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MAY 2020 • ISSUE 177

GVHEALTHNEWS.COM

On the

Frontline

The role of nursing has taken on even greater significance, as nurses and other healthcare providers are frontline responders in the battle against COVID-19. As nurses celebrate their month in May, we profile three of them. Coronavirus Special Issue Inside

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That’s the number of times most people touch their faces in an hour. We have tips to reduce that.

HEART ATTACK

Chief of cardiology at Rochester Regional, physician Gerald Gacioch, says he has seen a dramatic drop in the number of people coming to the hospital with heart attacks.

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U.S. Suicide Rate Climbed 35% in Two Decades Report shows people in rural areas are at greater risk

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he U.S. suicide rate has jumped 35% in the past two decades, health officials reported earlier in April. From 1999 to 2018, the suicide rate rose from 10.5 to 14 per 100,000, according to a new report from the U.S. Centers for Disease Control and Prevention. Researchers found the rate of suicide rose by about 1% a year from 1999 to 2006, then increased to 2% a year from 2006 through 2018. The report also shows that men are more likely to die by suicide than women, and people in rural areas are at greater risk than their urban counterparts. “This report shows that there continues to be differences in suicide rates by sex, age group and urban and rural location,” said lead researcher Holly Hedegaard, an injury epidemiologist at CDC’s National Center for Health Statistics. “Examination of suicide rates for different demographic groups can help identify those groups at higher risk,” Hedegaard said. “This information can help guide prevention efforts.” While the suicide rate rose for both men and women, it soared 55% among females compared with a 28% climb among males. Still, men are

nearly four times more likely to take their own lives, researchers reported. In 2018, the male suicide rate was nearly 23 per 100,000, and for females it was slightly more than six per 100,000. The highest suicide rate among women was among those 45 to 64 years old. Among males, the rate was highest for those 75 and over. The lowest rate in both sexes was for kids 10 to 14. “No one knows why suicide rates are climbing,” said Jonathan Singer, president of the board of directors of the American Association of Suicidology. Singer thinks some of these suicides are what have been called deaths of despair — including deaths due to drug and alcohol abuse. Many of these deaths of despair occur in rural areas where there are fewer economic opportunities, he noted. Poverty breeds hopelessness, loneliness and depression, all emotions that increase the risk for suicide, Singer said. The report noted some good news in the last few years of the study period. “After years of increase, the suicide rates for several demographic groups, including females aged 45 and over and males

aged 45 to 64, have stabilized,” Hedegaard said. But suicide rates continued to increase for males and females aged 10 to 44, and men 65 and over, she said. In 2018, men and women in rural areas were more likely to die by suicide than city dwellers, the researchers found. Among males, for example, the rates ranged from 18 in cities to 31 in the most rural counties (per 100,000). For the study, CDC researchers used data from the U.S. National Vital Statistics System. The numbers beg the question, “Why?” There’s no easy answer, said Singer, who is also an associate professor of social work at Loyola University Chicago. “What we do know is that research on suicide is underfunded, that there are many different pathways people take to become suicidal and to make the decision to die,” he said. Singer is concerned that job losses and isolation related to current COVID-19 stay-at-home orders might result in a spike in suicides. On the other hand, being in

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2020

lockdown with family might also be protective, he said. “It’s possible that some of those might actually find comfort and support while being quarantined.” Singer said it’s important to recognize signs of impending suicide. “If you see somebody whose mood has changed rapidly, and if they’re usually pleasant and fairly optimistic or realistic, and suddenly they become incredibly needy and sad and hopeless, they might be on the path to take their life,” he said. If these changes last for a while and they start saying things like, “I don’t think anybody would mind if I were dead,” these are pretty clear warning signs, Singer said. To get help for someone feeling this way, you can contact the Suicide Prevention Lifeline or reach out to a primary care provider or therapist, he said. “Suicide remains a national problem and the rates are rising and we don’t know why,” Singer said. “There’s a need for more folks to be trained in addressing suicide risk, particularly in rural areas, and a need for more research.”


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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Telemedicine Use Soars in Wake of Pandemic Members of Excellus BlueCross BlueShield log nearly 40,000 telemedicine visits between Jan. 1 and April 3

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he number of health care visits delivered via telemedicine technology spiked in recent weeks as health care providers continue to “see” their patients while practicing physical distancing.    “When we chart our member usage of telemedicine, we see a steep, nearly vertical rise in the line graph,” said Marya Vande-Doyle, director of workplace wellness and telemedicine for Excellus BlueCross BlueShield. “It’s not an overstatement to say that patients and their providers have wholeheartedly embraced this method of care.” Excellus BCBS members logged nearly 40,000 telemedicine visits between Jan. 1 and April 3, or about 14,500 more visits than were made in all of last year. In 2019, the health plan had a total of 23,767 telemedicine visits. Extrapolating its member experience across the entire state population, Excellus BCBS estimates that New Yorkers used telehealth benefits 470,000 times in the first three months of 2020. To encourage the use of telemedicine and eliminate roadblocks to getting care, Excellus BCBS expanded telehealth coverage to all members and waived any member cost-share responsibility for telemedicine services, regardless of the medical issue.  A 24/7 nurse line also allows members to speak with specially trained registered nurses, day or night. “Physician interest in telemedicine exploded nearly overnight, and we were ready,” said VandeDoyle. “Our provider relations team immediately hosted three

webinars that were filled to capacity to train more than 500 health care providers in the use of telemedicine technology and proper claims submission for telemedicine visits.” Excellus BCBS increased its provider reimbursement for telehealth services to help replace some of the revenue they’ve lost due to the decline in in-office patient visits. Remote medical care, known as telemedicine, is when a patient and a provider communicate by audio, video or text messaging. An estimated 60% of telemedicine visits made by health plan members in the first quarter of 2020 were related to medical treatments, with the balance (40%) related to behavioral health services. Behavioral health specialists include psychiatrists, social workers, psychologists, counselors and nurse practitioners. “The ideal situation for receiving medical care or behavioral health services is when a patient can see their provider in person,” said VandeDoyle. “With the need to practice physical distancing making that all but impossible at this time, patients and their providers are embracing telemedicine technology as never before.”

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Serving Monroe and Ontario Counties A monthly newspaper published by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations. In Good Health is published 12 times a year by Local News, Inc. © 2020 by Local News, Inc. All rights reserved. P.O. Box 525, Victor NY 14564. Phone: 585-421-8109 • Email: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Mike Costanza, J Ernst Lamothe Jr., Ellen Baker, Melody Burri, Kimberly Blaker • Advertising: Anne Westcott, Linda Covington • Layout & Design: Dylon Clew-Thomas • Office manager: Nancy Nitz No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

Page INAd.indd GOOD Newspaper • May 2020 CAP 4 Good•health 1 HEALTH – Rochester / Genesee Valley Healthcare 4/6/20 3:54 PM


May 2020 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 5


Meet

Your Doctor

By Chris Motola

Gerald M. Gacioch, M.D. FDA Pulls Heartburn Drug Zantac From Market All versions of the heartburn drug Zantac (ranitidine) have been pulled from the U.S. market due to possible contamination with a probable cancer-causing chemical, according to the U.S. Food and Drug Administration. This is the latest step in an ongoing investigation of N-Nitrosodimethylamine (NDMA) in ranitidine medications, the agency noted. In some ranitidine products, NDMA increases over time and when the drugs are stored at higher temperatures, which may result in people being exposed to unacceptable levels of the chemical, according to the FDA. The agency’s order for immediate withdrawal of all ranitidine products means they won’t be available either by prescription or over-the-counter (OTC) in the United States. “Today’s action requesting companies to withdraw all remaining ranitidine products the U.S. market is being taken out of an abundance of caution,” Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, said in an agency news briefing dearly April. “Even though these products when they come off the factory line don’t contain unacceptable levels of (NDMA), we don’t know if they’re stored under various conditions what will end up at the end of the day,” she explained. According to Woodcock, storage temperature appears to be key to the accumulation of NDMA in ranitidine. “With ranitidine, the NDMA does not appear to be formed during manufacturing, but instead appears over time in storage, especially when stored at higher than room temperature,” she said. Packaging or specific formulations of the drug might play a role, too. All of that means that the buildup of NDMA in stored Zantac «may be a fixable problem,” she told reporters. “We’re open to companies demonstrating that they›ve reformulated their product in a way that is stable.” But for now, consumers taking OTC ranitidine should stop taking any tablets or liquid they have, dispose of them properly and not buy more. Those who want to continue treating their condition should consider using other approved OTC products, the FDA recommended. Page 6

Coronavirus unintended consequence: Dramatic drop in the number of people coming to the hospital with heart attacks, says chief of cardiology at Rochester Regional. He discusses role of cardiologists in treating COVID-19 patients Q: Hospitals are obviously under a lot of stress right now. What effect does the COVID-19 pandemic have on specialties like cardiology that aren’t as directly involved in treating the disease? A: It’s affected every aspect of healthcare. Cardiology is actually quite involved for a number of reasons. In the people who are sick enough to be hospitalized, many of them are going to have some kind of cardiac issue. It’s actually pretty common. There’s an enzyme in the blood when the heart is stressed called troponin that is elevated on 70-80% of people sick enough to be hospitalized for COVID. About a quarter of people will develop some degree of inflammation and weakening of the heart. We’re very involved with people sick enough to get admitted, and especially with those sick enough to end up in the ICU on ventilators, who can wind up with irregular heartbeats. The other thing that’s amazing to everyone across the world right now, not just locally, is that the number of people coming in with heart attacks or chest pain is a lot lower. Nobody really knows why for sure, but we think it’s because people are scared to come to the hospital. There are also some theories about how, with fewer cars and factories running, there’s less pollution. The drop in pollution makes a little bit of a difference, but doesn’t explain everything we’re seeing. Q: You touched on quite a bit there, so I want to zoom in on some of it. When you’re talking about stress on the heart, are we talking preexisting conditions or stress from the disease itself? A: So if you have coronary disease, valve disease, you’re more likely to have some complication from COVID, but the majority of people who have the enzyme elevated have never had any heart history in the past. It’s a strain on anyone’s heart who gets it bad. As you well know, 80% of people get the virus and it’s pretty mild. It’s the

20% who get it bad where all these complications happen. Q: What kinds of interventions are you doing for those patients? A: In most people it’s a secondary concern, so the vast majority who develop complications are being treated with medications. We have a lot of effective medications that help a weakened heart. We had a case last week with a gentleman who came in with COVID, who was having a heart attack. And we treated him like any other patient who comes in with a heart attack. We brought him to the heart catheterization laboratory and got him new supply to his heart. So the thing to stress to people is that, even if you’re COVID-positive, we’re treating your heart like we would with any other patient, even without the pandemic. Q: Moving on to the patients you’re not seeing, what can you do to make sure people who need to be seen aren’t being discouraged from being seen? A: I fully understand that no one really wants to come to the hospital ever, and I can fully understand that people really don’t want to come to the hospital when they’re afraid of getting exposed to COVID. It’s perfectly understandable, but people need to remember the warning signs of a heart attack: chest pain, breathing troubles, unexplained dizziness. Just like in normal times, they need to be treated for that. I can tell you there was an article I saw yesterday that emergency systems in New York City are coming to a lot more cardiac arrests at people’s homes because people aren’t coming in. So they’re waiting until their heart stops to call and, as you well know, your chance of survival is much, much lower at that point. So people need to understand we’re still open for business for the normal stuff. Don’t come here for trivial problems,

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2020

but if you’re having chest pains or shortness of breath, that’s not normal. Get checked out. Q: You mentioned the reduction in pollution related to lockdowns and quarantines around the world. Is that having a measurable effect on health? A: In some places, for sure. Places like Los Angeles, India, China. Rochester’s pollution isn’t that bad this time of year, so it’s probably a negligible to small effect around here. We do have some days in the summer where the ground ozone level is very high and can be dangerous, but it’s a small effect compared to cigarette smoking, diabetes, high blood pressure here in Rochester. We luckily have this big lake right next to us that keep fresh air circulating. It’s bigger problem out West because the pollution gets trapped behind the mountains, and in India and China because they lack many pollution controls. There’s a very strong correlation between higher pollution levels, especially particulate pollution, and more heart and lung troubles. Q: What role has telehealth been playing during the pandemic? A: That’s actually what I’m doing with the rest of my day. We are seeing a few patients in the office, mainly new referrals who need a physical examination, but everyone else I would see in the office we’re doing telephone or video visits. We’re doing it on 100% of our revisits, because we really want people to stay home unless absolutely necessary. The 5% or so who aren’t comfortable with that, we’re just moving their appointments back. Q: What permanent effects, if any, do you think the pandemic will have on the way hospitals operate? A: Good question. I would be guessing, obviously, but a lot of it will come down to what Medicare and the insurers do. Up until the pandemic, reimbursement rates were low on the visits. During the crisis they’re paying us the same whether it’s a video visit or in-person visit. If the public feels this is a good thing, they should keep pressure on insurers and the government. I like to see people face-to-face, so I don’t think it’ll ever stay at 100% like it is now out of necessity, but 50% of my visits could easily be done this way.

Lifelines Name: Gerald M. Gacioch, M.D. Position: Chief of cardiology at Rochester Regional Health Hometown: Syracuse Education: Bachelor’s degree in biology from SUNY Albany; medical degree (1984) from the Johns Hopkins University in Baltimore. Medical residency at Johns Hopkins and general cardiology and interventional cardiology fellowships at the University of Michigan in Ann Arbor. Also earned his master’s in medical management from the Carnegie Mellon University in Pittsburgh. Affiliations: Rochester General Hospital Organizations: American Medical Association; American College of Cardiology; American Heart Association Family: Wife, four grown children, three granddaughters Hobbies: Running, backpacking, kayaking


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Healthcare in a Minute By George W. Chapman

COVID-19 Deaths Compared to Deaths from the Flu, Diabetes and Other Diseases

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arious computer models have attempted to predict U.S. deaths from the coronavirus pandemic. The earliest estimates were upwards of one million deaths. These early predictions were based on spurious data from China, very little experience with the virus in the U.S., no established federal game plan or preparation, and no change to everyday life. A few months into this, we have more experience, we have a federal game plan and CDC guidelines are in place to mitigate the spread of the virus like distancing, hand washing and isolation. As of mid-April, models are predicting less than 100,000 deaths. In any event, life as we know it will be altered for

months (years?) until a vaccine is discovered. However, it is important to keep things in perspective. Far more of us die every year due to other diseases and illnesses. Here are the major causes of death for 2018: Heart disease, 655,381; cancer, 599,274; Alzheimer’s and dementia, 267,311; emphysema/COPD, 154,603; stroke, 147,810; diabetes, 84,946; drug overdose, 67,367; pneumonia/flu, 59,690; liver disease, 55,918; renal failure, 50,504; car crash, 42,114; septicemia, 40,718; guns, 39,201; falls, 37,558; hypertension, 35,835; Parkinson’s, 35,598; digestive diseases, 31,015; arterial diseases, 24,808. In 2018 the U.S. population was 327 million.

Hospital Beds in NYS

the fact that we do not have a unified healthcare system in the U.S. For hospitals, it has always been “every man for himself.” The pandemic has decimated already fragile operating margins. The $2 trillion plus stimulus package contains $100 billion for providers.  

Currently, New York state has 214 hospitals with about 35,000 beds. About 3,000 of those beds are equipped for intensive care, which is where patients on ventilators end up. Contrary to what some critics have said, Gov. Cuomo does not determine or control the number of beds in the state. Twenty years ago, in 2000, we had thousands more beds. The reduction of hospital beds over the last two decades is a reflection of what has happened across the U.S. Hospital closures and mergers, shaky bottom lines, wonder drugs, better technology and the proliferation of procedures now performed as outpatient have contributed to the reduction of, or need for, inpatient beds. Hospitals simply can’t afford to keep open enough beds for a pandemic every 20 years or so. Most budget for 90% occupancy. About one third of hospitals operate in the red; one third breakeven; one third make a modest profit. Even large hospital chains, both for profit and nonprofit, struggle financially. The COVID-19 has highlighted

Ventilators

A hospital-style vent costs from $25,000 to $50,000. If the typical hospital is somewhere around break-even, just as it can’t afford to stockpile unused beds, it can’t afford to stockpile ventilators for the every 20 year or so pandemic like COVID-19 let alone a smaller scale epidemic. Again, the U.S. does not have a healthcare system that would be prepared to deal with a pandemic or an epidemic. Most hospitals plan on using up to 90% of their vents on any given day. So, considering the thin operating margins of hospitals, it begs the question: “Who should finance an expensive and rarely used stockpile?” The next shortage facing hospitals will be the medicaMay 2020 •

tions they need to treat the virus and other respiratory diseases. President Trump may have to use the Defense Production Act to force drug manufacturers to step up. About half of our U.S. population lives in an area where an uptick in the virus would overwhelm the number of ventilators available in local hospitals.    

PPE

Highly infectious COVID-19 has drastically increased the need for personal protective equipment like masks, gowns and gloves in hospitals and medical practices. Hospitals are going through their supplies 17 times faster than under normal conditions where typically only staff in the operating suite or treating patients in isolation wear PPE. Now everyone that comes into contact with any patient must wear PPE, since every patient is assumed to be a carrier, given the high number of asymptomatic COVID patients. To make matters worse, healthcare workers that wear PPE must also remove their clothes before entering their homes to avoid contaminating their homes and families.  

Telemedicine

Most likely, because of the highly infectious virus, your provider has either postponed your upcoming routine office visit or has offered to “see” you via telemedicine. Medicare has relaxed privacy and billing requirements for providers, (MDs, NPs, PAs, social workers, therapists, mental health providers) making it far easier for them to offer and bill for virtual visits. Smart phones and personal computers are acceptable for virtual visits. Medicare will waive office copayments, but the 20% coinsurance and deductibles still apply. The virtual visit cannot be related to a prior visit, usually a follow up, that occurred within the prior seven days and does not lead to a personal visit within 24 hours or next available appointment. You must agree to the virtual visit verbally. Commercial insurers typically, but not always, mimic Medicare. If you are uninsured, Medicare will pay your provider normal Medicare rates. Telemedicine has

been available for years, but providers and consumers alike have been slow to incorporate it into practice. COVID-19 may be the catalyst for the widespread acceptance and use of the virtual visit, especially as both consumers and providers adapt over the next several months. Medicare is also relaxing physician supervision of nurse practitioners and physician assistants, granting these two advanced practitioners more independence. Physicians will also be allowed to provide virtual care across state lines regardless of the state they are licensed.

Testing

As of this writing, in mid-April, about 2 million of us have been tested for SARS 2/COVID-19. That is a start, but still not even 1% of the U.S. population of 330 million. There are plenty of labs to perform the tests including 4,900 CDC labs and 228,000 public health labs. The overwhelming problem right now is the inability for most of us to get tested. The shortage of testing presents another problem in that physicians cannot verify that a patient died of the virus if they were never tested. Consequently, fatalities due to the virus are probably somewhat understated, as scarce tests are being saved for the screening and diagnosis of the more ill patients. To get back to “normal,” if we ever do, it is imperative that all of us have immediate access to testing. Social distancing is working but until there is universal, or just better, testing epidemiologists believe it won’t be safe to “open up the country” again.    George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 7


Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Alone in the Time of Corona

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t’s been said that too much of a good thing can be too much of a good thing. While I love living alone, this concerning, confusing and, for some, depressing time of self-isolation and social distancing has taken “alone time” to a whole, new level. Solitude by choice is one thing; solitude by necessity is another. In the first week under the stay-at-home order, I managed just fine. I cleaned, I cleared out the clutter, and I took care of minor repairs and maintenance projects inside and outside my home. I was fine. So I thought. By week two, I found myself walking in circles with too much time on my hands. I was flitting from one thing to another, unable to focus. Still, I thought, I’ve got this. Alone time is my wheelhouse. But then reality set in. So did self-awareness and reflection. I was not fine. I felt lonely and unmoored. My empty calendar became a source of anxiety. Gone were my weekly touchpoints: the fitness classes I led at the YMCA, my band rehearsals, my volunteer job at the fair-trade shop, and my get-togethers with friends and family. My home and life were quiet. Too quiet. And so I did what I usually do when confronted with a challenge: I went into problem-solving mode. I knew I needed to create a new normal for myself — a new daily routine in which I could find fulfillment and joy. I started by making a list of things I wanted to accomplish each day and then created a schedule in one- and two-hour increments. Do I stick to my timetable religiously? No. Do I leave plenty of room for spontaneity, incoming

phone calls/texts, invitations to walk, and most every interruption? Yes! Below, I’ve shared my daily schedule in the hope that it might inspire you to embrace this unique time in our lives and to make the most of our collective solo experience.

Today and Every Day 5:30 a.m. Wake up on the dot before sunrise with no alarm clock. Even in retirement, I can’t break this habit. Before I get out of bed, I do a series of stretches and repeat my morning affirmation: “I am filled with gratitude and positive energy.” 6 a.m. I make a pot of coffee and carry my cup into the living room, where I light a candle in the darkness and prepare to meditate. Sitting comfortably on my couch, I concentrate on my breathing, focus on the present and center myself for the day ahead. In this soothing, safe and contemplative space I feel surrounded and uplifted by a universe of caring souls. I feel connected and so blessed to be a part of it. Abundant compassion, love and kindness are shared in this tranquil moment. I am not alone. 7 a.m. After enjoying yogurt and a banana, I move to my desktop computer to read digital copies of the local newspaper and “New York Times.” Then, I send and answer emails with friends and family with the aim to support, cheer up, console and commiserate. Humor always seems welcome! Following that, I check out COVID-19 stats and updates, and glance at my go-to websites for breaking news, movie/book reviews, cat videos (kidding!), spring gardening tips, and — drum roll — 30% off

s d i K Corner

All That Social Media Hasn’t Hurt Kids’ Social Skills: Study

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oday’s youngsters are as socially skilled as previous generations, despite concerns about their heavy use of technology, like smartphones and social media, new research shows. The researchers compared teacher and parent evaluations of more than 19,000 U.S. children who started Page 8

kindergarten in 1998 — six years before Facebook appeared — with more than 13,000 who began school in 2010. That’s when the first iPad came on the market. “In virtually every comparison we made, either social skills stayed the same or actually went up modestly for the children born later,” said

sales with free shipping. Woo-hoo! Can’t wait for my new pair of wellies to arrive. 8 a.m. Time to shower and make myself presentable. I want to look pretty under my face mask. Ha! Then I make my bed, fold laundry and do a little ironing (one of my cherished “Zen” activities). 9 a.m. I devote this hour to my music. I play percussion in a local community band and like to practice my pieces and double-stroke rolls in the morning when I’m feeling fresh. I also tried something new just for the fun of it: I subscribed to a learn-to-play piano app and decided to start from scratch. I know how to play the piano, but I’m rusty, so I thought what better time than now to revisit the rudiments. 10 a.m. I need a change of scene and, more importantly, human contact (even at six feet apart). Every day around this time, I take a long walk. Alone or preferably with my sister Anne or a friend, I walk for over an hour. I believe that — at a safe distance — in-person companionship is vital to my emotional well-being. And perhaps to my immune system, too. I love nature, so walking in a park, re-purposed railroad trail or canal path does my heart good. I try valiantly to smile at passers-by with my eyes, above my mask. 12 p.m. Time for lunch. This may be my favorite time of day. I’ll prepare something healthy to eat and take it outside to enjoy on my back patio. On the bistro table, I create a nice place setting and “equip” it with a pen, paper, and notecards. In this peaceful oasis, I write handwritten get-well wishes, sympathy cards (sadly) and heartfelt thankyou notes to friends, family and even perfect strangers, e.g., frontline caregivers at our local hospitals. I wish I could do more. 1 p.m. Catch-all time — so much to do, so much time! I make a list of household chores and knock them off in half-hour increments. I use my oven timer to stay on track. It works. 3 p.m. Time to exercise. Working out has always been a huge part of my life. With no fitness classes to lead or attend, I created an exercise studio

in the hayloft of my barn. In this rustic, fragrant space I am producing homemade workout videos for my friends and neighbors who want to stay in shape. On YouTube, it’s called “Workout at Home with Gwenn.” It’s one way I can help. Together, we can stay strong. 4 p.m. Nap time. I like to kid myself and refer to it as “reading time,” but, well, you know how it goes ... 6 p.m. I watch the local news, followed by the national news. On commercial breaks, I pop into the kitchen to experiment with new recipes. Last night it was homemade pizza with slices of hot sopressata, instead of pepperoni. It was delicious, if I do say so myself. I’ll be happy to share the recipe. 7 p.m. Hunkering down for the evening. After checking my inbox one last time, I watch a Netflix or Amazon Prime movie or original series, a PBS special or reruns of a favorite childhood TV show. I can’t get enough of “The Andy Griffith Show!” At 9 p.m. I switch over to watch Rachel Maddow on MSNBC for a news recap and then call it a night. So, there you have it, a recipe for living alone in the time of Corona. Make it your own! And know that what initially might seem like too much of a good thing can turn into a great thing — a time to slow down, to make new connections with yourself and others, to pitch in and help, and to remind yourself that you can do this. You can create a wonderful life, make a meaningful contribution, and find contentment on your own.

study lead author Douglas Downey, a professor of sociology at Ohio State University. “There’s very little evidence that screen exposure was problematic for the growth of social skills,” he added in a school news release. Both groups of youngsters had similar ratings on interpersonal skills — such as the ability to form and maintain friendships and get along with people who are different — and on self-control, such as the ability to control their temper. The only exception to the overall findings was that social skills were slightly lower for children who accessed online gaming and social networking sites many times a day. “But even that was a pretty small effect,” Downey said. “Overall, we found very little evidence that the time spent on screens was hurting social skills for most children,” he added. While he was initially surprised

to discover that time spent on screens didn’t affect children’s social skills, Downey said he shouldn’t have been. “There is a tendency for every generation at my age to start to have concerns about the younger generation. It is an old story,” he noted. “The introduction of telephones, automobiles, radio all led to moral panic among adults of the time because the technology allowed children to enjoy more autonomy,” he explained. “Fears over screen-based technology likely represent the most recent panic in response to technological change.” New generations are learning that having good social relationships means being able to communicate successfully both face-to-face and online, according to Downey. The study was recently published online in the American Journal of Sociology.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2020

Gwenn Voelckers leads Alone and Content empowerment workshops for women held in Mendon and is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about workshops, to purchase her book, or invite her to speak, call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com.


COVID-19

The New Normal – COVID-19, Face Masks, Social Stigma By Kimberly Blaker

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he alarming rate at which COVID-19 has swept the world has left researchers little time to discover all we need to know about the illness other than that it’s both highly contagious and deadly. Researchers, doctors and governments as of mid April recommend we all stay home and avoid mingling with anyone who doesn’t live in the same household. When we must go out, we should keep at least six and a half feet away from others to prevent the spread of the illness. Unfortunately, we must still leave our homes for essentials. So how can we keep ourselves and others safe? The CDC and Gov. Cuomo now recommend wearing a cloth mask whenever we leave our home and are around others. Many cities have joined in and are making efforts to enforce wearing masks in public. Even many stores now require employees and customers to wear masks or cover their faces while in the establishments. 

How masks help Current studies indicate COVID-19 spreads mainly between people in close proximity through respiratory droplets from coughing, sneezing and even talking. The incubation period between exposure

23

That’s the number of times most people touch their faces in an hour. Here are five tips to reduce that

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ou’ve been told over and over not to touch your face during the coronavirus pandemic, but that’s easier said than done. Most people touch their face up to 23 times an hour and don’t even realize they’re doing it, a psychologist says. “Typically, we’ll do something like shaking someone’s hand and then failing to wash our hands properly, followed by touching our faces and then we’re off to the races with an infection and symptoms that will show up in two to 14 days,” said Jim Pomerantz, a professor of psychological sciences at Rice University in Houston. “It’s much better to prevent an

and showing symptoms can range between two to 14 days. A significant number of people are also asymptomatic or have mild symptoms. Yet they can still spread the disease to others who may be affected more severely. The primary purpose of wearing a cloth mask is to prevent spreading the virus to others because anyone may have it and not experience symptoms. Since it’s transmitted through respiratory droplets, keeping our noses and mouths covered helps contain the droplets preventing the spread to others. 

Social Stigmas Both those who wear masks and those who don’t may experience social stigma related to the covers. Earlier recommendations that only those who are symptomatic wear masks may lead some people to assume anyone wearing a mask is infected with the virus. As a result, those wearing masks may be treated differently by some individuals. On the other hand, many people are following the latest guidelines that everyone wears masks to prevent the spread of the virus. Those who are wearing masks may, therefore, see those who aren’t as either irresponsible or lacking regard for the welfare of others.

It’s impossible to control how others think and behave. So we must each make responsible choices that are not only in our own best interest but also for the safety of those around us. Each of us can do our part by following the CDC guidelines. At the same time, whether someone around you is wearing a mask or not, try not to pre-judge, since you don’t know their situation. Because wearing a mask is so new, it may feel strange at first, especially if others aren’t wearing one. In all likelihood, though, you won’t be the sole person wearing a mask when you’re out. Plus, the more people wear them in public, the more that’ll join in the battle to eradicate the virus, until it becomes the new norm. 

Recommended protocols Currently, there’s a severe shortage of N95 respirators and surgical masks for healthcare workers and first responders who are regularly

being exposed. So the CDC does not recommend the general public wear these medical-grade masks. Cloth masks, however, are easy to make at home. Tutorials and videos are available on the CDC website, among many other websites and social media pages with instructions on how to make various designs.  You can also buy masks online from the many companies and individuals now selling premade cloth masks. When making or buying masks, make sure they:  • snugly cover your nose and mouth • are secured with ties or loops  • have multiple layers • are easy to breathe through  • can be machine washed after each use  It’s also vital to wash your hands immediately after removing your mask and machine wash it after each use to remove viral droplets that may have landed on the mask. 

infection than to try to deal with it after the fact, and that’s the purpose of our work here,” he said in a university news release. Here are Pomerantz’s tips to keep your fingers off your face. Ask a partner to alert you when you touch your face. Wear perfume or bracelets to remind you not to touch your face, and write down how many times you touch your face each day. Remind others when you see them touching their face to stop. Keep your hands busy. Put them in your pockets, hold a ball or a deck of cards, or make fists for one minute if you bring them near your face. Keep your elbows off the table, sit in chairs without armrests or in the middle of the couch. If you find it is hard not to touch your face, sit on your hands. Practice relaxation by focusing on long, slow, deep breaths and on relaxing muscles that feel tense. Sit in a quiet place and dwell on the present moment, not the past or future. Spend time in nature, but keep a safe distance from others. “Many of us have taken a course in introductory psychology where we learned about conditioning and the laws of behavior, and how we can establish and change behavior,” Pomerantz said. “We know that this works. And if people put these ideas into practice immediately, we’re going to see, we hope, some flattening of the curve much more quickly than otherwise,” he added.

1.

2. 3. 4. 5.

May 2020 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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COVID-19

Safer Shopping for Seniors By Deborah Jeanne Sergeant

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ustling crowds during coronavirus-fueled panic shopping may have presented an annoyance to some shoppers. But for an older adult with balance issues, going to stores during a time like this can increase the risk of falling and a subsequent broken bone. Of course, during the pandemic, it’s important to follow health and safety protocols about going places in public; however, in general, a few strategies for shopping can make it safer to reduce the risk of falling for older adults. Susan Schermerhorn, director of marketing at Ashton Place in Clifton Springs, recommended shopping at less busy times (see box with story). Schermerhorn said that some Ashton Place residents who use a cane park near the cart corral and use the shopping cart for stability while walking. If possible, bringing along the cane in the cart can help if the shopper needs to step away from the cart. Planning the route through the store can make the trip easier by reducing the need to backtrack. “We outline the store near us by department — the way the store flows — so their list coincides with the store layout, Schermerhorn said. “It can save them time and exposure to germs.” To save steps, shop online. Amazon Prime Pantry, for example, can deliver shelf-stable goods free with orders of $35 or more. That can whittle down the shopping list to fewer items. Or shop with a store such as Wegmans, Tops and Price Chopper, which offer curbside pick-up or delivery through the Instacart app. This includes a store’s perishable goods, too.

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Grocery stores are least busy before 8 a.m., according to InMarket, a company that analyzes retail shopping patterns. Once it’s noon, the store likely will stay busy until 7 p.m. As a plus, the store will likely be its cleanest and best-stocked early in the morning. Weekends, especially Saturday morning and early afternoon on Sunday (the post-church crowd) are very busy times, as are the day before a holiday or food-oriented event, such as the Super Bowl. Shopping on weekdays — especially during morning working hours — is a much better bet for experiencing thinner crowds.

Tips for Safe Grocery Shopping

Daniel Jones has a certificate in gerontology and owns Daniel Teaches. He teaches technology lessons, specializing in helping older adults access technology. Lately, he’s been developing online tutorials on apps such as Grubhub and Instacart. “If you take your time and go through them, both are very straightforward,” Jones said. Grubhub and DoorDash, a similar app, deliver restaurant food based upon ZIP code. Just enter the ZIP and see what restaurants use the delivery services. “By default, it brings up menus for your area,” Jones said. “They may charge more because you live far away. There’s a point where the app itself is not going to work for you. But that will be pretty rare.” Instacart works in a similar fashion, linking users to the stores nearest to the user, including grocery stores, mass merchandisers and drug stores. While having someone else pick out your food may be an adjustment,

Are Ventilators Helping or Harming COVID-19 Patients?

echanical ventilators have become a symbol of the COVID-19 pandemic, representing the last best hope to survive for people who can no longer draw a life-sustaining breath. But the ventilator also marks a crisis point in a patient’s COVID-19 course, and questions are now being raised as to whether the machines can cause harm, too. Many who go on a ventilator die, and those who survive likely will face ongoing breathing problems caused by either the machine or the damage done by the virus. The problem is that the longer people are on ventilation, the more likely they are to suffer complications related to machine-assisted breathing. Recognizing this, some intensive care units have started to delay putting a COVID-19 patient on a ventilator to the last possible moment, when it is truly a life-or-death decision, said physician Udit Chaddha, an interventional pulmonologist with

Best Time to Grocery Shopping

Mount Sinai Hospital in New York City. “There had been a tendency earlier on in the crisis for people to put patients on ventilators early, because patients were deteriorating very quickly,” Chaddha said. “That is something that most of us have stepped away from doing. “We let these patients tolerate a little more hypoxia [oxygen deficiency]. We give them more oxygen. We don’t intubate them until they are truly in respiratory distress,” Chaddha said. “If you do this correctly, if you put somebody on the ventilator when they need to be put on the ventilator and not prematurely, then the ventilator is the only option.” Experts estimate that between 40% and 50% of patients die after going on ventilation, regardless of the underlying illness, Chaddha said. It’s too early to say if this is higher with COVID-19 patients, although some regions like New York report as many as 80% of people infected with the virus die after being placed on ventilation.

You’re in lockdown, yet you still have to go grocery shopping, but how do you stay safe and avoid catching the coronavirus? The American Medical Association has some timely tips. When you go to the store: • Stay at least six feet away from other shoppers. • Don’t shake hands, hug or have any physical contact. • Wipe down grocery carts or basket handles with disinfectant wipes if you have them. • Don’t touch your face. • Wear a cloth face mask.

• While waiting and after leaving the store, use hand sanitizer if you have it. • If you’re sick, don’t go shopping. But if you must, wear a mask, wash your hands often and keep a safe distance between you and others. When you get your groceries home: • Although it’s unlikely you’ll be exposed to the virus from the items in your shopping bag, wash your hands after unpacking your groceries. • Wipe surfaces with a household disinfectant. Take precautions when preparing food: • Wash your hands before eating. • Do not share plates or silverware with others. • Rinse fruits and vegetables before eating them. If you’re 65 or older: • Ask a neighbor or friend to pick up groceries and leave them outside your house or bring them in while keeping at least six feet apart. • Check with your local market and go during store hours reserved for older shoppers. • See if your grocer delivers and shop online. These tips were published online recently in the Journal of the American Medical Association.

“for the most part, when we all go shopping, we usually buy the same things,” Jones said. “I don’t need to check the back of the Ritz crackers every time. It’s a staple.” Using an app for delivery “does cost a little more, but curbside usually doesn’t have a fee,” Schermerhorn said. She added that since curbside groceries will be bagged in brown paper bags, which are more difficult to carry since they lack handles. “Bring a reusable bag,” Schermerhorn said. “They could put the brown bags into the reusable bag so

when you carry them to the house, you have a handle on them.” Schermerhorn said that those with balance issues and concerns about stability should ask for help. Most stores have personnel available to reach items on high or low shelves or to load groceries, for example. Family members may also feel willing to help if they’re asked. Once home, it’s okay to focus on putting away the perishable items and just leave the other items for later if fatigue is an issue.

These critically ill patients die because they are so sick from COVID-19 that they needed a ventilator to remain alive, not because the ventilator fatally harms them, said physician Hassan Khouli, chairman of critical care medicine at Cleveland Clinic. “I think for the most part it’s not related to the ventilator,” Khouli said. “They’re dying on the ventilator and not necessarily dying because of being on a ventilator.” ‘People don’t come back from that’ However, mechanical ventilators do cause a wide range of side effects. Those complications, combined with lung damage from COVID-19, can make recovery a long and arduous process, Chaddha and Khouli said. New York City lawyer and legal blogger David Lat spent six days on a ventilator last month, in critical condition at NYU Langone Medical Center after he was diagnosed with COVID-19. “This terrified me,” Lat wrote in an opinion piece in the Washington Post. “A few days earlier, after my admission to the hospital, my physician father had warned me: ‘You better not get put on a ventilator. People don’t come back from that.’” Lat survived, and he thanks the

ventilator but he also is struggling to recover his ability to breathe. “I experience breathlessness from even mild exertion,” Lat wrote. “I used to run marathons; now I can’t walk across a room or up a flight of stairs without getting winded. I can’t go around the block for fresh air unless my husband pushes me in a wheelchair.” Mechanical ventilators push air into the lungs of crucially ill patients. The patients must be sedated and have a tube stuck into their throat. Because a machine is breathing for them, patients often experience a weakening of their diaphragm and all the other muscles involved with drawing breath, Chaddha said. “When all these muscles become weaker, it becomes more difficult for you to breathe on your own when you’re ready to be liberated from the ventilator,” Chaddha said.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2020


COVID-19

Another Study Finds Loss of Smell Is Early Sign of COVID-19

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new study adds to a growing pile of evidence that suggests losing your sense of smell and taste is an early sign of COVID-19. While there has been anecdotal information about this link, these are the first empirical findings that make a strong connection, according to the researchers at the University of

California, San Diego. Other known symptoms of coronavirus infection include fever, fatigue, cough and difficulty breathing. “Based on our study, if you have smell and taste loss, you are more than 10 times more likely to have COVID-19 infection than other causes of infection. The most com-

mon first sign of a COVID-19 infection remains fever, but fatigue and loss of smell and taste follow as other very common initial symptoms,» said study author Carol Yan, an otolaryngologist and head and neck surgeon at UC San Diego Health. “We know COVID-19 is an extremely contagious virus. This

study supports the need to be aware of smell and taste loss as early signs of COVID-19,” Yan said in a university news release. The study was published April 12 in the journal International Forum of Allergy & Rhinology.

Coronavirus: More People in Rochester Region Seek Animal Interactions Use of pets to de-stress is one of the reasons, experts say By Deborah Jeanne Sergeant

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o wonder about 85 million American households in the U.S. have animals, according to figures from Human Animal Bond Research Institute. Whether it’s a pleasure horse or a pet poodle, an animal brings companionship, activity and a few health benefits, like lowered blood pressure and reduced risk of stroke and heart attack, according to numerous studies. More people than ever have tapped into the benefits of emotional support animals and therapy animals, which can help with anxiety, post-traumatic stress disorder, and many other mental health issues. But outside those concerns, many people crave connections with animals and find them relaxing. Suzanne Vullers operates Mountain Horse Farm in Naples, a B&B operation that provides guests with “cow cuddling” and a “horse and cow experience” with her six horses and two cows. Vullers wants to give her clients the same experience she gets from it: “Connecting with nature and animals — in this time, we’re so focused on being inside and in front of screens. Everything you can do virtually.” She wants to offer guests a reprieve from screens and the companionship of farm animals, such as lying in a pasture against one of her placid cows or grooming friendly horses. Vullers is certified by the Equine Assisted Growth and Learning Association, an organization for mental health and equine professionals that incorporates horses to address mental health and personal development. She has worked with horses all her life. “I know what they do for me,” she said. “It’s always been the relationship, not competing and winning prizes. It’s always been about getting that connection and forming that friendship.” When visiting family in the Netherlands, she observed similar work with cows and realized she needed to add bovines to her herd. “We work with them differently, as cows like to lie down,” Vullers

said. “They’ll lie down for long periods of time. Horses, they don’t really interact that way with people they don’t know. They may lie down, but that’s rare.” By offering experiences with both animals, Vullers can meet the needs of more guests who crave animal interactions. To meet her animals’ needs, she limits the opportunities for guests to visit with the animals to one to two sessions up to four days a week and hosts the interaction in a space where the animals are free to move around. “You see the animal relax,” Vullers said. “That’s where the benefits of your heart rate and blood pressure going down and you relax and can breathe. All that good stuff happens because it comes from mutual desire to connect.” It seems that many people in recent times are seeking animal companions. Cheri Roloson, farm manager at Cracker Box Palace in Alton, has noticed an uptick in adoptions from the shelter’s rescued farm animals. It’s hard to say exactly why, but since the beginning of the coronavirus crisis, “we’ve had so many adoptions,” Roloson said. “We were at 246 animals before. It’s gone way, way down. We’re all a little nervous about when people go back to work and they may want to return them. People have time now and it’s companionship and something to do.” She said that part of the reason people de-stress in the presence of animals is that “animals don’t judge people. They don’t care as long as you’re kind to them and feed them. We’ve seen it here a million times.” Even visiting the animals seems to bring some people benefits. Though not a formal animal therapy site, shelters such as hers can offer opportunities for animal interactions. Cracker Box allows visitors and hopes to do so again once social isolation is over. Roloson knows of a dialysis patient who would regularly stop in to visit the animals and find that his blood sugar and blood pressure stabilized. Another man undergoing chemotherapy would stop and pet a May 2020 •

Suzanne Vullers, owner of Mountain Horse Farm in Naples, a B&B operation that provides guests with “cow cuddling.

A guest at Mountain Horse Farm gets cozy with Bella the cow. horse over the fence. “He said it got him through the treatments,” Roloson said. “You can tell a horse anything.” She advises anyone seeking to adopt an animal to check with their municipality’s zoning laws for farm animals or exotic pets and to research the type of animal in question. Shelters like Cracker Box perform a site check and confirm that those applying to take hope an animal can adequately do so, including securing a veterinarian. “Anyone can foster an animal, and we encourage that, especially with larger animals, for three months,” Roloson said. “We have a clause in the contract that in any point in the animal’s life we have dibs on the animal for them to come back here.” Of course, bringing home an animal without being ready can increase stress. Roloson encourages would-be owners to “go work with that kind

of animal at a shelter or farm so you know what you’re getting into. Make sure you have a vet for your animal. They don’t always deal with potbellied pigs, for example. You really have to do your research. “I know a lot of people are impulsive, but to really get that right connection and ‘happily-ever-after’ story, we are serious about when they adopt an animal from us,” she added. Anyone seeking a farm animal “fix” can find it among the animals at Cracker Box, even if they cannot keep large animals at their property. Like most other shelters, Cracker Box Palace welcomes guests and volunteers, who complete orientation and training to work around the animals. Those who want but cannot have a dog or cat may volunteer at shelters caring for pets, walk a busy or elderly neighbor’s dog or offer to pet sit at a friend’s home.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 11


New URMC Coronavirus Research Examines Immune Response

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2020

he University of Rochester Medical Center (URMC) is launching a new study to understand how the body’s immune system responds to COVID-19, including if and when a person could be re-infected with the virus and whether some people have pre-existing immunity. The findings could have significant implications for the public health response to the pandemic, the development of COVID-19 vaccines, and decisions related to re-opening the economy and society. The new coronavirus research is being led by David Topham, Ph.D. and physicians Angela Branche and Ann Falsey, under the URMC New York Influenza Center of Excellence (NYICE), one of the five international centers in the Centers of Excellence in Influenza Research and Surveillance network. The research is supported by approximately $5 million in funding from the National Institute of Allergy and Infectious Diseases (NIAID), the institute headed by physician Anthony Fauci. “This research will seek to answer several important questions, including the durability of immunity from the virus once a person has been infected and recovered, whether the virus is mutating, whether previous exposure to other seasonal coronaviruses provides a degree of protection from COVID-19, and how long potential vaccines could provide immunity from the virus,” said Topham. The study will recruit up to 100 COVID-19 positive individuals across all age groups from the Rochester community and follow them for 90 days. The researchers will collect samples that will enable them to isolate and study the virus, and measure immune response to the infection.  Specifically, it will track the production of antibodies that seek out and flag the virus for destruction by immune cells. Once produced in sufficient quantity, these antibodies and other cells generated by the immune system provide protection from re-infection. These cells are also activated after vaccination. However, as is the case with other viral infections such as the flu, it is speculated that immunity to COVID-19 will weaken over time. This research builds on more than a decade of influenza and respiratory pathogens research by the NYICE. For the past 13 years, URMC researchers have been conducting surveillance studies in an effort to better understand the immune response to the flu and vaccination. At the request of NIAID, URMC researchers have retooled and expanded the influenza study to include on COVID-19. 


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Things You Need to Know About Viruses By Ernst Lamothe Jr.

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he world is learning more about how fast certain viruses spread and how long they can linger. Virus-laden droplets may infect an area for several hours, depending on where they fall. Viruses generally remain active longer on stainless steel, plastic and similar hard surfaces than on fabric and other soft surfaces, according to the Mayor Clinic. Other factors, such as the amount of virus deposited on a surface and the temperature and humidity of the environment, also determine how long viruses stay active outside the body. We’re also learning it’s possible to catch a virus after handling an object that an infected person sneezed or coughed on a few moments before. But personal contact with an infected person through a handshake or breathing in droplets from a cough or sneeze is the most common way these viruses spread, said Anja Bottler, infectious disease physician at Unity Hospital, which is part of Rochester Regional Health. Bottler describes five traits of viruses.

1.

Viruses are different than bacteria The most important distinction between bacteria and viruses is that antibiotic drugs usually kill bacteria, but they aren’t effective against viruses. Infections caused by bacteria include strep throat, tuberculosis and urinary tract infections. Diseases caused by viruses include chickenpox, AIDS and the common cold. “Viruses cannot survive by themselves. They need to live inside

a human or animal cell,” said Bottler. “Viruses feed off the cells and use protein and amino acids and they grab onto the cell and replicate to form new little viruses. Once they form, then we can directly spread it to others in various ways.”

2.

Social distancing That’s the reason why Bottler said social distancing is so essential to prevent the spread. Social distancing is deliberately increasing the physical space between people to avoid spreading illness. Staying at least six feet away from other people lessens your chances of catching the coronavirus or other types of virus. “It is easier to spread viruses when you get in close quarters and are directly in front of someone’s face,” said Bottler. “When you are farther apart, it is more difficult for the droplets to come in contact with you and they can simply fall to the ground and can’t reach another person’s face, hands or clothing. This is one of the only ways we can prevent the spread of a disease and avoid infecting each other.” Another reason she suspects the virus spread so quickly is travel. “People traveled all over the world in the past three to four months, and when they landed back home, they spread the virus without knowing,” she added.

3.

Vaccines take time Many have wondered, with COVID-19 being an issue first overseas for months, why hasn’t an established vaccine been

May 2020 •

created and distributed to the public? Well, it is not that easy. As Bottler explained, there is a process through the Federal Drug Administration that involves different scientific trials before it is given to the general population. It first starts with bench scientific trials to identify how the immune system and virus travels from person to person. Then there are tests on animals and then you start the first phase on a few dozen people. “There are many factors that play a role in how quickly we can get a vaccine to the public. There are reasons why we have multiple trials to make sure everything is safe and that we are not injecting people with something that could give them serious side effects,” Bottler said. “If we gave the vaccine to 1,000 people in Rochester, we have to make sure that the vaccine works or they could easily just spread it as if they were not vaccinated.” Bottler mentioned that it was easier coming up with an H1N1 vaccine because it resembled the flu strain as opposed to coronavirus, which is a different beast itself that the medical community is still trying to decipher.

4.

Upper vs lower respiratory Because a virus can hit various aspects of the body, where it attacks can determine the severity. Viruses can cause a wide range of illness in humans. They can be anything from subtle to deadly. Various viruses can cause headaches, chills, vomiting or more serious problems. “Where the virus comes into the body, this is some of the reasons why the coronavirus is so deadly. When

Anja Bottler, infectious disease physician at Unity Hospital. you have a regular cold, it often hits the upper respiratory portion of your body and affects your throat and sinus,” she said. “But the coronavirus is hitting the lower respiratory portion, which is where the lungs are at and that can cause pneumonia and respiratory failure.”

5.

Global warming and viruses Today, worldwide, there is an apparent increase in many infectious diseases, including some newly-circulating ones. Climate change will also affect infectious disease occurrence “We don’t realize the impact that global warming and climate changes are having in our society. It is now affecting viruses that are in places that they were never before,” said Bottler.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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ON THE FRONTlINE

They and other healthcare providers are frontline responders in the battle against COVID-19. Thank a nurse — May is Nurses Week. By Deborah Jeanne Sergeant

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urses perform tasks that few other people could do as they care for patients who are sick and hurt. Currently, the role of nursing has taken on even greater significance, as nurses and other healthcare providers are frontline responders in the battle against COVID-19. The nature of their work places them in direct contact with infected and possibly infected patients every day. Nurses provide the physical and emotional care patients need, especially while isolation prevents loved ones from visiting. While recent events have drawn the public attention to nursing as they work long hours — sometimes with insufficient supplies and

equipment — caring for COVID-19 patients, the industry has long experienced staffing difficulty. As of May, 209, 178,320 registered nurses work throughout thesState of New York. Of those, 12,400 work in the Rochester area. Even outside of the pandemic, nurses often work under circumstances unlike most other positions in healthcare and stressors not known in many other industries. It’s commonplace for nurses to care for eight or nine patients at a time on a particular shift. This problem has prompted the New York Nurse’s Association to promote the statewide Safe Staffing for Quality Care Act, which supports nurse ratios, staffing for acuity, publicly disclosed staffing levels, maximum

number of patients assigned to an RN, and more. Most of the ratios are 1:1, such as trauma and surgery to 1:3, such as newborn nursery. Rehabilitation and subacute nurse-to-patient ratio is 1:5 and the highest is the well baby nursery at 1:6. Nursing education began as much less formal than now. Caring women learned the folk remedies and wisdom passed down from experienced elders. While the standard now is two years’ education to become a registered nurse and four years to earn a bachelor’s (BSN), the industry in New York has moved toward a required four-year degree as the standard. As of 2020, New York students beginning their studies may com-

Recuperation Experience Prompted Nursing Career For Alexandria Lovejoy, a knee injury led to a career in nursing By Deborah Jeanne Sergeant

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hen she was a senior in high school, Alexandria Lovejoy of Stanley never imagined herself in a nursing career. A ballet dancer, she had lined up a variety of opportunities in New York City, where she intended to move. A knee injury and a few surgeries derailed her professional dancing aspirations. She said that as she recuperated in the hospital, she started to think. “I felt kind of lost. I honestly thought my life was ended as a 17 year old. The nurses said, ‘Your life isn’t ending; it may mean your life is supposed to go somewhere else.’ Page 14

They were so supportive and helped me though that process.” That experience led her to a desire to help others. At the time, she didn’t know how she would work as a nurse. While she pursued her bachelor’s in nursing at Nazareth College, she took a class on public health and decided to take on public health as a second major, in addition to the bachelor’s in nursing. “It let me see healthcare from two different lenses: the bedside and the policy and government side,” Lovejoy said. “It gave me a holistic perspective. That drew me to critical

care because I saw how much policy and ethics and decision making goes into decisions about those patients and how important it is.” Throughout her four years at Nazareth, she worked as a part-time care technician at Clifton Springs Hospital and completed a few internships with Rochester Regional Health and Clifton Springs Hospital, shadowing nurses in a variety of departments. “I realized I loved critical care and the ICU,” Lovejoy said. “The rest of my years of my schooling, I specialized in critical care. I did my cap-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2020

About 12,400 registered nurses are in the workforce in the Rochester area today plete an associate’s degree and then have 10 years after they receive their RN credential to complete their BSN degree. The goal is to improve patient outcomes through improving nurses’ critical thinking skills. New York is the only state to pass such a measure — and it took a decade for New York to pass the law. It’s likely that the nationwide nursing shortage plays into others state’s decision so far to resist laws such as this. According to the National Nursing Workforce Study, half of current RNs nationwide are 50 or older. In addition, the Health Resources and Services Administration estimates that within the next decade, over a million RNs will retire from nursing. Historically, women have dominated nursing; however, in recent decades, men have become more commonplace in the field. In New York, 157,439 women were working as nurses as of 2017. Male nurses numbered 11,048, according to Kaiser Family Foundation. Nationwide, about 12% of RNs are male, up from 2.7% in 1970, states the Bureau of Labor Statistics. Part of the reason may lie in the fading stereotype of nursing as “women’s work” and the sharp increase in the need for nurses. With more nurses retiring and the aging baby boomer population increasing the demand for health care, nursing represents one career path with a guarantee of available employment. While the $66,890 annual mean salary in the Rochester area is a good salary, nursing is taxing work which often involves long shifts, unpredictable hours (depending upon the place of employment) and heavy responsibility. Despite this, many nurses refer to their occupation as a “calling” that they feel privilege to perform. Since May is Nurses Month, take time to thank a nurse you know.


stone placement — the last semester of nursing school — where you’re placed with a nurse you follow and learn from them for a whole semester. You choose a specialty you want to follow in. I chose the ICU.” She graduated in 2019. Her experience at Clifton Springs led her to accept a position as registered nurse in the intensive care unit at Clifton Springs Hospital, where she currently works. The variety of patients she sees — and the health needs they have — challenges Lovejoy. “Each person is very, very different,” she said. “Treatment plans may look very similar on paper but the person is so much more than the diagnosis itself. It’s really important to learn about the patient, family and the barriers that may prevent successful completion or execution of the treatment plan. “Nurses get the opportunity to see those barriers and psycho-social dynamics. In critical care, it’s not the patients, necessarily, who can talk with you. It’s important that the family is educated and that we’re advocating for the patient. It’s such a privilege and also a challenge.” She said that it’s important for her to treat patients as individuals beyond their diagnosis. “As a newer nurse, that’s something I’m continuing to learn how to get better at,” Lovejoy said. She said that her nursing mentors at Rochester Regional Health and Clifton Springs Hospital have helped her develop how she relates to patients and their families. “One thing I’ve done in my practice is I talk with patients even if they can’t talk with me,” she said. “I truly believe they can hear, even if they can’t respond. Just talking with them helps me see them more as a person. Talking with the family helps, too, as they give insights as to what the person is like when they’re not lying in an ICU bed. They help bring that perspective that they’re more than a person trying to get through this hard time in their life. It gives us motivation to help us get them back to their baseline.” It’s those human connections that she said she enjoys most about nursing, along with seeing patients meet their goals, whether that means recovery or if that’s not possible, “adapting to whatever their new life is going to look like. I love being able to be there and supporting the family and patient.” Recently, Lovejoy was accepted into Keuka College’s two-year adult/ gerontology practitioner program. “That will enable me to be in a provider role,” Lovejoy said. “I will be able to diagnose, treat and prescribe and come up with treatment plans for patients. As a nurse, you execute treatment plans; as a nurse practitioner, you make the plans.” In her free time, Lovejoy likes to stay active hiking and traveling.

Gold Standard

F.F. Thompson Hospital is an ANCC Magnet designated hospital for nursing excellence.

for Nursing Excellence

“To know even one life has breathed easier because you have lived; that is to have succeeded.” - Ralph Waldo Emerson When 2020 was deemed the international Year of the Nurse and Midwife by the World Health Organization, few could have predicted the crucial role that nurses around the world and in our own community would play during a global pandemic. What was to be a year of celebration has instead become a year of solemn appreciation for the strength, commitment and resilience shown by those who pursue these noble professions. This Nurses Week, we salute the nearly 500 registered nurses, licensed practical nurses, nurse practitioners, certified registered nurse anesthetists and certified nurse-midwives throughout our health system. Each and every one is a hero in their own right, and we are sincerely grateful.

Thank you.

In Good Health,Rochester’s Healthcare Newspaper.

Call 585-421-8109 to advertise. Read every month by nearly 100,000 healthy-counscious people May 2020 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Connection with Elders Fosters Nursing Career Priscilla Salgado started at St. Ann’s as an aide in the dining and nutrition department. She is now the organization’s associate director of nursing By Deborah Jeanne Sergeant

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ack in 1998, Rochester resident Priscilla Salgado began working at St. Ann’s Community in Rochester as an aide in the dining and nutrition department. It was a good job for a recent high school graduate; however, a member of St. Ann’s education staff saw something more in the young adult and suggested she take CNA classes. “I hadn’t given it much thought until she spoke with me about it,” Salgado said. What Salgado failed to see in herself at that time was her ability to easily make connection with the residents — a trait that would prove helpful in providing excellent patient care. By 2001, she earned her CNA certification with St. Ann’s help, at Monroe Community College. The longer she worked, the more she realized she wanted to “grow within [her] career.” In 2004, she earned her LPN through the Educational Opportunity Center and in 2014, she earned a further nursing degree at Finger Lakes College of Nursing. In 2016, she earned her Bachelor’s of Nursing

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Science at Roberts Wesleyan. “It continues to evolve,” Salgado said. “Nursing changes and I often crave to learn more so I cannot only be a better nurse for those I take care of but if I’m able to help others who want to pursue their nursing career and be an inspiration to others.” Salgado is now St. Ann’s associate director of nursing. One of her biggest day-to-day challenges is coping with the widespread staffing challenges that affect the entire healthcare industry. Working with different work ethics among employees is another challenge she faces often, since employees come with their own backgrounds and previous employment experiences. “I’m trying to meet the employees where they are and build trusting relationships,” Salgado said. “There’s a team of us that continues to work on recruitment and retention.” St. Ann’s recruits from the area’s schools of nursing and also receives applicants through word-of-mouth from current employees. “We look to see who’s interested and try to reach those individuals,” Salgado said.

Of course, retaining current employees also helps improve staffing. To encourage retention, she works on engaging with staff through good communication. “We’re supporting them and trying to communicate with them as to their desires for their career and supporting that, whether being flexible with schedules or the educational scholarships and tuition reimbursement St. Ann’s offers,” Salgado said. “I talk about my career and journey at St. Ann.” By telling others about how she worked her way up in the company—and in her nursing career—Salgado hopes she can inspire others to consider nursing as a good career option. Afterall, it’s one she has enjoyed for much of her working life. She believes that any good nurse should have compassion, patience, empathy, adaptability and a good work ethic. “I definitely encourage anyone

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2020

interested in nursing to pursue it and let them know it’s a truly rewarding career,” she said. “It has ups and downs but we’re in need of dedicated nurses. They should not ever give up or allow anyone to persuade them that this isn’t the right opportunity for them.” It certainly seems a good fit for Salgado. “I really love connecting with our elders and building relationships with their families,” Salgado said. “If I can bring a smile to their faces and ensure quality care is being provided, I feel I’ve done a good job.” She plans to pursue more training in geriatrics and, eventually, earn a nurse practitioner degree with a specialty in geriatrics. In her spare time, Salgado enjoys time with her family and traveling when she can.


Kind Nurses Drew Youth into Nursing Matt Mallow, an RN, enjoys working in a more one-on-one relationship with patients By Deborah Jeanne Sergeant

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ochester resident Matt Mallow will never forget the kindness shown by nurses while as a high school student he recovered in the hospital from emergency surgery. The experience eventually resulted in his current position as registered nurse at Caring Hearts of Rochester, a home health agency. “The nurse was really nice and made me feel very comfortable, doing things like making me milkshakes,” Mallow recalled. “I stayed in the hospital for a week or two and they were so caring. I realized I wanted to be there for people too,” he said. Once he graduated from high school, he enrolled at Genesee Community College in Batavia and graduated as a registered nurse in December, 2013. He realized that he enjoyed working with elderly patients so he worked at a few nursing homes. “They don’t get a lot of visitors,” Mallow said. “They don’t see a lot of people who want to hear what they have to say. They’re so smart and they can teach you so much and learn so much. If you were in their shoes, you’d want to have others hear what you have to say.” Eventually, he realized he wanted to care for patients in a more one-on-one relationship. The staffing ratio and demands on nurses in many nursing homes means that staff don’t get as much time with patients as he would want. Sometimes he had 20 patients in his care. Now he works in home health, where he cares for only one patient at a time. Mallow relishes the opportunity to spend time one on one and really get to know his patients. Despite this, one of the daily

challenges of nursing is the workload. “You have to be a good time manager,” Mallow said. “You have to watch over the home health aides and supervise them, too, to make sure they’re doing their jobs, too. As long as you’re organized, you can handle it.” The weather in New York also presents a challenge since he must drive to patients’ homes. He tries to plan visits so that he can make a few stops in the same neighborhood in a row and not crisscross the region. “I always try to group things together and make a weekly plan of what I need to get done,” Mallow added. “You don’t want to stress yourself out. I try to do the same things certain days.” He encourages people to think about a career in nursing as long as they have good motives. “Make sure it’s something you really want to do before you get into it,” Mallow said. “There are people who are in this field who shouldn’t be and just play the part. It’s deeper than just knowing diagnoses and bookwork. It’s about being personable and being there for people.” Although nurses may make some mistakes while they’re learning, Mallow said that listening to experienced nurses helps new ones perform better every day. “Don’t look like you think you know everything,” he advised. “Learn from your peers and coworkers.” He feels very appreciative for the nursing mentors who helped him learn patient care. Working during a pandemic has been a learning experience for all

You don’t have to face hearing loss alone. workers in healthcare. Mallow said that his agency follows all the safety protocol guidelines from the New York Department of Health. Caring Hearts keeps staff updated on the latest information and outfitted with personal protective equipment to curb the spread of the coronavirus among all patients, especially those who may have higher risk factors and reasons for concern. “We do in-services and find ways around having so many people together for these meetings, like videos and calls,” Mallow said. “It’s tricky but we’re getting through it.” Mallow likes to stay fit by training to run races and playing hockey in a summer league. He also enjoys listening to music.

The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details: HearingLossRochester.org

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CaringHeartsofRochester.com We would like to recognize Matt Mallow, our Director of Patient Services, for his great contributions to Caring Hearts and the community. Thanks Matt! May 2020 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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COVID-19 Crisis Shows the Need for Advance Care Planning T he coronavirus pandemic is shedding new light on the often-abstract concept of advance care planning, where individuals document what matters most to them, and then select the right health care agent to make decisions on their behalf if they are unable to speak for themselves. During this pandemic, many people have had to make medical decisions for loved ones who were unable to communicate. National Healthcare Decisions Day, observed on April 16, is the day selected to encourage family discussions and advance care planning. “Advance care planning gives patients peace of mind in knowing that health care decisions will be made on their behalf by a person they trust,” said physician Patricia Bomba, vice president of geriatrics at Excellus BlueCross BlueShield. “For health care agents, advance care planning gives them the confidence to make decisions based on their loved one’s values and beliefs.”   Completing or updating a health care proxy can be done at an office visit to the individual’s physician, nurse practitioner or physician assistant. The practice of social distancing may require this to be done with a telemedicine visit via telephone or by using video conferencing technology such as Skype or Zoom.

The health care proxy form requires two witnesses to the signature. This can be accomplished in person, or by using video conferencing technology. A photo of the signed health care proxy can be mailed to the health care provider or uploaded to the medical practice’s secure patient portal. Individuals also should email a copy to family members. If video conferencing is unavailable, speak with your physician, nurse practitioner or physician assistant about the process for providing verbal consent over the phone. And, if a patient is unable to sign a health care proxy, the name of their chosen health care agent, and their stated values and beliefs for care, can be documented in their medical record and treated in the same way as an oral advance directive. Individuals with an advanced illness or advanced frailty, are advised to reach out to their physician or nurse practitioner to discuss the Medical Orders for Life-Sustaining Treatment (MOLST). MOLST reflects a patient’s preferences for treatment, including resuscitation, respiratory support on a ventilator, and hospitalization. It is based on the patient’s current health status and prognosis. “MOLST is not an advance directive and is not for healthy people,”

said Bomba. “It is a set of medical orders signed by a physician or nurse practitioner that must be followed.” Excellus BCBS encourages all adults aged 18 and older to start advance care planning conversations with their health care providers, family members and trusted friends. Then, they should complete a health care proxy to formally name a health care agent. Excellus BCBS led the development of a free community website, CompassionAndSupport.org, that includes information on advance care planning, free downloadable forms and instructional videos and MOLST.org, that includes COVID-19 Guidance on MOLST, eMOLST and how to have thoughtful MOLST discussions.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2020


WITH GRATITUDE You have been caring for the community since 1890 — you were with us then; you are with us now and we know we can count on you always because your commitment is unrelenting. You are compassionate. You care. You work hard and always put others first. You accomplish the impossible and people’s lives are better because of you. In celebration of National Nurses Week, we thank nurses everywhere. And, to the 162 nurses that are part of the Nascentia Health Family, remember that you are valued for the people that you are, and we thank you for everything you always do.

888-477-HOME • nascentiahealth.org May 2020 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Q A & with

Melinda Merante Gilda’s Club Rochester CEO talks about providing support to cancer patients during the coronavirus pandemic Interview by Mike Costanza

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ilda’s Club Rochester offers over 1,000 free programs for those who have been impacted by all forms of cancer, and their families. The coronavirus, and a government edict, forced the nonprofit to temporarily close its headquarters on Rochester’s Alexander Street. The nonprofit has approximately 1,100 members, and serves about 5,000 more via its outreach programs. Melinda Merante, CEO of Gilda’s Club Rochester, answered In Good Health’s questions about the steps it has taken to continue aiding its members despite current conditions. Q. Who does Gilda’s Club serve? A. Gilda’s Club is here to serve people living with cancer —men, woman, teens and children — and families. A lot of times, when people come to us, they’ve got the diagnosis. The diagnosis can be very overwhelming, and that creates a certain level of anxiety, and sometimes depression. What’s going to happen to me? What’s going to happen to my family? Am I going to be able to work? Am I going to be able to afford this? Q. What kinds of services do you provide for those affected by cancer?

A. Gilda’s is here generally to support the nonmedical side of things. We provide a source of information, comfort, hope and support, and help them feel part of a community and a sense of connection to others living with cancer. We offer support groups. We offer educational seminars with experts from the local community, like doctors from Wilmot [Cancer Institute], Rochester Regional [Health] and other health professionals so that we can provide the most current information on cancer. In addition, we provide cooking classes, and a lot of art programming and a fair amount of social programs. If somebody was coming in for an education seminar, we would generally add on a little bit of dinner with it. There might be a little bit of a reception where there’s a finger food, or there might be a full dinner. We also provide programs for children affected by cancer. Q. Has the coronavirus crisis left your members feeling more in need of support and assistance? A. I think the needs are basically the same, perhaps more heightened anxiety and fear due to the uncertainty of our times. Anxiety or cancer-related stress is why they come to us,

so we help them examine their cancer stressors. Q. Cancer and its treatment can compromise the immune system, making social distancing much more important. What programmatic changes have you made in order to continue serving your members under these conditions? A. Our services have for the most part remained the same — what is now different is how we deliver them. We can’t do the in-person stuff, so we’ve taken that stuff virtual — YouTube, Facebook, Zoom. We have done support group sessions by Zoom, one-on-one sessions over the phone. We’ve haven’t been able to have the cooking classes, so we’ve been able to do them on video, and then provide a recipe. We do wellness programs like yoga virtually, through videos and demonstrations. We haven’t been able to do the art programs in person, but we’ve been able to do those through live demonstrations from our art instructors. Q. How are your members responding to the suspension of one-on-one and

group sessions? A. Overall, very positively — we have seen an increase in calls. Since day one of the social distancing guidelines, we have made it a priority to communicate weekly. We have upped our one-to-one connections via phone calling, making sure they feel connected to us and that we are indeed here for them. I think our members and the community know and appreciate that we are doing our best to keep things business-as-usual through personal connection and offering services virtually. Q. If the coronavirus continues to be a problem into this summer or beyond, how will Gilda’s Club Rochester respond? A. We are committed to looking for new and innovative ways to continually deliver and to improve our virtual infrastructure. Our plan is to add more programs each and every week, and to expand our capability until we can reopen our doors. Gilda’s Club Rochester: 585-4239700, www.gildasclubrochester.org/

Group of Rochester Nursing Homes Promises Transparency

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s the coronavirus, spreads across the country and throughout the community, the Alliance for Senior Care understands and recognizes that the elderly have been and will continue to be the community’s most at-risk population. “This is a pandemic, and without a vaccine, COVID-19 will continue to be a threat,” said Glen Cooper, president and CEO of Friendly Senior Living, one of the members of the alliance. “The most important thing that nursing homes can do in the face of this threat is to continue fighting our front-line battle. We are doing everything we can to protect, treat and mitigate the risk for the most vulnerable among us.” The alliance is a consortium of five nonprofit skilled nursing facilities in Greater Rochester: Episcopal SeniorLife Communities, Friendly Senior Living, Jewish Senior Life, St. Ann’s Community and St. John’s. Together, they have a combined 4,440 employees and represent more than a third of all skilled nursing and

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assisted living beds in the region, with more than 2,000 beds. The alliance has a strong history of collaboration and sharing of best practices. Alliance members have been and will continue to be transparent with residents, families and staff. According to the New York Times and other national news reports, as of mid April, COVID-19 has led to more than 6,900 deaths at nursing homes nationwide. In New York state, the virus has led to over 2,600 nursing home and assisted living deaths, according to the state health department. As of Friday, April 17, the alliance’s combined confirmed 36 residents and 27 employees with COVID-19. The combined COVID-19 deaths total 10, all of whom were residents. “As an alliance, it is our belief that these numbers will continue to increase within the next few weeks,” said physician Scott Schabel, medical director of The Friendly Home. “We know that it’s only a matter of time before the number of confirmed cases, as well as, sadly, the number

of deaths, increase — not only at our facilities, but at nursing homes across the region, across the state, and across the nation. This is the devastating and sobering reality of a pandemic. The enemy, COVID-19, is raging on, without mercy.” Michael E. McRae, president and CEO at St. Ann’s Community, said the sense of loss has been felt by all who work in nursing homes. “Like hospitals, nursing homes and our care workers are on the front lines of today’s public health crisis,” McRae said. “The coronavirus pandemic has caused immense suffering across the country, especially among our most at-risk population — the elderly. The stress and anguish that our residents, families, and healthcare workers have had to endure is heartbreaking.” The elderly are at the greatest risk for COVID-19. This is due in large part to age, existing chronic conditions, and the fact that many reside in communal living, like nursing homes. That’s why the alliance’s members continue to work hand-in-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2020

hand with the New York State Department of Health (DOH) and Monroe County to implement numerous and necessary steps to minimize the risk to residents and staff. “Our care workers include our own on-site medical teams — physicians, nurses, certified nursing assistants, and critical support staff who are providing care to our residents every hour of every day and putting themselves at risk,” said Loren J. Ranaletta, president and CEO, Episcopal SeniorLife Communities. “Our alliance CEOs, medical directors, administrators, and medical staff connect regularly, sharing updates, best practices, and resources to ensure that we all have the latest information to make the best medical care decisions possible for our residents, their families, and our employees.”   Submitted by the Alliance for Senior Care.


SmartBites

Helpful tips

By Anne Palumbo

The skinny on healthy eating

Immune-Boosting Fava Beans Promote Good Health

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onger days, singing birds, the fresh scent of cut grass: spring is here and nothing heralds the season quite like rhubarb, asparagus, peas and pale green fava beans. While fava beans look a bit like lima beans, they’re less starchy and fuller in flavor: nutty and slightly sweet. First-of-the-season favas, coveted for their buttery, melt-inyour-mouth quality, are worth the preparation time. Like most legumes, fava beans brim with healthy nutrients. Low in fat, cholesterol and sodium, they stand out for their folate, fiber, protein, manganese and immune-boosting antioxidants. Why do we need folate? An essential B vitamin, folate is needed to make red and white blood cells, convert carbs into energy and produce DNA and RNA. Adequate intake

of this vital nutrient is extremely important during periods of rapid growth such as pregnancy, infancy and adolescence. A good intake is equally important beyond adolescence as folate helps to maintain a healthy heart, plays an important role in brain function and mental health and may even have protective benefits against certain cancers. One cup of cooked fava beans dishes up 44% of average folate needs. A good source of dietary fiber, fava beans may help lower cholesterol in both healthy adults and those with elevated levels. The soluble fiber, in particular, promotes healthy bowel movements by softening your stool and can also bind to and remove cholesterol from your body. In addition, several studies have shown that a diet rich in fiber may improve

feelings of fullness, which can then result in lower calorie intake and weight loss. One cup of cooked fava beans has 9 grams of fiber. Fava beans are rich in two nutrients that may prevent bone loss: manganese and copper. Although their exact role in bone health is unclear, some studies suggest that these two essential minerals are crucial to bone strength. Research has also suggested that manganese may help postmenopausal women maintain normal bone density, which may then lower the risk for osteoporosis. Looking to boost your immune system? Fava beans are loaded with compounds that may enhance antioxidant activity. Antioxidants are vital to your body’s immune defense, as they fight free radicals that may lead to cell damage and disease. Bone-strengthening manganese also plays a key role in forming a specific antioxidant enzyme that is one of the body’s most powerful antioxidants.

Fava Beans and Asparagus with Toasted Almonds Adapted from Martha Stewart Serves 8

1½ pounds fresh fava beans, shelled 1 pound asparagus, tough ends removed and cut into 2-inch pieces 4 tablespoons olive oil, divided 2 cloves garlic, minced 3 tablespoons fresh lemon juice; 1 teaspoon lemon zest salt and pepper, to taste ½ cup slivered almonds, roasted Blanch fava beans in a pot of salted boiling water just until tender, about 1 minute. Transfer to an ice bath; drain after 5 minutes. Pat dry and remove loose outer skin. Heat 1 tablespoon olive oil in a

When buying favas, choose plump pods with a grassy-green color and few brown spots. Select small to medium pods, which are more tender and sweeter than the larger, starchier beans. Avoid burst pods: this means they’re old. Unshelled fava beans, stored in a plastic bag, last about 10 days in the fridge; cooked favas last about 5 days. Favas also come canned, dried, and frozen. large skillet over medium-high heat. Add asparagus and cook, stirring frequently, until asparagus is crisp-tender, about 3 minutes. Remove from heat; transfer to a large bowl; set aside. In same skillet, heat 1 tablespoon olive oil over medium-high heat. Add garlic and fava beans and cook, stirring frequently, until garlic is softened, about 2 minutes. Remove from heat and add to asparagus. Whisk together lemon juice and remaining 2 tablespoons olive oil, adding salt and pepper to taste. (Add more oil if dressing is too tart.) Add to bowl mixture and gently toss to coat. Combine almonds and lemon zest in small bowl. Transfer asparagus-fava bean mixture to a platter. Sprinkle with almond-zest mixture and serve.

Anne Palumbo is a lifestyle colum-

nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

How to Avoid Unwanted Weight Gain During COVID-19 Pandemic

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eware of your fridge, pantry and couch during the coronavirus pandemic. Being cooped up at home with easy access to food can lead to overeating. Couple that with routine housekeeping, working from home, homeschooling your kids and tending to loved ones, and it’s a sure-fire recipe for weight gain, experts at the University of Georgia in Athens warn. “These tasks have been added to our many other responsibilities,” said Emma Laing, director of dietetics in the College of Family and Consumer Sciences. “So if something has to give as we strive to find our new normal, routines surrounding eating and physical activity might go out the window.” To stay on track, get up off the couch. Try to set times during the day for physical activity you enjoy, and to eat regular meals and snacks that provide adequate energy and hydration. “In creating this schedule, do so while maintaining flexibility,” Laing said. “It’s important to trust our bodies’ cues for hunger, so listen to

those first.” Try to avoid mindless snacking. Social distancing during the coronavirus pandemic doesn’t mean you have to stop exercising. In fact, physical activity is a crucial stress management strategy. Ali Berg, a Cooperative Extension nutrition and health specialist, pointed out that «physical activity is good for maintaining immunity, in addition to adequate nutrition. Being active is also good for mental health.” Even though gyms and yoga studios are closed, you can find other ways to be active, said Tracey Brigman, a clinical assistant professor. “I start each day with a 2-mile walk,” said Brigman. “Anytime I cook, I dance (and embarrass my kids). Music also lifts my spirits so I don’t stress eat. If I have down time waiting for a timer, I jog around the rooms in my house while I wait.» Other simple ways to stay active include playing with your pets, finding workouts online or through free apps, playing games with the family -- and even cleaning the house.

May 2020 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 21


‘Every Individual Deserves the Right to Die Well’

The concept for Light Hill Comfort Care Home in Canandaigua was birthed in 2012, four years before its doors officially opened in July 2016. The facility offers a comfortable place for people at the end of their lives, and their families.

Volunteers at Light Hill Comfort Care Home in Canandaigua talk about living, dying well By Melody Burri

L

iving well — it’s the dream many spend a lifetime pursuing. But hospice champion and pediatrician Mary Brady says living well is only half of the prize.  “I believe every individual deserves the right to die well,” said Brady, a longtime hospice instructor and board member of Light Hill Comfort Care Home in Canandaigua.  “I want people to know that dying is doable,” she said. “It’s something we will all do eventually. And it’s important that Light Hill is here to support individuals as they die a meaningful death.”  Like other comfort care homes in Upstate New York, Light Hill’s primary focus is to ensure the richest possible experience for residents and their loved ones as they approach the final stages of life. Care offered by medical professionals and volunteers focuses on pain control, symptom management and safety.  And it’s free.  Residents and their families pay nothing for food, housing, compassion and round-the-clock attention from medical professionals and trained volunteers.  “They can trust that they will be cared for, that their suffering will be relieved and they will be remembered,” said Brady. “A lot of joyful family time happens here. A lot of storytelling, a lot of expressions of love and gratitude. People find a path to forgiveness that they never found before. And people have the opportunity to say a very meaningful goodbye.” The concept for Light Hill was birthed in 2012, four years before its doors officially opened in July 2016.  Since that time, more than 60 residents and their families have received care at the two-bed comfort care home, according to Light Hill Page 22

Executive Director Suzanne Underhill. “Our hope is to give the support our residents and their families need to make their final chapter the best it can be,” she said. ”Here, we will neither hasten death nor prolong life. Rather we will do our very best to promote comfort, peace and living well until death occurs.” Residents may come in with the idea that Light Hill is about dying, but they soon learn it’s really about living, Underhill said.  That may explain the number of baby showers, family meals, barbecues, cocktail hours, holiday celebrations, veteran appreciation ceremonies, and multi-generational gatherings hosted on site. Residents may relax in comfortable chairs or their beds inside or outside on the porch overlooking the garden, Underhill said. They may have visitors of all ages, at all times of day or night if they choose. Family members may also sleep over in comfortable second floor guest rooms.  “Anything you would do in your home, we try to make possible here,” said Underhill. It takes about 125 trained volunteers to provide 24-hour, seven days a week hands-on care. And prior to serving, each volunteer is vetted and receives 21 hours of comprehensive training in hospice care, communication skills, palliative management of pain and symptoms, attending to emotional and spiritual needs, family dynamics, ways of processing grief, finding meaning in one’s life and ending disagreements, and veterans’ needs. It may come as no surprise that many volunteers and board members are motivated by their own family members’ end of life experiences. Board President Rich Russell said Light Hill’s mission, in part, is to

reduce or remove the stress families feel so they’re free to savor and enjoy end-of-life moments together. “When my parents were transitioning, my sisters were able to keep them at home through the entire transition,” said Russell. “Unfortunately, I was 200 miles away and wasn’t able to be as involved as I wanted to be. This is my way of paying back my sisters and this community.” Board Treasurer Katie Harrison is also driven by personal experience, and believes the service Light Hill provides is essential to the community. “It’s especially important to me because my grandmother was in hospice before she passed and I want to be able to give back,” she said.

Volunteers take care of individuals who are near the end of their lives, said board secretary and volunteer Ellen Polimeni. “But we also take care of their family, help them accept what is coming and help them transition through that,” she said. “Having experienced the loss of a loved one, I know what a difficult time it is. I’m very willing to help others prepare for that.” As a 501(c)3 non-profit organization, Light Hill receives no third-party funding, but is fueled through donations, memorials, gifts, and grants.  For more information, visit https://lighthillhome.org, find Light Hill CCC on Facebook or stop by at 5160 Parrish St. Ext. in Canandaigua.

Area Comfort Care Homes Advent House 1010 Moseley Road, Fairport 585-223-6112  theadventhouse@frontiernet.net  www.theadventhouse.org Aurora House 2495 S. Union St. P.O. Box 21, Spencerport 585-617-4863  Info@aurorahousewmc.com  www.aurorahousewmc.com

Hospeace House 7824 County Road 33, Naples 585-374-2090 info@hospeacehouse.org  https://hospeacehouse.org  Isaiah House 71 Prince St., Rochester 585-232-5221  isaiahhouse@rochester.rr.com  http://theisaiahhouse.org

Benincasa 3880 Rush-Mendon Road, Mendon 585-624-8070 benincasa@benincasainc.org www.benincasainc.org

Light Hill Comfort Care Home 5160 Parrish St. Ext., Canandaigua 585-393-1311 lighthilldirector@gmail.com  https://lighthillhome.org

House of John 14 Spring St., Clifton Springs 315-462-5646 house@houseofjohn.org www.houseofjohn.org

Serenity House 1278 Brace Road, Victor 585-924-5840 serenityhousevictor@gmail.com https://serenity-house.org

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2020


By Jim Miller

Medicare Expands Telehealth Services to Help Keep Seniors Safe at Home Dear Savvy Senior, Does Medicare cover telehealth services? My 71-year-old mother has chronic Type 2 diabetes but is very concerned about going to the doctor for fear of exposing herself to coronavirus. What can you tell us? Avoiding the Doctor

Dear Avoiding, Yes! Due to the coronavirus (COVID-19) pandemic, Medicare recently announced that it will be expanding coverage for telehealth services to help keep vulnerable seniors safe at home. Here’s what you and your mom should know.

Telehealth Services If you’re not familiar with telehealth or telemedicine services, they are full visits with a health care provider (who isn’t at your location) using telephone or video technology device — i.e. smartphone, tablet or computer. Telehealth services allow Medicare beneficiaries to take care of ongoing medical problems as well as new concerns, while following public health advice to stay home during the coronavirus outbreak. Medicare patients with chronic health conditions now don’t have to postpone a regular follow-up visit with the doctor to keep safe. They can do it via Skype or FaceTime. And people concerned they may have the virus could see their doctor or nurse practitioner virtually to find out how to get tested. Nursing home residents will also be able to have telehealth consultations with their doctors. If your mom isn’t familiar or comfortable with technology, you or another relative or friend can assist her. You may need to go over to her house to help her do this. Bring your smartphone, tablet or laptop – but remember, don’t visit if you’re feeling sick. Risk of serious illness from the coronavirus is much greater for older people and those with underlying health problems such as lung conditions, diabetes or heart problems. Many seniors are also managing chronic health issues that put them at heightened risk.

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Until recently, telehealth coverage under original Medicare has been limited to beneficiaries only in rural areas, and patients often need to go to specially designated sites for their visits. The expanded telehealth coverage, which will remain in effect during the coronavirus outbreak, now allows doctors and hospitals to bill Medicare for visits via telemedicine that previously had to take place in person, at a medical office or facility. If your mom happens to get her Medicare benefits through a private Medicare Advantage plan, they will also be expanding their telehealth services. For coverage details, contact her plan directly.

Other Medicare Coverage In addition to the expanded telehealth services, Medicare will also be covering all coronavirus testing costs to see if your mom has been infected, and medically necessary hospitalizations, so if her doctor recommends that she remain in quarantine at the hospital rather than self-isolating at home, she will not have to pay for these costs. And if your mom has a Medicare Part D prescription drug plan, it will cover the coronavirus vaccine when it becomes available and will waive prescription refill limits so she can have extra medication on hand during the pandemic. For more information on how Medicare is covering the coronavirus see Medicare.gov/medicare-coronavirus. And for the latest information on the coronavirus, visit Coronavirus.gov. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. May 2020 •

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Ask St. Ann’s

Ask The Social

Security Office

From the Social Security District Office

Social Security Honors Our Military Heroes

O Staying Connected While Keeping Your Distance By Ellen Baker

T

ime spent with loved ones is often the high point of any senior’s day. As the spread of the coronavirus makes it necessary for everyone to practice social distancing to stay physically safe, people still need human connection to nurture their social and emotional health and well-being. Social distancing is necessary because respiratory illnesses such as coronavirus place seniors at a higher risk of infection. For this reason, senior living communities follow the guidelines of the Centers for Disease Control and Prevention and Department of Health and restrict visitors to prevent the spread of COVID-19. Here are some ways you can help the seniors in your life stay healthy and connected while practicing social distancing.

Buddy up Stay in touch with the people close to you, especially those who are social distancing, too. The CDC recommends creating buddy systems so vulnerable, hard-to-reach people have someone keeping an eye out for them and sharing updates on news about COVID-19. If you’re healthy and able to do so, virtually check in on your older friends and relatives, too. Drop off groceries or pick up medications for them, so they don’t have to go out. It’s a great way to feel needed and to help those in need. St. Ann’s Community established a buddy program in the face of the COVID-19 pandemic. This program pairs residents with team members who volunteer to visit them multiple times a week to check in, talk and listen. These volunteers also help the seniors contact their families via video chat, phone, or other means.

Learn new technology Using social media is the next best thing to being there. FaceTime, Zoom, Skype, Facebook, Twitter and Snapchat are desktop or mobile platforms that make it fun and easy to talk with family and friends anywhere in the world. If you’re not very tech-savvy, there are plenty of how-to videos online to help you set up a free account. Page 24

To promote well-being during restricted visitation, the St. Ann’s Community Foundation collaborated with social work and IT teams to buy more tablets so skilled nursing and assisted living residents and their buddies could take advantage of video chat technology. The virtual visits do wonders to keep everyone’s spirits up and minimize feelings of isolation. After each visit, every tablet gets disinfected to ensure everyone’s safety.

Stay active in your community from home Use your downtime to become a virtual volunteer. You can make phone calls to check in on elderly neighbors. Say prayers for members of your faith community who might be sick. Send out email blasts or start a Facebook group to share news, conversation, and words of encouragement with your social circle.

Send a letter or card. Pick up a pen and paper and write a heartfelt letter — something your loved one can hold and enjoy many times over. While St. Ann’s Community welcomes mail for residents, the staff keeps all letters and packages for three days before delivering them to minimize possible virus exposure. Now, more than ever, a safe and nurturing human connection is what we need to stay healthy, comfort each other, and foster hope for the future.

n Memorial Day, our nation honors military service members who have given their lives for our country. Families, friends and communities pause to remember the many great sacrifices of our military and ensure their legacy lives on in the freedoms we all enjoy. We recognize these heroes who, in President Lincoln’s words, “gave the last full measure of devotion.” The benefits we provide can help the families of military service members. For example, widows, widowers, and their dependent children may be eligible for Social Security survivors benefits. You can learn more about those benefits at www. ssa.gov/survivors. We also offer support to our wounded warriors. Social Security benefits protect veterans when an injury prevents them from returning to active duty or performing other work. Wounded military service members can receive expedited processing of their Social Security disability claims. Are you a veteran with a 100% permanent and total compensa-

Q&A Q: I went back to work after retiring, but now the company I work for is downsizing. I’ll be receiving unemployment benefits in a few weeks. Will this affect my retirement benefits? A: When it comes to retirement benefits, Social Security does not count unemployment as earnings,

tion rating from the U.S. Department of Veterans Affairs? We will expedite your disability claim. Both the Department of Veteran Affairs and the Social Security Administration have disability programs. You may qualify for disability benefits through one program but not the other, or you may qualify for both. Depending on your situation, some of your family members, including your dependent children or spouse, may be eligible to receive Social Security benefits. Want more information? Visit www.ssa.gov/woundedwarriors for answers to commonly asked questions or to find information about the application process. Thinking about retirement? Military service members can receive Social Security benefits in addition to their military retirement benefits. For details, read the Military Service page of our Retirement Planner, available at www.ssa.gov/planners/ retire/veterans.html. Please share this information with the military families in your community. To the veterans who bravely served and died for our country, and to the military service members who serve today, we honor and thank you.

so your retirement benefits will not be affected. However, any income you receive from Social Security may reduce your unemployment benefits. Contact your state unemployment office for information on how your state applies the reduction to your unemployment compensation.

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Ellen Baker is a licensed master of social work (LMSW) and is currently the manager of social work services at St. Ann’s Community in Rochester. Contact her at ebaker@MyStAnns.com, or 585-6976676 or visit www.stannscommunity.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2020

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WHEN IT MATTERS MOST, WE’RE ALL AT OUR BEST. It’s the most unique and inspiring aspect of humanity. Facing the darkest times, toughest odds and most daunting challenges is when we find our greatest strength. And when we’re furthest apart, we find new ways to remind each other that we’re not alone. At Excellus BlueCross BlueShield, we’ve been protecting communities across Upstate New York for generations. And today, we’re here for you in more ways than ever before. You can turn to us to make care more accessible and affordable by offering telemedicine services at no cost to members. We’re also waiving all out-of-pocket costs associated with COVID-19 testing for all members, and for treatment of COVID-19 for fully insured employer groups, individual market, Medicare Advantage members and self-funded groups who wish to participate. Find confidence and stability through low or no cost plans for those experiencing hardship. Maintain human connections in spite of physical barriers, thanks to things like a 24/7 nurse hotline, expanded support for emotional well-being and online access to behavioral health specialists including therapists.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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