Long-Term Care Survey Alert

To stay on top of your game at work, avoid this No. 1 dietary mistake.

To care for others well over the long term, you have to keep your own wellbeing on the front burner. And a few nutritional strategies and efforts to stay infection-free can help you cover two of the major bases.

Start by avoiding the No. 1 nutritional habit known to backfire: skipping meals due to stressful schedules, advises Sarah-Jane Bedwell, RD,LDN, a nutritional specialist in Nashville, Tenn. Going several hours without eating can lead to low blood sugar, irritability -- and slower metabolism, she warns.

Solution: "Eating small frequent snacks every four hours can keep your energy, blood sugar, and metabolism up," she suggests. What types of snacks are best? Ones that provide lean protein and a complex carbohydrate, says Bedwell. "The carbohydrate gives you a quick burst of energy and the protein helps promote satiety and helps you feel fuller longer."

Examples: Options include "a piece of string cheese and apple, or a small handful of almonds with half a banana, or yogurt and a couple of whole grain crackers." A half sandwich with lean deli meat will do the trick, as will a half of a peanut butter sandwich with banana, she adds.

"Stress can make people be hungry and crave carbohydrates," warns Bedwell. The carbs "help release serotonin in the body which helps people relax." A lot of times when people are stressed out and haven't eaten for several hours, "they will binge on simple sugars and starches."

Antidotes: "Exercise is one of the best ways to lower stress and stress-related hormones in the body," says Bedwell. "Massage can also help. Anything you do that's relaxing and that specifically improves blood flow can be very helpful."

Bedwell also counsels people to drink water throughout the workday. She notes that "dehydration is one of the most common problems in people who work long hours -- and dehydration is the most common cause of headaches." Coffee is OK in moderation, adds Bedwell, noting that research shows that drinking two to three cups a day may provide some benefits. More than that can cause you to become irritable or develop insomnia -- "or even a rapid heartbeat," she cautions. To prevent insomnia, "people doing shift work should limit their coffee drinking to the first half of the shift."

The perks: "Studies show coffee can help prevent onset of type 2 diabetes, increase metabolism slightly, and improve short-term memory skills," says Bedwell.

On the other hand, consuming large servings of sugary beverages provides empty calories that don't promote and maintain your energy levels, Bedwell cautions. "You get a sugar high but then a sugar crash."

Taking a few precautions can help you close the door to diseasecausing microorganisms -- literally. For example, when Joy Jordan, MSN, RN, RAC-CT, provided direct care, she took her uniform and shoes off at the door of her house. "Those things never traveled through the house," says Jordan, clinical operations consultant for Boyer & Associates in Brookfield, Wis.

"Caregiving staff should make sure their immunizations are current, urges James Marx, RN, MS, CIC, which he believes is the most important way to avoid serious infections. For one, "staff should have a diptheria and tetanus booster every 10 years," counsels Marx, principal of BroadStreet Solutions in San Diego. And "adults need a one-time pertussis booster which can be given along with the DT booster." And make sure you have had the measles, mumps and rubella (MMR) and chicken pox vaccinations or a titer, Marx advises.

"Anyone who had a chicken pox titer before 2004 should have it repeated using a current test method," Marx says. "The method used before that date caused false positives, which means someone could think they  were protected when they weren't."

Also take advantage of hepatitis B and flu vaccinations which employers often give free of charge. In addition, anyone 60 years of age or older should consider having a shingles vaccination."You can't catch shingles from someone but if you haven't had chicken pox or a chicken pox vaccination (or if your titer isn't high enough to offer protection), you can catch chicken pox from someone with shingles," says Marx. Staff who are 65 or older should have a pneumococcal vaccination. And staff with risk factors, such as diabetes, COPD, or other chronic disease, should receive the pneumococcal vaccination, says Marx. And they should receive a second dose after turning 65, if they received the first dose before age 65 -- "and it's been at least five years."