Healthy Aging: Spring 2015

A Publication from monmouth medical center, southern campus

HEALTHY AGING spring 2015

SHINGLES Shot: should you get it?

BETTER BREAST CARE AN E.R. JUST FOR SENIORS INFUSION COMES TO TOWN

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WElcome Letter I am excited to welcome you to the inaugural edition of Monmouth Medical Center Southern Campus’s Healthy Aging newsletter.

My name is Dr. Jessica Israel. I am new to the Southern Campus’s community, but not new to caring for healthy older adults.

I trained initially in internal medicine at the Mount Sinai Medical Center in New York, then pursued a fellowship in geriatrics and adult development with a special focus in palliative care there as well. After my training I stayed at Mount Sinai for the first three years of my career, focusing on medical education and doctor-patient communication. In August 2002 I moved to Monmouth Medical Center’s Northern Campus, where I became the section chief of geriatrics and palliative medicine. Recently, I took on the role of regional director of geriatrics for Barnabas Health’s southern campuses—that is what brought me to Ocean County.

Exciting things are beginning at Monmouth Medical Center’s Southern Campus, some of which you will read about in this issue of Healthy Aging. For example, there’s the Geriatric Emergency Medicine unit (GEM), our state-ofthe-art emergency room specifically designed to meet the needs of seniors (see page 4). Maybe you know that our hospital was certified as a NICHE (Nurses Improving Care for Healthsystem Elders) in September of 2014 (at right). And construction is under way to build a beautiful new inpatient unit called the ACE (Acute Care for Elders) within the medical center. It will offer services to seniors that aren’t typically available on regular medical floors, such as daily case conferencing, educational opportunities, family care and daily physical therapy.

Caring for older adults is my passion. I have been a physician now for almost 20 years and the most important lessons I have learned both about medicine and about life have come from my patients. I look forward to learning from this new community, and hopefully teaching you a few things too. I hope you will share my excitement, and I look forward to meeting you and hearing from you! If there is something you would like to know more about, please feel free to email me at jisrael@barnabashealth.org.

Enjoy the first issue.

Sincerely, Jessica L. Israel, M.D. Section Chief of Geriatrics and Palliative Care Monmouth Medical Center

The interdisciplinary clinical team at Monmouth Medical Center, Southern Campus displays the NICHE certification it earned as part of the hospital’s efforts to provide the highest level possible care to the community’s aging population.

Carving

our

NICHE

IN senior care, Monmouth Medical Center’s Southern Campus has earned a credential that counts.

What does it mean for a hospital to be “senior-friendly”?

Any institution can use that term, but only one that has truly demonstrated a commitment to improve the care and experience of elder patients and their families can earn the designation known as NICHE (Nurses Improving Care for Healthsystem Elders). Last fall, Monmouth Medical Center’s Southern Campus was named a NICHE hospital, joining Long Branch-based Monmouth Medical Center, which received NICHE designation in January 2014.

NICHE, based at New York University College of Nursing and comprising more than 500 hospitals and healthcare facilities throughout North America, is a nurse-driven program designed to ensure that patients 65 and older receive sensitive, exemplary care.

To earn the honor, a five-member team of nurses participated in a NICHE leadership training program to develop a vision, short- and long-term goals and an action plan for caring for the elderly patients at the campus. The plan includes making geriatric resource nurses available throughout the hospital, improving patient satisfaction, decreasing lengths of stay and readmission within 30 days and improving outcomes in falls and skin integrity, two major concerns in older patients.

Focusing on the senior community in Ocean County is more important than ever as those 65 and older are the fastest-growing population in the area, says Jessica Israel, M.D., section chief of geriatrics and palliative care at Monmouth Medical Center and Monmouth Medical Center, Southern Campus. “Our approach in caring for the elderly is not the same as it is for other patient populations,” she says. “As a NICHE-designated hospital, we design care for seniors, utilizing the best and most up-to-date practices, offering evidence-based medicine and employing an interdisciplinary approach to address seniors’ unique needs.”

To learn more about our senior services, please visit barnabashealth.org/monmouthsouth.

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Located at 500 River Avenue in Lakewood (about a block north of the hospital), the Jacqueline M. Wilentz Comprehensive Breast Center at Monmouth Medical Center, Southern Campus, now offers breast ultrasound and diagnostic mammogram screenings. This is in addition to bone density and regular mammography screenings.

W

hen you’re checking out a possible medical condition, the last thing you need is the hassle of a long drive. That’s why it’s important for women in Ocean County that the Jacqueline M. Wilentz Comprehensive Breast Center at Monmouth Medical Center Southern Campus has recently expanded its menu of services for breast care, adding diagnostic services to its regular screenings.

What’s the difference? Screenings are the regular mammograms most women over 40 should have yearly, according to the American Congress of Obstetricians and Gynecologists.

They are meant to detect the first signs of a suspicious growth. With the latest screening technology, three-dimensional tomosynthesis, radiologists are better able to tell what is really suspicious and what is normal, sparing many women the need to come back for more testing.

Diagnostic services are provided when a screening mammogram reveals something that may be problematic. There could turn out to

Better breast care

close to home for diagnostic follow-up after a mammogram, Monmouth’s Southern Campus is the place to go.

be nothing wrong at all, but a further check is needed. When women are called back so that what the screening mammogram found can be identified and a diagnosis made if necessary, the radiologist takes enhanced images using screening ultrasound or magnetic resonance imaging (MRI). While screening images are read one to three days after they are taken, with diagnostic imaging “the radiologist is on site and reads the images right away,” says Ilona Hertz, M.D, a diagnostic radiologist at the Medical Center who specializes in breast imaging. The radiologist reports the results immediately to the patient so that if treatment is required it can begin promptly.

“You might have your screening on Monday, and get called back on Wednesday for diagnostics,” says Portia Lagmay-Fuentes, regional cancer services administrator. “We don’t want women to have to wait a week, and having this service at the Southern Campus gets patients back much more quickly.”

Advances in radiology are making mammograms more effective than ever in spotting malignancies, Dr. Hertz explains. “Don’t procrastinate in getting your mammogram,” she says. “If there is a problem, the earlier we find it, the more likely we are to be able to cure it.”

Mammography, says the doctor, is the “absolute best screening exam for breast cancer.”

The place for imaging The Jacqueline M. Wilentz Comprehensive Breast Center at Monmouth Medical Center Southern Campus is located at 500 River Avenue, Suite 200, in Lakewood. The center offers screening mammography services in a comfortable and compassionate setting. All imaging exams are performed by experienced mammography technologists and interpreted by Monmouth Medical Center’s highly skilled radiologists. for more information or to request an appointment, Call 732.942.5925 or visit barnabashealth .org/mmcscwilentz.

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An E.R. gets

senior-friendly

Thanks to a special redesign, the facility is now better prepared than ever to meet older patients’ needs.

T

he aging of America poses a challenge for health care, and Monmouth Medical Center’s Southern Campus in Lakewood is acting to meet it: It has made its Emergency Department a much more senior-friendly place.

Because of the “baby boom” bulge in the population, says Victor Almeida, D.O., the Medical Center’s chairman of Emergency Medicine, “every day an estimated 10,000 people are turning 65. We need to find ways to care for them more effectively.”

That’s why the Medical Center has redesigned its Lakewood ED to be safer and more comfortable for seniors and to feature a special section for them. Patients check in at the main desk of the ED, and if time is not of the essence seniors are then directed via a separate entrance to the special Geriatric ED. “That area is quieter, and the older people have it to themselves,” he says. “Many seniors don’t do well in noisy, overstimulating environments.”

The Geriatric Emergency Medicine (GEM) unit has seven private rooms, with lower ambient lighting and skid-resistant flooring; the lights even diminish at night to more closely conform to natural circadian rhythms. The beds are equipped with air mattresses to better prevent bedsores, and they can be lowered to the ground so that elderly people can get in and out easily. Bed controls are easily reached, meaning that patients don’t have to call someone to do it for them.

“These creature comforts make the Geriatric ED different, but that’s not all,” Dr. Almeida says. Staff nurses also receive special training in NICHE—Nurses Improving Care for

Victor Almeida, D.O., and Johnny Larsen, D.O., are seen at the hospital’s Geriatric Emergency Medicine (GEM) Unit.

The GEM Unit is a special, isolated section of the hospital’s Emergency Department where seniors receive the highly specialized care they need.

Healthsystem Elders, a nurse educational program. Based at New York University’s School of Nursing, NICHE has been embraced by more than 500 healthcare facilities throughout North America. It’s designed to promote sensitive, patient-centered care for older adults that meets their special needs. “For example,” says the doctor, “seniors may need more time for things like going to the bathroom.

And NICHE teaches nurses to take time to listen to them.”

Each room in the Geriatric ED has its own computer terminal, so the nurse can get information in real time “without running back to a nurses’ station,” he says. There’s also a social worker who helps patients make the transition out of the hospital, identifying those at high risk for falling and reviewing their medications to spot possible trouble.

No one should rely on the Emergency Department for routine care, of course. But for true emergencies, seniors should know that there is a place nearby that is set up to provide them the best possible care. “We’re challenged to adjust our practices as well as our physical space to meet seniors’ needs,” says Dr. Almeida.

“This ED is doing just that.” for more about the GEM unit, visit barnabashealth.org/monmouthsouth.

Stats on emergency care at Monmouth Medical Center South Patients seen last year: 38,000, of whom 4,800 were admitted to the hospital Patient satisfaction score: 92 percent, tied for first place in New Jersey

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for more information or to request an appointment,

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convenient

Infusion

A nurse interacts with a patient at Monmouth Medical Center, Southern Campus’s Outpatient Infusion Unit, which provides private and semiprivate patient rooms for those requiring infusion services.

Many patients with cancer and other conditions now can receive regular treatments right here in Lakewood.

F

or some medications, a pill taken orally isn’t enough.

They need to be infused—administered gradually, that is, through an IV drip or a port surgically inserted into the body. Often that requires a trip to a far-away facility, but it has become much more convenient for Ocean County residents. Outpatient infusion therapy patients can now receive their treatments at Monmouth Medical Center’s Southern Campus in Lakewood.

That new option, available since March, is possible because Seth Cohen, M.D., a medical oncologist at Monmouth Medical Center, now spends one to two days a week at the Lakewood location. A physician must be on hand during infusions, he says, because “there is a potential for reactions to the drugs, and a doctor can make sure patients can get the best care, safely.”

The Infusion Center has been remodeled to include both double and private rooms, with new chairs and flat-screen TVs for patients to watch while they’re getting their medications—a process that takes from 20 minutes to three hours. “It’s really quite a nice, relaxing environment,” says Dr. Cohen. “And it’s easily accessible right off Route 9.”

Along with chemotherapy infusion for cancer treatment, drugs for Crohn’s disease, rheumatoid arthritis, multiple sclerosis and other diseases also require infusion. The procedure is performed by oncology-certified nurses, and Dr. Cohen is there to answer any questions.

There’s another plus for patients. In his role as medical director of Monmouth’s Oncology Research Program, Dr. Cohen participates in clinical trials. Explains Portia Lagmay-Fuentes, regional cancer services administrator: “When standard care has been exhausted and patients need to look for research trials, now they can get many of them right here. We have never had that option before.”

The center hopes to expand operations as the practice grows. “The goal is to be open every day of the week,” Dr. Cohen says. “The bottom line is this: Now there is no need to travel long distances because the treatments are available locally. Patients receive loving, caring and skilled care from highly trained providers who have the expertise to take infusion treatment to the next level in this area.”

For more information or to schedule an appointment, please call 732.222.1711.

“When standard care has been exhausted and patients need to look for research trials, now they can get many of them right here. We have never had that option before.”

Seth Cohen, M.D., (center) poses with the team from Monmouth Medical Center, Southern Campus’s Outpatient Infusion Center. Dr. Cohen, of Monmouth Hematology Oncology Associates, now sees patients at the Lakewood hospital.

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The main lobby at Monmouth Medical Center’s Southern Campus recently got an ambitious facelift.

A hospital reborn

The merger that created Monmouth Medical Center, Southern Campus, means better service for Ocean County residents.

I

t’s great to have a top-notch hospital close by, and that’s what Ocean County residents had for years in Kimball Medical Center. Now that the Lakewood facility has become Monmouth Medical Center, Southern Campus, in key ways it has become even better.

“The merger with Kimball, which took effect May 1, 2014, created a new network to provide high-quality, efficient health care to communities in the region,” says Michael Mimoso, president and CEO of the Southern Campus. “It also establishes a stronger healthcare delivery model for the future, enabling us to expand outpatient services to better meet patient populations’ healthcare needs.”

The Lakewood hospital’s new identity gives patients seamless access to Monmouth Medical Center’s specialty services, especially in geriatrics, oncology and neurology, he says. The Southern Campus expands Ocean County residents’ treatment choices for stroke, breast and lung cancer, arthritis, obesity, back pain, sleep disorders and much more.

What hasn’t changed is the quality care this hospital provides. The Southern Campus recently received an “A,” the highest hospital safety score, from The Leapfrog

Renovations update: Conversion to all private rooms for overnight stays is under way Monmouth Medical Center’s Southern Campus is undergoing a three-part renovation. Part one, a main-lobby facelift, is completed, says Jay Tango, assistant vice president of support services for Monmouth Medical Center.

In the second part, to be completed this summer, room renovations in the three-floor Heritage Wing will result in 18 private inpatient beds per floor; the third floor will be entirely for geriatric patients. Rooms will feature new flatpanel TVs, a new nurse call system, brighter lighting, safer

Group, an independent national not-for-profit organization of employer purchasers of health care and leading experts on patient safety. The report cards awarded letter grades for more than 2,500 institutions in the nation, including New Jersey’s 71 hospitals.

“We are very proud of how well we performed on these important quality and safety measures,” says Mimoso.

“Our dedication to patient safety and quality continues here every day.”

beds and more security to help prevent falls and wandering.

The final phase, to begin in the spring, will include renovating the grounds and parking areas and the lobby and entrance to Outpatient Services on Route 9. This wing of the hospital serves patients using services such as cardiac and pulmonary rehabilitation, outpatient infusion, wound care and hyperbaric treatment.

“People want private rooms when they’re in the hospital and easier access to services when they’re outpatients,” says Tango, “and this investment by Barnabas Health in the Southern Campus will help fulfill these desires.”

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Ask

Is the shingles vaccine for you?

A question for Todd Phillips, M.D., chief medical officer, Monmouth Medical Center, Southern Campus.

Q: “I’ve been seeing lots of TV ads for Zostavax lately. What is it, and should I get it?”

A: Zostavax is the brand name of the vaccine for herpes zoster, the virus that causes shingles. And the reason you are seeing so many ads is simple: Shingles primarily affects people over 65, and their numbers are growing rapidly.

And yes, seniors should get the vaccine. Herpes zoster is the virus that causes chicken pox, which most adults have been exposed to. The virus lives on in the body after chicken pox subsides, but the immune system keeps it at bay. As we grow older, however, our immune systems weaken because of disease, immuno-compromising treatments such as chemotherapy or simply age. About 20 percent of adults who have

the virus will develop shingles.

Shingles causes a painful rash, which subsides in two to three weeks in most people. But about 15 percent of those who develop shingles continue to have severe pain and what they call a burning sensation weeks or even months after the rash subsides.

The vaccine is a safe and effective way to prevent shingles or at least minimize its symptoms. It is recommended for all adults age 60 or older, but many doctors will prescribe it if you are over 50, when the risk for shingles begins to rise. You should get vaccinated even if you have already had shingles, because it can recur.

The vaccine is covered by Medicare Part D and by many commercial insurance plans, which speaks highly for its benefits.

FOUNDATIONFOCUS

On living wills Have you thought about how decisions about your finances and medical care will be made if someday you’re unable to make them?

That topic was addressed at a seminar presented recently by the Monmouth Medical Center Southern Campus Foundation for 75 members of the Women’s Club of Four Seasons at Metedeconk Lakes in Jackson.

Speakers were Robert Novy and Linda Conroy, members of the Monmouth Medical Center Southern Campus Planned Giving Committee.

Novy, an attorney, explained that a medical power of attorney is a document that entitles someone you trust to make decisions on your behalf in case of illness or disability, while a financial power of attorney provides authority to pay bills, borrow money and complete tax, medical and other official forms. “This power is far-reaching and must not be taken lightly,” he said.

Conroy told listeners that New Jersey and most other states have adopted “living will”

statutes. A living will allows you to decide what, if any, forms of treatment you desire should you become too seriously ill to communicate your wishes clearly. “A living will also enables you to select someone to act on your behalf for other medical decisions,” she added. These include hiring physicians, nurses and other healthcare professionals; entering or leaving a hospital; and arranging for treatment at home. “Remember—a living will is revocable and is only valid when you are incapable of speaking on your own behalf,” said Conroy.

At the seminar, Denice Gaffney, vice president of the Monmouth Medical Center Southern Campus Foundation, also gave an update on the merger that created Monmouth Medical Center Southern Campus (see page 6) and Victor Almeida, D.O., discussed the Geriatric Emergency Medicine Unit (see page 4).

COMMUNITY CALENDAR Here are some upcoming events that will be of interest to seniors. The location is the Center for Healthy Aging, Monmouth Medical Center, Southern Campus, unless otherwise noted.

APRIL • 14, 15, 21, 22, 28, 29 caregivers support group Tuesdays 12:00–

2:00 p.m., Wednesdays 12:15–2:00 p.m.

• 15, 22, 29 GRANDPARENTS SUPPORT GROUP Wednesdays

10:30 a.m.—12:30 p.m.

• 15 Diabetes SelfManagement Education 3:00–6:00 p.m.

• 21 Avoiding Falls 1:00–2:30 p.m. (A Country Place, Lakewood) • 22 Age-Related Hearing Loss

10:00–11:30 a.m. presented by Sue Ellen Boyer, Au.D., FAAA (Monmouth County Parks, Manasquan Reservoir) • 27 Age-Related Hearing Loss

10:00–11:30 a.m. presented by Sue Ellen Boyer, Au.D., FAAA • 28 Self-Defense for Older Adults

10:00–11:00 a.m.

to learn more about monmouth medical center southern campus foundation’s seminars, call 732.886.4148.

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What’s your

‘REAL’ AGE?

Take this quiz to illuminate your likely lifespan as mere birthday candles can’t.

We all know vibrant people who appear younger than their years— and others who seem to age prematurely, even without being seriously ill. Clearly, our chronological age is an imperfect guide to how many healthy years lie ahead.

A few years ago, Clevelandbased internist, anesthesiologist and author Michael F. Roizen, M.D., used that insight to start an enterprise called RealAge. “In almost everything in life we have numeri-

cal targets—our earnings, our grade point average, our golf score,” he said. “But for the most important part of our life—our health—we have no target.”

RealAge fills that gap with a questionnaire that turns information about your life and habits into a “real” age figure that’s personal to you. And the good news is that if it comes out too high for comfort, there are a number of behavioral changes you can make to bring it down.

You can take the full-scale Real Age quiz in about 20 minutes online at RealAge.com. It will ask questions about your parents, your medical history, your vices, your weight patterns, your sleep habits and 44 different ways you could be—and maybe already are—slowing the rate at which you’re effectively aging.

But in just five minutes you can get a ballpark figure by answering and scoring the eight simple questions on this page.

A quick quiz to discover your ‘real’ age Start with your calendar age, then add or subtract as directed as you answer these eight questions.

1. How often do you eat breakfast?

• More than five times a week (subtract ½) • Four or five times a week (no change) • Two or three times a week (add ½) • Fewer than two times a week (add 1) 2. On average, how long do you sleep at night?

• 6½ to 7½ hours per night (subtract 1) • 7½ to 8½ hours per night (no change) • Less than 6½ hours per night (add 1)

4. How do you feel about the quality and quantity of your sex life?

7. Do you have a good sense of humor, if you say so yourself?

• Very happy (subtract 1½)

• Yes (subtract ½)

• Satisfied (subtract ½)

• No (no change)

• Unsatisfied (add ½) 5. What is your marital status?

8. Do you floss your teeth daily?

• Yes (subtract 2)

• Happily married (subtract ½)

• No (no change)

• Single (no change) • Widowed (add 1)

• YOUR CHRONOLOGICAL AGE:___________

• Divorced (add 2)

• YOUR REALAGE®___________

6. Do you have a dog?

• Yes (subtract ½)

Copyright © and Trademark ® 1999–2004 Real Age, Inc. USA. All rights reserved. Real Age.com

• No (no change)

• More than 8½ hours a night (add 1½) 3. What is your cigarette smoking history?

• No more than 5 cigarettes in life (subtract 3) • None for more than 5 years (subtract 2) • None for 3 to 5 years (subtract 1) • None for 1 to 3 years (no change) • None for 5 months to 1 year (add 1) • A pack a day for 1 to 20 years (add 2) • A pack a day for 20-plus years (add 3)

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