Tips for staying well on vacation

So you’re going on vacation. Lucky you!

It may be easy to get wrapped up in visions of beaches and buffets, but before you hit the road, there are some important things to take into consideration. When you travel, the health care resources you’re used to at home may not be readily available. There are also different risks and infections that you can be exposed to away from home. Follow these recommendations for a safe and healthy vacation.

Before you go

1. Check travel health notices

Check to see if there are any travel advisories for the place you’re visiting. The Centers for Disease Control and Prevention (CDC) outlines three types of notices: Watch Level 1 (practice usual precaution), Alert Level 2 (practice enhanced precautions) and Warning Level 3 (avoid nonessential travel). Search by country to see if there is anything to be concerned about:

2. Make sure vaccinations are up-to-date

On the same CDC website, you can check the required and recommended vaccinations by country:

Ensure your routine vaccinations are up to date and consult a health care professional to see if any additional vaccinations are required or recommended based on where you are travelling to and the types of activities you have planned (for example, if you may come in contact with malaria or rabies).

Routine vaccinations include measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine, and your yearly flu shot. Sometimes, your doctor may recommend a Hepatitis A, Hepatitis B, or Rabies shot (only if you’re at risk for bug or animal bites, travelling in remote areas or working with wildlife).

View out the airplane window

3. Purchase travel insurance

The thought of something going wrong on vacation is the last thing you want to consider during travel planning. But it’s better to be safe than sorry. If you’re travelling outside of Canada, purchase comprehensive health insurance that covers medical procedures in other countries and/or the cost of getting you home if needed for peace of mind. Make sure you keep this documentation on your person while travelling.

4. Book an appointment with a travel health clinic

If you’re travelling outside Canada and the U.S., you may want to learn about the specific risks of the place you’re visiting and get any necessary prescriptions for vaccines or medications.

5. Research the health care system of your destination

It’s important to know what your options are if you get sick or injured. Know hospital locations and phone numbers before you go. Carry them on you when you leave your primary residence, especially if there is a language barrier.

6. Be aware of:

• Traveller’s Diarrhea, caused by bacteria in food or water. Medication can relieve diarrhea and symptoms like nausea, vomiting, cramps and fever.
• Hepatitis A, contracted through contaminated food and water (food, drinks and swallowing swimming or bathing water).
• Hepatitis B, contracted through sexual contact, contaminated needles and other equipment (spa treatment, tattoo needles, etc.) blood and other bodily fluids (transferred from first aid to an infected person, sex, etc.).
Heat stroke
Zika virus

What is Zika virus?

You may have heard of Zika virus, a disease spread through mosquito bites.

Besides mosquitos, the virus can spread from an infected pregnant person to their baby (and potentially cause a birth defect called microcephaly). It can also spread through sexual activity.

The virus can live in semen for up to seven months after infection (even if no symptoms are present) and can spread to sexual partners during that time. If someone is infected with Zika, it’s important to abstain from sex or use a condom every time. The virus doesn’t last as long in women’s bodily fluids. Women should wait at least 8 weeks after travel before trying to get pregnant.

The most common Zika virus symptoms are fever, rash, headache, joint and muscle pain, and red eyes. Many people show no symptoms. There is no medication to treat Zika virus. The best means of prevention is to avoid mosquito bites by using insect repellant, wearing clothing that covers your body when mosquitos are out, and removing any standing water around your home.

VIDEO: What to pack in your vacation first aid kit

Packing is one of the few downsides of going on vacation (if you can call it that!). Fitting everything you need into a compact bag can be stressful, especially if you don’t know what to expect on your trip. Jason Thomas, pharmacist at the Juravinski Hospital and Cancer Centre Retail Pharmacy is here to help. He’s taken the guesswork out of packing your vacation first aid kit with a handy list of must-have supplies.

While you’re thereDaiquiri on the water

1. Watch what you eat and drink. Water in many countries contains bacteria or parasites. Drinking tap water, using ice cubes, or eating fresh fruit or vegetables that have been washed in that water can increase your risk of infection. Pay close attention to how your food is cooked and served. Avoid food that has been left sitting out, or isn’t cooked all the way through. Remember: boil it, cook it, peel it, or forget it!

2. If you’re visiting a country with a disease that is spread by insects, wear long clothes and bug repellant that contains at least 20 per cent DEET or icaridin.

3. Protect your skin from the sun. Wear a cover-up if possible, and use sunscreen with an SPF of at least 15 (30 or higher is recommended for children). Melanoma is one of the most preventable forms of cancer. Learn how to be sun-safe with cancer specialist, Dr. Elaine McWhirter.

4. Avoid high-risk activities. Take precautions like wearing a life jacket or helmet if you ride on a boat or ATV. Remember – scuba diving and mountain climbing activities can be dangerous if you are not experienced.

5. Take your first aid kit (or a mini version) on excursions or when you’re out in nature. There’s no point packing it if it’s not there when you need it.

6. Remember- sexually transmitted infections are generally much more common in countries outside North America and Western Europe.

7. Keep hydrated, especially in hot places or during physical activity. Bring a reusable water bottle with you to fill up constantly.

8. Wash hands frequently, avoid animals, prevent bug bites, get your flu shot, and use your judgement to consume safe food and drink.

For more information on how to protect yourself, and additional precautions you may need to take, visit a travel health clinic. You can find a list of clinics on Ontario here.

teenage girls

How to recognize the signs of eating disorders

by Dr. Sheri Findlay, Adolescent Medicine Specialist, McMaster Children’s Hospital Eating Disorder Program

Eating disorders are serious mental health conditions that usually begin in teens, but can also appear in pre-adolescents. Although they can occur in boys, about 90% of sufferers are girls. Families, teachers and coaches should be aware of early warning signs. Catching the disease early can improve the recovery process and reduce the long term impact on the young person and their family.

Eating disorders symptoms

The most common way for an eating disorder to begin is with a deliberate attempt to lose weight. The reason is often a desire to look better for a special event (such as a vacation or prom) or due to comments from others about appearance. Witnessing or experiencing bullying can trigger this behaviour.

Scale with tape measure and apple implying weight loss

Parents should watch for:

  • Rapid or steady weight loss
  • Skipping meals
  • Avoidance of high calorie foods
  • Frequent visits to the bathroom after meals
  • Episodes of over eating
  • Avoiding eating with family and friends
  • New onset of pickiness around foods
  • Obsession with nutritional content and burning calories by exercising

These symptoms are often noticeable for parents. However, some teens will try to hide their symptoms out of fear they’ll be forced to stop.

Other situations

In some situations, eating disorders can be harder to spot, as not all young people have a desire to lose weight. Instead, they want to “get in shape” or “be healthy”. In which cases they’ll increase their exercise or change their eating patterns to accomplish those goals. This behaviour is considered an eating disorder when the young person becomes unable to function and maintain balance in their life due to their preoccupation with exercise and nutrition. In these cases, parents will notice:

  • A rigid obsession with exercise
  • An inflexible approach to eating
  • Placing too much importance on “healthy eating”

runner tying her shoe

Another scenario is the young person who experiences trouble eating or weight loss due to symptoms such as stomach aches, nausea, or food intolerances. This can be a difficult scenario for the family, and sometimes the doctor to sort out. If the persistent digestive symptoms are unexplained and leading to weight loss, particularly in teenage girls, it could represent an eating disorder.

Don’t delay in contacting your family doctor

Parents worried about a child with a possible eating disorder, should make an appointment with their family doctor as soon as possible. Serious medical complications can arise quickly in children and teens who diet, over exercise, or engage in other eating disorder behaviours, such as purging. The family doctor can help make the diagnosis, and make a referral to specialty services.

Five simple ways to reduce your cancer risk

Studies estimate that as many as half of all cancers in Ontario could be prevented by eliminating known risk factors like smoking, lack of exercise, and poor eating habits. Cancer screening is also an important part of prevention and early detection. Although not all cancers are preventable, there are ways to reduce your cancer risk. Here are five habits you can incorporate for a healthier lifestyle.

Cancer screening

The Province provides free cancer screening through the Ontario Breast Screening Program, Ontario Cervical Screening Program and ColonCancerCheck program to look for signs of breast, cervical, and colon cancers. Thousands of Ontario residents are alive and healthy today because they were able to either prevent cancer or find it early through screening.

The Ontario Breast Screening Program (OBSP) provides free mammograms for women ages 50 to 74 with no signs of breast cancer, every two years. Early detection through mammography can result in more treatment options. For a list of local OBSP locations, click here. You can book your own appointment or book through your healthcare provider.

Dr. Amy Montour stands in front of the Mobile Cancer Screening Coach with her parents
Dr. Amy Montour and cancer screening coach.

The Ontario Cervical Screening Program (OCSP) recommends Pap tests for anyone with a cervix ages 21 to 69, every three years. Pap tests are free and are available through your healthcare provider. Most cervical cancers are found in people who are not screened regularly. However, cervical cancer is almost entirely preventable, but that means getting a Pap test.

ColonCancerCheck provides a free, take-home screening test every two years for anyone, ages 50 to 74, living in Ontario with no symptoms or family history of colon cancer. This test is available through your healthcare provider. Anyone without a healthcare provider can call Telehealth Ontario’s colon cancer screening line at 1-866-828-9213 for information on how to obtain a test. Colon cancer is highly treatable when caught early. In fact, nine out of every 10 people with this cancer can be cured, thanks largely to early detection.

If you have never been screened for cancer and/or don’t have a healthcare provider, you can access all three screening tests on the Mobile Cancer Screening Coach. Call 1-855-338-3131 to book your appointment. Drop-ins are also welcome on a first-come, first-served basis.

Cut back or quit smoking

Smoking is responsible for an estimated 30 per cent of all cancer deaths in Canada. It also causes about 85 per cent of lung cancer cases. The more you smoke and the longer you smoke, the greater your risk of developing lung and other cancers. Other cancers that pose a higher risk to smokers include cancers of the oral cavity and pharynx, nasal cavity esophagus, stomach, colon, liver, pancreas, larynx, cervix, ovary, kidney, bladder and bone marrow.

Your best chance for quitting successfully is through a combination of support and medication.

Ashtray with cigarette buds

Consider sharing your goal with friends, family members and coworkers, as well as ways they may be able to assist. Community resources can be extremely helpful too. Smokers’ Helpline offers a free phone service and 24/7 online and text messaging support. Also, consider

Over-the-counter nicotine replacement therapy comes in many forms including patches, gum, lozenges, mouth spray and inhalers. In addition, there are prescribed medications that you can discuss with your healthcare provider.

Some tips to help you quit include:

  • Identify triggers like drinking alcohol, coffee and smoking after meals and how best to avoid or replace them
  • Manage cravings with the 4 Ds: deep breathing, drinking water slowly, distraction and delaying by reminding yourself that the craving will pass
  • Use rewards as an incentive, such as saving the money not spent on tobacco to treat yourself to something special

Knowing your risk

Cancer Care Ontario (CCO) offers a free online risk assessment tool,, to help people determine their risk for six types of cancer — breast, cervical, colorectal, lung, melanoma and kidney. Anyone can use this easy tool. It takes less than five minutes to complete.

If you’re not comfortable answering some of the questions, there’s a “why is this important?” link that explains the significance of each question. It’s important that you answer each question honestly. You’ll then receive a personalized risk assessment and action plan including information on how to reduce your risk. This assessment is meant to help with lifestyle changes, and is not intended to diagnose cancer.

Since risk can change over time, CCO suggests using this online tool every so often to see whether there has been a change.

Eating well

A diet full of fruit and vegetables may help your body fight many kinds of cancer. They can also help you maintain a healthy body weight, which may also lower your risk of developing some cancers. Health Canada has just issued its new Canada’s food guide with healthy eating recommendations.

Half a plate of vegetables and fruit, a quarter of a plate of protein, a quarter of a plate of whole grains, make water your drink of choice

Physical activity

Maintaining a healthy body weight through exercise can reduce the risk of developing certain cancers, including breast and colon cancer. Although it’s ideal to incorporate physical activity into each day, this doesn’t mean you need to go to the gym everyday for an intense workout. Daily activities like walking the dog, gardening and household chores help keep your body moving and contribute to your daily exercise. Check out the Public Health Agency of Canada’s tip sheets tip sheets for great ways to ensure physical activity is part of your daily routine.

an ipad and computer on a desk

Tips for improving your family’s digital health

by: Dr. Ashley Legate, psychologist

Do you ever think about the relationship between technology and mental health? Technology is a great resource. It can provide connection, information and entertainment at the touch of a button. But as with all things, it should be enjoyed in moderation.

Start by taking stock of your technology habits. How much are you using? How does it make you feel? Is your technology use negatively affecting those around you?

Then use a collaborative approach to improve your family’s relationship with technology. Discuss realistic limits for screen time and social media use and create a family media plan to keep you on track.

How does technology affect our mental health?


Watch for:
• Losing interest in offline hobbies and friendships.
• Technology use overpowering important activities like exercise and school work.
• Setting unrealistic tech limits—this can cause people to become secretive about screen time.

Focus on:
• Using social media to connect with faraway family and friends.
• Finding online groups with similar interests and identities.
• Having conversations about screen time and social media use.


Watch for:
• Too much focus on gaining approval on social media through likes, comments, etc.
• Using technology to avoid face to face interactions that make you anxious.
• Frequent worry about how people will perceive your comments on social media.

Focus on:
• Doing one thing at a time. Avoid dividing your attention between multiple apps and activities.
• Maintaining both face to face and online relationships.
• Practising mindfulness. Try the Stop, Breathe & Think app to refocus.


Watch for:
Difficulty falling asleep. Bright light from technology before bed can disrupt sleep patterns.
• Anxious thoughts about social media that keep you awake.
• Secrecy around late night screen use.

Focus on:
• Giving yourself time to wind down before bed without devices.
• Keeping technology out of the bedroom if it’s too tempting.
• Including rules about bedtime tech use in your family media plan.


Watch for:
• Decreased time spent on other, previously enjoyed activities.
• Sudden academic problems.
• Serious difficulty managing emotions after stopping gaming.

Focus on:
• Establishing gaming rules in your family media plan.
• Offering gaming time as a reward for completing chores and homework. This is much more effective than withholding gaming as punishment.
• Game together as a family and make it a social activity.

Technology and mental health: take it day by day

Does this seem overwhelming? Changing habits can take time. If you want to improve your relationship with technology:

  • focus on one small thing you’d like to change
  • make a plan to change it
  • tell someone about it to keep yourself accountable!

a printable handout on technology and mental health. The text on the handout mirrors what is in plain text above.

Want to keep these tips handy? Download this info sheet and stick it on your fridge!

Screen Time

The average Canadian child racks up 7.5 hours of screen time every day. While there are benefits to certain types of screen time, it’s important for parents to make informed decisions about how and when their children use screens.

For typically developing children, the Canadian Paediatric Society recommends no screen time under age two and less than one hour per day between ages two and five. Even in school-aged children, screen time should be limited and should focus on activities that support health and learning. Young children who are exposed to too much screen time are at greater risk of:

  • Becoming overweight
  • Having difficulty sleeping
  • Being less prepared for school
  • Becoming inattentive, aggressive, and less able to self-soothe

Creating good screen habits early on prepares children to better manage their screen time independently as they get older.

Remember the four M’s

Minimize: Set limits on daily screen time, maintain ‘screen-free’ time for reading and family meals, turn off screens when not in use, and avoid screens for at least one hour before bed.

Mitigate risk: Be aware of the content your child is engaging with and be present and involved during their screen time.

Be Mindful: Take stock of your family’s screen habits and make sure they aren’t interfering with meaningful activities. Teach your children to question advertising messages and think about what they’re watching.

Model good behaviour: Minimize your own screen time when kids are present, especially during meals. Focus on conversation, interactive play and healthy activities.

Did you know? Artificial light and stimulation from screen time before bed can make it difficult to sleep. Make your child’s bedroom a screen-free zone!

Trouble managing screen time? Talk to your family doctor or call your local Contact agency. Contact Hamilton: (905) 570-8888.

An analog watch

This tiny object can cause big damage if swallowed

Magnet injuries now rarely seen

Most of us have heard a story or two about a kid swallowing something they shouldn’t have, either in person or in the media. Any diehard Grey’s Anatomy fan can recall the episode where a collection of ball bearings ripped through a young boy’s intestines as their magnetic forces drew them together. Several years ago, these little magnets became popular toys, and raised wide-spread concern when kids began to swallow them. The powerful magnets could puncture intestines as they gravitated toward one another in a child’s abdomen.

“Thankfully, we haven’t seen a case like that in a long time,” says Dr. Helene Flageole, chief of pediatric surgery at McMaster Children’s Hospital (MCH).

“Their alkalinity is very corrosive.”

After much public outcry, the magnets were banned in Canada. Dr. Flageole says the order seems to be working, and has seen a drastic decrease injuries related to the magnetic toys. But she continues to be concerned by another item that is sometimes swallowed. It has a lot in common with the magnets: it’s small, it’s shiny, and it’s incredibly dangerous.

A button battery.

Surgery often required when kids swallow these batteries

“They can cause major tissue damage in just a few hours,” says Dr. Flageole. “Their alkalinity is very corrosive.”

Button batteries are commonly used in watches, hearing aids, and other small devices. Dr. Flageole says they’re often purchased in multipacks, and when extras are left lying around, they can be tempting for children.

“Many of us have that junk bowl or drawer where we put little odds and ends. When these batteries end up in there, they may look like candy to children.”

She estimates between five and ten children undergo endoscopic surgery at MCH each year after swallowing one of these batteries. Surgery is often required because the contents of the battery are corrosive, and can eat through intestines so they must be removed quickly.

“They can create a hole in the food pipe within six to eight hours,” she says.

Safe disposal is a must

Dr. Flageole recommends people dispose of extra button batteries through a battery recycling program, or store them in a locked cabinet. Carefully secure all devices that use button batteries, adding a layer of tape if the closure can be popped open easily. If you suspect a child has eaten one, call 9-1-1 or go to the emergency department immediately.

Did you know?
Lego bricks, coins, and hair clips are some of the most commonly swallowed objects. About 80 per cent of inedible objects swallowed by kids will pass naturally. Of the remaining 20 per cent, most can be removed using a flexible tube called an endoscope. Only a small number require surgery.


A football player dodges a tackle

You may have more in common with Super Bowl athletes than you think

By Maggie Hitchon and Dr. Ryan Williams

Watching elite athletes on screen or in person, it’s hard to imagine having much, if anything in common with them. The unfortunate reality is that you may have more in common than you think…when it comes to injuries.

Have you ever thought that you could suffer the same injury as an elite, highly trained NFL athlete? Take Rob Gronkowski of the Super Bowl bound New England Patriots as an example. Standing 6’7” tall and weighing in at 265lbs, he has sustained multiple injuries over his years as an accomplished football player. Regardless of protective equipment, the force applied on the field makes football players prone to injuries pretty much anywhere on their bodies. Some say it’s just part of the job. And while many of us spend plenty of time and money trying to be more like the athletes we idolize, beware—copying their on-field injuries is all too easy.

Common injuries on and off the field

Both overuse injuries and traumatic injuries can occur on the football field. The top three most commonly injured joints in football include the ankle, the shoulder and the knee. These injuries can be as simple as a rolled ankle during a practice or as devastating as a dislocated shoulder during a game. They can also just as easily happen to average folk, even people who have never stepped foot on a playing field. They can happen in the workplace, in the backyard, or while out for a walk with the dog.

Ankle injuries

a diagram of the ankle ligamentsThe most common ankle injury is an ankle sprain. This is also known as a rolled ankle. Sprains occur when the foot twists, turns or rolls beyond its normal range of motion. This causes the ligament to stretch beyond its limit like an overstretched elastic band. The most commonly injured part is the anterior talofibular ligament or the ATFL for short. Ankle sprains can happen when you misstep while walking or running on uneven surfaces.

What to look for: Pain, swelling, and bruising.

Diagnosis and Treatment: If you think you’ve injured your ankle, it is important to seek medical care from a trained healthcare professional. The mainstay of treatment for ligament sprains is Rest, Ice, Compression, and Elevation (Remember R.I.C.E.). When returning to sport, athletes often tape their ankles for increased stability. When you are watching the Super Bowl on Sunday, take a look at the athletes’ ankles. You’ll see something called spats taped around the outside of their cleats. This covering both keeps the cleats clean, and provides ankle support for the players.

Shoulder injuries

The two most commonly injured parts of the shoulder include the acromioclavicular (AC) joint and the labrum. The AC joint, which sits at the top of the shoulder, is usually injured from a direct blow to the shoulder, such as a tackle that throws a player to the ground. The labrum is a rubbery tissue that surrounds the shoulder socket to keep the ball of the joint in place. This is most commonly injured in linemen while they are blocking. Because the shoulder joint has a large range of motion, it is easily forced beyond its limits, making it prone to injury.

What to look for: Shoulder injuries can appear differently, but symptoms may include pain, stiffness, and limited movement. You are at risk for a shoulder injury if you do repetitive overhead movements or lift heavy weights regularly.

Diagnosis and Treatment: After assessment by a trained healthcare professional, X-ray and MRI imaging is often ordered to diagnose these types of shoulder injuries. Rest and therapy are the first steps for treatment. Sometimes surgery is required for the AC joint or labrum depending on the severity of the injury.

a person downhill skiing

Knee injuries

Football players commonly injure their knees when they plant and twist to carry out a play, or when they’re tackled to the ground at the knee level. When ligaments of the knee are stretched beyond their limits they can tear partially or completely, depending on the amount of force applied. Commonly injured structures in the knee include the anterior cruciate ligament (ACL), the medial collateral ligament (MCL) and the meniscus. Knee injuries are common in contact sports, as well as skiing and trampoline. They may also occur with something as simple as an awkward twist when getting up from a chair.

What to look for: These types of injuries can cause pain in the knee and a feeling of instability. Some people describe hearing or feeling the tear when it happens.

Diagnosis and Treatment: After your initial assessment, ultrasound or MRI imaging is often used to determine which structure in the knee is affected. Remember your R.I.C.E. principles for treatment. After the initial pain has improved, therapy is a great way to regain strength and mobility in the injured knee.

Injury prevention

The first step in preventing these injuries is to avoid being tackled to the ground by large NFL football players. But in all seriousness, there are ways you can reduce your risk of injury.

• Exercise regularly
• Maintain proper posture
• Eat a healthy diet, and generally take good care of your body

Regular participation in strengthening exercises and stretching can help keep your bones, joints, and muscles stay strong in order to avoid the injuries mentioned above. If you think you’ve been injured, it is important to seek treatment from a trained healthcare professional early on. You know your favourite athletes would!

Maggie Hitchon is a physician assistant at Hamilton Health Sciences’ Regional Rehabilitation Centre. Dr. Ryan Williams is a physiatrist at Hamilton Health Sciences, and a member of the Hamilton Tiger-cats medical staff.

Happy New Year 2019

Expert-approved New Years resolutions

It’s that time of year. The transition from one calendar year to another is considered by many a fresh start. A time to get rid of bad habits and create new, better ones. Many people do this in the form of one or more New Years resolutions.

About half our population makes a New Years resolution and health related resolutions are some of the most common. Did you know that quitting smoking, exercising more and losing weight rank as three of the most popular New Years resolutions?

Less than half of people keep their resolution past July

Only about 40 per cent of people have stuck with their resolution by the time July rolls around. The key to keeping on track is setting a clear goal, writing it down and tracking your progress. You can find some tips on creating “SMART” goals here.

We asked our experts to recommend some healthy resolutions for our community. Scroll down to see what they suggest you strive for this year!

“Resolve to never get behind the wheel of your vehicle impaired.” Dr. Alim Pardhan, Emergency Physician

Dr. Alim Pardhan, a doctor in our emergency departments at Hamilton General Hospital, Juravinski Hospital and Cancer Centre, and McMaster Children’s Hospital, doesn’t want anyone to drive while intoxicated. Drinking alcohol, and now consuming cannabis, may be legal, but driving while impaired is not. In his role in the emergency room, he sees far too many injuries that result from impaired driving, and unsafe drinking in general. Watch this quick video on how to stay safe if intoxicated.


“Quitting smoking will take multiple tries, so resolve to keep trying. Talk to your family doctor about medication and ensure you have a strong support system.” Monica Bennett, Health Promotion Specialist

Although quitting smoking is a common New Year’s resolution, it can be a difficult one to keep due to the additive nature of the substance. It will likely take you multiple attempts to quit, but Monica Bennett, a health promotion specialist at the Juravinski Hospital and Cancer Clinic wants you to keep trying. Find what works for you to curb the cravings, talk to your family doctor, and surround yourself with a network of support, including the Smokers’ Helpline.

Additional resources are available and Monica offers other tips in this video.


“Resolve to follow a self-care routine.” Marie Reynolds, Clinical Manager, Nursing Resource Team

Marie Reynolds, clinical manager of the nursing resource team at Hamilton Health Sciences wants you to take care of yourself this year. Ensuring you have a proper work-life balance promotes a healthy mind and body. If you’d like to try some mindfulness meditation, here’s a quick video.


"Resolve to get your pap test done if you're due for one." Dr. Dustin Costescu, Obstetrician and Gynecologist

Dr. Dustin Costescu, an obstetrician and gynecologist at Hamilton Health Sciences wants women to pay better attention to their reproductive health this year. In addition to committing to regular pap tests, he has two more recommendations.

“Protect yourself from sexually transmitted infections by using condoms each and every time. And talk to your healthcare provider before stopping birth control. If you’re stopping because you want to get pregnant, take folic acid before stopping.”


“Resolve to build and nurture meaningful connections with others, be it with family, friends or work colleagues.” Dr. Paulo Pires, Psychologist

Dr. Paulo Pires, Clinical Director, Child and Youth Mental Health at Ron Joyce Children’s Health Centre wants you to maintain and strengthen relationships with the people in your life.


 “Commit to seeing the best in others and looking for similarities, especially when common ground seems implausible.” Dr. Natasha Johnson, adolescent medicine specialist

Dr. Natasha Johnson, an adolescent medicine specialist at McMaster Children’s Hospital, has worked hard to develop a framework for gender diversity services within the adolescent medicine clinic. She wants you to consider seeing the best in others regardless of the circumstances.

She also says, “this will set the stage for fruitful conversations and genuine curiosity instead of conflict.”


"Resolve to bring the medications you're taking to all your medical appointments." Dr. Alexandra Papaioannou, Geriatrician

Dr. Alexandra Papaioannou, a geriatric specialist and executive director of the Geriatric Education and Research in Aging Sciences (GERAS) Centre, wants to see patients resolve to bring their medications to all medical appointments so their providers can keep track of what they’re taking safely. This goes a long way to prevent harmful medication errors.


"Regular physical activity is an important part of your heart health, so resolve to use sedentary activities - watching TV or Netflix - only as a reward that follows physical activity." Dr. Richard Whitlock, Cardiac Surgeon

Inactivity has become a major issue in our society. Especially with easy access to entertainment on our devices and the ability to “binge watch” shows through streaming services like Netflix. Therefore, Dr. Richard Whitlock, cardiac surgeon at Hamilton General Hospital suggests using our sedentary activities as a reward for physical activity. Go for a walk, a bike ride, anything that gets you moving. After that, enjoy your favourite TV show. Regular activity does the brain, body, and heart a lot of good!

Are you inspired? We hope you’ll adopt one or more of these resolutions for 2019!

Happy New Year!

Man eating a donut

Tips for night shift workers

While the 9-5 grind is typical, one in five Canadians works night shifts. A large portion of these shift workers are working in health care. While these jobs are very rewarding, they do come with challenges. We’re sharing some tips for night shift workers to help you feel your best in the workplace.

Staying alert overnight

Although your internal clock may tell you it’s time for bed, night shift workers will need to stay awake and alert. To keep concentration and productivity high, there are some steps you can take. Tackle more complicated tasks at the start of your shift and if possible, try to vary your work routine throughout the shift to stay fresh. Talking with a coworker, bringing in a bright lamp, and staying cool can help. If you take medications, discuss your work schedule with your doctor to determine the best time to take them to avoid drowsiness.

Eat foods that energize you

Though your work shifts may change, try to keep your eating schedule consistent. Have your main meal before your shift and eat healthy snacks rather than full meals while you’re at work to boost your energy level. Eating small portions at night is the best way to prevent health problems like obesity and diabetes. Eating a full meal may cause drowsiness and indigestion.

Avoid fried foods and foods high in fat that are hard to digest, and sugary snacks that lead to cravings and spikes in blood sugar. Instead, opt for snacks like apples, carrots, whole-grain crackers, yogurt, hummus, or protein-rich foods like peanut butter, eggs, tuna, and roast turkey or chicken. Save carb-rich foods like breads and cereals for a light meal in the morning before bed.

Planning ahead and packing snacks will help you avoid vending machines and fast food when your stomach rumbles during the night.

Stay hydrated

Trade your coffee for lots of water to stay alert. Caffeine and sugary carbonated beverages can cause an initial spike in energy followed by a decline. Too much caffeine can dehydrate you and cause fatigue, plus it can irritate your stomach and interfere with your sleep when you get home. If you enjoy your coffee, drink it at beginning of your shift.


Strive to get active for at least 30 minutes each day. Take breaks from your work to get up and stretch, walk around your work space, or take the stairs. If you sit most of the time, try standing to do your work. Take some time for deep breathing breaks to increase oxygen to the brain. Check out our desk stretches to reduce pain and injury and learn how to organize an ergonomic work space.

Catch enough Zs

Adults need 7-9 hours of sleep, so make it a priority. Avoid caffeine and alcohol before bed, don’t go to bed hungry, and use blackout curtains and earplugs to make sure you’re able to sleep during the day.

Driving home safely

Ensure you get enough sleep the night before your work shift so you can perform well and safely drive home in the morning. Drive carefully and be aware. If needed, take a quick nap at your workplace before getting behind the wheel or do a quick exercise to get energized. Consider using public transport or carpool so you have someone to chat with.

Managing lifestyle

Shift work can make it hard to catch up with loved ones when you’re on different schedules. Plan some meals together where possible and let friends and family know your schedule so they can include you in social activities.

For more information on Shift Work nutrition, see our guide.

A family gathers around the Christmas tree opening gifts

Supporting loved ones with dementia over the holidays

By Dr. Joanna Sue, Neuropsychologist, St. Peter’s Hospital


If you have a loved one with dementia, you may have noticed their ability to participate in celebrations or large gatherings has changed. While the holiday season is a wonderful time of year to spend with family and friends, some common holiday activities can be overwhelming for people with dementia.

Every person with dementia is different, but some common symptoms include:

• memory loss
• difficulty with communication and problem-solving
• reduced ability to plan, organize, and complete multi-step tasks

Modifications can make holiday preparations and gatherings easier and more enjoyable for people with dementia, and their families. To prioritize, and set manageable expectations, ask yourself: what do the holidays mean to our family? Thinking about the true purpose of the holidays may help you decide which aspects of the holidays are worth spending your time and energy on. You may want to consider shortening gatherings, having a potluck or catered meal, having lunch instead of dinner, having an earlier dinner, or hosting a few smaller celebrations rather than one big gathering.

As you prepare for the holidays, also consider these tips.

Advanced preparation

● If possible, talk to your loved one about preparing for upcoming holiday events. Describe each part of the event and discuss ways you and others can provide support.

● If your loved one lives in long-term care, tell the staff about your holiday plans and ask for tips about how to make them a success. They may be able to make suggestions based on your loved one’s current routines and preferences.

● Update family members on how your loved one is currently doing. Your loved one may have experienced cognitive and physical changes since the last family gathering, and providing an update helps others know what to expect.

Getting your loved one involved

Dementia affects parts of the brain differently. For example, your loved one may be unable to tell you what they ate for lunch but can describe a childhood memory in vivid detail. Identifying your loved one’s preserved abilities can help you to select activities and conversation topics they can participate in, even if it is in a modified way. Some examples of commonly preserved abilities are: reading, singing, and actions that rely on “muscle memory,” such as rolling dough or washing dishes.

Having your loved one assist with holiday preparations, or take part in traditions can make them feel valued and included. These are simple ways to include them in activities:

● Break down tasks into parts and give them one thing to focus on at a time. For example, when wrapping presents give them one present at a time. When decorating, hand them one ornament or decoration at a time.

● Even though your loved one may not be able to follow a recipe or list of instructions, they can help when given a specific hands-on task such as peeling fruits or vegetables, rolling dough, mixing ingredients, or polishing silverware. Set them up with all the materials they will need. Remember: the task may take longer and may not be done “perfectly,” but the purpose is to provide your loved one with the chance to contribute and be a part of the festivities.

● Play holiday music and sing along together. If reading is a preserved ability, print out the lyrics in large font for everyone, so your loved one can sing along easily.

Social gatherings

For longer events, plan rest and bathroom breaks ahead of time, because with the excitement of the festivities, it is easy to lose track of time. Set an alarm on your phone or pair breaks with scheduled activities, for example taking a bathroom break before every meal.

Identify a quiet area where your loved one can go to rest during the event. In addition to offering scheduled breaks, watch for signs of fatigue and encourage your loved one to take more breaks if needed.

Use labels to increase your loved one’s independence and confidence. Consider name tags with each person’s name written in large font with a thick black marker. This can help your loved one to feel more comfortable and reduce anxiety. You may find that others appreciate this as well! If you are going to someone else’s house for an event, create signs with a word and picture to identify important rooms like the bathroom. This will promote your loved one’s independence in finding their way around.

Conversation tips

Focus on conversations that don’t have a “right” or “wrong” answer. Stay in the present moment—try to avoid asking questions that rely on your loved one recalling a specific memory. Share history—asking about events that happened a long time ago is likely to elicit more memories than asking about recent events.

Here are some good conversation starters:

• What were the holidays like when you were growing up?
• How are you enjoying the food/music?
• What do you think of the decorations?


Remember this important quote: “When you’ve met one person with dementia, you’ve met one person with dementia.” This disease affects everyone differently, so pick and choose the tips that you think will work best for you and your loved one. Remember to build in some time during and after the holidays to unwind and take care of yourself!


A man's hand holds a vape pen in his hand as smoke comes out of it

Beyond Cigarettes: How Smoking Affects Your Health

By Monica Bennett, Health Promotion Specialist – Tobacco


How does smoking affect the body?

Every cigarette smoked is harmful.

Smoking is the largest cause of preventable deaths in Canada. One in two smokers will die from a smoking-related disease. It causes more than 39,000 deaths each year in Canada. How? Some of the chemicals in tobacco smoke cause changes in the human body, which can lead to disease, disability, stroke and early death. Some of these chemicals cause cancer. Others affect normal heart and breathing function.

What happens when you inhale smoke?

The respiratory system extends from the nose and mouth to the surface of the lungs. As tobacco smoke moves through the respiratory system, it leaves behind small chemical particles that get absorbed by the body. Since these particles contain harmful chemicals, continued exposure can greatly affect the health of people who smoke.

Types of smoking

Smoking cannabis

Smoking cannabis (for example, smoking a joint) is the most harmful way of using cannabis because it directly affects your lungs. There are safer, non-smoking options like vaping or taking edibles that are better for your lungs. Keep in mind that these alternatives aren’t risk-free either. If you choose to smoke cannabis, avoid inhaling deeply or holding your breath. These practices increase the amount of toxins absorbed by your lungs and the rest of your body, and can lead to lung and other problems.

The more frequently you use cannabis, the more likely you are to develop health problems, especially if you use on a daily or near-daily basis. Limiting your cannabis use to occasional use at most, such as only using once a week or on weekends, is a good way to reduce your health risks. Try to limit your use as much as possible.
Synthetic Cannabis

Canada’s Lower Risk Cannabis Use Guidelines warn against synthetic cannabis products. Compared with natural cannabis products, most synthetic cannabis products are stronger and more dangerous. K2 and Spice are examples of synthetic cannabis products. Using these can lead to severe health problems, such as seizures, irregular heartbeat, hallucinations and in rare cases, death.

Rolling a joint

Mixing Tobacco and Cannabis

Tobacco and cannabis are among the most commonly used substances worldwide, and are often used in combination. However, together they are more dangerous. Evidence suggests that using tobacco with cannabis contributes to an increased chance of becoming dependent on cannabis. It also can result in more intensive tobacco use. This of course can result in increased health risks and making it more difficult to quit using tobacco.

Smoking Hookah

Also known as shisha, narghile, argileh, hubble-bubble, and goza

A young woman smoking from a hookah pipe

Hookahs are water pipes that are used to smoke specially made tobacco that comes in different flavors, such as apple, or mint. Hookah smoking is typically done in groups, with the same mouthpiece passed from person to person. It’s often thought to be less harmful than smoking cigarettes, but it has many of the same health risks. Even the smoke from “herbal” shisha preparations contain carbon monoxide and other toxic agents that increase the risks for smoking-related cancers, heart disease, and lung disease.

Pipe sharing may pose the additional risk of the spread of infectious diseases.

How does hookah compare to cigarettes?

• Daily use of hookah produces has equivalent level of nicotine to that of smoking 10 cigarettes a day.
• When measured in a scientific experiment, a hookah session produced 1.7 times more nicotine, 6.5 times more carbon monoxide, and 46 times more tar than smoking a single cigarette.
• Like cigarette smoking, hookah smoking is associated with a number of poor health outcomes including decreased lung function, lung cancer, respiratory illness, gum disease and low birth weight.
• Secondhand smoke from hookah poses a hazard to nonsmokers too. It contains smoke from the shisha as well as smoke from the heat source, such as the charcoal used in the hookah.


Vaping is also known as “juuling” after popular e-cigarette brand.

Unlike smoking cigarettes, nothing is burned during vaping. The liquid is heated so it becomes vapour, and contaminants get into the vapour during this process. Although e-cigarettes are marketed as a safer alternative to smoking, they still contain nicotine. So, if you’re a smoker already, it’s less harmful, but if you’re not a smoker it’s increasing your exposure to harmful chemicals. Even the second hand smoke from e-cigarettes contains cancer causing chemicals and is a risk to nearby nonusers.

The e-cigarette industry is not regulated so it is not possible to know what is being vaped – including the amount of nicotine it may or may not contain. Vaping can have negative effects on your health. Side effects include increased heart rate and blood pressure, lung disease, chronic bronchitis, and insulin resistance leading to type 2 diabetes.

Smoking cigars, cigarillos etc.

Cigar smoking poses many of the same serious health risks as cigarette smoking, and some others. These include cancer of the mouth, larynx, esophagus, lung, and possibly of the pancreas. It also causes other types of lung disease, heart disease and oral disease. The more cigars you smoke and the deeper you inhale, the greater the risks.

Switching from cigarette smoking to cigar smoking can be particularly harmful because you might inhale cigar smoke the way you inhaled cigarette smoke. If you inhale cigar smoke, you can get as much nicotine as if you smoked cigarettes. And even if you don’t intentionally inhale, large amounts of nicotine can be absorbed through the lining of your mouth.

Need help quitting? Check out these resources.

Guide to buying developmentally appropriate gifts

By: Barbara Campbell, infant-parent therapist, Jamie Gleed, occupational therapist and Angela Zajcenko, early childhood resource specialist, Developmental Pediatrics and Rehabilitation


With the holiday season fast approaching many of us are on the hunt for that perfect gift! It can often be challenging to pick toys for children or teens that are developmentally appropriate, but it’s an important thing to consider when you’re gift giving.

For some children, chronological age does not match developmental age. Many children develop more quickly or slowly than their peers, so purchasing gifts based on chronological age isn’t always the most appropriate option. Developmental age gives us more information on where a child is socially, emotionally, physically and intellectually. When you buy toys for a child’s developmental age, you are more likely to pick a toy that is the right fit for their skills, and will help them learn new things as well.

Remember that a child may not be at the same developmental age for all areas of their development. Consider their developmental stage in different areas like gross motor skills, fine motor skills, communication and more when selecting a gift.

The toys listed below are examples of toys that would be developmentally appropriate at different stages. We’ve tried to pick toys that help with fine and gross motor skills, cognition, communication and social skills and are of course FUN! Keep in mind that this list is not comprehensive and there are many alternatives that could also meet your child’s interests.

Recommendations for developmental age

In this developmental stage, many new skills are emerging. Infants are working on developing the strength and control of their arms and legs for later crawling, walking, self-feeding and of course play! This is also the stage where early interaction skills start emerging – cooing, smiling and intentionally playing with toys.

Children in this stage are typically working on tummy time, rolling, crawling or pulling to stand. They will also be starting to grab at and grasp toys so those that are easier to hold (such as the Winkle) are recommended. Parent and child interaction is important to build your child’s social and emotional wellbeing.

Toys that would appropriate at this developmental stage may include:

1. Tummy Time Books

2. The Winkle

3. Stacking Rings

4. Board Books

5. Activity Table or Cube

Developmental Age of 1-2

In this developmental stage, children are becoming more exploratory. Their hand skills allow them to play with more complex toys. They are developing some early language skills and their interest in interacting is increasing. Most children will be mobile (crawling, walking, running).

Children in this developmental stage tend to enjoy toys that involve pouring or dumping, building or demonstrate cause and effect. Children are also starting to understand the purpose or role of common objects (i.e. a barn is where animals live). Little People sets are a great toy to foster imaginative play, language and development of hand skills. Toys that encourage turn taking or waiting are also a good fit. For children who are more active, a small basketball or soccer net can be a great way to work on hand eye coordination and gross motor skills.

Toys that would be appropriate at this developmental stage may include:

1. Little People

2. Sports Zone

3. Whacky Ball

4. Foam Building Blocks

Developmental Age of 3-4

In this developmental stage, children are starting to become more independent in their play. They are typically very good at giving direction to other children or adults around how they want to play with the toy! Pretend and imaginary play are emerging. Many children are interested in dressing up as and taking on different characters. Children also start to become more physically active during this stage. Many children are interested in kicking or throwing a ball and pedaling a tricycle. Their hand and finger skills continue to develop and most children will start to practice holding a crayon and working with puzzles with smaller pieces.

This is a great stage for dress up clothes which encourage children to ‘take on’ the role of someone else. This help build a child’s ability to understand different perspectives, an important skill for positive peer interactions.

Children at this stage have better control of their shoulder, arm and hand muscles. They are also able to use their fingers with more dexterity and accuracy. Children in this developmental stage are ready for puzzles with smaller knobs or those that have a magnetic wand. For children that enjoy crafting, Mosaics may be a fun idea.

Construction type toys such as Duplo or blocks are also a great fit for this age group to encourage them to work on their imagination, hand skills and language. Construction type toys can be used for a variety of play activities, because they are open ended and allow the child to create as they go.

Toys that would be appropriate at this developmental stage may include:

1. Dress Up Clothes

2. Magnetic Wand or Small Knob Puzzles

3. Duplo, Building Blocks or Brillo Block

4. Mosaics

Developmental Age of 4-6

Children during this developmental stage are continuing to develop their hand and finger skills, and are learning more about constructional, imaginative and social play. Hand eye coordination and gross motor skills continue to become more refined.

Toys like Magformers or Squigz provide children in this stage more complexity in open ended play. These toys also require more hand strength and finer movements. They will also challenge kids to be creative in their play ideas. Kinetic sand is a mess free sensory rich activity that encourages children to work with their hands. The Velcro ball and mitt or scoops are a great active activity and a good fit for targeting children’s hand eye coordination and gross/fine motor skills. These toys are also a safe option for playing indoors in some homes. Both of these activities offer a great opportunity for children to begin to negotiate and cooperate during play. Magnatabs are another great fine motor activity and for kids who are resistant to working on their early pre-printing and printing skills they tend to be quite motivating!

Toys that would be appropriate at this developmental stage may include:

1. Squigz or Magformers

2. Kinetic Sand

3. Velcro Mitt and Ball or Scoop Ball

4. Magnatabs

Developmental Age of 6-10

Children at this developmental stage become more organized in their play and choice of games. Most children at this age have specific interests and hobbies. They often have improved memory and executive functioning skills (initiating, planning, organizing and stopping/starting play). Gross motor skills are more refined, and most children have mastered balls skills and riding a bike.

At this age children are usually very social and interested in peer play, however they also tend to be good at independent play. They may enjoy a challenge and they will have the patience to persist with more complex activities. Games and puzzles that require cooperation and problem solving are a good option.

Toys that would be appropriate at this developmental stage may include:

1. Board Games – Eye N’ Seek, Yoga Spinner or Headbanz

2. Balance Board Maze

3. Marble Tower

Development Age of 10-12

Most children/’tweens’ at this age have well developed interests and ideas. Many children at this age enjoy working in small groups. There tends to be a strong influence by peers at this age.

Activities that encourage positive peer interactions, such as multiplayer games, make great gifts. We also see many children moving from concrete to more abstract thinking so toys and games with increased problem solving and complexity work well.

Toys that would be appropriate at this developmental stage may include:

1. Board Games – Telestrations, Cranium or Labyrinth

2. Lego or Robotics Sets

3. Rainbow Loom

Developmental Age of 12 +

This can be one of the most challenging developmental stages to buy for! Teens are this age tend to have varied interests and they might not always relate to a typical toy or gift.

Activities that encourage independence are suggested. For some teens, gift certificates to preferred stores or activities where they can practice money management, socialization and communication may work well. This may be also be a good stage to work on time management, so gifts like watches or clocks can be useful.

Gifts like board games or books can never be underestimated. Both have endless possibilities for enjoyment while also encouraging socialization, communication and motor skills.

A woman washes her hands under a faucet

The power of proper hand washing

It’s no secret that proper hand washing is one of the simplest and most effective ways to prevent the spread of germs. The key word being “proper.” The way you wash your hands makes a big difference to how many germs remain when you’re done.

Follow these steps:

1. Wet your hands with clean, running water.
2. Apply soap.
3. Lather the soap all over your hands. Scrub your palms, the backs of your hands, between your fingers, and under your nails for at least 20 seconds. Singing “Happy Birthday” twice will help you keep time.
4. Rinse your hands well under clean, running water.
5. Dry your hands using a clean towel, paper towel, or an air dryer.
6. Use a paper towel to turn off the tap.

Alcohol-based hand sanitizer is a good alternative to hand washing, provided you use a generous pump, and rub it all over your hands. Ensure it has fully dried before touching anything.

See for yourself!

Want to see the difference proper hand washing makes? Just look!

Watch this video with medical microbiologist, Dr. Cheryl Main.

We tested handwashing techniques with a simple experiment in our Microbiology Lab at Hamilton General Hospital. We printed our fingers in petri dishes before hand washing, after poor hand washing, and after proper hand washing, then incubated them overnight to allow the bacteria to grow. The results were clear: poor hand washing leaves a large number of bacteria on the hands, while proper hand washing removes nearly all bacteria. Each of the dots you see represents thousands of tiny bacteria.

a petri dish with bacteria growing on fingerprints
Bacteria growth after no hand washing at all

A petri dish with bacteria growth on fingerprints
Bacteria growth after poor hand washing

A petri dish with very few dots of bacteria on it
Bacteria growth after proper hand washing

To dry or not to dry?

Proper hand washing isn’t enough! You must also dry your hands thoroughly. We also tested well washed, but undried hands in our experiment, and here’s what we found. LOTS of bacteria. Bacteria love moist surfaces, so they thrive on wet hands.

moderate bacteria growth in a petri dish
Bacteria growth after proper hand washing, but no drying

How do germs spread?

Germs spread through the air in sneezes, coughs, or even breaths. They can also be passed from person to person by touching each other or common objects and surfaces. That’s why proper hand washing is so important.

There are two main types of germs: bacteria and viruses. Both can cause illness. In our experiment, only bacteria are visible, because viruses can’t survive outside a living cell. They tend to exist in the same places, so the germs you see remaining in the petri dishes we showed represent both bacteria and viruses.

During cold and flu season, lots of these germs are passed around, particularly in places where people gather, like schools, offices, and shopping malls.

Here are some more ways you can prevent the spread of germs:

• Always sneeze or cough into your elbow.
• Wash your hands often with soap and water, especially after using the toilet.
• Avoid touching your eyes, nose and mouth.
Stay home if you’re sick so you don’t bring germs to work or school.
• Clean and disinfect common surfaces and objects, including bathroom and kitchen counters and toys.
• Get all recommended vaccines, especially the flu vaccine every year.

As part of our experiment, we coughed into a petri dish to show just how many germs live in the spray that comes out of your mouth and nose. Eww!

strands and flecks of bacteria growth on a petri dish
Bacteria growth from a cough

The five second rule?

One last experiment, we promise! Have you heard about the five second rule? Or the ten second rule? Or depending who you ask, the thirty second rule? It doesn’t take long for germs to transfer from one surface to another.

We dropped a cracker on the floor for five seconds and then printed it on a petri dish. The results aren’t pretty!

mouldy looking bacteria on a petri dish
Bacteria growth from a cracker that was on the floor for ten seconds

Hand hygiene in the hospital

In Canada, one in nine patients will develop an infection during their hospital stay. Many of these infections can be easily prevented through proper hand hygiene in the hospital. While healthcare providers have a big role to play in helping to prevent the spread of germs to their patients, germs can also be spread by patients on their own hands.

At Hamilton Health Sciences, many teams have initiated hand washing promotion initiatives that encourage open communication between patient and caregiver around hand hygiene. The key message? That it’s okay to ask your healthcare provider if they’ve remembered to clean their hands. Don’t feel shy about reminding someone to wash their hands before coming into a patient room!

For visitors coming to the hospital, we recommend cleaning your hands at the stations on the way in, before entering the patient’s room, and again when you leave.

The 5 most important times to wash your hands in hospital

If you or a loved one is in hospital, it’s important for you to know the five most important times to wash your hands:

1. Before touching your eyes, nose, or mouth.
2. Before eating or handling food.
3. After coughing or sneezing (it’s best to cough into a tissue or your sleeve)
4. Before entering shared spaces and when returning to your/your loved one’s room.
5. After using the washroom or a commode.

The preferred method of hand hygiene in a health care setting is to use alcohol-based hand rub. It’s important to rub it in all areas: the backs of your hands, in between your fingers, your finger tips, your thumbs.

If your hands are visibly dirty, you should use soap and water. See the steps above for this method.