Sunrise Memory Care

Reminiscence Neighbourhoods are our safe, secure, engaging environment for residents with memory loss. Our care isnt based on a formula - it's personalised to meet each individual's needs. But here are some of the numbers that add up to the Sunrise Difference.

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CoHealth

CoHealth is a patient access platform delivered to patients in any healthcare setting. We capture patient attention through our personal health manager by partnering with health providers to create customized, digital care pathways for a variety of health related conditions.

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Digital Healthcare

Impact of Social Media on Healthcare Marketing

Article | November 29, 2023

Social media has become a powerful tool to connect people with friends, relatives, family, and other loved ones. Worldwide, around 4.2 billion people are actively using the internet. Among them, 3 billion are regularly active on social media channels. Social media is not just about interpersonal conversations; at least 80 percent of users follow one business on Instagram. With all the ads on your Facebook news feed, you connect with various brands or become aware about many brands. But does social media in healthcare make any impact? Almost all industries have started to realize the power of social media and how it can impact connecting with consumers. Various social media platforms help companies share information, increase brand awareness, and partner with industry influencers. Social media has overpowered traditional marketing strategies. Social media has become the wave of the future. Regarding the uptake of social media, the healthcare industry has been a bit slower. However, the industry now has accepted the undeniable importance of social media in healthcare. The reluctance might have been due to the risks associated for the providers as well as patients. Privacy and confidentiality of patient information has to be maintained always. Those were the challenges of social media in healthcare. However, consumers can get information from social media faster than any other tool. The Healthcare industry includes both the healthcare technology providers as well as the healthcare service providers. Whether you are a service provider or a technology provider, social media can impact your customers equally. This article discusses the positive effects and benefits of social media in healthcare, especially healthcare service providers. Embraced by the Medical Community The healthcare industry took notice of social media when government agencies and other business industries started to reap the benefits of social media. A recent survey revealed an interesting fact about the use of social media in healthcare. More than 1500 healthcare providers around the US have social media presence online. Hospitals miss key opportunities if they don’t use social media. These hospital systems have started effectively using social media to reach out to their past, current, and future patients. Social media in healthcare is an easy medium to share vital information with consumers and patients in the industry. The survey also revealed that more than 30% of medical professionals use various social media platforms to network with their peers. Many physicians also use these social media platforms for multiple activities in open forums. Having an active online presence evokes transparency among clients and peers. Healthcare providers can join various platforms such as Twitter to become healthcare influencers. Through social media in healthcare, providers can make connections, engage the community, and explore the industry. The Case of Cleveland Clinic, Ohio Cleveland Clinic in Ohio, US is the best example of how social media can be used to reach out to patients, engage them online, and stay ahead of competitors. They have more than 2 million followers on Facebook, 1.9 million followers on Twitter, and around 5 lack followers on LinkedIn. They have very different and unique social media strategies. They do post about whatever happens on the campus, including doctors practicing in their respective departments and interactive sessions with doctors and HODs, etc. Also, they do provide health tips and information, general health advice, and updates on the latest medical technologies and treatments. Apart from these, the hospital also reaches out to patients for queries and feedback through social media and responds to them promptly. These effective social media strategies help them in building up a brand, reputation management, create a patient relationship and build patient loyalty. Loved by Healthcare Consumers To find advice and new treatments, healthcare consumers widely use social media. This creates an opportunity for providers to connect with consumers through various forms of healthcare educational content. More than 40 percent of consumers believe that social media in healthcare affects their wellness decisions and health. Among 18 to 24 years old, 90 percent of people trust the medical information they get on social media. This shows the importance of healthcare providers on social media channels. Mobile healthcare is expanding as consumers depend more on the internet for information. Countless fitness and health apps are available online. However, many of them are not effective and do not cure diseases but can change behaviors. Having an app will help you increase your accountability, as a provider, among consumers. Positive Impact of Social Media on Healthcare The healthcare community is widely embracing the scope of social media in healthcare. Healthcare technology providers, hospitals, and other service providers are opening new accounts to create a consistent image among consumers. There are many ways to improve care by reaching out to patients through social media in healthcare. Some of the positive impacts of best practices for social media in healthcare are as follows: Increasing Access Across Generations Healthcare companies have almost stopped employing the traditional ways of advertising. Patients always need quick access to information to reduce the risk of getting flu or to find new providers, including baby boomers, every generation is online. According to Forbes, as of 2017, 9 percent of Facebook users were above 55 years of age. This present generation is very tech-savvy, they search online for local healthcare services and healthcare information. They use Facebook and YouTube. So, you need to create a marketing strategy that targets baby boomers. Generation X also searches health-related topics online, which accounts for 1.5 billion views on YouTube each day. As they care for children and aging parents, they may search for the best long-term care facilities, how to soothe a colicky baby, and so much more. As millennials are focused on healthy living and being cost-conscious, they depend more on social media platforms for healthcare information. Ninety-three percent of millennials say that they do not rely on healthcare providers for preventive health information. Thus, as everyone goes online for healthcare information, healthcare service providers should consider the role of social media in healthcare seriously. By providing reliable and accurate information, healthcare providers can engage with consumers and increase the patient experience through social media. Creating Authenticity The days that the patients trust doctors blindly have gone. Healthcare consumers have become smarter and want to have relationships with providers who care for them. Allowing your tech-savvy employees to share videos and pictures of events or office helps have a human touch. It also improves patient engagement and overall patient satisfaction. If patients know the people in your reception or nurses of respective departments, it helps them relax, engage, and makes them share their health history more openly. This is possible as they connect with those in the office through your social media in healthcare. It increases your authenticity. Keeping an Eye on Competitors Administrators and marketers keep an eye on their competitors through their social media platforms. They evaluate pain points, community involvements, service lines, and marketing strategies sitting in their offices. Hospitals and other providers can quickly get feedback on technologies and marketing strategies the competitors are using. This would help them if they want to incorporate these things in their care process before investing. You can take note of the social media platforms where your competitors are performing well. This approach to social media in healthcare would remove the possibility of failure with your social media strategy, especially when you begin with it. Real-time Updates During emergencies and other situations, social media in healthcare allows you to communicate quickly. Social media updates can provide life-saving information, from crisis alerts to census notifications. World Health Organization (WHO) is an excellent example; they provide real-time information to the masses regarding any health crisis, warnings, and other critical safety information during disasters, using social media, especially Twitter. Similarly, by providing real-time information to your consumers through your social media channels, you can increase your authenticity, authority, and dependency. Real-time access to information saves lives. Gathering Feedback Patients often want to communicate with their doctors quickly. They may need to share something about a recent appointment or about a reaction they had to medication. Making patients provide feedback on social media helps you learn how they feel about their medicine and care. You can get essential feedback that might help you improve your care. It also helps you recognize and reward the staff that the consumers recognize. As a provider, you can also get back to them for additional information after the feedback you get from them on social media. This possibility of social media in healthcare will work more to provide better care next time. Social Media for the Future Social media in healthcare is going to stay here and have advancements from time to time. Most of the modern consumers are tech-savvy and want to have everything at their fingertips. Modern patients have no patience. Therefore, social media works to engage patients and enhance the patient experience and satisfaction. Whether you are a large service provider, a solo practitioner, or run a hospital, you need a social media presence. For engaging with your community, social media in healthcare helps a lot. It can make an impact beyond your imagination. Use these strategies to improve the quality of the healthcare you provide. It may be a tiresome job to do it all alone. We, at Media7, provide social media services to engage your consumers. Whether you are a service provider or a technology provider, we are here to help you with our compelling social media strategies. We help healthcare companies generate leads, brand themselves, increase sales, and make them your happy customers. For more details about us, visit https://media7.com/. Frequently Asked Questions What are the advantages and disadvantages of using social media in health care? When used cautiously, social media can provide clear benefits, such as clinical education, professional networking, and patient’s health promotion. However, there can be disadvantages too, including privacy and confidentiality of patients, resulting in formidable consequences. How has social media influenced the marketing of health care? For establishing public awareness and managing reputation, social media is practical means. As part of an effective marketing plan, social media has become an essential medium for healthcare professionals to interact with consumers and engage them. What is the Importance of Social Media in the hospital? By providing important and general information on healthcare, hospitals can make their presence more valuable to consumers. Encouraging patients to share their feedback and thoughts makes hospitals connect with them and improve the care process. { "@context": "https://schema.org", "@type": "FAQPage", "mainEntity": [{ "@type": "Question", "name": "What are the advantages and disadvantages of using social media in health care?", "acceptedAnswer": { "@type": "Answer", "text": "When used cautiously, social media can provide clear benefits, such as clinical education, professional networking, and patient’s health promotion. However, there can be disadvantages too, including privacy and confidentiality of patients, resulting in formidable consequences." } },{ "@type": "Question", "name": "How has social media influenced the marketing of health care?", "acceptedAnswer": { "@type": "Answer", "text": "For establishing public awareness and managing reputation, social media is practical means. As part of an effective marketing plan, social media has become an essential medium for healthcare professionals to interact with consumers and engage them." } },{ "@type": "Question", "name": "What is the Importance of Social Media in the hospital?", "acceptedAnswer": { "@type": "Answer", "text": "By providing important and general information on healthcare, hospitals can make their presence more valuable to consumers. Encouraging patients to share their feedback and thoughts makes hospitals connect with them and improve the care process." } }] }

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Health Technology, Digital Healthcare

Six Ways Technology Can Help Dialysis Centers Strengthen Their Revenue Cycle

Article | September 7, 2023

Dialysis providers face many of the same financial and operational pressures that affect other provider organizations, including flat or reduced reimbursements, chronic staffing shortages, and increasingly complex insurance requirements. Dialysis centers, nephrologists, and renal pharmacies also grapple with the impact of a growing shift in dialysis care to the home setting. End-to-End Automation Can Reduce Denials, Improve Cash Flow The good news is that despite these challenges, dialysis providers can sustain strong cash flow, reduce costs, and mitigate denials by applying advanced technology to the revenue cycle. Here are six ways technology can help strengthen the dialysis center revenue cycle in the today’s difficult operating environment: Identify undisclosed insurance coverage Because patients often present as self-pay even though coverage exists, determining their true insurance status can be challenging. Yet failure to identify existing insurance can result in significant write-offs. That’s why renal providers need technology solutions that can uncover patient coverage information before care is provided. Change Healthcare’s Coverage InsightTMsolution provides an expansive network and search-and-matching capabilities necessary to identify and confirm patient coverages at the outset of care. The solution uses machine learning algorithms—coupled with access to vast stores of available third-party-data—to develop robust patient profiles, which can then be linked to potential funding sources. Notably, it identifies a variety of indicators, including high probability of disability, income levels and financial status, insurance sources, and other actionable information to help you verify coverage and recover revenue. We can help identify undisclosed coverage for end-stage renal disease (ESRD) patients through Medicare/Medicaid, Disability/SSI, third-party liability, commercial insurance, state and county programs, social programs, and charity. Expedite seamless prior authorizations Streamlining the prior authorization process is essential to help ensure optimal reimbursement for renal care rendered, particularly with commercial insurance and Medicare. But traditional prior authorization processes are frequently time-consuming and labor-intensive and can delay necessary care. Our Clearance Authorization software addresses the chronic problem of prior authorizations with automated functionality that can determine if prior authorization is required and on file with the payer. The solution also will automatically check medical necessity requirements at the time of registration and electronically submit requests to integrated payers. Change Healthcare’s Connected Authorization Services go a step further by deploying pre-authorization experts to handle routine authorizations quickly using intelligent technology while working complex cases by exception to improve authorization efficiency and accuracy. Speed adjudication with electronic attachments As claims management processes have grown more numerous and complex, providers have struggled to ensure that the correct information is provided to the payer at the appropriate time. The result can be delayed, denied, or rejected claims. Assurance Attach AssistTMcontributes to faster reimbursement and reductions in denials, organizational expense, and administrative burden by automating the attachments process to meet payers’ increased demands for additional documentation. Attachments are automatically delivered and matched to the appropriate claim, and once the claim is released, claim and attachment status can be easily tracked. Expedite claims workflow for recurring services Creating claims for ongoing ESRD care requires repeatedly documenting the same details on each claim. Revenue Performance Advisor, an end-to-end medical billing platform, provides automation that allows dialysis staff to save time by quickly replicating unchanged data from prior visits while updating date-of-service and other information to expedite claims processing. Revenue Performance Advisor also includes eligibility and benefits verification and automated claims scrubbing that flags incomplete or incorrect claims prior to submission, resulting in a first-pass clean claim rate of 98%. Accelerate your Medicare claim cash flow Medicare is one of the largest payers of dialysis services, so ensuring a problem-free and expedited Medicare claims submission process is essential to strong cash flow. Our Assurance Medicare Direct EntryTMsolution provides a single system for the real-time submission and processing of Medicare claims. It can help expedite reimbursement, reduce AR days, and speed your Medicare primary claim cash flow by at least one full business day. Assurance Medicare Direct Entry also checks your Medicare claims for eligibility errors using the CMS eligibility transaction system (HETS). Claims needing attention are flagged and posted in Assurance Reimbursement Management for editing. You can quickly correct errors within the system before transmitting the claim directly to Medicare for validation and payment processing. Optimize patient liability Making it easy for patients to receive, understand, and pay their portion of the medical bill is key to ensuring a healthy revenue cycle, mitigating the need for collection services, and improving patient goodwill. With our Patient Billing and Statements solution, Change Healthcare serves as your strategic communications partner, delivering multi-channel, personalized print and digital statements to help expedite patient payment collection. The solution is designed to provide fast, effective statement and invoice processing, printing, and mailing—cutting your costs and getting you paid sooner. Our advanced statement printing allows you to bypass conventional and time-consuming folding, stuffing, and stamping. SmartPayTMconsolidates each step of the billing and payment process into one place, enabling you to collect more patient payments, get paid faster, reduce your collection costs, and lower patient write-offs. With multiple payment channels, including online, mobile, telephone and via mail, SmartPay helps expedite patient payments before, during, and after the encounter. A single, trusted partner Change Healthcare’s deep knowledge of the renal care landscape and our development of disruptive technologies to overcome traditional revenue cycle barriers can help dialysis centers achieve unprecedented revenue cycle excellence. And unlike many point solutions that only address a specific revenue cycle issue, Change Healthcare’s technologies are part of a comprehensive approach delivered through a single, trusted vendor. That translates into improved process integration and continuity, as well as simpler overall accountability.

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Health Technology, Digital Healthcare

9 Ways UVC Light Tech Can Safeguard Staff & Patron Health

Article | September 8, 2023

As COVID-19 rages on, warning sirens have sounded of late amid a flurry of headlines surrounding Ultraviolet-C (UVC) light device safety issues. Rightfully so, as the current pandemic has ushered in a veritable “wild west” of UVC gadget deployments with subpar consumer safeguards, instructions or guidance. So important are the concerns amid this rapidly proliferating product sphere, the FDA recently issued a consumer advisory regarding UVC light technology that’s applicable for industrial, business, travel and residential use. Once largely a germicidal method leveraged in hospital, industrial and other commercial settings for its extreme efficacy, today’s breed of UVC technologies are small, portable and inexpensive enough to be making their way into businesses of every type across the globe—and even traverse with individuals while they’re out and about. This, as generalist retailers like Amazon and Walmart have joined the fray in their attempts to divert market share from the more specialized, expert-driven, safety-focused UVC purveyors. While germ-killing UVC technologies do proffer tremendous advantages and results for users—serving as a potent tool for easily and effectively eradicating harmful viruses, bacteria, pathogens and microorganisms—there are a number of considerations a business (or employee) should heed before procuring and using such a powerful device. This includes, but is certainly not limited to, why; when; where; and how it will be used—variables that impact safety and risk concerns related to UVC wavelength, dose and duration of radiation exposure. Shopping in this category can be equally overwhelming. One need only Google “UVC lamps,” which delivers nearly 100,000 results, to realize how bloated this category has become. Amid the chaos, I did happen upon a highly targeted, category-dedicated source wholly dedicated to UVC technologies: CureUV.com. This company draws on over 20-years of expertise in the design, development and provision of technologically advanced UV products and solutions. Today, they are a premier provider of germicidal UVC light solutions for commercial, industrial, portable, residential and even water applications. While its form factor catalog is copious, below are a few of CureUV’s more popular UVC devices starting under $90 that proffer chemical-free disinfection, which can help ensure your spaces remain free of illness-causing microbial contaminants like viruses, bacteria, mold and other fungi: Rechargeable Handheld UV Sanitizer Wand With Digital Timer Here's a highly portable way to eliminate germs and have a cleaner environment no matter where you may be. This powerful UVC illumination system, which retails around $89, eradicates up to 99.9 percent of viruses, bacteria, germs, mold, dust mite eggs and flea eggs on surfaces. This non-chemical option adds an extra layer of safety to you with no hazardous residue. It contains a 6-inch UVC lightbulb allowing for a wider coverage of area as well as accelerating sanitation in the process. A built in timer inside the device allows you to keep track of desired dosage creating precise sanitation sessions-- anywhere from 5 to 60 minutes to indefinite. Its silent operation allows for a noise free solution for sanitation, and sleek and cordless and lightweight design is perfect for travel however near or far--daily around town or those hotel visits. Sanitize how you want in your desired target area or on your personal items keeping them germ free. An internal rechargeable battery saves money on replaceable battery purchases as compared to various other handheld wands on the market. GermAwayUV 18-Watt Handheld UVC Surface Sanitizer This device offers reliable and highly portable sanitizing performance at an entry-level price. Indeed, at under $120, this is an affordable, dual-bulb, handheld UV sanitizer that still maintains power levels similar to more industrial UV surface sanitizers. This lightweight and ergonomically designed 18-watt UVC sanitizer will give you much peace of mind. It has a 6-foot cord adequate for most applications, but the sanitizer will run easily with virtually any simple power extension. Its two 9-watt UVC sanitizer bulbs are guaranteed to produce UV light in the 253.7 nanometer (nm) wavelength, which has been consistently proven to eliminate all illness-causing microorganisms. It's the perfect tool to disinfect high use and traffic areas, as well as locations where bacteria and viruses congregate like bathrooms, door handles, seating areas and cooking/dining spaces. It'll prevent the spread of harmful bacteria and microorganisms, or simply add an extra layer of cleanliness and protection to your cleaning procedures. It comes bundled with protective amber UV safety glasses. Deluxe GermAwayUV 95-Watt UVC Surface Sanitizer with Cage With a 95-watt bulb, this chemical-free, tabletop UV room and surface sanitizer is the strongest of its kind. It will result in effective room sanitation by killing up to 99.9 percent of bacteria, viruses, mold spores, yeasts, C. diff, odors and other harmful microorganisms. With a simple touch of a button you'll be able to leave the room while the entire space is cleaned and disinfected in a matter of minutes. The device has five time settings: 10, 20, 30 and 60 minutes; and hold for indefinite run time. After the selected dosage time has elapsed, the device will automatically shut off. You can use it regularly to ensure a consistently clean room. Heavy Duty Dual Bulb 72-Watt HVAC UV Air Purifier Suitable for use anywhere, including schools, offices, work-floors and medical rooms to sanitize air and environmental surfaces, this device is effective in small and large rooms/buildings alike, up to 2,400 square feet. With a powerful 72-watt bulb and a standard electrical unit, you can insert this premium UVC bulb into any HVAC system as an easy add on to sanitize the air in the system. Typical air purifier units and HVAC systems are definitely useful, designed to filter and ventilate air well. But even the finest filters can’t stop atomic sized bacteria and viruses. This device is therefore a great extra add on because it really does target and stop bacteria and viruses from circulating. It sanitizes and disinfects air passing through the HVAC system. Its 72-watt bulb emits UVC light of 254nm and is the most powerful bulb. Most devices are typically only effective in small rooms, but with this level of wattage you can use this device in large rooms and building types. At its wavelength, the emitted light is able to penetrate and kill the DNA of atomic sized organisms that create problems for humans. UVC emission also acts to eliminate mold spores, yeast and fungi. So, inserting this unit device into your existing HVAC system ensures that not only will the air that moves through your building be ventilated, it will also be irradiated and disinfected as it passes over the bulb. Instead of just filtered air in your system, you’ll end up with sanitized, healthy air. Add on (retrofit) features like this one are great because you can just insert them into an already installed and operating HVAC system with minimal additional running costs. This device is easy to install and is capable of DIY application. Other available HVAC retrofit air sanitation and purification solutions include a coil scrubber or 36-watt HVAC UVC air purifier. GermAwayUV High Occupancy Wall Mountable 150-Watt Air Purifier and Sanitizer This is a safe and efficient way to sanitize and disinfect the air in high traffic occupied areas. Simply mount the sanitizer on the wall as you would hang a TV or mount a standalone AC system and let the system do its magic. The air purifier will use its powerful, yet quiet, fan to continually cycle all of the air in the room through the system. Once the air does so, it will be met by a quintuple filtration and sanitation system that culminates in a full 150-watt UVC germicidal irradiation. Put this system in a busy hallway, a crowded restaurant, a veterinary clinic with high traffic, a busy office, etc… and it will eliminate bacteria, viruses and harmful pollutants as quickly as possible without exposing anybody to any UVC rays. It proffers optimum perf

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Digital Healthcare

The digital hospital of the future

Article | June 4, 2022

​As the cost of care continues to rise, many hospitals are looking for long-term solutions to minimize inpatient services. Learn how technology and health care delivery will merge to influence the future of hospital design and the patient experience across the globe in this report developed by Deloitte US. Five use cases for the digital hospital of the future The future of health care delivery may look quite different than the hospital of today. Rapidly evolving technologies, along with demographic and economic changes, are expected to alter hospitals worldwide. A growing number of inpatient health care services are already being pushed to home and outpatient ambulatory facilities. However, many complex andv very ill patients will continue to need acute inpatient services. With aging infrastructure in some countries and increased demand for more beds in others, hospital executives and governments should consider rethinking how to optimize inpatient and outpatient settings and integrate digital technologies into traditional hospital services to truly create a health system without walls. To learn what this future of health care delivery may look like, the Deloitte Center for Health Solutions conducted a crowdsourcing simulation with 33 experts from across the globe. Participants included health care CXOs, physician and nurse leaders, public policy leaders, technologists, and futurists. Their charge was to come up with specific use cases for the design of digital hospitals globally in 10 years (a period that can offer hospital leaders and boards time to prepare). The crowdsourcing simulation developed use cases in five categories Redefined care delivery Emerging features including centralized digital centers to enable decision making (think: air traffic control for hospitals), continuous clinical monitoring, targeted treatments (such as 3D printing for surgeries), and the use of smaller, portable devices will help characterize acute-care hospitals. Digital patient experience Digital and artificial intelligence (AI) technologies can help enable on-demand interaction and seamless processes to improve patient experience. Enhanced talent development Robotic process automation (RPA) and AI can allow caregivers to spend more time providing care and less time documenting it. Operational efficiencies through technology Digital supply chains, automation, robotics, and next-generation interoperability can drive operations management and back-office efficiencies. Healing and well-being designs The well-being of patients and staff members—with an emphasis on the importance of environment and experience in healing—will likely be important in future hospital designs. Many of these use-case concepts are already in play. And hospital executives should be planning how to integrate technology into newly-built facilities and retrofit it into older ones. Technology will likely underlie most aspects of future hospital care. But care delivery—especially for complex patients and procedures—may still require hands-on human expertise. Laying the foundation for the digital hospital of the future ​Building a digital hospital of the future can require investments in people, technology, processes, and premises. Most of these investments will likely be upfront. In the short term, hospital leadership may not see immediate returns on these investments. In the longer term, however—as digital technologies improve care delivery, create operational efficiencies, and enhance patient and staff experience—the return result can be in higher quality care, improved operational efficiencies, and increased patient satisfaction. These six core elements of an enterprise digital strategy can help you get started as you begin to push your hospital into the future Create a culture for digital transformation It is essential that senior management understands the importance of a digital future and drives support for its implementation at all organizational levels. Consider technology that communicates Digital implementation is complex. Connecting disparate applications, devices, and technologies—all highly interdependent—and making certain they talk to each other can be critical to a successful digital implementation. Play the long game Since digital technologies are ever evolving, flexibility and scalability during implementation can be critical. The planning team should confirm that project scope includes adding, modifying, or replacing technology at lower costs. Focus on data While the requirements of data interoperability, scalability, productivity, and flexibility are important, they should be built upon a solid foundation of capturing, storing, securing, and analyzing data. Prepare for Talent 2.0 As hospitals invest in exponential technologies, they should provide employees ample opportunities to develop corresponding digital strategies. Maintain cybersecurity With the proliferation of digital technologies, cyber breaches can be a major threat to hospitals of the future. Executives should understand that cybersecurity is the other half of digital implementation and allocate resources appropriately.

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Spotlight

CoHealth

CoHealth is a patient access platform delivered to patients in any healthcare setting. We capture patient attention through our personal health manager by partnering with health providers to create customized, digital care pathways for a variety of health related conditions.

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e-cigarettes and managing memory loss

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