IGH - CNY-245 - May 20 by In Good Health: CNY's Healthcare Newspaper

CNYHEALTH.COM

MAY 2020 • ISSUE 245

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 four of them. Coronavirus Special Issue Inside

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

BETTER HEALTH IN AUBURN Physician Paul Fu is Auburn Community Hospital’s new deputy chief medical officer. He wants to improve quality of care his hospital offers.

More People in the Region Seek Animal Interactions Fava Beans Promote Good Health P. 26

The New Normal: Face Masks, Social Stigma P.11

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Strong teamwork with our local and regional EMS partners

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Aggressive door-to-treatment times exceed national average

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Earned Gold Plus–Elite Honor Roll status from AHA

Proud to be the official healthcare provider of Syracuse Athletics. ®

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

Discover howTelemedicine Use Soars Discover howAccountant says goodbye to 47 painful pounds, says, “hello size 2!” Accountant says goodbye to 47 painful pounds, says, “hello size 2!” in Wake of Pandemic Members of Excellus BlueCross BlueShield log nearly 40,000 telemedicine visits between Jan. 1 and April 3

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.”

Being overweight was

younger andmore like than myself again. with just weight Hypnosis me I loss: has I’m helped less stressed, withsleep morebetter, than just my weight confidence loss:is much I’m less stressed, I better, my self-consleep better, confidence fidence is my through the is much better, mylike self-conroof now, I feel I can fidence is through the I want accomplish anything roof I feel likeI have I can the to now, now because accomplish want tools nowanything to go andI reach to my nowgoals. because I have the tools to go and reach Afternow hypnosis, I feel I’ll never myback goals. go to having a problem After I feel I’ll never with hypnosis, gaining weight again The go back to having problem way I eat and staya active now, it’s with weight justgaining the person I amagain and I The know it way active now, it’s willI eat lastand the stay rest of my life. justFREE the person I am and I know it SCREENING willI last the rest of my won’t cost you onelife. red cent to

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In Good Health is published 12 times a year by Local News, Inc. © 2019 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Deborah Sergeant, Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Anne Palumbo, Melissa Stefanec, Chris Motola, Eva Briggs (M.D.), Ernst Lamothe Jr., Simardeep Mangat (M.D), Kimberly Blaker, Kim Townsend • Advertising: Amy Gagliano, Cassandra Lawson 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.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 3

Meet

Your Doctor

By Chris Motola

Paul Fu, 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 4

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New deputy chief medical officer at Auburn Community Hospital to focus on inefficiencies, telemedicine, staff burnout, quality of care

Q: You’re currently in a bit of a transitional role at Auburn Community Hospital. A: I’m currently the deputy chief medical officer. The eventual plan is to transition over to chief medical officer. Dr. [John] Riggio has been in that position for about 20 years and has plans to eventually retire. Q: What attracted you to Auburn Community Hospital? A: I have to say I really like the people. Coming here, meeting the team running the hospital. Everyone’s so nice and dedicated to patient care. There’s the fact that within several counties, they’re the main hospital, which is a big responsibility that they take seriously. For me, it was a really good learning opportunity coming from a larger institution that’s very bureaucratic, with a lot of tasks that were subdivided. Here, being the deputy chief medical officer, you have a lot more responsibility on your plate. You manage a lot of things on an operational scale from day to day. Q: One of your areas of focus is on efficiency. What inefficiencies do you commonly run into in hospitals? A: Previously at Yale I was the physician lead for clinical optimization. What that means is we were an internal consulting group. We’d go from clinic to clinic looking at their various policies, and how they were taking care of patients. We took a lot of data and tried to improve it. Over six months, we worked with clinical staff and leadership to try to make things a little bit better. From a hospital standpoint, there are a lot of inefficiencies on a day-to-day basis. So anytime you have a delayed test or a patient who was told something was going to get done but they get bumped, those

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

things can be frustrating for patients, but also from an operating standpoint. We want to make sure patients are getting the most efficient care that they can receive. Q: You also have done a lot of work concerning faculty and staff burnout. How big an issue is burnout, and how do you address it in a work culture where, for example, residents brag about not sleeping for days on end? A: [laughs] You get used to working without sleep! Actually, burnout on the whole is one of the main things that got me interested in going into healthcare management. During my second year of residency, I thought being a provider would make people happy, but what I noticed working in a hospital is that many times the providers, the nursing staff, and the people working with patients weren’t happy. That made me want to go into healthcare management and to create a work environment that is dedicated to not only taking care of patients, but also the providers. And it’s my opinion that happy providers will do a better job of taking care of patients. People who really want to come to work and do the things you set out to do in your career. Q: How do you go about that? A: In terms of solving burnout, I think it’s all about creating culture. A lot of hospital work is going to be the same from location to location, but having a culture where the administration really cares about each provider and tries to make their day go as smooth as possible makes a big difference. Q: Where do you see telehealth fitting into the picture? A: I was the medical director of telehealth at Yale. It was tough. Connecticut actually has a really strict telemedicine law and [is strict about] which provid-

ers can get credentialed. There are a lot of reimbursement issues. The exciting thing about telemedicine is that it’s definitely the frontier of medicine. Having patients travel two to three hours to see you, parking, taking time off from work, finding a babysitter; instead they can just stay home and see their provider from there. Telemedicine was difficult to implement in Connecticut, but Auburn being a rural hospital with patients who travel from far away mean there are a lot of possibilities for telemedicine here. It’s something we hope to work on in the medium-term over the next several years. Q: Do you still practice neurology as well? A: Yes. I’m a general neurologist, so I see lots of different types of patients, from stroke, to MS, Parkinson’s disease, seizures. I see them both in an outpatient setting and through doing inpatient consulting as well. Q: Did your knowledge of neurology help address burnout issues? A: I definitely think so. From a physician standpoint, a lot of doctors want to see that administrators know what they’re going through. So, I think it’s really important to continue the practice of medicine. As soon as you stop practicing medicine as an administrator, you kind of lose touch with what it means to be a doctor. In order to promote a good culture you need to be able to see it from a doctor’s perspective as well. Q: You’re on the young side for an administrator. Are there any challenges or advantages that come with that? A: [laughs] The answer is yes. I’m 32. This happened at Yale too, when I was the director of telemedicine. People can be surprised that the person overseeing all that is so young. It was initially kind of scary for me, being the youngest person in the room. It made me want to be absolutely sure what I said was 100% correct, and sometimes that led me to not talking as much as I needed to. So, I had to push through that fear and put myself out there. I think the case is the same at Auburn, but people have been really nice here. As long as I’m contributing positively, I don’t think it’s that much of an issue.

Lifelines

Name: Paul Fu, M.D. Position: Deputy chief medical officer at Auburn Community Hospital Hometown: Troy, Michigan Education: Medical degree from Wayne State University (2014); residency and internship at Yale New Haven Hospital (2018) Highlights: Was the first graduate of Yale Neurology specialty track in healthcare management and also received the Glaser Award for most helpful colleague as voted on by his peers; medical director telehealth, Yale Medicine; physician lead Yale Clinical Optimization, Yale Medicine. Currently enrolled in Yale Executive MBA program Affiliations: Auburn Community Hospital Organizations: American College of Hospital Executives; American Academy of Neurology; American Medical Association Family: Wife Hobbies: Basketball, soccer, hiking, planning to get into cross-country skiing

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

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

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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

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

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

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.”

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 •

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Page 7

Say hello to healthy.

66 dedicated physicians and healthcare providers. Say hello to a more convenient way to stay healthy in Oswego County. ConnextCare offers a comprehensive set of services family and internal medicine, pediatrics, dentistry, psychiatry, social work under one medical group. Patients within our network can now visit any of the six locations at any time. And because we’re seamlessly connected, our staff can access your medical records at the touch of a button. It’s a faster, more convenient and easier way to keep yourself and your family healthy. Page 8

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

Learn more at connextcare.org — or better yet, stop in to one of our six sites Located in Fulton, Mexico, Oswego, Parish, Phoenix, Pulaski and say hello.

COVID-19 May Cost Health Insurers More Than $550 Billion

he cost to US health insurers of the COVID-19 pandemic might be anywhere between $56 billion and $556 billion in 2020 and 2021 combined, depending on how many people are infected, according to a new report prepared for America’s Health Insurance Plans (AHIP), the

industry trade association. The report, by the Wakely Consulting Group, modeled healthcare utilization and costs on the basis of published studies for infection rates ranging from 20% to 60% of the population. The researchers also calculated the costs if only 10% of the popu-

lation — half of the lower bound of infection rates in the studies — was infected with the coronavirus. The report evaluated these scenarios for a population of 255 million insured people, including members of commercial, Medicare Advantage, and Medicaid managed care plans. If just 10% of this population was infected, insurance-allowed costs would range from $56.2 billion to $92.7 billion during the two-year period. If 20% of the people were infected, the cost range would be $112.5 billion to $185.4 billion. If 60% caught the virus, it would cost insurers from $337.5 billion to $556.1 billion. Wakely also estimated that plan enrollees would pay 14% to 18% of the annual allowed costs. Thus, copayments and deductibles would cost plan members $10 billion to $78 billion in 2020 and 2021, again depending on the infection rate. For each person admitted into intensive care, the costs — on average — could exceed $30,000, according to

an AHIP news release. The researchers modeled the costs and utilization of COVID-19 patients on data for patients who had been treated for seasonal influenza and pneumonia. To estimate inpatient costs, they used the 75th percentile of admission costs for patients with ICU admissions and the 25th percentile of admission costs for non-ICU cases. Other cost figures came from claims databases. The researchers assumed that 75% of total costs would be incurred in 2020, and 25% of costs would occur in 2021, after the pandemic waned. It’s notable, however, that such a high cost was projected for the second year of the disease. While experts disagree on how long the pandemic might last, there is a consensus that only a vaccine will knock it out completely. Such a vaccine may be available in a year to 18 months, but it may take longer, some experts say.

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.

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.

Healthcare in a Minute

By George W. Chapman

Perspective: How Deaths from COVID-19 Compare to Deaths from the Flu, Diabetes and Other Diseases

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 medica-

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 May 2020 •

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.

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Alone in the Time of Corona

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

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

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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

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

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.

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.

‘Keeping Our Residents Healthy and Happy During COVID-19’

COVID-19

By Kim Townsend CEO, Loretto

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

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 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.

he lack of personal connection while we are social distancing can be tough on anyone, it’s particularly so for older adults living in a long-term care facility. But the staff who care for our residents every day makes a world’s difference. Many have gone beyond their call of duty to bring joy and laughter to the residents. So, even though we cannot celebrate May as Older Americans Month in the ways that we originally planned, we’ve seen again and again that simple gesture can help lighten the mood and put a smile on someone’s face. Singing and dancing proved to be a terrific remedy. On numerous occasions, our staff members turned the hallways into concert venues and sang. One staff member went door to door, belting out classic tunes while playing her guitar. And whenever there was live music, there were big smiles and applauses all around. It was heart-warming to see that through the power of music, the caregivers and care receivers lifted each other’s spirits. Technology is also a great way to stay connected. Live video chats can help residents stay updated with family and friends from across the miles and keep track of any physical changes such as a haircut. If live video chats are not possible, recorded videos with special messages for loved ones can be a good way to maintain the connection. While video chats are good alternatives, there’s no replacement for seeing someone face-to-face. That’s why, when possible, we’ve facilitated

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.

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

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 infection than to try to deal with it after the fact, and that’s the purpose of May 2020 •

Loretto has facilitated several “almost in-person” visits between residents and their families. Families stand outside the window of a resident’s room at a specified time and are able to establish eye contact. “Knowing that they are remembered and loved means the world to our residents,” says Kim Townsend, chief executive officer at Loretto. several “almost in-person” visits. Families stand outside the window of a resident’s room at a specified time and our staff direct a resident to the window to “see” his or her family. Knowing that they are remembered and loved means the world to our residents. The national theme for this year’s Older Americans Month was “Make Your Mark.” By showing compassion and kindness beyond their job descriptions, our staff has truly made a mark on all our residents’ lives during this challenging time. Kimberly Townsend is president and CEO at Loretto, and author of “Lifecircle Leadership: How Exceptional People Make Every Day Extraordinary.” 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.

2. 3. 4. 5.

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COVID-19

The Best Material for Homemade Face Masks May Be a Combination of Two Fabrics

esearchers affiliated with American Chemical Society report in ACS Nano that a combination of cotton with natural silk or chiffon can effectively filter out aerosol particles –– if the fit is good. SARS-CoV-2, the new coronavirus that causes COVID-19, is thought to spread mainly through respiratory droplets when an infected person coughs, sneezes, speaks or breathes. These droplets form in a wide range of sizes, but the tiniest ones, called aerosols, can easily slip through the openings between certain cloth fibers, leading some people to question whether cloth masks can actually help prevent disease. Therefore,

Supratik Guha at the University of Chicago and colleagues wanted to study the ability of common fabrics, alone or in combination, to filter out aerosols similar in size to respiratory droplets. The researchers used an aerosol mixing chamber to produce particles ranging from 10 nm to 6 μm in diameter. A fan blew the aerosol across various cloth samples at an airflow rate corresponding to a person’s respiration at rest, and the team measured the number and size of particles in air before and after passing through the fabric. One layer of a tightly woven cotton sheet combined with two layers

Upstate Seeks Healthy People Exposed to COVID-19 Participants will take part in national study to test a drug to treat the disease and will be financially compensated

pstate Medical University is urgently seeking healthy, symptom-free people who have had direct exposure to COVID-19 for a national study to test a drug to treat the disease. Upstate’s Institute for Global Health and Translational Studies is one of seven sites nationwide participating in this COVID-19 post-exposure prophylaxis study. Good candidates for the study are likely

My Turn

living with someone who has tested positive for the disease but have not shown any symptoms themselves. Upstate is working to enroll 500 local participants, said Michelle Klick, clinical research manager at the Institute for Global Health and Translational Studies. Here’s how the study will work: Potential participants must be 18 years old or older and must have had close personal contact with someone

uring the COVID-19 pandemic, it is more important than ever to keep yourself out of the emergency room or urgent care. The idea is to reduce the chance that you will come to a place with sick individuals, as well as to reduce the chance of spreading disease. Here are some tips to accomplish this. • If your problem is not a life-threatening emergency, you can call your primary doctor. Or try telehealth, as many doctor’s offices and urgent cares offer virtual visits. For life threatening emergencies, call 911 and get to an emergency room. • Check whether you have all of your medications. Don’t forget about the medicines you don’t use every day. As spring rolls on, pollen counts will rise, triggering allergies and asthma. Obtain all your allergy medicines or inhalers now, before you need them. Do you suffer from migraines, gout or other maladies that

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1% gap reduced the filtering efficiency of all masks by half or more, emphasizing the importance of a properly fitted mask. The paper’s abstract is available at http://pubs.acs.org/doi/ abs/10.1021/acsnano.0c03252

diagnosed with COVID-19. In many cases that means living with someone with COVID-19. Participants may also be healthcare workers if he or she was exposed for at least 10 minutes and was not wearing personal protective equipment. For the study to be effective, the participant must begin taking the medication within four days of exposure, Klick said. An Upstate staff person will conduct an over the phone interview to determine eligibility. Good candidates will then proceed to a 30-minute telemedicine conference with a doctor. That conversation will include discussion of potential side effects and what conditions might prevent a person from participating, Klick said. Upon official enrollment, Upstate will deliver a box of supplies to the person’s home. The box includes medication, nasal swabs and directions.

The PEP study is a double-blind meaning participants will be taking either hydroxychloroquine (HCQ) or vitamin C. Neither the participant nor the Upstate study team will know what is given. Participants must take one dose every day for 14 days. Participants must also conduct a daily mid-nasal swab and fill out a brief, daily health questionnaire. Upstate will pick up the nasal swabs from the participant every five days and will monitor questionnaire responses should any health issues arise, Klick said. Participants must conduct one more nasal swab and complete a final questionnaire again on the 28th day before their work is complete. Participants are compensated $100 after successfully completing the first 14 days and then again after the 28th day for a total of $200. Interested parties may call Upstate at 315-464-9869 or email trials@ upstate.edu to enroll.

ing into your skin. The head itself is unlikely to spread tick borne disease. It’s in the most superficial layer of skin and will work its way out over a few days. You can apply warm compresses to hasten the process. A small area of redness, up to one inch across, at the site of the tick bite is typical. If the tick has been attached for longer than 24 hours and is engorged, you might be a candidate for a dose of antibiotics (doxycycline) to reduce the chance of acquiring Lyme disease. Try calling your primary care doctor first, as it may save you a visit to the urgent care. You still need to watch for signs of tick-borne illness such as rash, fever and joint pain. Often it is the tick that you never discovered that transmits tick-borne illness. Again, call your doctor if these symptoms develop. Most labs are not analyzing ticks for disease currently because their resources are focused on COVID-19. If you feel that you must have your tick analyzed, place it in a plastic baggie and freeze for future submission. • Give your animals space. They are not used to having you and your children home all day. At the urgent care we have seen an uptick in ani-

mal bites and scratches since stay-athome orders began. Supervise your children around your pets. • Be mindful of what you do if you are drinking or using recreational drugs. Don’t ride a bike, climb a ladder, use sharp implements, or operate power tools if your mind is altered. • Remember that many minor illnesses and injuries can be treated remotely by a phone call to your doctor or by urgent care telehealth. Your provider can order labs (such as a urinalysis and culture for a possible urinary tract infection) or X-rays (for a sprained ankle or similar injury). This could keep you out of the urgent care or emergency room. Stay safe out there!

By Eva Briggs

Stay Out of Hospital ERs, Urgent Care Centers

of polyester-spandex chiffon — a sheer fabric often used in evening gowns — filtered out the most aerosol particles (80–99%, depending on particle size), with performance close to that of an N95 mask material. Substituting the chiffon with natural silk or flannel, or simply using a cotton quilt with cotton-polyester batting, produced similar results. The researchers point out that tightly woven fabrics, such as cotton, can act as a mechanical barrier to particles, whereas fabrics that hold a static charge, like certain types of chiffon and natural silk, serve as an electrostatic barrier. However, a

require as intermittent treatments? If yes, keep the necessary medicine on hand. Contact your primary care provider now before the need arises. • Wear appropriate protective gear for any sports. Even if you are just in your yard, wear helmets and eye protection for bicycling, scootering, and 4-wheeling. Wear eye protection when operating tools. • Protect yourself from ticks and know what to do if you discover a tick bite. Reduce the chance ticks will attach with long sleeves, insect repellant, and treating clothing with permethrin. • Check for ticks as soon as you come inside. If you discover an attached tick, remove it using finetipped tweezers or a tick removal tool such as a Tick Twister. If the head remains attached to your skin and you cannot easily remove it, there is no need to panic. And no need to attempt to dig it out by goug-

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

Eva Briggs is a medical doctor who works at two urgent care centers in the Syracuse region.

Honoring Our Health Care Workers, Providers and Physicians

A Special Thank You to ALL Nurses... On the frontline and beyond!

Your unselfish devotion to mankind shines through all illness and adversity. We honor you...all of you...who go above and beyond to make sure we are safe. We continue to stay home...stay safe...so you can do your job...and go home.

THANK YOU ...THANK YOU...THANK YOU!!!

May 2020 •

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COVID-19

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

he world is learning more about how certain viruses spread in speed and how long they can linger. Cold and flu virus-laden droplets may infect a surface for many 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 Mayo 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 — such as a handshake or breathing in droplets from a cough or sneeze — is the most common way these viruses spread. “While the nation is just learning about the coronavirus, there are countless viruses,” said physician Helen Jacoby, an infectious disease specialist at St. Joseph’s in Syracuse. “They can affect the body in many ways with some causing respiratory issues while some can attack other areas of the body.” Jacoby talks about five aspects of viruses.

1.Viruses can live on objects

The length of time a virus can survive on a surface depends upon the type of virus and the surface involved. There is a reason why medical experts stress disinfecting consistently throughout the day and the fact that droplets can spread person to person and person to object to

person rather quickly. “Because viruses can linger on areas and inanimate objects for various lengths of time that is essentially the reason why it is important to wipe down surfaces or make sure you are constantly washing your hands if you do touch areas,” said Jacoby. “It is easy to transmit viruses if you are not being diligent in what the Centers for Disease Control and other health experts are telling you about how viruses spread.”

distancing is essential for some viruses 2.Social

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 COVID-19. Canceling events that are likely to draw crowds is an example of social distancing. “I understand that it has been an adjustment for people to not touch or be six feet away from each other, but it is imperative that these rules be followed if you want to avoid spreading the disease,” said Jacoby. “Viral droplets must attach onto something and then when they enter through your nose, eyes or mouth that is when the damage begins.”

are different from bacteria 3.Viruses

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. “People often confuse the two.

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Antibiotics are not going to help you if you have a viral infection such as the common cold or the coronavirus infection,” said Jacoby. “For example, traditional antibiotics are useful for bacterial infections such as pneumonia, bladder infections or sinus infections but viral infections like Hepatitis C or HIV would need anti-viral medication.”

4.Vaccinations

Many have wondered with COVID-19 being an issue first overseas for months, why hasn’t an established vaccine been created and distributed to the public? Well, it is not that easy. There is a process through the U.S. Food and Drug Administration that involves different scientific trials before it is given to the general population. It first starts with bench research to identify the correct components of the vaccine. Then there are tests on animals and then you start the first phase on a few dozen people. “There are risks with any vaccine which is why medical professionals go through such lengths to make sure that it is tested through several rounds. It would be dangerous to put anything out too quickly without knowing the side effects especially with any new types of viruses,” said

Welcome home!

Physician Helen Jacoby is an infectious disease specialist at St. Joseph’s in Syracuse. Jacoby.

cause a wide range of illness 5.Viruses

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. “Viruses can be anything from the common cold to herpes and they are all transmitted in different ways,” said Jacoby.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

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UPSTATE PHYSICIANS FROM LEFT:

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Timothy D. Ford, MD Luna Bhatta, MD Robert L. Carhart, Jr., MD Debanik Chaudhuri, MD Hani Kozman, MD Sakti Pada Mookherjee, MD Avneet Singh, MD Tama Szombathy, MD Amy Tucker, MD Daniel Villarreal, MD

May 2020 •

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COVID-19

Safer Shopping for Seniors By Deborah Jeanne Sergeant

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. Physician David Heisig, medical director at PACE in Syracuse, recommended shopping at less busy times, such as during working hours on weekdays. His theory of shopping times is supported by InMarket, a company that analyzes retail shopping patterns. InMarket states that grocery stores are least busy before 8 a.m. 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. As Heisig alluded, 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. Heisig said that people with balance issues should speak with their care provider about a cane, walker or wheelchair. These items may not be needed all the time, but may provide more safety while in crowded areas. “If they do well but have issues with distance, most grocery stores have motorized carts,” Heisig said. If possible, bringing along the

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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

cane in the cart can help if the shopper needs to step away from the cart. Heisig recommends writing a list before shopping. By planning the route through the store, shoppers can make the trip easier by reducing the need to backtrack to a different department. Reducing the number of trips to the store or the length of the trips can reduce risk of falls. “Take advantage of online shopping and catalog shopping,” Heisig said. “If you’re not computer savvy or are concerned, there’s usually someone in the family, a friend or someone in social services so you don’t get into a malicious website. We’re evolving into a society where we expect things to be delivered.” 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 de-

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

Best Time to Grocery Shopping

it is truly a life-or-death decision, said physician Udit Chaddha, an interventional pulmonologist with 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.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

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.

livery through the Instacart app. This includes a store’s perishable goods, too. Heisig said that those with balance issues and concerns about stability should ask for help. “Church groups will help in many cases or service groups,” he said. “If you call the administration, they’ll find a volunteer who will be thrilled to help you by driving you there and help you or take your list and do it for you. There’s a variety of options.” Many people want to help but don’t realize that others need help or what kind of help they should offer. Heisig said that it’s about “sitting

down with a younger friend or family member and being very honest and saying, ‘I feel concerned doing this. This is why. Let’s figure out a plan to get around this and figure out solutions.’ Explain to people what you need and give them a heads-up on how to give a hand.” Putting items in the cart and on the check-out stand may be fine except for a large bag of cat food, for example, or loading the items in and out of the trunk may be challenging. 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.

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. 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.”

“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.

‘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.

COVID-19

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

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. At Purpose Farm in Baldwinsville, Sandra Seabrook, her family and volunteers tend 11 acres and care for 40 rescued animals, including horses, donkeys, birds, pigs, and even a camel. Seabrook and her husband, Howard, have a big heart for animals and also for children from troubled and at-risk households. Every summer, they operate a mentoring program which brings each child in the program to the farm for 90 minutes once a week to learn animal care skills and, more importantly, life lessons on human relationships. “We once had a horse with a

wound and each kid took a turn washing it out, putting salve on it and wrapping it up,” Seabrook offered as an example. “It teaches empathy and responsibility.” The children could identify with the horse as a victim that didn’t deserve the treatment it received. They also connect with the animals as living beings that don’t judge them. “The ones we work with are rescues that came from neglected or abusive backgrounds,” she added. “They’re thankful to be where they are. We’re putting them out there and socializing them. They give unconditional love back.” Whether horses or small pets, animals can help people work through less traumatic emotional issues as well. It’s all about the way in which animals connect to people. “Pets love us unconditionally,” said Jodi Ann Mullen, Ph.D., professor at SUNY Oswego counseling and psychological services department, coordinator of mental health counseling at SUNY Oswego and owner of Integrative Counseling Services, PLLC in Oswego. “It fills a void for connection. You won’t be judged by a cow or a goat.” Mullen thinks that because more people see the benefits of connections with animals, the interest in emotional support animals has increased.

Another of the reasons why animals provide so much comfort is that many people had a pet during childhood or at least stuffed animals. Mullen believes many pet owners turn to the familiarity of pets to find that comfort again. Petting animals requires a gentle hand, soft words and a pleasant tone. Even making these changes for the sake of the animal seems to affect the human’s mood and measurable health statistics. “Studies show that just petting a cat or dog reduces blood pressure 10 to 15 points,” said Scott Mooney, Ph.D., and co-founder of Beacon Psychological Services LLC in Oswego. “We see that a lot in regard to people being comforted by animals. The love and companionship can reduce stress. Emotional support animals have become a big thing.”

Purpose Farm was noted by USA Today as a top venue for goat yoga in 2017. The nonprofit farm has been using goat yoga sessions as a fundraiser. Mooney said that goat yoga became popular because “it’s a warm life and body connection with us. A connection with an animal is very helpful.” Anyone seeking a farm animal “fix” can find it volunteering with the animals at Purpose Farm, even if they cannot keep large animals at their property. Like most other shelters, Purpose Farm welcomes the help. 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.

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

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.

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May 2020 •

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COVID-19

Q A & with

Anne Marie Mullin CEO of Laboratory Alliance of Central New York on the testing services it’s providing By Deborah Jeanne Sergeant

imely testing can help healthcare workers provide more responsive treatment and protective measures for patients with COVID-19. Until recently, it took up to three days to receive results to tests performed locally. Liverpool-based Laboratory Alliance of Central New York has been able to shorten that time. The lab is jointly owned by Crouse Health and St. Joseph’s Health. We spoke with Lab Alliance CEO Anne Marie Mullin. Q. When did Lab Alliance begin processing COVID-19 tests? A. We started that Tuesday, April 14. Q. Who is receiving testing? A. There’s a number of different companies manufacturing the tests. The tests we’re performing, like other companies’ tests, they’re not capable of making enough kits to meet the demand. We’re grateful for the orders we did receive. We don’t have an unlimited supply. We limit the tests to three groupings of patients: hospitalized patients of our two owners, Crouse Health and St. Joseph’s Health, the Crouse and St. Joseph’s healthcare workers with symptoms, and the ER patients of those. Q. How many tests have you performed? A. From Tuesday, April 14, through Thursday, April 16, we’ve processed approximately 120 tests. Q. Is it a matter of your firm’s capaci-

ty or only the supply of tests available? A. The test is performed at our main lab in Liverpool. Any other test requests for COVID received, we’re directing to the Wadsworth Laboratory, owned by the New York State Department of Health in Albany. That’s where all the specimens had been going until April 14. Their turnaround has been 24 to 36 hours. From the time the specimen is received in our laboratory in Liverpool, we’re looking at a two-hour turn-around time. That’s a great improvement. We’re not the only labs sending specimens to Wadsworth. They’ve been besieged with specimens. We have a relationship with a couple of courier companies that are delivering those specimens on a stat basis to Albany for testing. St. Joseph’s has a couple of urgent care locations. If there are any others coming to us, it would be from physician’s offices who are seeing patients they think might be symptomatic. Q. Are you hiring additional people? A. No, we’re capable of doing this with the staff we have. We’re doing it 24/7, Sunday through Saturday, all three shifts. We have 395 employees among three labs, corporate office and the 12 patient service centers performing the COVID assay. We employ 147 New York state-licensed personnel. We currently have 12 licensed laboratorians performing the COVID assay in our microbiology department at our operations center laboratory located in Electronics Business Park in Liverpool.

Q. Why was your lab selected to receive COVID-19 tests? A. I was one of 28 lab executives contacted by the governor’s office March 10. There were 28 labs handpicked by the New York State Department of Health who oversees us and inspects us. They’re the ones to whom we have a license to operate. They reached out to gauge our interest and capability. They learned in early March there would be a great need and demand for tests and knew that the demand of tests would cause a great surge to Wadsworth Lab. They spoke with us to see if we had an interest and a capability. We said yes and reached out to current vendors that are making a test for COVID from whom we had existing pieces of equipment. We were waiting to see who had test kits available. We received test kits April 8. There was a team of many people across many departments involved in some respect involved in onboarding these tests.

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Q. Why is a timely test important? A. If someone’s presenting, they have result in two hours. If they receive positive results, they can jumpstart the process of notifying people of possible exposure, putting people in quarantine, which reduces the possibility of transmitting the virus to anyone else. I want to give a huge shout out to all the staff that work so hard, 365 days of the year and 24 hours a day. All my colleagues are the hidden heroes of healthcare. I don’t want to draw attention away from providers on the frontline, but what the laboratory does is so vital. Seventy percent of the medical record is made of up of laboratory results. What the lab does is vital to the whole healthcare continuum. Our lab technicians are away from the public eye. The exceptional efforts of lab professionals are essential for public and patient health. I’m so proud of the team at Lab Alliance.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

COVID-19

Technology Beats COVID-19 Isolation for Nursing Home Residents Experts say technology doesn’t replace the need for face-to-face interaction, but it’s helpful during pandemic By Deborah Jeanne Sergeant

xperts agree that suspending social visits to nursing homes represents an important way to reduce breakouts of COVID-19 at nursing homes. While this can help slow the spread of COVID-19 within this vulnerable population, it severely limits the scope of social interactions available to nursing home residents. Family members are prohibited from stopping in but that doesn’t mean that residents cannot connect with loved ones. Some are calling on the phone while standing outside to wave through the window. Others use Skype or FaceTime to communicate remotely. Thomas Schur, marriage and family therapist in private practice in Syracuse, has retired from teaching at Syracuse University. “One thing that a lot of my colleagues are dealing with is telehealth,” he said. “A lot of their patients really don’t like telehealth and would much rather meet in person. With people waving to their loved ones through the window at the nursing home, it’s similar. Some politicians have said it’s important to social distance, but not social disconnection. The question is how do you distance without leaving people alone? Will technology inhibit our ability to relate?” He views efforts such as waving at the window or connecting through technology as better than nothing, but not as good as face-to-face interaction, especially for people who did not grow up with technology, since they’re accustomed to connecting in person. Scott Mooney, Ph.D. and co-founder of Beacon Psychological Services LLC in Oswego, also views technology-based connection as less than ideal, but said that is connection is imperative for everyone. “If someone’s feeling isolated and feeling a lack of control, visits from loved ones can help them cope better as they visit and reminisce.” Part of the increased need to connect stems from the maturation process. “The older we get, the more we realize that we need fewer things and we come to appreciate what’s more important: time with others we love,” Mooney said. “Especially when people are older, they appreciate quality time. That’s valuable and reaffirms they have self-worth.” Some nursing homes try to help residents feel more at ease during isolation by planning more time for staff to simply visit with residents and listen to them. That strategy can prove very helpful. “They have stories to tell; I think

“The older we get, the more we realize that we need fewer things and we come to appreciate what’s more important: time with others we love.” Scott Mooney, Ph.D. and co-founder of Beacon Psychological Services LLC in Oswego. those are important stories,” said Jodi Ann Mullen, Ph.D., professor at SUNY Oswego’s counseling and psychological services department where she coordinates the mental health counseling program and therapist at Integrative Counseling Services, PLLC in Oswego. In addition to benefit of younger people learning about the past, the oral history is also important for those doing the telling. “That’s a powerful and connecting experience, whether family history or general history,” Mullen said. She said that for nursing home residents with dementia, it may be difficult to remember why family members cannot come visit. Mullen hopes that nursing home activity directors plan more events and things to do to bring pleasure to residents. Communicating with family is essential and should not be interrupted. Matt Mallow, RN, with Caring Hearts of Rochester, works with elderly patients through home health and has worked in long-term care facilities in the past. He encourages family members to ask the staff about setting up a video chat if their relative needs help with the technology. “Talk with the activities director,” he said. “The aides and nurses are so short on time taking care of the clients.”

On this day, Auburn Community Hospital wishes to raise awareness of the incredible contributions nurses make on a daily basis to the health and well-being of patients and our community. This has been even more evident during the Coronavirus pandemic. Remember… not all heroes wear capes, but a lot of them wear scrubs and masks.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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ON THE FRONTlINE

Along with other providers, nurses are frontline responders in the battle against COVID-19. Thank a nurse — May is Nurses Month By Deborah Jeanne Sergeant

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 the State of New York. Of those, 6,120 work in the Syracuse 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

Experience with Seniors Prompted Nursing Career Katie Sovie, an RN with HCR Homecare: ‘No one can prepare you to sit with a patient who’s dying and have the right words to say’ By Deborah Jeanne Sergeant

aldwinsville resident Katie Sovie works as an RN at the CNY branch of HCR Homecare. She has always had a soft spot for older adults, including her grandparents. Even in grade school, she used to help them when they were sick, rubbing their feet and backs and offering whatever assistance she could. “I am a people person and love caring for people,” Sovie said. She began helping her uncle take care of her aunt in 2012. When Sovie’s aunt became seriously ill and was admitted to the hospital, she and her uncle went to visit her. “He needed a wheelchair at the hospital when he was visiting her and a nurse was snotty about it,” Sovie recalled. “He needed it; he was visiting because his wife was dying. That was a final push for me.” She enrolled at Cayuga Community College in Fulton to become an LPN and received her registered

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nurse credential in 2015 after graduating from Crouse. She initially worked at Upstate’s downtown campus for three years, and then shifted to HCR Homecare two years ago. “I really liked the hospitals, but I have two young kids and working nights and weekends — it wasn’t for me,” Sovie said. “Now that I’m here, I don’t see myself anywhere else.” She likes that she can apply more of her nursing skills in homecare than in a hospital setting, which has specialty teams that do things like insert IVs and care for wounds. “I didn’t get to do much of those,” Sovie said. “I didn’t get to do many different things. I like the flexibility to be there and be the mom I want to be and be the nurse I want to be.” Winter travel is one of the drawbacks to providing home care; however, she said the company requires only necessary visits when the

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

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 complete 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

weather is bad and assigns the nearest employees to make those visits. “I have a four-wheel-drive vehicle so the snow doesn’t bother me,” Sovie added. She said that anywhere a nurse works, staffing ratios is every nurse’s complaint. “There are a lot of things I want to do but we can’t because we have so many people who need us.” “It is hard to leave work at work and not bring it home because you get attached to patients, especially with homecare.” She has cared for some of her patients for the nearly three years she’s been with HCR. “When they get ill, it’s almost like a family member,” she said. She uses skillful scheduling to ensure she can cover all her patients’ needs and keep her staff informed. “I enjoy caring for people and making them happy,” Sovie said. “I’ve had so many people tell me things like, ‘You’ve restored my faith in humanity.’” Sovie believes that while nursing school prepares students for nursing, “no one can prepare you to sit with a patient who’s dying and have the right words to say. Classes can’t prepare you for that. I have a friend whose daughter is going to nursing school and I help her as much as I can. I love nursing, but if you’re not all in, it’s rough.” She also lists an outgoing personality, good work ethic, dedication and caring as important traits for nurses.

As of May, 2019, 178,320 registered nurses work throughout the state of New York. Of those, 6,120 work in the Syracuse area. Annual mean salary is $69,970 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 healthcare, nursing represents one career path with a guarantee of available employment. While the $69,970 annual mean salary in the Syracuse 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.

“Sometimes, it’s just that extra touch to make someone’s day, especially now with COVID-19,” Sovie said. “People are lying in a bed and their family can’t even visit. In hospitals, some are facetiming through a biohazard bag so people can see their family member who’s dying.” In her free time, she helps her sons who race quarter midget racecars all summer long and ride snowmobiles all winter long.

Caring for Family Prompted Nursing Career Director of nursing at Loretto challenges her staff to do a TikTok dance to lighten the mood By Deborah Jeanne Sergeant

ursing has become much more of a challenging career in recent days as work hours lengthen and providers feel stretched to their limits battling COVID-19. Meredith Boss, director of nursing at Loretto Health and Rehabilitation, said that it’s been difficult ensuring staff are safe and comfortable. While most safety measures are mandates and decisions made outside her control, Boss has come up with some creative ways to generate esprit de corps. “I’ve challenged all the staff to do a TikTok dance to lighten the mood,” Boss said as one example. “It’s scary out there; people are afraid.” Boss has been nursing over 10 years. Her desire to care for others stemmed from aiding her father’s recuperation from emergency quadruple bypass surgery since her mother would have to take time off from work to care for him. “My mom was a nurse so I was raised by a nurse,” Boss said. “There’s something about having a seasoned nurse as your mother.” She said that her mother taught her how to lead patients and do her

part in working with a team. By caring for her father, Boss realized that she enjoyed taking care of others. The experience inspired her to complete nursing classes at Crouse Hospital College of Nursing in 2008. She obtained her registered nurse credential and began working at St. Joseph’s Hospital Health Center. “I love caring for other people and making a difference in their day,” Boss said. Four years ago, she began working at Loretto, initially, as a nurse manager for a 46-bed rehabilitation unit. After she worked a year in that role, Loretto started a telemetry unit, which helps patients prepare for returning home. Boss was tapped to head the unit. Last July, Boss became director of nursing at Loretto. She feels especially drawn to working with patients in their last days. “I comfort those who are at end of life,” Boss said. “It’s meaningful to know you did that last back rub, put that lotion on their legs.” She also likes working with family members in meaningful ways, like explaining the disease process and the symptoms their loved one is experiencing.

Experience as a Teen Drew Woman to Nursing ‘We’re the soldiers on the battlefield,’ says Upstate University Hospital nurse By Deborah Jeanne Sergeant

s a teenager, Syracuse resident Naquia “Kia” Worrell inexplicably wanted to be a stockbroker. To this day, she’s not sure why she thought that was a good idea, but an experience while she worked as a kitchen aide in a nursing home changed her career aspirations and her life. One day she saw a patient in the dining room fall out of a chair, choking. “It was traumatizing,” Worrell recalled. “I was 17. They didn’t teach us CPR.” She immediately alerted a staff member whose only response was, “It’s not my patient.” The calloused attitude shocked Worrell. The patient did receive help from another staff member and was all right. Worrell told a supervisor about what happened and asked, “’How do I become her boss?’” she said. “That started me on the road to take nursing training. It developed in me a passion for helping people.” Worrell earned her Associate in Applied Science degree at St. Joseph’s College of Nursing in 2012, and, from the University of Phoenix, her Bachelor of Science in Nursing in 2016 and Master of Science in Nursing with a concentration in nursing education in 2018. Her initial goal was to go back to

the nursing home at age 20 and rectify the lax attitude nurses had about the care provided for the residents; however, during her education, she was exposed to emergency room nursing. She felt that offered a way to touch the community and influence many others for good health. After receiving her RN credential in 2012, she was one of four graduates selected to work at the emergency room at St. Joseph’s Hospital. She worked there for three years and transitioned to Upstate University Hospital in 2015. “I needed a change, as I was getting my bachelor’s degree and I had my daughter,” she said. She started working in ambulatory care in the pulmonary clinic, coordinating care for patients who have returned home after a hospital stay. “I was able to see nursing from a completely different view and try to keep my patients out of the hospital and make plans to keep them healthy and form relationships that last years,” Worrell said. Once she earned her master’s degree, she was tapped to head the pulmonary hypertension program. “We hope to have that regionally accredited by the Pulmonary Hypertension Association, a national organization, by 2021,” Worrell said. Upstate University Hospital had

“I like being there to step up when we’re short-staffed, whether it’s a CNA, RN or whatever,” Boss said. Though she’s the nurse manager, she’s willing to fill in as needed at whatever level, she said. She believes that nurses need to bring to the job a sense of compassion, selflessness, dedication and genuine desire to help. “Definitely, you need to have math skills and a science background to understand disease processes,” Boss said. Her biggest day-to-day task is meeting staffing problems. “Nursing and staffing shortages are challenging,” Boss said, “and making sure they have the right skillset. Critical thinking isn’t always coming out of the schools.” She reminds nurses to “never forget why you became a nurse. Don’t get caught up in the money; it’s not about the money. The biggest reward is making a difference, making a

hoped to complete that project by the end of 2020; however, COVID-19 has taken time and resources away from the accreditation efforts, she said. COVID-19 has also affected the day-to-day activities of nurses. “It’s challenging all nurses to be flexible and creative in the way we do our daily care to our patients,” Worrell said. “We’re also being challenged to be better team players and support one another. Our communities are looking to us as leaders. We’re the soldiers on the battlefield along with other personnel and they’re looking to us for guidance to keep them safe. We can use our platform to better service our community.” Even outside the crisis, personnel shortages make nursing difficult. To meet those challenges, “nurses become flexible and adaptable with what we’re given,” Worrell said, “but if we had more, we could serve the community so much better. Nurses can be such a huge help to make sure patients are not only doing well at the hospital but also make sure they take care of their health throughout their lives.” That’s one of the aspects of nursing Worrell enjoys the most: making a difference in patients’ lives, whether it’s listening to a patient or saving a life. Worrell said that those considering nursing should follow their hearts.“If you have always had a feeling that you want to be able to help people, it’s a very giving profession. There’s no applause for any one person. It’s not one of those ‘recognition professions.’ If you enjoy taking care of people and want to see others be May 2020 •

patient smile.” Boss hopes to continue her education to become a family nurse practitioner and “continue to be a leader in nursing and have an impact on the nursing profession and the staff I work with,” she said. The single mom has two teenagers. She likes to take vacations with them and spend time with her children and their English bulldog.

their best self, go for it.” She believes that people interested in nursing should have good communication skills with people of all backgrounds and a positive outlook. Worrell hopes to someday change how nurses are able to advocate for patients on a broader basis to all sorts of healthcare providers. “Whatever that looks like, whatever role I’m in, I want to make those types of changes,” Worrell said. “I want to get back to nursing homes to ensure changes happen. They should get the care they deserve. They have lives and stories. They deserve dignity. The CNAs need to be weeded out if this isn’t for them. They need to learn compassion and to appreciate the people.” In her free time, Worrell likes to spend time with her daughter and fiancé as well as perform in her band, Menage a Soul, which perform at venues like Turning Stone Resort Casino in Verona, wineries and festivals.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 21

Desire to Help Prompted Nursing Career Amanda Commisso: “Seeing the patients we discharge is a great help to us. That ultimately makes up for the anxiety and fears.” By Deborah Jeanne Sergeant

manda Commisso, a registered nurse at Crouse Hospital, didn’t take a direct route to her nursing career; however, her motivation was always present. “I just wanted to help people,” Commisso recalled. “Helping people is something I wanted to do since high school. I went to school to be a paralegal. I was a hairdresser for a while and neither was that satisfying.” Commisso, a Warners resident, found her perfect fit in nursing. She earned her associate degree from Crouse Hospital School of Nursing in 2011. She also earned certification in medical surgical nurse through the Medical-Surgical Nursing Certification Board, a national professional body based in Pitman, New Jersey, that verifies nurses excelling in the surgical niche with care coordination and managing patient transition. Since her graduation, she has worked for Crouse and usually works on a bariatric surgical and colorectal floor. Currently, she’s working in a COVID-19 unit. “There’s a degree of anxiety and fears that come with that, and stress,” Commisso said. “We rely on each other, the nurses here.” Constantly following social

media can increase stress levels, she has found. “We help each other out and stay away from social media,” Commisso said. “We try to decrease that exposure.” While caring for patients who are sick with COVID-19 isn’t easy emotionally, she and her coworkers find encouragement as patients recover. “Seeing the patients we discharge is a great help to us,” Commisso said. “That ultimately makes up for the anxiety and fears.” Her day-to-day stressors are similar to those of any nurses. In

general, most healthcare providers nationwide struggle to sufficiently staff positions at all levels. Commisso said that understaffing can make the environment stressful. “Between me and the other nurses on the unit, we’re good at working together and make sure our patients are taken care of.” Remaining flexible and working as a team help the nurses ensure they provide good quality care. Despite the struggles with staffing issues and the current COVID-19 outbreak, Commisso enjoys providing care. “I like improving people’s lives and making sure they’re healthy so they can enjoy their life,” she said. She believes that nursing is a great career choice for anyone who possesses a good deal of empathy, and a willingness to go above and beyond the job description. “You’ve got to be willing to be self-sacrificial,” Commisso said. “You have got to be confident and willing to go that extra mile to do the work. You have to be able to advocate and be self-sufficient. Not everyone will have answers for you. Being a nurse is a little like being an investigator. You have to put in time to solve problems and be a creative thinker.”

Though nursing can be a challenging career choice at times, Commisso is happy she chose it. “It’s one of the most rewarding positions you’ll ever have and the most trustworthy,” she said. “Anyone thinking about nursing should go for it.” When she’s not working, Commisso enjoys spending time with her family, such as playing outside and going to movies.

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THANK YOU

TO OUR HEROES To our brave, talented, and selfless women and men on the front lines of this fight, we give our unending gratitude. In the face of all of the chaos and fear that the past few months have wrought not only on our health care system but on our communities, families, and futures, you have stood tall, worked hard, and carried on for the good of those around you. Your caring hands have not shaken. Your passionate hearts have not wavered. Your committed and brilliant minds have not rested. To say we are proud of the work that you have done and will do would be true, but it would not be enough. You make us proud, yes. But you also make us better, safer, tougher, and stronger. Thank you for your care, your time, your sacrifice, yourselves. You are more than our heroes. You are our hope.

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Page 23 4/27/20 2:04 PM

COVID-19

Social Media: Mental Health Friend or Foe? By Deborah Jeanne Sergeant

hether it’s to alleviate boredom from quarantine, connect amid social isolation or get the latest news on COVID-19, social media seems to be a busy place these days as the world turns more and more virtual. In general, and in light of current events, the effects of social media on mental health are mixed. “There’s ways that it has improved the mental health of adults who have chosen to use it,” said psychologist Ann Altoonian, who operates offices in Rochester and Syracuse. “It helps reconnect old relationships and it helps more easily maintain current relationships during a time of life that’s stressful with a lot of family demands.” Posting can help one stay motivated to drop 40 pounds or finish a remodeling project; however, Altoonian calls it a “double-edged sword.” While the accountability is good, it can also give others a skewed view of the poster’s life. For example, the do-it-yourselfer who renovated the kitchen may not show that his lawn is overgrown and his family has not been able to use the kitchen for sever-

al weeks. Or the dieter showing off a tremendous weight loss doesn’t share about the social outings missed to ensure sticking with the new eating plan. It’s easy for social media to turn into a showcase of perfect moments that can leave others feeling like they don’t quite measure up if they haven’t fixed up their home or lost the weight they want to lose. “You’re not going to see all the ups and downs, just highlights of ups and downs,” Altoonian said. “When those posts are positive, it can lead someone to feel ashamed or inferior.” She encourages posters to be authentic and genuine in a mentally healthy way. The “humble brag” is one sneaky way some people like to make themselves look good, such as posting, “No make-up, no filter. This is just ugly me.” The poster uses put-downs to fish for compliments. Receiving positive feedback like this trigger’s the brain’s release of dopamine, a chemical that fosters good moods. While superficially connecting with others online may offer diversion, Altoonian said that real-life relationships are what’s more important. Especially during isolation, social

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media can help reach out to people one actually knows — not “friends” never met in-person. As the coronavirus pandemic continues, many people turn to social media for news; however, since any person can post anything on social media, the information may not be accurate. Instead, stick with sources such as the World Health Organization and the Centers for Disease Control and Prevention—and limit time looking at news stories promoted through social media. Accurate news can still focus too much on negativity. “You can’t go overboard spending a lot more time on social media than you did before,” Altoonian said. “Find a way to limit it. You have to be smart about it and check things out.” Look at social media not as a news source, but for entertainment and connection. Elizabeth Szlek, licensed mental health counselor and owner of The Door Counseling Center in Yorkville, sees a few plusses of social media in that regard. “You can stay in touch with many people very easily compared with the past,” she said. “It’s nice to know what’s happening with people. Or on LinkedIn, you can find jobs and learn about news.” But she also sees potential for

social media to become too important to the point that people miss out on what’s happening around them. The “addictive” quality of social media helps it attract and retain users. “Facebook admits that they’ve constructed this to be addictive,” Szlek said. “What if you couldn’t go on social media or the Internet for a while? Would that be okay? If the answer is no, it may be a bad thing.” Instead of relying on social media for a pick-me-up, Szlek recommends connecting with friends known in real life, not “friends” online. “If you have 3,000 ‘friends’ on Facebook, how many would come over at 3 a.m. if you called them?” she said. “Things aren’t really what they seem. It takes a lot of investment to be a real friend.” Social media can keep known friends closer, as well as expand one’s horizons. Jodi Ann Mullen, Ph.D., and licensed mental health counselor, owns Integrative Counseling Services, PLLC in Oswego. She sees a few positives with social media, such as the ability to stumble upon knowledge and experiences users otherwise wouldn’t. “You connect to something new that is stimulating to you, like a different workout program, or a new recipe,” she said. “It allows for some novelty in your life.”

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Parenting By Melissa Stefanec

MelissaStefanec@yahoo.com

This Won’t Be My Best Column • This won’t be my best column. I’d love to write something witty, something to make others laugh, something to take the edge off the load we’re all bearing. I’d like to paint pictures of the amusing videoconferences I’ve had while trying to work full time and homeschool my two children. I’d like to offer valuable insights into how I am coping. But, it’s been another very full day, and I don’t have much to give. It’s not just this column. These days, nothing is getting my best. • This won’t be my best column, and I feel guilty about it. I also feel guilty about the quality of the education I am giving my children. I feel guilty about muting myself during work meetings to deal with my kids. I feel guilty that I can’t give more to everyone in my life. This feeling is nothing new, but this pandemic has a way of casting light on all the things I usually manage to hide. The expectations are higher than they’ve ever been, and there is a direct correlation between the height of that bar and my guilt. • This won’t be my best column, and I am skipping me-time to write it. According to social media, I should be doing yoga right now or binge-watching some show about captive tigers. Last night, I skipped me-time to finish up the work I couldn’t finish while schooling my kids on my lunch break. Me-time is a strange concept for parents right now. • This won’t be my best column, because the world is hurting. The world around me is hurting, and I am feeling that pain. I can’t watch so much suffering, without it affecting me. I have so many aces in my hand: a loving husband, loving children, a job, loving pets, supportive friends, enough food to last for months and my health. When I think about someone lacking even one of those aces, I start to unravel. This has an emotional toll. • This won’t be my best column, because I am so tired. That emotional toll quickly turns physical. I am finding a lot of joy in having so much quality time with my family. I am finding myself unable to homeschool and work full time. I am finding myself to be a new kind of tired — the kind that leaves me barely functional by bedtime. • This won’t be my best column, because I have to be strong. I used up so much of my energy on maintaining my strength today. I need to be a strong mom, a strong

teacher and a strong professional. For the sake of myself and my family, I have to stay positive. Staying positive isn’t easy. It takes strength. I need to teach my kids that being strong in the face of adversity is what builds character and long-term happiness.

WE’RE HERE FOR YOU.

NOW. ALWAYS.

• This won’t be my best column, and I’m sure you will forgive that. I don’t know you, but, chances are, you’re more likely to forgive others than yourself. This pandemic is a good time to work on forgiveness. Maybe this difficult time will teach us to forgive ourselves more. Maybe we will learn to forgive our family members. Maybe we will remind each other that we are all doing the best we can. Alexander Pope once wrote, “To err is human, to forgive divine.” We need to accept shortcomings as part of the human condition and recognize what forgiveness grants us. • This won’t be my best column, but I’m doing my best. I’m everything at once. Stressed and blessed is my new credo. Some days, my best looks a little different. I hope this difficult time teaches us all that “best” is relative. Somedays, my best is yelling at the kids a few times. Somedays, my best is putting together a stellar science project and crushing it at the home office. Not all days are winners. • This won’t be my best column, but I am having some of my best times. One of the hardest aspects of quarantine is the conflicting emotions I feel. I love spending more time with my children and husband. I like how simple and pure life has become. Many aspects of this situation are truly a blessing. However, I’m also scared, over-extended, socially isolated and depleted. I need to recognize and own all of these emotions. They can exist in the same spheres. This pandemic is driving home something really important: life is complicated and beautiful. • This won’t be my best column, but after writing it, I’m feeling better. Putting all of my difficulties down on paper altered my perspective. It allowed me to feel tired and stressed, instead of feeling guilty about it. It cleared some space in my mind. I now feel like I have more capacity for the good stuff. Sometimes, you just have to get the pain out. I encourage other parents to do the same. It’s OK to be angry and discouraged, as long as you can find the courage to be honest and set those emotions free. Let’s make this a quarantine to remember for our children (for all the right reasons).

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 25

SmartBites

The skinny on healthy eating

Immune-Boosting Fava Beans Promote Good Health

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

How to Avoid Unwanted Weight Gain During COVID-19 Pandemic

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

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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.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

Helpful tips

By Anne Palumbo 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 favas 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.

Controlling High Blood Pressure to Support Kidney Health By Simardeep Mangat, M.D.

ay is National Blood Pressure Month, and it is a great time to remind people in Central New York of the importance of maintaining a healthy blood pressure. Hypertension is the term used to describe high blood pressure. High blood pressure usually causes no symptoms. That is why it is sometimes called a “silent killer.” Some symptoms to watch for include headache, unexplained bloody nose and swollen ankles, but these may not always be present. This is why regular blood pressure checks are important. Hypertension is very common in patients with chronic kidney disease, and if not well controlled, can result in worsening of kidney disease. This is more likely if you also have diabetes. Hypertension can also increase the chance of heart disease. This makes controlling high blood pressure a top priority. The treatment of hypertension not only includes taking medications, but also management of lifestyle measures, including regular exer-

cise, healthy diet and maintaining ideal weight. Kidney disease, on the other hand, is a progressive disease, meaning that it usually does not go away unless the patient has a kidney transplant. All efforts are focused on slowing down the progression of kidney disease. Kidney doctors like myself provide specialized care and expert medical knowledge to help control blood pressure and preserve the highest level of kidney function for as long as possible. A care plan is developed based on the patient’s current lab results and stage of kidney disease. This individualized plan includes a multidisciplinary approach comprised of medication changes, dietary education, implementing healthy lifestyle changes and management of risk factors, such as controlling high blood pressure. As we all navigate through the COVID-19 pandemic, the physicians and staff at Nephrology Associates of Syracuse are working hard to ensure that care for kidney disease and re-

lated conditions like hypertension is accessible and available. The goal is to help patients manage their disease and to prevent unnecessary ER trips or hospital admissions. Our practice remains open and safety screening measures are in place. Telemedicine visits are now available. It is crucial for patients with kidney disease to have access to ongoing nephrology care, including periodic lab work for monitoring and decision-making. Private lab draws in a sanitized setting are available. We also offer blood pressure checks, kidney disease education, medical nutrition therapy, follow-up care after a hospitalization and chronic care management. We encourage our community to take good care of their health and maintain a healthy lifestyle. You will find more resources, including information regarding telemedicine, at www.nephrologysyracuse.com.

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o help meet the needs of patients during the COVID-19 pandemic, Oneida Health has implemented telehealth at all of their primary care offices, Quick Care, and many of their specialty practices throughout Madison and Oneida counties. Telehealth gives patients an opportunity to have a face-to-face visit with their medical provider without a traditional visit to the office. Using telehealth, a provider can evaluate, develop a treatment plan, order medication and, if needed, schedule a follow-up appointment. Patients can access telehealth by clicking on a link sent to their smart-phone, computer, or tablet from the comfort of their home just prior to the start of their appointment. “During this unprecedented time, it remains important for us to continue our mission to find ways to deliver care to the communities we serve,” said Gene Morreale, chief executive officer and president at Oneida Health. “Telehealth is a convenient, secure, and user-friendly option to receive quality health care from a remote location while maintaining social distancing.” Current patients of their primary care office or specialty practices can schedule a telehealth appointment by calling the office. Individuals seeking urgent care for non-life-threatening conditions can call for an on-demand telehealth visit at one of Oneida Health’s Quick Care locations. Quick Care offers telehealth visits seven days a week during open office hours. Those who

still require a face-to-face visit can come directly to the closest Quick Care location, if needed. Some common conditions that can be treated using telehealth in a primary care setting or at Quick Care include allergies, asthma, colds and flu, diarrhea, rashes, sore throats, toothaches, urinary tract infections, sinus infections and vomiting, to name a few. Telehealth services can vary by a health provider’s specialty. A gynecologist might use telehealth to provide birth control counseling. An endocrinologist may use it to discuss recent test results and follow-up. Each patient is triaged to determine if a telehealth visit is appropriate for the level of care they are seeking. “As a healthcare provider, it’s important for us to address barriers to care,” said Morreale. “We have seen a number of patients recently suffer unnecessarily due to putting off care due to the pandemic. We hope that by implementing telehealth patients will be more likely to access care when they need it and when it is the most treatable. For patients who require care for life-threatening conditions, our emergency department is always open.” Oneida Health has 32 medical providers throughout their network providing telehealth with more being added each week. Telehealth is currently covered by Medicare, Medicaid, and most commercial insurers. For more information on telehealth at Oneida Health, please visit oneidahealth. org or yourquickcare.com.

Simardeep Mangat, M.D., is a certified hypertension specialist with Nephrology Associates of Syracuse, P.C. He is also a board-certified in nephrology and board-certified in internal medicine. For more information, visit www. nephrologysyracuse.com.

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How to Get Help from Social Security During the Coronavirus Pandemic By Jim Miller

he Social Security Administration has closed its 1,200 field offices throughout the country to protect benefit recipients and workers from the coronavirus pandemic. Their offices have been closed since March 17 and remain closed as we go to press at the end of April. How long they will be closed is unclear. It will depend on the course of the pandemic. In the meantime, services will continue to be available online at the SocialSecurity.gov website, and over the phone. You can also rest assured that monthly payments to the more than 69 million Social Security beneficiaries will not be affected in any way. Here’s a rundown of how you can get help and get answers to your Social Security questions, while their offices are shut down.

Online Help For any Social Security business you need to conduct, go to SSA.gov/ onlineservices. There you can view your latest statement and earnings history, apply for retirement, disability and Medicare benefits online, check the status of an application or

appeal, request a replacement Social Security card (in most areas), print a benefit verification letter, and much more — from anywhere and from any of your devices. Their website also has a wealth of information to answer most of your Social Security questions without having to speak with a representative. For answers to your Social Security questions see their frequently asked questions page at SSA.gov/ ask.

Phone Assistance If you can’t conduct your Social Security business online, check the SSA online field office locator (see SSA.gov/locator) for specific information about how to directly contact your local office. Your local office will be able to provide critical services to help you apply for benefits, answer your questions, and provide other services over the phone. Or, you can also call the Social Security national toll-free number at 800-772-1213 (TTY 800-325-0778). This number has many automated service options you can use without waiting to speak with a telephone representative.

If you already have an in-office appointment scheduled, Social Security will call you to handle your appointment over the phone instead. The call may come from a private number and not from a federal line.

Beware of Scams Be aware that Social Security telephone impersonation scams are growing. These scammers may falsely tell you that there is a problem with your account, that your Social Security number has been suspended because of suspected illegal activity, that you’re owed a cost-of-living benefit increase, or that your monthly benefits will stop because of the coronavirus pandemic. The caller may also threaten your

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.

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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,”

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2020

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.

benefits, suggest you’ll face legal action if you don’t provide information, or pressure you to send money via wire transfers, cash or gift cards. They may even “spoof” your caller ID to make it look like Social Security is actually calling. If you receive one of these calls, hang up. Social Security rarely contacts anyone by phone unless you have ongoing business with them, and they never threaten you or ask for any form of payment. For more information on how to get help with Social Security during the coronavirus shutdown, visit SSA. gov/coronavirus. Jim Miller is the author of Savvy Senior, a column published in In Good Health every month.

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.

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Other Medicare Coverage In addition to the expanded telehealth services, Medicare will also be covering all coronavirus testing costs to see 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.

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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.

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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: My child receives SSI. He will be 18 in a few months. Will his SSI payments continue after he turns 18? A: When a child who is on SSI turns 18, we conduct both a medical and a non-medical review to see if they are still eligible for SSI payments. If the child continues to meet the income and resource requirements, and is still considered to be disabled under the adult disability rules, then payment continues. For more information, read What You Need to Know About Your Supplemental Security Income (SSI) When You Turn 18 at www.socialsecurity. gov/pubs. 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, 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.

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.

Q: I have been getting Social Security disability benefits for many years. I’m about to hit my full retirement age. What will happen to my disability benefits? A: When you reach “full retirement age,” we will switch you from disability to retirement benefits. But you won’t even notice the change because your benefit amount will stay the same. It’s just that when you reach retirement age, we consider you to be a “retiree” and not a disability beneficiary. To learn more, visit www.socialsecurity.gov. Q: Will my Social Security disability benefit increase if my condition gets worse or I develop additional health problems? A: No. We do not base your Social Security benefit amount on the severity of your disability. The amount you are paid is based on your average lifetime earnings before your disability began. If you go back to work after getting disability benefits, you may be able to get a higher benefit based on those earnings. In addition, we have incentives that allow you to work temporarily without losing your disability benefits. For more information about disability benefits, read our publications Disability Benefits and Working While Disabled — How We Can Help. Both are available online at www.socialsecurity.gov/pubs.

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