Prairie Doc Perspective Week of July 19th, 2026
“The Critical Need for More Nurses in the State of South Dakota”
By Dawn R. Warren, Ed.D., MSN, BSN, RN, University of South Dakota Department of Nursing
As a registered nurse (RN) in South Dakota for the past 35 years, I can honestly say that it has been one of the greatest blessings in my life and yet is a profession in dire need of more, especially in our rural areas. According to Klinski (2025), South Dakota is projected to have the third-worst nursing shortage in the United States by 2030, needing an additional 1,900 registered nurses (a 14% deficit). The state faces an estimated 1,000 nursing job openings annually as rural healthcare systems struggle with an aging workforce and geographic challenges. 
I have had the honor of working as an RN in South Dakota in a multitude of areas, all with similar, yet different, benefits. I have worked in home health nursing, critical care, progressive care, the emergency department at Monument Health, a small rural critical access hospital, and currently, as a nurse educator at the University of South Dakota. I have been involved in the birth of a newborn baby, the peaceful death of a terminal client dying at home, the tragic deaths of children in the emergency department, the joy of discharging a patient who received life-saving treatments, the sense of pride when my nursing students have graduated and everything in between. Don’t get me wrong- it’s not all good. There are days that are incredibly sad, days that are exhausting, patients that are challenging and days I have left in tears.  Fortunately, those days are far and few between compared to the days that are filled with joy and a great sense of accomplishment.    
With nursing being such a rewarding career with so many different areas to work in, and with the extreme nursing shortage, it is important to share how people can become a nurse. South Dakota is fortunate to have multiple nursing programs available.  People can become a licensed practical nurse (LPN) in approximately one year, with multiple vocational schools in South Dakota offering the degree. A second option is to become a registered nurse (RN) with an associate degree, taking approximately two years to complete, and offered at a number of vocational schools and universities. The third option is to become an RN with a Bachelor of Science in Nursing (BSN) degree. The BSN degree takes approximately four years to complete, often times opens the doors to more leadership positions, and is offered at many universities in South Dakota.  
Living in South Dakota has many benefits and challenges all at the same time. We are blessed to live in beautiful wide open spaces, but with that comes the challenges of sparse healthcare resources and a lack of nurses to staff them. It is not uncommon for a farmer in South Dakota to have to drive two hours one way to get basic healthcare, and further to get advanced care. Despite this challenge, for those who choose to practice as a nurse in rural underserved facilities, it can be extremely rewarding. While working at Dell Rapids hospital, I had the honor of caring for women in labor, pediatrics, medical surgical patients, trauma victims in our ER, patients with mental health needs and more, all while enjoying the culture of a small rural town where everyone truly cared about each other. 
It is my overall hope that more people in South Dakota will look into the many benefits of being a nurse, especially rural South Dakota, and that they will choose to get educated at one of the many excellent nursing programs our state offers.
Dawn has had the honor and privilege of being a registered nurse for 35 years. She earned her BSN in 1991, her Master of Science in Nursing Education in 2000, and her Doctor of Education in 2016. Dawn’s areas of expertise as an RN are critical care nursing, emergency nursing and in nurse education at the University of South Dakota. Dawn and her husband have two sons, both of whom are in college studying to become nurses.  Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
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Prairie Doc Perspective Week of July 12th, 2026
Sip to Stay Strong: Why Hydration Matters More Than We Think
By Carissa Regnerus, RDH, MA, FADHA
During the warm summer months in South Dakota, many of us spend extra time outside walking, working or enjoying community events. The heat and wind can pull moisture from the body faster than we realize. Hydration becomes important for everyone, from kids running around at the park to adults juggling busy schedules to older adults who may not notice thirst as quickly. Water supports our health in every season, but summer reminds us just how essential it is.
We often think of dehydration as something that only happens when a person is ill, running a marathon or working outside on a hot day. But in reality, our bodies lose two to three liters of water every day just by breathing, urinating and through our skin. If we don’t replace that water, the body begins borrowing it from tissues, including the mouth and brain.
And here’s the remarkable truth: every single cell in the human body requires water to function. We can survive for weeks without food, but only a few days without fluids. Water fuels energy production, carries nutrients, removes waste, regulates temperature and supports the electrical signals that keep our hearts and brains working. It is the foundation of life.
Hydration needs change across the lifespan
While everyone needs water, the reasons vary across the lifespan. Children lose water faster and may forget to drink while playing. Teens and adults often push through busy days relying on caffeine instead of water. Athletes and outdoor workers lose more fluid through sweat.  
Although dehydration can affect anyone, it can be especially impactful on older adults and is a well-recognized contributor to confusion. Older adults are more prone to fluid loss because they don’t sense thirst as easily, many take medications that cause the body to lose water, and they naturally have about 15-20% less total body water than younger adults.
Hydration and oral health: a connection for all ages
Saliva is 99% water, and dehydration can cut salivary flow by half. When the mouth dries out, problems follow:

• Higher risk of cavities and gum disease
• Denture discomfort
• Difficulty chewing and swallowing
• Changes in taste that reduce appetite

Hydration and the brain
The brain is about 73% water, and losing just 1-2% of that water can affect you even before you feel thirsty and negatively impact things like attention span, memory, mood and reaction time. For kids, this can mean trouble focusing in school. For adults, it may feel like brain fog. For older adults, it can increase fall risk.
Simple habits that help everyone

• Keep a bottle or glass nearby at home, school or work and sip it regularly even if you’re not thirsty
• Choose infusions that don’t lower pH, such as mint, basil or cucumbers. If you enjoy citrus, use it occasionally rather than sipping it all day to protect enamel. 
• Choose hydrating foods like fruits, yogurt, soups and smoothies
• Avoid excessive salt and alcohol intake which can both contribute to dehydration

As we move through the warm months, staying hydrated is one of the simplest ways to support comfort, clarity and wellbeing. Water helps us enjoy the activities we love- working, learning, playing and aging well. Small habits that support hydration can help people of all ages stay healthy and strong throughout the South Dakota summer and beyond.


Carissa Regnerus, RDH, MA, FADHA, has been a licensed dental hygienist for more than 25 years and a faculty member in the University of South Dakota’s Department of Dental Hygiene since 2001. She teaches courses in dental public health, nutrition and preventive care, with a focus on helping students understand the oralsystemic connections that shape overall health. Her work in medical mission settings reflects her dedication to improving oral and systemic health across diverse communities. She can be reached at [email protected].  Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of July 5th, 2026
“Finding Balance in a World That Never Stops”
By Curstie Konold MPH, CSW-PIP, QMHP


Finding Balance in a World That Never Stops
Stress surrounds us every day. We experience it in our personal lives, at work, in our relationships, and through the constant stream of information from the news and social media. We live in a world of endless notifications, growing expectations, and competing demands that pull us in multiple directions at once. We are often expected to be constantly available and do more than our time and energy allow. However, our body and brain were not designed to handle this level of continuous stress and demand. As a result, many people struggle to maintain balance, manage stress effectively, and protect their overall well-being.
In healthy amounts, stress can be beneficial. It can motivate us to try new things, work toward our goals, and overcome challenges. Our bodies and brains are designed to respond to stress by addressing a stressor and then returning to a state of balance and recovery. However, when stress becomes constant or overwhelming, the body may struggle to return to this balanced state. Instead, it can remain in a prolonged state of stress, which may have lasting effects on both physical and mental health, as well as overall quality of life.
In a world of constant news, social media, and other sources of stress, it is important to be intentional about disconnecting from these influences and reconnecting with the habits and practices that support overall well-being. One framework for achieving balance is the eight dimensions of wellness identified by the Substance Abuse and Mental Health Services Administration (SAMHSA): emotional, spiritual, intellectual, physical, environmental, financial, occupational, and social wellness. By supporting each of these dimensions, individuals can build resilience, manage stress more effectively, and improve their overall quality of life.
Wellness is about creating balance between different areas of life. Being mindful of the dimensions of wellness can help you better understand where you are thriving and where you may need additional support. Taking time to reflect on each dimension individually by asking yourself what is going well and what feels challenging can provide valuable insight into your overall well-being. The dimensions of wellness are interconnected, and challenges in one area can impact other areas. For example, occupational stress may influence emotional wellness, while financial concerns can impact social relationships and physical health.
Regularly checking in with the dimensions of wellness can help you better understand what your mind and body need in a given moment. If you identify an area where you are struggling, consider what actions or resources might be helpful. Writing down specific, achievable steps can be an effective way to address your needs and restore a greater sense of balance.
Stress is a natural part of life, and it is not something we can eliminate completely. However, we can take intentional steps to care for ourselves while navigating life's challenges. The eight dimensions of wellness provide a practical framework for understanding our needs and identifying areas that may require additional attention.
Wellness is not about achieving perfection in every area of life. Instead, it is an ongoing process of self-awareness and growth. By making small, consistent choices that support our well-being, we can build resilience, find greater balance, and feel better equipped to meet the demands of everyday life


Curstie is a certified social worker in private or independent practice and holds a Master of Public Health degree. Curstie owns Mindful Matters, LLC, where she provides mental health services and promotes trauma-informed care to her clients. Curstie is also the Associate Director at the Center for Rural Health Improvement at the University of South Dakota, where she supports projects that advance rural health initiatives, strengthen community partnerships, and improve access to quality care across rural communities. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
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Prairie Doc Perspective Week of June 28th, 2026
A Critical Time for Public Health Advocacy
By: Jennifer Noll Folliard, MPH, RDN and DenYelle Baete Kenyon, Ph.D.
There is a common saying in public health: "Everything is public health." That is because public health touches nearly every aspect of our daily lives. It is the clean water we drink, the air we breathe, the safety of the food we eat and the environments where we live, work, learn and play. These conditions do not happen by accident; they are shaped by policies, systems and collective investments. Much like public education, public health reflects a shared commitment to creating the conditions where all people have the opportunity to thrive.
Public health is your local school nurse caring for children, your extension agent helping families and farmers, your WIC dietitian supporting healthy pregnancies and babies and your food inspector ensuring meals are safe to eat. Public health is as dynamic as the communities it serves. As communities change, public health must adapt to meet new challenges, respond to emerging threats and address evolving needs.
Yet we are facing a troubling reality. For the first time in generations, today's children are not on track to live as long as their parents. One reason for this is that public investment in health has not kept pace with the growing challenges facing our communities. We have seen significant disinvestment in public health infrastructure, prevention programs and community-based services. These decisions have consequences. When we underinvest in public health, we increase the risk of chronic disease, infectious disease outbreaks, preventable deaths, higher health care costs and reduced quality of life.
In South Dakota, nonprofit organizations, faith communities, health systems and private businesses often step in to fill gaps and support community well-being. Their contributions are essential. However, preparing for large-scale challenges such as natural disasters, emerging infectious diseases and public health emergencies requires coordinated local, state and federal systems. The COVID-19 pandemic reminded us that diseases do not recognize city, county, state or national borders. Maintaining strong public health infrastructure requires ongoing investment so communities can respond quickly and effectively when threats emerge.
Public health works best when science and community experience inform one another. The most effective solutions are rarely simple, and they are seldom captured in a single headline or sound bite. They emerge when community members, health professionals, policymakers, businesses and local leaders work together to understand problems and develop practical, evidence-based solutions.
The South Dakota Public Health Association (SDPHA) serves as a trusted source of public health information, and our role goes beyond sharing data and research. We want to help elevate the stories, challenges and successes happening in communities across South Dakota.
Is your community struggling to access healthy food? Are you concerned about air quality, housing, transportation or other factors affecting health? Have local residents come together to solve a problem in an innovative way? Policy makers and community leaders want to hear those stories.
Public health is strongest when it reflects the experiences of the people it serves. Now is the time to share your stories of challenges and successes in your communities. SDPHA can help amplify community voices, share promising solutions and connect local experiences to state and local decision-makers.
Together, we can build healthier, stronger and more resilient communities. We invite you to share your challenges, successes and ideas so that we can learn from one another and create solutions that work for all South Dakotans.


Jennifer Folliard, MPH, RDN, is the founder and principal consultant at Health + Nutrition First and lead of the rapid response team for South Dakota Public Health Association. She is a registered dietitian with expertise in public health systems and policies. Jenn received her Bachelor of Science in human nutrition and food/nutrition in business from Purdue University and her Master of Public Health, focused on public health policy and systems of care, from the Johns Hopkins Bloomberg School of Public Health. In her previous position as the maternal child health director for the South Dakota Department of Health, Jenn worked with multi-sector partners to develop and advance priorities that would improve the health of South Dakota families. Before moving to South Dakota, she worked in Washington, D.C., for 10 years, conducting state and federal policy research and advocating for these policies to build effective public health systems.


DenYelle Baete Kenyon, Ph.D., holds several positions, including legislative chair of the South Dakota Public Health Association; University of South Dakota associate dean of Community Health & Engagement and Master of Public Health Program director; and professor of pediatrics at the Sanford School of Medicine. She received her B.S. in family social science from the University of Minnesota and went on to receive a Ph.D. in family studies and human development from the University of Arizona. DenYelle worked at Sanford Research for 11 years as a public health researcher, focusing on teen pregnancy/STI prevention, undergraduate research training and helping lead the Collaborative Research Center for American Indian Health. At USD for the past seven years, DenYelle leads community health and engagement efforts for the medical school and the Master of Public Health program, where she is fortunate to work with teams on increasing underrepresented students in health care careers and training future medical and public health practitioners on achieving health equity. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
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Prairie Doc Perspective Week of June 21st, 2026
“Dementia and Home Safety: Tips for Caregivers”
By Ranelle Nissen, Ph.D., OTR/L and Allison Naber, Ph.D., OTD, OTR/L
Caregivers of people with dementia are often tasked with keeping their loved ones safe at home. Unpaid family members or friends, referred to as care partners or caregivers, dedicate significant time and resources to assist the person with dementia as their needs intensify. Caregivers may find themselves providing increased assistance with everyday tasks like cooking and cleaning, and self-care tasks like dressing, bathing and toileting. This is often due to a decline in the person with dementia’s awareness of time and place, ability to solve problems or assess situations, strength and mobility, and senses (vision, hearing or depth perception). These declines also put people living with Alzheimer’s disease or other related dementias at increased risk of injury, especially as the disease progresses. 
Caregivers can take steps to create a safe home environment that minimizes the risk of injury or harm while maximizing the person’s independence for as long as possible. First, organize important information, including insurance information, names and contact information for healthcare providers, medications and allergies, emergency contact numbers, legal papers (living wills, advance directives and power of attorney), and contact information for friends and family members. Next, assess the home and outdoor spaces for potential barriers, such as uneven terrain or thresholds, poor lighting, chemicals or other potentially hazardous items. Once safety concerns are identified, caregivers can implement helpful strategies and adaptations to keep their loved ones safe, including: 

• Checking the temperature of food, beverages and bathwater
• Removing throw rugs, cords or other items that could cause someone to fall
• Installing adaptive equipment in the bathroom, like grab bars or shower chairs
• Adding extra lighting or nightlights in entryways, stairwells, bathrooms and hallways
• Using a hidden breaker or gas valve, or removing knobs to limit use of the stove when unattended
• Storing hazardous items or tools in a secure location
• Locking up medications and supplements

Some people living with dementia may exhibit wandering behaviors, such as forgetting how to get to familiar places in the home or community, talking about past obligations like going to work, restlessness or pacing, or being nervous in crowded or new locations. Structured routines, exercise or movement, deadbolts or locks on upper doors and cabinets and increased supervision or support can decrease the risk of wandering. 
While the journey with dementia brings many challenges, creating a safe home can help foster peace of mind for everyone involved. A sense of purpose and connection through participation in familiar routines, favorite activities and nurturing relationships with family and friends can promote safety, comfort and quality of life for people living with Alzheimer’s disease or other related dementias. 
If you or someone you love is impacted by Alzheimer’s disease or other related dementias, resources are available through organizations such as the Alzheimer’s Association and the Veterans Affairs, as well as state agencies such as the Department of Human Services. No one needs to face this journey alone. These organizations provide education, home safety checklists and recommendations, extra help in the home and support groups. Check with your state to see what resources may be available to you. 
Ranelle Nissen, Ph.D., OTR/L, serves as an associate dean and associate professor in the School of Health Sciences at the University of South Dakota. Nissen is a licensed occupational therapist in South Dakota. She has helped families and individuals affected by dementia through both her professional work and her volunteer work with the South Dakota Alzheimer’s Association.
Allison Naber, Ph.D., OTD, OTR/L, is the academic fieldwork coordinator and an associate professor in occupational therapy at the University of South Dakota. Naber is a licensed occupational therapist in Minnesota and South Dakota. She volunteers for the South Dakota Alzheimer’s Association as a support group facilitator and community educator. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of June 14th, 2026
“Don't Rub Your Eyes!”
By Dr. Vance Thompson


Keratoconus is one of the most important eye diseases for parents, teachers, coaches, and adults to understand because, if caught early, we now have the ability to help save vision and reduce the chance of future corneal transplantation. One of the most overlooked contributors to this disease is something many people do every single day without thinking about it: rubbing their eyes.
People often do not realize how much repetitive eye rubbing can damage the eye. When we rub our eyes, we are pushing on the eyeball and especially on the cornea, the clear front window of the eye that provides most of the eye’s focusing power. Over time, repeated pressure can weaken this delicate structure. For many people, rubbing begins innocently because their eyes itch from allergies, dryness, or irritation. Unfortunately, rubbing can become habitual. Patients often push harder and harder over time to achieve the same temporary feeling of relief, without realizing they may be harming their vision.
In some individuals, especially those genetically predisposed, repeated rubbing or pressure can contribute to the development or progression of keratoconus. Keratoconus occurs when the cornea becomes weakened and begins to thin and bulge outward into a cone-like shape. When this happens, light no longer focuses properly, leading to blurred vision, increasing astigmatism, glare, halos, ghosting, and progressive visual distortion. If left untreated, severe cases can eventually require corneal transplantation.
Eye rubbing is not the only source of pressure. We also see damage from what some doctors call “pillow diving,” where patients press their eye into a pillow while sleeping, particularly stomach sleepers or side sleepers. Sometimes we see one eye with very little astigmatism and the other eye with a large amount, and the patient will tell us that the worse eye is the one they constantly rub or sleep on against the pillow. Many patients later say, “I wish someone had warned me earlier.”
Children are especially important to watch because keratoconus often begins during the teenage years and can progress rapidly in younger patients. Parents may notice frequent eye rubbing, squinting, changing glasses prescriptions, headaches, or declining school performance related to vision. Kids with allergies are particularly at risk because itchy eyes drive the urge to rub. Treating allergies and dry eye disease early can help reduce this cycle.
That is why comprehensive eye examinations are so important. Modern corneal imaging called corneal topography allows eye doctors to map the shape of the cornea and detect early keratoconus, sometimes even before vision becomes severely affected. Detecting the disease early can be life changing.
One of the greatest advances in eye care has been corneal crosslinking. In this treatment, riboflavin (vitamin B2) eye drops and ultraviolet light are used to strengthen and stabilize the cornea. Crosslinking does not simply treat symptoms, it addresses the underlying weakness of the cornea itself. When performed early, especially in children and young adults, it can dramatically reduce progression and lessen the likelihood of needing a corneal transplant later in life.
It is very important to stop rubbing your eyes, treat the underlying causes of itching, and make sure children and adults at risk are screened for keratoconus. Early detection and modern treatments like crosslinking are helping preserve vision for an entire generation of patients.
A Gregory, South Dakota native, Vance Thompson, MD has been Refractive, Corneal, and Cataract surgery in Sioux Falls, South Dakota, the state he grew up in, since 1991. He is an internationally recognized specialist in refractive corneal laser, phakic IOL, and lens replacement surgery. He is the Founder of Vance Thompson Vision Sioux Falls, SD which has grown to serve the mid and mountain west with nine locations.  Dr. Thompson also serves as a Professor of Ophthalmology at the Sanford USD School of Medicine. As a leading international researcher, he has played a key role in the development of the most advanced technologies and techniques for both laser and implant vision correction. He has served as the medical monitor or principal investigator in over 130 FDA monitored research trials studying laser and implant surgery.  Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of June 7th, 2026
“Every Story Is an Act of Power: Why Direct Service Providers Must Practice Dignified Storytelling”
By Darla Biel, Ed.D.


Stories are at the heart of direct service and clinical work. Whether written in case notes, shared in supervision, included in grant reports, or told at community meetings, stories help others understand the impact of our work. They build emotional connection in ways data alone cannot. But storytelling is also an act of power, and when we’re not careful, that power can unintentionally cause harm.


For many families, their stories are told about them, not with them. Direct service providers often hold the microphone through professional language, reports, and presentations. Even with good intentions, stories can strip dignity, reinforce stereotypes, or expose families to stigma, especially in small or close-knit communities where anonymized details are often still identifying.


Dignified storytelling asks us to slow down and be intentional. At its core is a simple truth: it’s not our story. The direct service provider’s role is not to extract compelling narratives for program promotion, but to honor people’s humanity, safety, and agency while still communicating the value of direct service work.


One of the most common pitfalls is what some call “hardship” or “bootstrap” storytelling. This is the idea that success comes only from individual effort and that suffering must be emphasized to prove impact. These stories often rely on pity-inducing language, exaggerate trauma, or cast providers as heroes while families appear passive or broken. Not only does this framing erase strengths and resilience, it ignores the real systems that shape people’s lives, such as access to housing, healthcare, childcare, and economic opportunity.


A more ethical approach focuses on balanced, multidimensional stories. Dignified storytelling acknowledges challenges while also highlighting strengths, goals, decision-making, and progress. It shows people as parents, workers, community members, and partners and not just as clients or problems to be solved. It shifts the narrative from rescue to relationship.


Consent is another critical piece of ethical and dignified storytelling. Consent is not just a form signed once and filed away. True informed consent requires that people understand why their story is being shared, what will be created, where and how it will be shared, and for how long. It must happen in accessible language, in settings where it’s genuinely safe to say no, and with the clear understanding that consent can be withdrawn at any time. What felt acceptable at intake may not feel safe months or years later.


Sometimes, the most ethical storytelling choice is not to share a story at all. If there is any risk of harm, retraumatization, stigma, or identification,  especially in situations involving young children or families facing substance use, violence, or child welfare involvement. The answer may need to be no. Saying no to sharing a client’s story isn’t a failure; it’s ethical leadership.


Fortunately, there are always alternatives. Aggregated data, composite stories, systems-level insights, and reflective narratives can demonstrate impact without putting individuals at risk. And when individual stories are shared. Co-creation, with families reviewing and approving how they’re represented, offers one of the strongest safeguards.


A useful litmus test is this: If you wouldn’t want the family to read what you wrote about them in an article or report, don’t write it. People are always more important than program promotion.


Every story is an opportunity to honor or to harm. The choices that clinicians and other direct service providers make every day shape not only individual experiences, but organizational culture and public understanding. Practicing dignified storytelling helps ensure that the stories we tell today build trust, respect, and dignity for years to come.


Darla Biel, Ed.D. is Assistant Director of the Center for Prevention of Child Maltreatment (CPCM) within USD's School of Health Sciences. Her research interests include community-engaged scholarship, social determinants and health, and cross-sector collaboration efforts in primary prevention of childhood adversity. Biel leads the Early Childhood Comprehensive Systems (ECCS) grant funded by HRSA and is a member of the SD Childcare Task Force's executive committee. She lives in Brookings with her husband, Marc. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of May 31st, 2026
Understanding the Ups and Downs of Pain During Recovery
By Kory Zimney, PT, DPT, PhD
Many equate pain with injury and thus assume that pain should be a straight line when recovering. So, if pain flares up a bit, they worry that something is wrong. Maybe the injury is getting worse, or they “overdid it” the day before. In reality, pain often rises and falls during normal recovery, and these ups and downs do not automatically mean you’re injuring yourself. Pain is more complex than a simple measure of tissue damage.
Healing tissues and a sensitive alarm system
Pain is best thought of as your body’s alarm system. Early after an injury or surgery, that alarm is turned up on purpose to protect healing tissues. Even as the tissues recover normally, the alarm may remain slightly sensitive for a while. This means everyday movements, increased activity, or changes in routine can trigger pain, even when the tissues themselves are safe.
This sensitivity usually settles with time, movement and confidence. A short-term increase in pain does not automatically mean damage has occurred. It often reflects a nervous system that’s still learning what is safe again.
Next day pain
Pain that shows up later, such as soreness the next day, is often blamed on “overdoing it.” While extreme overload can contribute to flare-ups, changes in pain from one day to the next are often a normal response to increased movement. Your body adapts to activity gradually, and mild soreness or stiffness can be part of that process, especially when trying something new or returning to activities you’ve avoided.
Pain levels don’t always match how well your body is healing. You are recovering successfully, even on days when pain feels worse.
Stress, sleep and mood matter
Your nervous system doesn’t work in isolation. Poor sleep, emotional stress, worry or fatigue can increase pain sensitivity. We often say, “You’re getting on my nerves” when someone stresses us out. Biologically, that’s true. Stressful events release chemicals that make nerves more sensitive. On stressful days, the pain alarm becomes easier to trigger, which is why pain may spike during busy weeks, after poor sleep or during emotional strain without any change in the injury itself.
These influences are real and biological; they are not imagined or “in your head.”
Your body’s healing chemistry
Your body naturally produces both pro-inflammatory chemicals (which increase sensitivity) and anti-inflammatory chemicals (which reduce sensitivity) as part of the healing process. This balance shifts from day to day, like a teeter-totter. Some days you may feel more sensitive, and other days less so. These shifts are a normal part of recovery and help explain why pain often fluctuates.
Pain doesn’t equal harm
One of the most important principles of recovery is this: pain does not always mean damage. Pain is often a sign of sensitivity rather than danger. Gradually continuing to move, even with some discomfort, is often part of restoring normal function and confidence.
When to check in
While fluctuating pain is common, steadily worsening pain, new symptoms or pain accompanied by significant swelling, weakness or loss of function should be discussed with a health care provider. Otherwise, ups and downs are a normal and expected part of recovery.
Healing isn’t about eliminating every painful moment. It’s about helping your body and nervous system feel safe enough to move forward, one step at a time.
Kory Zimney, PT, DPT, PhD is a professor at the University of South Dakota, School of Health Sciences Physical Therapy Department and director of the PhD in Health Science program. Dr. Zimney is part of the Center for Brain and Behavioral Research at the University of South Dakota and the Therapeutic Neuroscience Research Group, conducting research specifically in the areas of pain science and therapeutic alliance. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

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Prairie Doc Perspective Week of May 24th, 2026
“Adverse Childhood Experiences: From Public Health Crisis to Clinical Opportunity”
By Chrissie Young, MS
Since the landmark 1998 study conducted by the CDC and Kaiser Permanente, it has been understood that Adverse Childhood Experiences (ACEs), traumatic events occurring before age 18, have a profound and lasting impact on adult health. These experiences, ranging from abuse and neglect to household dysfunction like substance misuse or mental illness, are remarkably common. Approximately 62% of adults have experienced at least one ACE, and one in six report four or more.
The evidence for a dose-response relationship between ACEs and negative health outcomes is striking. Individuals with high ACE scores (four or more) face significantly increased risks for nine of the ten leading causes of death in the United States. This includes a 2.1-fold increased risk of heart disease, 2.3-fold for cancer, and 3.1-fold for chronic lower respiratory disease. The impact on behavioral health is even more acute, with high ACE scores associated with a 4.7-fold increase in depression, a 10.2-fold increase in substance dependence, and a staggering 37.5-fold increase in suicide attempts.
The biological mechanism driving these outcomes is the toxic stress response. When significant adversity is experienced without the buffering protection of safe, stable relationships, it leads to prolonged activation of the body’s stress response systems. This disruption to neuro-endocrine-immune-metabolic (NEIM) function, alters gene expression via epigenetic markers, and accelerates cellular aging through the shortening of telomeres.
However, the most critical takeaway for clinicians is that ACEs are not destiny. The brain and body remain malleable throughout the life course, and targeted interventions can improve outcomes even for adults with high ACE scores. A modern clinical response requires moving beyond isolated medical treatments toward a multidisciplinary "Network of Care" that leverages the expertise of Community Health Workers (CHWs).
CHWs are essential mitigating factors because they are uniquely positioned to solve for social determinants of health (SDOH). Because ACEs often co-occur with challenges like housing instability, food insecurity, and economic hardship, CHWs help patients secure these basic needs. By addressing these external stressors, CHWs effectively lower the "cumulative dose" of adversity the patient experiences, which is necessary for the body to return to a state of homeostasis. Furthermore, as culturally congruent navigators, they build the trust needed to coach patients in self-care and "stress-busting" strategies.
Robust evidence suggests that seven key evidence-based strategies can mitigate NEIM disruptions and enhance neuroplasticity:

1. Supportive Relationships: Buffering stress through strong emotional connections.
2. Quality Sleep: Improving immune regulation through healthy sleep habits.
3. Balanced Nutrition: Counteracting pro-inflammatory states with anti-inflammatory diets.
4. Regular Physical Activity: Promoting neurogenesis and metabolic health.
5. Mindfulness Practices: Reducing stress hormones and improving emotional regulation.
6. Access to Nature: Lowering blood pressure and calming the stress response.
7. Mental and Behavioral Healthcare: Trauma-informed therapies to reverse cellular "wear and tear".

Implementing trauma-informed care (TIC) allows providers to move the clinical inquiry from "What is wrong with you?" to "What happened to you?". By recognizing toxic stress as a treatable health condition and utilizing CHWs to address underlying social needs, we can offer genuine healing. In doing so, we not only improve individual adult outcomes but also interrupt the intergenerational transmission of adversity, providing a healthier foundation for the next generation
References:
Bhushan, D., Kotz, K., McCall, J., Wirtz, S., Gilgoff, R., Dube, S. R., Powers, C., Olson-Morgan, J., Galeste, M., Patterson, K., Harris, L., Mills, A., Bethell, C., & Burke Harris, N. (2020). Roadmap for resilience: The California Surgeon General's report on adverse childhood experiences, toxic stress, and health. Office of the California Surgeon General. https://doi.org/10.48019/PEAM8812
Centers for Disease Control and Prevention. (2021). About the CDC-Kaiser ACE study. https://www.cdc.gov/violenceprevention/aces/about.html
Dube, S. R., Fairweather, D., Pearson, W. S., Felitti, V. J., Anda, R. F., & Croft, J. B. (2009). Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine, 71(2), 243–250. https://doi.org/10.1097/PSY.0b013e3181907888
Felitti, V. J. (2002). The relation between adverse childhood experiences and adult health: Turning gold into lead. The Permanente Journal, 6(1), 44–47. https://doi.org/10.7812/TPP/02.994
Merrick, M. T., Ford, D. C., Ports, K. A., Guinn, A. S., Chen, J., Klevens, J., Metzler, M., Jones, C. M., Simon, T. R., Daniel, V. M., Ottley, P., & Mercy, J. A. (2019). Vital signs: Estimated proportion of adult health problems attributable to adverse childhood experiences and implications for prevention — 25 states, 2015–2017. MMWR. Morbidity and Mortality Weekly Report, 68(44), 999–1005. https://doi.org/10.15585/mmwr.mm6844e1
Schultz, K. (2018, September 18). We have to talk about childhood trauma and chronic illness. Healthline. https://www.healthline.com/health/chronic-illness/childhood-trauma-connected-chronic-illness
Tan, H., Zhou, H., Chen, J., Ren, H., Guo, Y., & Jiang, X. (2024). Association of early life adversity with cardiovascular disease and its potential mechanisms: A narrative review. Frontiers in Public Health, 12, Article 1341266. https://doi.org/10.3389/fpubh.2024.1341266
UCLA Health. (2021, November 23). Is there a link between childhood trauma and adult neurologic conditions? https://www.uclahealth.org/news/article/is-there-a-link-between-childhood-trauma-and-adult-neurologic-conditions


Chrissie Young, MS, is the Director of the Center for the Prevention of Child Maltreatment at the University of South Dakota. She leads statewide efforts to strengthen child- and family-serving systems through training, technical assistance, prevention initiatives, and cross-sector collaboration. Her work focuses on building community and professional capacity to better recognize, respond to, and prevent child maltreatment and adverse childhood experiences. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on,YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
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Prairie Doc Perspective Week of May 10th, 2026
“Pump Handles and Public Health”
By Jill Kruse, DO
Health care is often thought of as something that happens one patient at a time in a clinic or hospital. Public health takes a broader view and is focused on improving the health of entire populations. In 1854, a London physician helped stop a deadly cholera outbreak by removing a simple pump handle. That moment would become one of the earliest and most powerful examples of public health in action.  Back then no one understood how cholera spread. Many believed it was caused by “bad air” or mysterious environmental forces. They did not know that it was actually caused by a bacterium that was spread through contaminated water sources.  
Dr. John Snow noticed a pattern. In London’s Soho neighborhood, a cluster of cholera cases seemed concentrated around a single public water source, the Broad Street pump. When he mapped where people lived, most of the infections pointed back to that pump. Even those who lived farther away, but became ill reported getting their water from the same source. Meanwhile, workers at a nearby brewery, who drank beer instead of water, were largely spared. The brewing process, alcohol and acidity of the beer made it difficult for the cholera bacteria or other pathogens to survive. 
Armed with this evidence, Dr. Snow convinced local officials to remove the pump handle. This cut off public access to the contaminated water.  After this happened, the number of new infections quickly declined.  That simple act marked the beginning of modern public health; using data, observation, and intervention to stop disease at its source.
Today, public health has evolved from reacting to outbreaks to preventing illness before it starts. Public health professionals work behind the scenes to protect and improve the health of communities.  They do this through providing education, guiding policy, and conducting research. They are the unsung heroes of healthcare. When Public Health works well, it can be almost invisible or easy to ignore. However, when there is a breakdown in Public Health services, the results can be devastating to a community and the effects are obvious.  
Federal, state and local health departments prepare for emergencies, monitor for disease outbreaks, ensure food safety, and safeguard water quality. They also advocate for health screenings in underserved or high-risk populations. Public health officials work to reduce barriers to care and promote healthier lifestyles for everyone. They may not be removing pump handles anymore, but they are still working every day to protect our water, our food, and our communities. They are helping us all, as we say on the show, to stay healthy out there people.
Dr. Jill Kruse is a hospitalist at the Brookings Health System in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of My 3rd, 2026
A Bump in the Crossroads of the Body 
By Andrew Ellsworth, MD


When was the last time you thought about your neck?


It’s easy to overlook, but your neck is a remarkably busy place. It houses the spinal cord, carrying signals between your brain and the rest of your body. It allows food to travel from your mouth to your stomach. It delivers blood to your brain. It contains muscles that support and move your head, along with your vocal cords, thyroid, and parathyroid glands.


In many ways, the neck is a crossroads of vital structures, and it can offer clues when something is not quite right elsewhere in the body.


Take a moment and gently feel your neck. Become familiar with what is normal for you. If you notice a lump or something that does not feel right, it’s worth paying attention.


Many neck lumps are not dangerous. Some are simply swollen lymph nodes reacting to an infection. A cold, flu, sinus infection, strep throat, dental issue, or even a skin infection can cause lymph nodes in the neck to enlarge. These typically improve over a couple of weeks as the body recovers.


However, as with any area of the body, if you feel a new lump or bump, consider an appointment with your provider to have it examined. 


As a general rule, if a neck lump persists beyond two to three weeks in an adult, it should be evaluated. In children, lymph nodes may remain enlarged a bit longer and still be harmless, but in adults, persistence deserves a closer look.


The feel of a lump can also provide clues. Lymph nodes from infection are often soft, movable, and a bit rubbery. In contrast, a hard, fixed, or rapidly growing lump is more concerning and should be checked promptly. Lumps that continue to enlarge or change over time also warrant evaluation.


Other symptoms also matter. Fever, unexplained weight loss, night sweats, or difficulty swallowing are important signals that should not be ignored. Swelling in multiple areas of the body may suggest a more widespread process, such as some infections or, less commonly, a cancer like lymphoma.


Another common finding is a thyroid nodule, located in the front of the neck. These are fairly common and usually benign, but they are often evaluated with ultrasound to better understand their size and appearance and to determine if follow-up is needed.


Some people experience a “globus sensation” which is the feeling of something stuck in the throat when nothing is actually there. This can be related to acid reflux, post-nasal drip, muscle tension, or even stress and anxiety. Once again, persistent symptoms should be checked out. 


The bottom line is simple: if you notice a lump or bump in your neck, do not ignore it. While many causes are minor and temporary, some require further attention. When in doubt, have it evaluated.
A quick check today can provide reassurance, or catch something early when it matters most.
Dr. Andrew Ellsworth is a Family Medicine Physician at Avera Medical Group Brookings in Brookings, SD. He serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of April 26th, 2026
“Anesthesia: Biting the Bullet is No Longer Necessary”
By Andrew Ellsworth, MD


Anesthesiology is the branch of medicine committed to pain relief and patient care before, during, and after surgery and other procedures. It has origins in ancient times but made large advances in the last two centuries.


It is one of medicine’s greatest achievements that someone can comfortably drift off to sleep, have their knee replaced, or their gallbladder removed, and wake up with minimal pain.  


Ancient civilizations used herbal remedies to help numb pain with forms of cannabis, opium, mandrake, or alcohol. Even by the time of the Revolutionary War, these remained the only options, which did little for the pain of an amputation. Survival depended on the speed of the surgeon. Patients would “bite the bullet” and literally clench down on a lead bullet or piece of leather to help endure the pain and protect their teeth. Surgeries were completed in minutes, and most amputees did not survive due to infection or blood loss.  


Major advances in anesthesia came in the mid-1800s with the emergence of ether and chloroform. American dentist William Morton was the first to publicly show ether’s use as an anesthetic, famously demonstrated at Massachusetts General Hospital in 1846.


During the Civil War, anesthesia became widely adopted in the military and used in the vast majority of surgeries. Typically, ether or chloroform was soaked in a cloth and placed over the patient’s face for inhalation. After the war, the physicians with a new understanding of anesthesia were dispersed across the country, and use of anesthesia went from a sporadic, questionable intervention to standard practice.


Epidurals are another major advance in anesthesia, decreasing the pain of childbirth, surgery, and some forms of back pain. Epidurals numb pain by delivering medication near the spinal nerves with an injection in the back. First developed in the early 1900’s, epidurals became widely used in the United States by the 1970’s. The addition of a catheter allowed continuous pain relief throughout labor, replacing a single injection. 


Modern anesthesia has continued to evolve. Propofol, first developed in the 1970s and approved in the United States in 1989, is now commonly used to start and maintain anesthesia. Often called the “milk of amnesia,” it works quickly and allows for a smooth, clear-headed recovery.
Anesthesia techniques continue to improve and become safer and more effective. With the expertise and close monitoring of an anesthesiologist or nurse anesthetist, patients can undergo complex procedures with excellent pain control and minimal risk. 


Dr. Andrew Ellsworth is a Family Medicine Physician at Avera Medical Group Brookings in Brookings, SD. He serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of April 19th, 2026
“Medications for treating substance use disorders”
By Kelly Evans Hullinger, MD
Substance use disorders like alcohol and opioid use disorders can be diverse, and every patient has a different story when it comes to their addiction. Social factors, genetics, history of trauma or mental health disorders, and many other contributors may be at play, which can make treatment of substance use disorders challenging.
Because of these challenges, successful treatment of substance use disorders often requires multiple approaches. Just like a patient with diabetes is best treated with diet, exercise, education, and medication, a patient with a substance use disorder is most effectively treated with a multi-disciplinary plan. For many patients, medication can be an important piece of the approach.
I have had several recent experiences with patients successfully abstaining from alcohol and opiates with the help of medication. The most common example that I see is alcohol use disorder, which can range from alcohol dependence to binge drinking behavior which causes disruption in a person’s social and family life and often leads to other medical problems.
One evidence-based option that I often use for patients with an alcohol use disorder is an oral medication called naltrexone. Recently, a patient who previously struggled with binge drinking described the effect of this medication to me, which was an enlightening explanation. “Doc, I’ve always been someone who, if I had one beer I was going to have 6 or 12 more. But on this med I can have one or two beers with my friends and I just don’t feel like having any more.” As a quite safe and accessible medication, naltrexone is an option I discuss frequently in my primary care clinic.
Another common and sometimes devastating problem is opioid use disorder. We have very good evidence that medications can significantly improve the probability of a patient being able to stay off opioids, and those options are gradually becoming easier to access as well. One of my patients who for many years struggled with opioid use disorder, even as it wreaked havoc on their life from a medical and legal perspective, has done extremely well with medication assisted therapy. They described the effect of medication as, “the first time I can remember that I have gone days without thinking about finding opioids.”
A current area of research is around GLP-1 agonists (commonly used in diabetes and obesity) as potential treatment for substance use disorders. While the verdict is still out on these, we may soon have some data on whether they hold up as effective treatment options for this group of patients as well.
While social support, therapy and counseling, and other facets of treatment will always be important, medications to help patients with some forms of substance use disorder are an essential piece of the puzzle. I have witnessed many of my own patients who have hugely benefited from those treatments. I am hopeful that medications will become easier for patients to access and have more options in the future.
Dr. Kelly Evans Hullinger practices internal medicine at Avera Medical Group in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and  streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of April 12th, 2026
“Death, Taxes, and Aging Eyes”
By Debra Johnston, MD


Benjamin Franklin famously wrote “in this world nothing can be said to be certain, except death and taxes.”


Franklin was a legendary intellect, and it’s hard to overstate the impact he had. But I’d suggest an addition to that particular quote, one with which I suspect he’d agree.


Most of us know him as one of the Founding Fathers, as the author of Poor Richard's Almanack, as the guy who flew kites during lightening storms. Perhaps less famously, Franklin was also an inventor. He is credited with the creation of the bifocal lens, reportedly inspired by his frustration with switching between pairs of glasses.


As a woman of a certain age, who has needed corrective lenses since childhood, I can well appreciate that frustration, and in turn, that invention! Our eyes are complex organs. In the very front, there is the clear dome of the cornea. Then we have the iris, the colored part of the eye. This is a muscle, and it controls the size of the pupil, the black central hole through which light is allowed entry. From there, light strikes the lens, which is pulled into different shapes by small muscles around its edge, and focused onto the retina in the very back of the eye. Specialized cells in the retina convert light to electricity, and the optic nerve transmits these messages to the brain. 


When I talk to my middle aged patients about symptoms they may be having, they frequently volunteer that they now need glasses for the first time, or that they have “upgraded” to those bifocals. They are usually surprised when I reassure them that this is not only normal, but frankly expected! The cells that create the lens loose the ability to repair or replace themselves over time. The lens becomes less flexible. It doesn’t change shape as easily, and as that happens the eye has a harder time focusing up close. Eventually, a person develops presbyopia: age related far-sightedness. 


This same process leads to a condition quite familiar to most people: cataracts. As those cells in the lens deteriorate, they become increasingly cloudy. Light has a harder time penetrating, and it may be scattered on the way through, instead of sharply focused. People may notice blurry vision, muted colors, glare around lights. They may need brighter light to read, and find it very difficult see at night. By 80, approximately 50% of people either have cataracts, or have had cataract surgery. 


Presbyopia and cataracts may be a normal, readily treated part of aging, but you shouldn’t neglect those eye exams. As we get older, other eye conditions become more common. Diseases like macular degeneration and glaucoma can be detected by the eye doctor well before they cause symptoms. Since those symptoms include irreversible vision loss, we should all be motivated to make that appointment!


Medicine is ever changing. Research avenues that seem promising turn into dead ends. Dead ends become detours to unexpected and exciting places. Maybe in the future, we will have drops or supplements or some other way to keep our eyes young. But for now, nothing can be said to be certain, except death, taxes. . .  and presbyopia.


Dr. Debra Johnston is a Family Medicine Physician at Avera Medical Group Brookings in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and  streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

​Prairie Doc Perspective Week of April 5th, 2026
There’s No Place Like Home – Home Safety Evaluations
By Jill Kruse, DO
In my role as a hospitalist, I am always happy when a patient is healthy enough to be discharged.  A resounding majority of people want to go back to their home after they leave the hospital.  What we do not want is an unsafe environment leading to repeat injuries resulting in a hospital readmission.  
At discharge we can have members of the Home Health team perform a “Home Safety Evaluation”. Physical Therapists, Occupational Therapists and sometimes Speech Therapists will evaluate a person’s home for safety concerns and ensure it is set up optimally for best function.  The team looks at areas where injuries typically occur.  This could include the instillation of grab bars in the bathroom or having a shower chair.  Paying attention to slipping or falling hazards – such as throw rugs or loose stair railings.  Good lighting, especially on stairs and in hallways, can help prevent tripping and falling.  
Before hospital discharge Physical Therapists will evaluate how well a person can walk including their balance.  If there are steps in the home, they will ensure the ability to navigate stairs is evaluated.  They perform tests which can help predict who is at a higher risk for falling.  The proverb may be, pride goeth before a fall, but a walker or cane could help prevent that.  Unfortunately, too often pride is the reason that the walker or cane is not used in the first place.  Using someone else’s old walker may be a bargain, but proper walker and cane height is important. A used device may be more dangerous if not adjusted properly and therapists can help confirm they are at the correct height. 
Occupational Therapists evaluate a person’s ability to perform “Activities of Daily Living”. These include being able to feed, dress or bathe themselves, and using the bathroom.  They have lots of assistive devices, tricks and tips to assist people if arthritis, injuries, or recent surgery prevents the person from moving like normal.  
Speech Therapists are asked at times to assess a person’s cognition and “safety awareness”.  They evaluate and determine if this person can the person recognize an emergency and get to safety or call for help.  With dementia, the part of the brain responsible for logic and good decision making is no longer working.  Dementia patients often make impulsive mistakes such as walking into traffic or forgetting to turn the stove off after cooking.  
There is no place like home, but it needs to be a safe home.  With a few tips and modifications, your home can be a safer place to live thereby keeping you there longer.  We want you to “Stay healthy in there.”
Dr. Jill Kruse is a hospitalist at the Brookings Health System in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).