only long-term acute care hospital serving Montana and surrounding states. JC Hospitalists is a physician group that provides services to critical-access and long-term acute care hospitals in Idaho and Montana.

Healthcare professionals from JC Hospitalists who will have a routine schedule at Advanced Care Hospital of Montana include internal medicine physicians Drs. Ann Agnew, Dr. Julie Lyon, Dr. Carolyn Matzinger, and nurse practitioner, Heidi Gonzales.

“We’re excited to welcome JC Hospitalists to our healthcare team,” says Dr. Daniel Talley, Medical Director of Advanced Care Hospital of Montana. “By developing relationships and collaborating with physician groups like JC Hospitalists, we can provide the best care possible to our patients, helping them recover as fully as possible.”

Hospitalists are physicians who specialize in caring for patients in a hospital environment. Because hospitalists practice medicine only within the hospital, they can provide patients with physician-based medical care 24 hours a day, 7 days a week.

“Often it’s difficult for a patient’s primary care physician to see patients in the office and in the hospital at the same time,” Talley says. “A hospitalist acts as a patient’s primary care doctor while he or she is in the hospital, becoming the center-point for communication between the patient, family members, and the hospital’s healthcare team. The hospitalist can spend time with a patient and remain readily available for tests, results, and consultations. This can help eliminate wait time and possibly even help the patient return home sooner.”

When a patient is discharged home, the hospitalist and members of the patient’s healthcare team communicate with the patient’s primary care physician to ensure necessary follow-up care.


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Heart Health – What Women need to Know

With most of the research into heart disease focused on men, how heart disease affects women is not nearly so well known, even though more women die of cardiovascular disease than men. In 1998, a study by the National Center of Health Statistics revealed that 46% of women perceived their most serious health threat as breast cancer and only 4% indicated they believed heart disease was the most serious threat. In fact, at that time the real incidence of heart disease in women was 36% and breast cancer was 4%. Hopefully, women are better informed now.

We’ve known for a long time that there are none of us who escape an increased risk of heart disease as we get older. It’s also fairly common knowledge that smoking, a high-fat diet, obesity, high blood pressure, diabetes, a family history of heart disease and an inactive lifestyle raise anyone’s risk at any age. Since 1998, we’ve learned more about how the risks for heart disease change during a woman’s lifetime and how symptoms of a heart attack can differ from what most men experience. We now know that women who have not yet experienced menopause seem to enjoy some unique risk-lowering benefits as a result of estrogen and that these benefits are lost with menopause.

At about the age of 50, the age when natural menopause often begins, a woman’s risk for heart disease increases dramatically. (The same rise in risk applies to younger women who undergo early or surgical menopause and don’t take estrogen.) In addition to changes in estrogen, the effects of aging usually affect heart health. Blood pressure may rise with menopause. Cholesterol levels may change. Certain types of fat in the blood may increase. Unknown factors are also likely to be at work. More research focused on heart disease in women suggests that these factors may be better understood in the future.

Meanwhile, we need to adopt practices that lower the risk of heart disease while also learning more about how to identify heart attack symptoms. For example, both men and women may have a tightness, squeezing, pressure or pain in the chest, shortness of breath, sweating, or pain that spreads to shoulders, neck, arm or jaw. They may also have a feeling of heartburn without indigestion, nausea or vomiting, as well as sudden dizziness or a brief loss of consciousness.

According to the American Heart Association, women also report experiencing an uncomfortable pressure, squeezing, fullness or pain in the center of the chest that can last more than a few minutes, goes away and comes back. They can feel pain or discomfort in one or both arms, the back, neck, jaw or stomach, as well as shortness of breath with or without chest discomfort. Some women report a sense of impending doom.

Because heart attack symptoms in women may be misinterpreted, women are more likely to die from their first heart attack. Rather than reporting a crushing pain in the chest, as men often describe a heart attack, women may feel pain under the breastbone. They may report indigestion, difficulty breathing, abdominal pain, nausea or unexplained fatigue. If they are elderly or have diseases such as arthritis or diabetes, these symptoms may be incorrectly attributed to another cause or disease, delaying medical intervention.

If you experience symptoms of a heart attack, the first step is to accept that you may be having one. Denial can be deadly. Dial 911 for an ambulance. A patient being transported in an ambulance will begin receiving life-saving medical treatment while en route to the hospital. Only ambulances with medical personnel are equipped to revive a patient if her heart suddenly stops beating.

To lower your risk of a second heart attack, participate in both inpatient and outpatient heart rehabilitation programs. Inpatient rehabilitation should include comprehensive daily medical management by a board-certified rehabilitation specialist and rehabilitation nursing focused on development of self-management skills. Medical management should include respiratory care and wound care if surgery was performed. Every heart patient should receive individualized rehabilitation, including one-to-one therapeutic exercise and functional retraining by an interdisciplinary team. These therapies should include a program that addresses gait and mobility, training in how to safely accomplish activities of daily living, and nutritional instruction and counseling.

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