Igh cny 200 august 16 final

in good Meet Your Doctor

Interventional cardiologist Michael Fischi discusses difference between cardiac arrest and heart attack and why he’s rejoining St. Joe’s, this time as an employee

Farmers, Fishermen, Foresters More Likely to Commit Suicide See what other professions are high on the list

U.S. Car Crash Deaths Down, But Still Surpass Other Nations

August 2016 •

Issue 200

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CNY’s Healthcare Newspaper

MEDICAL ERROR A new study shows that medical errors are the third leading cause of death in the U.S. Officials from Syracuse hospitals explain how local hospitals confront, contain the element of human errors Page 10

No Stopping at 90

Marilyn Ribyat is a petite dynamo who is constantly active — whether it’s taking fitness classes through the town of Dewitt Parks and Recreation, walking the Erie Canal, attending classes at OASIS, playing bridge, lunching with friends, or participating in a book club.

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Peaches

Broccoli? Yes. Garlic? No question. But peaches?

Read about surprising news about peaches. in SmartBite Page 13

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Our 200th Edition

The first issued of In Good Health was published in October 1999 as one of the first local healthrelated newspaper. Find out more about the major changes in the medical sector in the last 17 years Page 12

Tips for Visiting a Memory Care Patient Follow a few tips to get the most out of a visit with a memory care patient.

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U.S. Car Crash Deaths Down

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ar crash deaths on American roads fell nearly one-third over a recent 14-year period, but the nation’s collision death rate still tops that of other high-income countries, health officials reported in July.

About 90 Americans die in crashes every day. That’s the highest roadway death rate among 20 countries examined, the U.S. Centers for Disease Control and Prevention said.

Crash deaths in the United States fell by 31 percent from 2000 to 2013.

In other countries studied, crash deaths declined by an average of 56 percent during the same time, the researchers found. Spain had the greatest reduction in crash deaths —

75 percent. The United States had the smallest reduction, according to the report.

Alcohol and a lack of seat belts figured in many of the U.S. deaths, suggesting much more progress is possible, the CDC said.

“We know what works to prevent crashes, injuries and deaths,” said Erin Sauber-Schatz, transportation safety team lead at the Center for Injury Prevention and Control at the CDC. “About 3,000 lives could be saved each year by increasing seat belt use to 100 percent, and up to 10,000 lives could be saved each year by eliminating alcohol-impaired driving,” Sauber-Schatz said.

If the United States had the same crash death rate as Sweden — the country with the fewest crash deaths — more than 24,000 U.S. lives could’ve been saved in 2013.

Community Information Seminar:

Bariatric Surgery August 9, 2016 • 6:00 pm Presented by

Dr. Obradovic, Medical Office Center St. Joseph’s Hospital Campus 104 Union Ave. • Suite 809 • Syracuse, NY

To register call 315-477-4740 or toll free 877-269-0355 Parking will be validated

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

August 2016 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Farmers, Fishermen, Foresters More Likely to Commit Suicide

CDC study shows workers in some occupations five times more likey to commit suicide

C

an the type of job you choose affect your risk of suicide?

Possibly, according to a new U.S. report that found for certain occupations, the odds of suicide were significantly higher.

From 2000 to 2012, the overall rates of suicide for people aged 16 and older rose 21 percent, the study found. That works out to an approximate increase from 13 to 16 suicides per every 100,000 people in the United States.

But among farmers, fishers and foresters, the suicide rate was dramatically higher — at 85 suicides per 100,000 people. For males in those jobs, the rate was even greater.

Their suicide rate was 90.5 suicides per 100,000, according to the report.

“People working in certain occupations are at greater risk for suicide due to job isolation, a stressful work environment, trouble at work and home, lower income and education, and less access to mental health services,” said lead researcher Wendy LiKamWa McIntosh.

She’s a health scientist at the U.S. Centers for Disease Control and Prevention.

“Farmers have additional risk factors like social isolation and unwillingness to seek mental health services,” McIntosh said. The report also noted that farmers’ exposure to pesticides may affect their neurological system and contribute to depression.

Other occupations that carried signifi-

cantly higher-than-normal rates of suicide included construction and extraction, with 53 suicides per 100,000; and installation, maintenance and repair with 48 suicides per 100,000, the study found.

For construction workers, the report authors suggested that a lack of steady work, isolation and a fragmented community might play a role in their higher risk. The investigators theorized that people working in installation, maintenance and repair may have long-term exposure to solvents that could damage their neurological systems. That might contribute to memory loss and depression, the researchers suggested.

Men working in fishing, forestry or farming had the highest rates of suicide for their gender.

Among women, the highest rate was seen in those working in protective services, such as policing and firefighting.

Their rate was 14 per 100,000. Men in the protective services field had a suicide rate of 34 per 100,000, the report noted.

Physician Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, pointed out that “work is increasingly stressful.”

People take their own lives “mostly because they are depressed,” he said.

“We live in a 24-hour world, so it can be easy to feel overburdened, which can lead to depression,” Manevitz added.

Onondaga, Oswego, Cayuga and Madison Counties in good A monthly newspaper published by

Health CNY’s Healthcare Newspaper

Local News, Inc. 5,000 copies distributed throughout more than 1,000 high traffic locations, including all Wegmans stores.

In Good Health is published 12 times a year by Local News, Inc. © 2016 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: Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Matthew Liptak, Aaron Gifford, Anne Palumbo, Melissa Stefanec, Chris Motola, Aaron Gifford, Mary Beth Roach • Advertising: Amy Gagliano, Cassandra Lawson Design: Eric J. Stevens • Office Assistant: Michelle Kingsley 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 • August 2016

August 2016 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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HEALTH EVENTS

Aug. 4, Sept. 14

Cayuga County offers seminar about Medicare Are you turning 65 soon? Are you overwhelmed by all the mail, calls and Medicare options? The Cayuga County Office for the Aging will offer complimentary monthly classes to help you make sense of Medicare.

Here you will learn how to determine whether the plan you are considering will give you peace of mind or potential headaches. You’ll learn about how Part D drug plans work and whether EPIC co-pay assistance is an option for you. If your income is limited, experts will provide information about programs to help pay for your insurance coverage, as well as a listing of the free and low cost preventive care under Medicare.

Classes will be held in the basement training room of the Cayuga County Office Building from 5 to 7 p.m. Aug. 4, and from 2 to 4 p.m.

Sept. 14; Registration is required. Call 315-253-1226, or visit www.cayugacounty.us/aging under the News & Activities section.

Aug. 13

SOS offers seminar on youth sports safety Syracuse Orthopedic Specialists’ (SOS) Sports Medicine team will hold a seminar on safety for young athletes starting at 7:30 a.m., Saturday, Aug. 13t at the Destiny USA Skydeck.

The event will provide educational information for coaches and parents of athletes about the rise in youth sports injuries and steps they can take to prevent injuries and keep players healthy.

The seminar is free and open to

the public with prior registration.

The seminar also includes an optional free CPR plus first aid course.

Topics to be discussed are issues in single sport specialization, nutrition for the youth athlete, safe return to play after injury and prevention of overuse injuries. The event will include a lunch break at 11:30 a.m.

For registration and information, visit sosbones.com/sportssafety16 or call 315-703-3442

Aug. 13

Oswego Health to hold ‘5K Run For Your Health’ Oswego Health will host its first Run For Your Health 5K at 8:30 a.m. on Aug. 13 on the Seneca Hill campus. This event is open to walkers and runners of all levels and is intended to be competitive, while also promoting good health and fitness.

The 5K run/walk will start and end at The Manor, 20 Manor Drive in Oswego, winding its way through Oswego Health’s Seneca Hill campus, including Springside, Oswego Health’s premier retirement living community. Along with the 5K event, there will be a one-mile fun run for kids aged 4 to 12 that will be held at 8 a.m. Awards will be presented to the top three overall male and female 5K finishers and the top male and female 5K finishers by age group.

Registration fee is $30. Visit https://www.oswegohealth.org/ foundation/run-for-your-health-5k/.

Sept. 6, 7

Free healthy living classes in Central Square, Oswego Residents who suffer from a chronic condition can learn how to improve their health status during free evidence-based healthy living

workshops offered this fall by Oswego Health. Sessions will be held in both Oswego and Central Square.

The Oswego classes begin Wednesday, Sept. 7, running from 1 to 3:30 p.m. every Wednesday through Oct. 12. The Central Square classes will begin Tuesday, Sept. 6, and will continue through Oct. 11 from 9 to 11:30 a.m.

The program, developed by Stanford University, is designed to help those with any chronic disease, such as arthritis, heart disease, osteoporosis or diabetes to improve their health status. The workshops will cover nutrition and exercise, as well as how to get support, deal with pain and fatigue and talk with your physician and family members about your condition. Participants will learn goal-setting techniques and establish a step-by-step plan to improve their health.

Those taking part in the program will be provided a free workbook and healthy snacks at each class session. To register, or if you have questions, call 349-5513.

Sept. 14

Golf tournament to benefit Upstate’s M.A.S.H. Central New York golfers are invited to participate in the 17th annual Fall Swing Golf Tournament hosted by The Advocates for Upstate Medical University Wednesday, Sept.

14, beginning at 8:30 a.m. at West Hill Executive Golf Course at 2500 West Genesee Turnpike, Camillus.

The tournament will use a captain and crew format and will feature a shotgun start, a continental breakfast, carts, snacks at the turn and an awards ceremony with a buffet lunch. Individuals must pre-register for the tournament by Tuesday, Sept.

6. The entry fee is $75 per player, or $20 for those who attend the awards ceremony and buffet only. The fee includes breakfast, greens fees, carts, and lunch, as well as refreshments on the course, and entry into the hole-in-one competition. For more information, and to register, contact Susan York at 315-464-5610 or at yorks@upstate.edu. Information is also available at www.upstate.edu/ advocates.

Excellus Named Presenting Sponsor for Oswego Health’s 5K Run For Your Health Event

E HOPE STARTS TODAY!

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xcellus BlueCross BlueShield is the presenting sponsor for Oswego Health’s Run For Your Health 5K walk/run, which will take place Aug. 13 on the Seneca Hill campus.

The 5K run/walk will start and end at The Manor, 20 Manor Drive in Oswego, winding its way through Oswego Health’s Seneca Hill campus, including Springside, Oswego Health’s premier retirement living community. While the main 5K race event is at 8: 30 a.m., there will be a 1-mile fun run for kids, aged 4 to 12 that will be held at 8 a.m.

Awards will be presented to the top three overall male and female 5K finishers and the top male and female 5K finishers by age group. Timing is provided by Auyer Race Timing.

There is a $30 registration fee.

Kids fun run is free. To complete the registration process, please visit: www.oswegohealth.org/foundation/ run-for-your-health-5k/

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

Excellus to sponsor event in Oswego. From left are Heather Huggins, committee member and activities director at The Manor; Jim Reed, regional president, Excellus BlueCross BlueShield; Lorrie Arcuri, workplace wellness consultant, Excellus BlueCross BlueShield; Jennifer Martin, committee member and Oswego Health’s director of marketing; and Myia Hill committee member and Oswego Health Foundation’s development manager.

U.S. Cancer Survivors Living Longer Likelihood of other chronic conditions will stress health care system in next two decades, report predicts

A

s the American population ages, more older adults will survive cancer and live with other chronic conditions that will burden the health care system, U.S. government health officials report.

“Increasingly, we are seeing the impact of an aging population — fueled by maturing baby boomers — on major diseases, including cancer,” said lead researcher Shirley Bluethmann, a cancer prevention fellow at the U.S. National Cancer Institute.

In 2016, nearly 62 percent of almost 16 million cancer survivors are aged 65 or older, the researchers said.

By 2040, an estimated 73 percent of 26 million cancer survivors will be 65 or older.

“This steady and dramatic growth will affect the health care system, and so is sometimes referred to as the ‘silver tsunami,’ “ Bluethmann said. “It not only has implications for older people who are at higher risk for cancer, it also means that we will have higher numbers of older patients with complex health needs.”

In the face of this challenge, health care providers will have to build collaborative care teams — including doctors, nurses and other caregivers — to be able to respond to the needs of this vulnerable population, Bluethmann noted.

“We also need to emphasize the benefits of lifestyle for cancer prevention and control across the life course,” she added.

“Lifestyle choices, including doing regular exercise and maintaining a healthy weight, may prevent some kinds of cancer, but also offer many benefits in preserving function, reducing symptoms and promoting a high quality of life into old age,” Bluethmann said.

The findings were published in the July 1 issue of the journal Cancer Epidemiology, Biomarkers and Prevention.

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August 2016 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

Meet

Your Doctor

By Chris Motola

Michael Fischi, M.D. Interventional cardiologist discusses difference between cardiac arrest and heart attack and why he’s rejoining St. Joe’s, this time as an employee

Study: Use of Chiropractic in the VA Rising Steeply

T

he use of chiropractic services in the Department of Veterans Affairs (VA) health care system has seen a steep rise over more than a decade, according to research published in the Journal of Manipulative and Physiological Therapeutics (JMPT), the official scientific journal of the American Chiropractic Association (ACA).

The study’s authors, who analyzed VA national data collected between 2004 and 2015, discovered an increase of more than 800 percent in the number of patients receiving the services of doctors of chiropractic. While authors attribute the increase to a natural growth of the chiropractic service, which was only implemented on-site at the VA in 2004, they also suggest it may be attributed to the successful performance of VA chiropractors and the perceived value of their care, among other factors.

“The fact that these services have expanded consistently and substantially beyond the minimum mandated level may suggest that some VA decision-makers perceive value in providing chiropractic care,” the study notes.

Key findings from the study show that: • the annual number of patients seen in VA chiropractic clinics increased by 821 percent; • the annual number of chiropractic visits increased by 694 percent; • the total number of chiropractic clinics grew from 27 to 65 (9 percent annually); • the number of chiropractor employees rose from 13 to 86 (21 percent annually); and • female and younger patients received chiropractic care at VA clinics at a greater rate than the national VA outpatient population. “This demographic tendency is consistent with the cohort of veterans from the recent conflicts in Iraq and Afghanistan, which is known to have a high prevalence of musculoskeletal conditions,” the study authors note.

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Q: You’ve recently joined St. Joe’s, but you’ve been working at the hospital longer, correct?

A: I’ve recently joined as a hospital-employed physician. I’ve actually been at St. Joe’s since 2005 as an interventional cardiologist in a private practice, but I left at the beginning of this year and am now part of a hospital-based practice at St. Joe’s.

Q: Why did you want to make the transition?

A: There are a lot of reasons.

Basically, the style of my old practice wasn’t suiting my personal and professional needs. The hospital gave me the opportunity to take care of patients in the fashion I felt was best for them. For myself, it provided me the freedom and flexibility I was looking for while being part of a progressive, forward-thinking team.

Q: St. Joe’s has a very strong reputation when it comes to interventional cardiology. From an inside perspective, what do you think the hospital brings to the table in that regard?

A: I think St. Joe’s has the best cardiac surgeons in Central New York. We also have a very well-organized interventional cardiology department with rapid access to the catheterization lab. We have protocols in place so patients can have their EKG transmitted from the ambulance to the hospital.

Or the physicians can activate the AMI call team, which will come in from home during off-hours, or we can remobilize our teams to make sure patients who need immediate care are getting it first.

We have a very dedicated staff.

You find a better group of cardiology techs and nurs-

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

es. We just function very well as a team.

Q: Is the discipline at a point now where you feel you can intervene confidently in most cardiac arrest scenarios.

A: Just to clarify, cardiac arrest is a different situation than a heart attack. With cardiac arrest, the heart has stopped and you’re trying electrical cardioversion to try to restart the heart or CPR. Whereas a heart attack patient may have a stable heartbeat, but they have a blocked artery and their heart is slowly dying. During a heart attack, there’s a plaque rupture, where it breaks loose and a clot forms in an artery. You want to get that artery open again as soon as possible. So the old expression is “time is muscle.” So we have a very responsive system in place here for getting those patients taken care of quickly. Our outcomes are very good. We’re almost spoiled to the extent that we actually expect all of our heart attack patients to live and it’s notable when they don’t. That’s very different than 20 years ago. The expectations of good outcomes here is very high. Now, cardiac arrest is a different situation. Due to lack of blood flow to the heart, the heart has become electrically unstable. If they can be rescusitated quickly — as in someone is there when they go down and can initiate CPR — they have about a 50/50 chance of survival.

If a significant amount of time passes before the heart is restarted, the patient can undergo brain death. A heart attack left untreated long enough can lead to cardiac arrest. Unfortunately, cardiac arrest can sometimes be the first manifestation of heart attack symptoms for a patient. But we do the best we can to get as many people taken care of as quickly as possible.

Q: As an interventional cardiologist, do you get much of an opportunity to interact with patients?

A: Sure. I have an office practice as well.

If I have a heart attack patient, I’ll care for them

throughout their whole hospitalization. In many instances, they’ll become my patient long-term and follow up with me in the office as well, which is something that’s a little different than some practices where the interventional cardiologist won’t be that involved outside of the actual intervention.

Q: Is that a St. Joe’s policy, or you in particular?

A: It’s particular to myself and the St. Joe’s cardiology group I’m a part of now. So patients will actually come in and see me. We also have a cross-coverage system where I might take care of another physician’s patients while I’m on call, but they’ll go back to their interventional cardiologist otherwise. So patients that don’t have a doctor already, I will become their doctor.

Q: What are the advantages of doing that?

A: We have first-hand knowledge of the patient’s anatomy, as well as what went on during the intervention. There can also be a trust and bond that forms knowing that you’re the one who came in and took care of them. You understand their situation, and that helps you treat them as an outpatient as well. It helps you put any symptoms they have down the road in perspective. That’s not to say a general cardiologist is incapable of doing that, but we have a little bit of an advantage in that regard.

Q: Are most interventions done through catheterization now?

A: Most of my procedures are through catheters. When we do open an artery, it’s usually an angioplasty, and we use a stent. In terms of surgery, when you talk about minimally invasive, that’s usually referencing surgery. There are two different ways of doing bypass surgery. One is the conventional way, where you make an incision in the sternum, spread the sternum, and expose the heart.

A minimally invasive approach is a reference to making a small incision under the ribs and using the DaVinci robot to do a cutdown. You can’t do as many bypasses that way. If you need three or four, a minimally invasive approach probably isn’t possible.

Lifelines Name: Michael Fischi, M.D. Position: Interventional cardiologist with St. Joseph’s Physicians Hometown: Minoa Education: SUNY Upstate Medical University, medical degree. Residency in internal medicine at SUNY Health Science Center in Syracuse, fellowship in cardiology at Duke University in Durham, N.C., and fellowship in coronary and peripheral intervention at Strong Memorial Hospital, Rochester Certifications: Certified by the American Board of Cardiovascular Disease & American Board of Interventional Cardiology Affiliations: St. Joseph’s Medical Center; SUNY Upstate Medical University Organizations: American College of Cardiology; Society of Coronary Angiography and Intervention Family: Married, three children (aged 12, 10, and 8) Hobbies: Painting, art shows, golfing, camping, guitar

Upstate Launches Fellowship Program in Addiction Psychiatry

U

pstate Medical University has established its first fellowship in addiction psychiatry. The Accreditation Council for Graduate Medical Education has approved the 12-month fellowship program, which will be housed in the department of psychiatry and behavioral sciences. It is one of only eight such fellowships in New York.

“People becoming addicted to heroin or chronic pain medications is a nationwide epidemic and Upstate felt a need to expand and develop these services,” said physician Robert Gregory, professor and chairman of the department of psychiatry and behavioral sciences.

Physician Tolani Ajabe, a senior resident in psychiatry at Upstate, will begin the fellowship this July.

His clinical interests include opioid use disorder, mental health advocacy, awareness of addiction-related issues in primary care settings, as well as alcohol and nicotine use disorder in schizophrenia.

The addiction psychiatry fellowship is jointly funded by Upstate and Crouse Hospital. As such, the fellow will spend time in each of these clinical settings delivering addiction recovery patient care.

“Crouse and Upstate decided to join forces because we see a need to increase the number of addiction psychiatrists in Syracuse, and to increase the level of expertise to begin to tackle the epidemic here,” Gregory said.

At Upstate, the fellow will be providing consultations about addiction treatment to the emergency department and inpatient services at Upstate University Hospital, in addition to patient care at the outpatient detoxification program offered by Upstate’s department of psychiatry and behavioral sciences.

Physician Brian Johnson, who will serve as director of the fellowship, created the detoxification program in 2009. Using a holistic approach to addiction recovery, John-

Upstate Medical University’s first addiction psychiatry fellowship, which begins this month, is one of only eight such fellowships in New York. Physicians involved in the fellowship program are, from left, Brian Johnson, fellowship director; Tolani Ajabe, the 2016-2017 addiction psychiatry fellow; and Robert Gregory, professor and chairman of the department of psychiatry and behavioral sciences. son uses an abstinence-based model with psychotherapy as the primary form of treatment.

Each year, Johnson has more than 3,000 outpatient visits, with patients coming from throughout the 17-county region Upstate service area. “The average duration of treatment is six weeks, which is why we can take so many people in,” Johnson said.

The addiction psychiatry fellow will also be involved with patient care at Crouse Hospital. There, the Chemical Dependency Treatment

Services offers a methadone maintenance treatment program, which replaces street opioids with doctor-prescribed methadone.

“By rotating through these various programs, the fellow will master every modality of addiction treatment over the course of the year,” Johnson said.

In addition to working in the clinical setting, the fellow will work with Johnson to publish medical papers on the subject of addiction psychiatry.

Healthcare in a Minute

By George W. Chapman

“Micro” Hospitals

Not that common yet in New York state, micro hospitals offer emergency care, surgery, lab and imaging services and are priced somewhere between urgent care centers and full scale hospitals. Micro-hospitals can treat more conditions than urgent care centers because they typically have about eight to 10 beds for observation and short stays. Most large hospital systems are establishing them in markets that cannot support a full scale hospital.

Hospital Affiliations

Most rural and smaller community hospitals are being encouraged to “affiliate” with larger hospital systems or face a slow lingering death in an increasingly competitive marketplace. Recently, Oneida Healthcare in Madison County announced an affiliation with the Bassett system, but Oneida retains its sovereign board and management. Without an actual merger, affiliations usually fail to achieve the necessary economies of scale when it comes to management, operating costs, market share and physician recruitment and retention. Without a total merger or full integration, most affiliations don’t last, have little to show and typically leave the smaller hospital worse off and in a poorer bargaining position.

Top Causes of Death in 2014

1) Heart disease, 23.4 percent (of all deaths). 2) cancer, 22.5 percent. 3) chronic lower respiratory disease, 5.6 percent. 4) accidents, 5.2 percent. 5) cerebrovascular disease, 5.1 percent.

6) Alzheimer’s, 3.6 percent. 7) diabetes mellitus, 2.9 percent. 8) flu and pneumonia, 2.1 percent. 9) nephritis, 1.8 percent, 10) suicide, 1.6 percent.

The age-adjusted death rate of 725

deaths per 100,000 people is an alltime low.

Most Expensive Inpatient Conditions in 2015

Septicemia, $23.6 billion; osteoarthritis, $16.5 billion; live birth, $13.3 billion; complication from graft, implant or device, $12.4 billion; acute myocardial infarction, $12.1 billion.

Three years ago the top five was the same but expenses related to septicemia (bacterial blood infection) was $3 billion less.

ACA Exchange Enrollment

As of March 31 about 11.1 million people purchased healthcare insurance on the exchange. 12.7 million people enrolled but 1.6 million lost coverage for failure to pay their premium. The 11.1 million is about 1 million more than the same time last year. The public exchanges remain an unpredictable and volatile market for some carriers. National insurers United and Humana are planning to pull out of the individual markets next year.

Inpatient OOP Costs Up

A study published in the Journal of American Medical Association’s Internal Medicine magazine found that despite the reasonable annual increase in healthcare spending of 2.9 percent between 2009 and 2013, the out-of-pocket expenses for hospitalized consumers grew more than twice that rate. In order to keep premium costs down, employers have been shifting more of the cost of care to employees through higher deductibles and coinsurance. In the past, most of the out-of-pocket expenses were for non-inpatient visits and procedures. Since the vast majority of

consumers will not be hospitalized in any given year, most probably overlook hospital benefits and coverages when considering a plan.

Overall Spending Down, But...

According to the Robert Wood Johnson Foundation, the ACA can take some credit for slowing down the annual increase in healthcare spending. The study says we could spend $2.6 trillion less this decade (2010-19) than originally projected prior to the passage of the ACA in 2006. Analysts attribute some of the slowdown to the recession that began in 2008. Before the passage of the ACA, trustees of the Medicare hospital fund predicted they would run out of money by next year. The fund is now projected to stretch through 2028. The historic battles between insurance companies and providers must end if there are to be meaningful decreases in costs and increases in value or outcome. More than just collaboration, there must be aligned incentives among insurers, hospitals, physicians and drug manufacturers.

Huge Fraud Bust

Last month, more than 300 physicians, nurses and other professionals across 36 federal districts were arrested by the Medicare fraud strike force.

They are accused of bilking Medicare for over $900 million in false claims.

Data Breaches Costly

The average data breach costs an organization an average of almost $4 million per incident per a study sponsored by IBM. The cost of a hospital breach is about $355 per record up $100 from 2013. The study found that slow responses to a breach resulted in much more damage to an organization.

August 2016 •

Advanced Practice Clinicians

The debate about increasing the scope of practice for nurse practitioners and physician assistants continues. Advocates for increasing their scope of practice point to advanced technology, low malpractice experience and the projected physician shortage. Those opposed believe increasing the scope of practice will result in more mistakes, more unnecessary care (tests) and poorer quality of care. The scope of practice varies by state. Many states — like New York — still require a formal relationship with a physician while other states allow them to practice relatively independently. The scope of practice debate often gets political.

While the AMA tends to be against expanding the scope of practice, virtually none of my hospital or physician clients that employ advanced practitioners are opposed to expanding their roles. According to a recent study published in the Annals of Internal Medicine, advanced practitioners were no more likely to order unnecessary care (lab, X-ray, drugs) than physicians.

George W. Chapman is a healthcare consultant who works with hospitals and medical groups.

He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

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Page 9

Medical Errors: A Hidden Killer How Syracuse hospitals confront, contain the element of human error

By Matthew Liptak

E

arlier this year, the British Medical Journal published a study that found that medical errors were the third leading cause of death in the United States.

Only cancer and heart disease were deadlier.

In Good Health sat down with the quality control officers at Crouse Hospital, St. Joseph’s Hospital Health Center and Upstate University Hospital to find out where the dangers are and what is being done about them.

In one area alone — blood clots that occur in the hospital — it is thought that up to 30 percent of occurrences are preventable, said Hans Cassagnol, chief quality officer at Upstate.

“If you look at the industry as a whole, one of the biggest challenges is the rate at which people get blood clots in the hospital setting,” Cassagnol said. “We tend to put them in bed when they’re sick. That can increase the chances of them getting a blood clot. We really Cassagnol should prophylaxis everybody when they come into the hospital unless there is a contraindication.”

Cassagnol said medical errors have been an issue in American medicine for a long time, but the health industry is finally taking a harder look at what can be done to help prevent them.

“We have incident report systems so that our staff can report anything,” said Derrick Suehs, chief quality

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officer at Crouse. “There are issues and events that are required by state and federal governments and then there are issues and events that aren’t required. Crouse is focused on any event. We don’t respond because it’s a requirement of the state or Suehs federal government. We respond because we don’t like what happened.”

Humans, even doctors and nurses, make mistakes. Each quality officer interviewed said creating an environment where staff are encouraged to report all errors, even small ones, is part of the solution to the medical error challenge. If they can create a culture of reporting and safety, hospital officials can learn from their mistakes and hopefully prevent them in the future.

Suehs said significant medical errors at Crouse may be as low as just one a week.

Christopher Jordan, the quality control officer at St. Joseph’s, was skeptical about that number saying that the rate of errors for any hospital in America tends to be higher.

“UnfortuJordan nately, medical errors do happen,” he said. “They happen in health care settings throughout the country.”

He said St. Joseph’s is always looking for ways to improve and cut down on readmissions, adverse

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

issues with medicine and diagnostic problems.

“First and foremost, it’s understanding human fallibility that occurs and designing systems and processes with that in mind in order to improve the overall outcome,” Jordan said.

Going to the next level

St. Joseph’s along with the other hospitals has done that in several ways. Other than trying to create a culture of accurate and upfront reporting on their floors, the staff believes wider use of technology and medical records will help ease the danger of human error.

One simple example is bar codes are scanned when administering medication to make sure it’s done at the right time, in the right amount and to the right person.

Another example is checklists and timeouts that take place between attending physicians and nurses before surgeries. It’s a concept that the medical industry picked up from the airline industry, where pilots give extensive scrutiny to checklists before taking off.

“We check off that the patient had a consent form, that we know the procedure — there’s a whole list of things that you check off,” said Grant Kelley, quality medical director at St. Joseph’s. “That incorporates a system that will check to make sure that errors don’t occur.”

Cassagnol said another way Kelley to cut down on errors is to assess what he calls the human factors that take place in the

hospital. He described human factors as the universal natural tendency for a person to always act the same way when approaching certain acts. He gave the example that most people would pull on a doorknob rather than push because that is what they are used to.

In the medical field, an example of human factors is the innate tendency for a staff member to recap a needle that has been used. That opens up the risk of the contaminated needle being reused.

“Going to a one-time-use needle, where the needle retracts and you can’t use it more than once, would be an example of using a different technique that will decrease negative events from happening,” he said.

Suehs said the future of lowering medical errors lies in medicine’s use of predicative analytics — when clinical information systems use real-time data collected on a patient to prevent a problem before it happens.

Crouse uses statisticians to analyze how successful its hospital procedures are and tries to determine when there might be red flags.

The industry in general no longer accepts known complications to procedures as unavoidable risks.

Instead, it is actively working to find ways to outthink the potential problems before they happen, Suehs said.

Medical errors are a serious problem for the health care industry and for Americans in general. Who wants to think when the end comes for them, it’s going to happen not because they didn’t go to get care, but because they got care and it killed them?

The industry is working to combat human error and lower the negative numbers, but it has a long way to go and is just getting started.

“It definitely will get better because more eyes are looking at the problem,” Cassagnol said. “I think as a medical community, we’re not to the point where we have the processes truly driving at the level that we want. We really would like to be highly reliable like the aviation industry or the nuclear industry. We’re not there yet.”

Medical errors: What you can do to reduce the risk • Communication is key: Speak up to your doctors and nurses and ask them what they are doing and why they are doing it.

• Vet your providers: Find out if they have a good success rate and try to find out from others what their perspective on medical errors is. Do they encourage a culture of open reporting?

• Wash your hands often.

Ask anybody who attends to you if they have washed their hands between patients. Make sure they do. Many dangerous infections are contracted in hospitals each year.

• Check to see how your hospital is doing online. The federal government keeps tabs and so should you. Go to https://www. medicare.gov/hospitalcompare/ search.html?

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Coming Home Alone: Put Out the Welcome Mat . . . For Yourself

I

remember it well. I was in my 20s, just starting out and working for a small non-profit agency. I was asked to deliver a document to one of our board members, and I set out to find her house in one of Rochester’s older, gentrified neighborhoods.

As I walked up the steps to Jane’s front porch, three things caught my eye: the fresh flowers in a hand-painted ceramic pitcher, the tasteful wreath on her door and a doormat that simply said, “All are welcome here.”

A good feeling came over me.

I announced my arrival by softly tapping the sweet little heart-shaped iron knocker on her front door. Then I waited. I stood on Jane’s porch feeling as if I had arrived at a special place — a place that held the promise of comfort and hospitality.

When Jane answered the door and invited me in, I saw that she had brought the warmth of her front porch into her home. I walked into an oasis of rich earth tones, subtle lighting and artwork and objects from around the world that invited inspection. I just wanted to plop myself down into one of her overstuffed

tapestry chairs and savor the warm embrace of her home.

And so it came as a big surprise to me when Jane told me she lived alone. I remember thinking: “What? This can’t be.” It just didn’t add up. I had assumed that a home this wonderful — a home this lovely and complete — could only be the home of a family or, at the very least, a couple. But no; this was Jane’s home. Her retreat.

Her wonderful life.

Little did I know that, years later, my experience on Jane’s front porch would stay with me and influence the way I decorate and furnish my home inside and out. Unbeknownst to her, she was a role model and, by example, showed me that a house can be a home, even when it’s occupied by only one person.

When I moved into my own home after my divorce, I didn’t immediately follow Jane’s good example. I didn’t feel up to it. The walls stayed bare for far too long and I didn’t fully unpack for months.

The worst part was coming home to a dark, empty house. In fact, it was so depressing, I often avoided going home after work and became a vagabond of sorts, working late or going

to the mall until I had no choice but to pull into my driveway.

I knew I had to make some changes and that’s when I recalled Jane’s front porch.

Thinking back on that experience, I found the inspiration to make my own home inviting for the most important visitor of all: myself. I now take special care to create an environment — and especially a front porch — that warmly greets me on my return home.

If returning home alone triggers feelings of loneliness and loss for you, you might consider making some changes yourself. Here’s what works for me: n Setting the stage. I want to feel welcome even before I set foot on my front porch. That’s why you’ll find flameless candles glowing in my windows all year long, not just during the holidays. Programmed with timers, the candles come on at dusk and their soft luminescence fills me with warmth and security as I approach my home after dark. n Making and keeping things nice.

It’s no fun (in fact, it can be a real downer) to come home to a dirty front porch covered with cobwebs, peeling paint and dead leaves or lawn clippings. I’ve learned that lesson!

I now hang a handmade artisan broom on my porch, and use it almost every day. And on a weekly basis, I clean the moths and “bug juice” off my porch lanterns, window sills and door frame.

Stepping onto a nice, clean and uncluttered porch makes me feel good about myself. A sense of pride wells up in me before I even walk through the threshold. That little ego boost gets my evening off to a good

August 2016 •

start. n Adding the inspiration. I see my porch as a blank canvas, and I’m the artist.

I delight in making decorative changes that reflect the seasons, capture my taste, and stimulate the senses — small inspirational changes that make coming home a joy.

The soft sound of wind chimes has an immediate soothing effect, my “Believe” wreath reminds me to have faith and my charming little chalkboard often sports messages from visiting friends and relatives.

One friend recently wrote “Welcome Home, Gwenn.” His kind message is still there, and I enjoy this friendly greeting on a daily basis.

I know that coming home alone can be a challenge, especially if you are accustomed to returning to a house filled with the hussle-bussle of family life. I also know that making “welcome” changes can ease the way into a new life and home. Roll out the welcome mat for yourself and discover all the good things that may arrive at your doorstep!

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, N.Y. For information about her upcoming workshops or to invite Voelckers to speak, call 585-6247887 or email: gvoelckers@rochester. rr.com.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 11

200 Issues

of In Good Health.

What Has Changed in 17 Years!

W

hen the first issue of CNY In Good Health was published in 1999, health maintenance organizations were all the rage.

Providers and health care consumers were just starting to get a grip on the vast wealth of medical information that was becoming available to them via the Internet, but few could imagine the advanced telemedicine functions that would revolutionize the industry within two decades.

Likewise, advances in genetic research in the years that followed were staggering. Even the way doctors are trained has changed immensely since the turn of the new millennium. Yet, the past 17 years also saw some low points in the health care business before the industry came full circle, giving providers and consumers much to be optimistic about for the future.

To mark its 200th edition, In Good Health interviewed local experts who explained how health care has evolved, and will continue to evolve, in Central New York and the rest of the United States. Here are some highlights:

By Aaron Gifford

explained. The pendulum swung too far in the other direction, and under the cloak of “total quality care” there was an era of skyrocketing insurance costs and unnecessary tests and services rendered by all types of providers to keep up with insurance company demands.

There was no incentive for anyone in the industry to contain costs.

But once again, negative publicity

Technology

Robotic surgery that allows surgeons a much greater degree of precision to reduce bleeding and recovery time is quite impressive, but perhaps the most astounding improvement is the ability for patients to complete routine tests using their cell phones.

Applications already exist that allow users to monitor blood pres-

The business model for how health care is delivered In 1999, it was commonplace for physicians to be employed by a HMO, says George Chapman of G.W. Chapman Consulting in Syracuse.

Under that type of managed care arrangement, primary care physicians almost acted as gatekeepers in referring patients to specialists in the same network, and a major emphasis was placed on preventive care, lower co-payments for patients and avoiding unnecessary services.

The intentions of HMOS were good, Chapman said, but negative publicity about overzealous cost containment measures just about destroyed that model of care.

In addition, electronic medical records were not in place then for most practices, so the communication between providers was poor and the relationship between primary care physicians and specialists was never properly maintained.

“Most insurers were still paying fee for service, but HMOs were running a capitation model,” Chapman said. “They were capitating the specialists. It just doesn’t get a lot of traction in the market. And without the [electronic] medical records, they couldn’t prove what they did and what they were going to do.”

What followed in the new millennium was definitely a low point in American health care, Chapman Page 12

•

The first issued of In Good Health was published in October 1999 as one of the first local health-related newspaper. brought change. There is now a re-emphasis on primary care, but instead of HMOs, it is the hospital networks that are employing the doctors and negotiating with the insurance companies. There are metrics in place to balance cost containment with patient outcomes, Chapman says, and the Affordable Health Care Act certainly helps by requiring health insurance providers to spend no more than 15 percent of its revenues on its own employees.

“Hospitals are buying up primary care practices to build up their patient base. They want to manage all of the care for patients and determine if they go to a specialist,” he said. “In a way, we have come full circle, but this way seems to be working.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

sure and even complete electrocardiogram tests and submit the information from their phones to their physicians.

“The days of grandpa having to come in regularly-for blood pressure checks are gone,” Chapman said.

He added that, in 1999, many practices had websites where patients could view hours of biographical information about the physicians and even set up appointments by emailing the office staff. Seventeen years later, many of those practices have online portals where patients can talk to a physician, physician’s assistant or nurse practitioner live and obtain a prescription.

“You don’t even have to leave work to get care now,” Chapman said. “With the next generation, al-

most everything will be online.”

Medical training

David Duggan, dean of Upstate Medical University’s College of Medicine, said the approach to teaching new doctors was reinvented over the past two decades. The old way — attending classroom lectures, participating in labs, Duggan taking tests and then following physicians during hospital rounds — was replaced by a curriculum that is much more interactive.

“They were evaluated almost solely on their ability to take tests and understand the facts,” Duggan said.

Now, a typical medical school classroom involves team exercises or role-playing activities where students, often with the help of a mentor, are challenged to solve problems and present their findings to the class. Some activities require students from a broad range of disciplines, including nursing, pharmacy and physical therapy, to work together. There is much more emphasis on equitable care and the commitment to serve people with different backgrounds.

The training doesn’t stop after doctors complete their residencies or pass their board exams. Continuing education and re-certifications are required throughout a career.

“There’s been a continual change in assessments, accreditations and expectations,” Duggan said. “It’s not a passive learning experience any more. This is the era of the active learning experience.”

Research

Duggan says perhaps the most impressive feat in research during the past 17 years is the ability to separate one molecule among a billion others under a high-powered microscope and use those findings to better understand the human genome.

Even into the 1990s, cancer research was still largely reliant on finding products in nature, whether in plants or animals, that could combat the disease. Now, Duggan explains, research completed in recent years has provided us a solid knowledge base to understand genetic abnormalities of tumors.

“We have the phenomenal ability to ask and answer questions,” he said. “It’s a very exciting time, and a dramatically different world scientifically.”

SmartBites The skinny on healthy eating

I

Surprising News About Peaches

’m always on the lookout for foods that may prevent or arrest cancer. Since mounting evidence shows that the foods we eat weigh heavily in the war against cancer, it just makes sense to consume as many of these foods as we can.

Never in my wildest dreams did I think that peaches — sweet, luscious, gorgeous peaches — would fall into that category.

Broccoli? Yes. Garlic? No question.

But peaches?

Researchers at Texas A&M University, in concert with food scientist

Giuliana Noratto, say “yes,” especially when it comes to breast cancer.

In a first-of-its-kind study, published online in the Journal of Nutritional Biochemistry, Noratto and her colleagues found that peach extracts drive breast cancer cells in mice to self-destruct, while leaving normal ones intact.

Two powerful antioxidants found in peaches appear to be the frontline warriors.

According to Noratto, we can get the same dose as the mice by eating two to three fresh peaches a day. Canned peaches, she said, don’t pack the same cancer-fighting punch. Of course, this is but one study and one team’s findings, but it certainly shows promise.

On the nutrition front, peaches rock with healthy doses of fiber, vitamins C and A, niacin and potassium.

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Fiber keeps us regular and helps regulate cholesterol levels; vitamin C is a tissue-builder and immune-booster; vitamin A is essential for growth and healthy vision; niacin assists in the conversion of food to energy; and potassium helps control blood pressure.

On the calorie front, peaches are remarkably low for such a sweet li’l thing: only 60 per medium peach.

As for grams of sugar, peaches have fewer than an apple, more than an orange and about the same as a banana.

Need a few more reasons to reach for a peach? Well, they’re delicious; they’re in season; and they’re awfully tasty with yogurt or vanilla ice cream.

Helpful tips

Select peaches with a rich color and a sweet aroma. Ripe ones yield to gentle pressure. Avoid peaches that are overly soft or that have surface cuts and bruises. Slightly hard but mature peaches can be kept at room temperature until they ripen. To hasten ripening process, put peaches inside a closed paper bag and set on counter, out of direct sunlight.

Honey-Glazed Chicken with Peach Salsa Adapted from Bon Appetit 1 3/4 cups diced peaches (about 3 large) 1/4 cup diced red bell pepper 1/4 cup chopped green onions 3 tablespoons fresh lime juice, divided 2 tablespoons chopped fresh cilantro or mint 1 tablespoon minced seeded jalapeño chile

2 teaspoons minced peeled fresh ginger, divided 1 garlic clove, minced 2 tablespoons soy sauce 2 teaspoons sesame oil 4 chicken breasts 2 tablespoons honey Fresh cilantro or mint leaves Mix peaches, red bell pepper, green onions, 2 tablespoons lime juice, chopped cilantro or mint, jalapeño, 1 teaspoon ginger, and garlic in small bowl to blend. Season to taste with salt and pepper. (Salsa can be made 2 hours ahead. Cover and refrigerate.)

Whisk soy sauce, sesame oil, and remaining 1 teaspoon ginger in medium bowl to blend. Add chicken and stir to coat. Marinate in refrigerator for 30 minutes, turning occasionally.

Whisk honey and remaining 1 tablespoon lime juice in another small bowl. Preheat the grill to medium-high heat; lightly oil grill grate.

Remove the chicken from marinade and place on grill. Grill the chicken until no longer pink inside, brushing occasionally with honey glaze, about six to eight minutes per side. Sprinkle chicken with cilantro or mint leaves and serve with peach salsa and (suggested) a side of brown rice.

Anne Palumbo is a lifestyle columnist, 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.

600 East Genesee St. Suite 114, Syracuse, NY 13202 Carolyn Christie-McAuliffe PhD, FNP

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 13

there to wobble and tumble beside us. It’s due time that dads got the glory and the weight that comes with being so valuable.

Parenting

By Melissa Stefanec

The Value of a Woman

E

verywhere you look, our society is selling value. Whether it’s the best value for your dollar, 15 percent more diapers in a package or increasing your self-worth, someone, somewhere is trying to sell you on rating people and things.

As a society, we value mothers for a lot of reasons. In fact, we assign a value to mothers that no other social group experiences. There is no question that mothers are amazing; mothers are special people. However, it seems that being a mother and, more so, a near-perfect mother, is the epitome of womanhood. There are still notions that when a woman becomes a mother, she has obtained the greatest of achievements. She has defined herself as something great, and she has accomplished all she is supposed to. Before middle age strikes, you have hit your pinnacle.

I think we value moms a little too much and women, too little. We put moms on pedestals that are dangerously high — the kind of pedestals that no human being should be placed upon, and the kind that are guaranteed to waver, tip and fall.

At the same time, women are often treated like second-class citizens.

We need to redefine the way we value mothers. Here are a few things I find problematic about giving mothers golden status and women second-class status: • It puts unnecessary pressure on mothers to be perfect — Mothers feel pressure from all directions. There are expectations placed on us that no human being can meet. Sometimes we put this pressure on ourselves, but society and tradition are very difficult things to remove and reject from your life and psyche. Mothers are people. We have faults. We lose our cool. We fail. We let our kids get dirty. Not only do we not have Pinterest-worthy homes, but our floors typically have specks of last night’s toddler dinner on them. Let’s stop pretending otherwise.

• It demotes fathers — By placing moms on the ultimate pedestal, it places dads and men somewhere below. This is a disservice to everyone.

If we are going to place moms on a pedestal, let’s at least put dads up

• It intrinsically places less value on women who aren’t mothers — When you act like having a child is paramount to womanhood, a great disservice is done to all the women in the world who aren’t mothers. Maybe that is by choice or maybe it’s by circumstance, but a woman’s value isn’t increased by motherhood; it is simply altered.

• When you become a mother, you don’t stop being a woman — I find this one particularly problematic. At the same time women experience the motherhood limelight, they are also experiencing all the double-standards and transgressions that occur as a result of being a woman. It’s very difficult to see motherhood as the ultimate human achievement, yet see so little female representation in leadership positions. It is strange to be told you are one of the most awesome things on this earth and then be discriminated against or victimized because of the very trait that enabled your awesomeness. This is incredibly hard to reconcile (and has to be damaging to one’s psyche).

• Men define themselves in many ways, and women should too — Ask almost any man about his passions and accomplishments, and he will likely regale you with an impressive list. If that man is a father, it’s likely to be on that list. If he is a husband or partner, those will likely be on that list too. If you ask a mother to list her passions and successes, the list is probably much shorter. That’s because society teaches mothers to define themselves as such. Fathers often

escape this paradox. I think men and women should define themselves by many accomplishments and actions.

That way, we don’t lose ourselves by being parents.

• It makes parenting more challenging — Moms are viewed as the backbones to their families. They keep all the engagements, appointments, shoe sizes, birthdays and shampoo preferences straight. They are keepers and trackers of all the family information. This puts a lot of extra pressure on moms. It takes time and energy away from what most of us enjoy best — things like playing with our kids and getting a little alone time. It’s time moms became valuable for other, more important things.

If there are two parents in a household, only good things can come of both of them being actively engaged.

(Ask my husband—he loves grocery shopping, really.)

• It keeps us from viewing virtue as a masculine trait — Throughout the ages, women have been viewed as, and expected to be, the fairer and more virtuous sex. Giving golden status to women only when they are patient, virtuous, kind and gentle isn’t doing anyone any favors. Some days I am angry, crude, or snappy.

That doesn’t make me any less of a woman or a mother. It makes me a real, breathing human being. There are good and bad apples in both sexes, so expecting women and mothers to be wholesome is unfair and counterproductive. We all need expectations that allow us to breathe, curse, nurture and succeed. In short, we need the opportunity to achieve some inner peace and spread that peace. At the end of the day, that is what’s valuable.

NOT TAKING YOUR PRESCRIPTIONS AS DIRECTED?

YOU’RE TAKING

A CHANCE.

If you have a chronic condition like high blood pressure, diabetes or high cholesterol, taking your prescriptions as directed is essential to healthy living. So remember:

If you’re not taking your prescriptions as directed, you’re taking a chance.

To learn more, visit ExcellusBCBS.com/TakeAsDirected. #TakeAsDirected

Page 14

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

Golden Years Tips for Visiting a Memory Care Patient

By Deborah Jeanne Sergeant

I

f your loved one lives in a memory care facility, visiting may seem intimidating.

Perhaps you have visited before and the interaction did not go well.

Or maybe you have not visited in a while because you don’t know what to say or what to expect.

“During the initial transition, if they’re coming from home or hospital, there’s what we call transfer trauma,” said Michael Voll, director of admissions and social work at Central Park Rehabilitation and Nursing Center in East Syracuse.

“Don’t visit for the first few days until they acclimate to the new surroundings and caregivers.

It allows the resident get used to the new environment. It’s their new home and they need to have mechanisms to deal with a new environment.”

Planning ahead can make your visit more enjoyable for both of you. Call the facility ahead of time to plan your visit for the time of day that your loved one typically feels at ease. Call the same day to see how your loved one is feeling that day so you can visit on a “good” day.

Turning off the TV or radio can help the resident focus better, as can spending time in a place where he feels relaxed, such as his room or the garden.

Set realistic expectations. A back-and-forth conversation may not be possible.

“A lot of times, their communication is based on emotion,” Voll said.

“If they’re happy, they’re happy.

They may not know you’re their daughter, but you’re a female who

has made them happy. You’re an emotion they remember.”

Get on eye level and slowly and clearly introduce yourself so he won’t have to struggle for your name. People in the early stages of dementia realize that activities and relationships they once enjoyed are slipping away. Don’t try to keep your loved one up-to-date on what

he’s missing, unless he asks for this information.

It’s important to realize that especially in the mid to later stages of dementia, people think their stay is temporary or they are living in a different reality, such as when they were younger.

“If they’re fixated on a memory like creating a lesson plan for their

class of students, we may provide them with paper or anything they need,” Voll said. “It’s not hurting anything.

It’s validating their feelings and thoughts.

Many times, they don’t fixate on it anymore after that.”

Talk about interests, current events or your surroundings, but don’t bring up any painful or embarrassing subjects. If you feel uncertain, Sharon Brangman, geriatrician with University Hospital, advises allowing patients to lead the conversation.

“Don’t spend energy correcting them if they offer information that’s not right,” Brangman said. “Just say, ‘I didn’t know that.’ Correcting them can create a lot of emotional discord.

“The moment they’re in is the most important moment. Keep the information simple, straightforward.”

People with dementia struggle to hold onto thoughts, so let him interrupt as needed before a thought escapes. Since many people with dementia often have difficulty expressing their thoughts and understanding speech, asking yes-no questions helps them, along with using visual cues.

Some memory care patients ask the same question repeatedly, but visitors must remain patient.

Dementia causes some people to experience changes in personality. In those moments, remember that it’s the disease talking, not your loved one.

Janet Haynes, a registered nurse and director of clinical services for Hearth Management in Syracuse, recommends using a family photo album, listening to music the patient enjoys, or bring Haynes in an animal (call first).

Many facilities welcome visitors to take part in on-site activities.

“Plan a visit when an activity is going on and you can do something together,” Haynes said. “You can live in their moment. If the activity is not something your loved one enjoys, have another plan such as a photo album.”

She encourages visitors to communicate through touch as well.

Holding your loved one’s hand, for example, can share your love without words.

Memory Loss: Normal or a Sign of Trouble?

Everyone experiences some forgetfulness, but the FDA explains when to be concerned

M

ild memory lapses such as forgetting where you put your keys or reading glasses, though worrisome, are normal, experts say.

But certain memory problems — such as putting your car keys in the fridge — may indicate a more serious issue.

So, what kind of memory issue suggests the need for a medical assessment?

Some examples include: memory loss that disrupts daily activities such as balancing a checkbook, maintain-

ing personal hygiene and driving; or frequent memory lapses such as regularly forgetting appointments or where you parked your car, the U.S. Food and Drug Administration (FDA) said in a news release.

Other warning signs include forgetting whole conversations, forgetting the names of relatives or close friends, frequently repeating yourself, or asking the same questions in the same conversation.

Another red flag is memory loss that's getting worse over time.

There are a number of things you

can do that might help reduce the risk of developing memory problems: keeping cholesterol and blood pressure levels low; not smoking and not drinking too much alcohol; eating a healthy diet; engaging in lots of social activity; and keeping your brain active by reading, writing, learning a new skill, playing games and gardening.

There are a number of causes of memory loss, including medications; heavy drinking; stress; depression; head injury; infections such as HIV, tuberculosis, syphilis and herpes; August 2016 •

thyroid problems; lack of quality sleep; and low levels of vitamins B1 and B12. Many of these causes can be helped with medical treatment, the FDA noted.

"As part of the normal aging process, it can be harder for some people to recall some types of information, such as the names of individuals.

Mild cognitive impairment, however, is a condition characterized by a memory deficit beyond that expected for age, but is not sufficient to impair day-to-day activities," according to the news release.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 15

Golden Years

Great Gadgets for Aging Golfers

By Jim Miller

T

here are actually a wide variety of nifty golf accessories and adaptive equipment that can help older golfers who struggle with injuries, arthritis or loss of mobility.

Here are several products for different needs.

Bending Substitutes

The game of golf requires a lot of repetitive bending and stooping that comes with teeing up the ball, repairing divots, marking the ball on the green, retrieving a ball or tee on the ground, along with picking up a club, sand rake or flag stick off the ground.

For teeing up the ball without bending over, consider one of the Northcroft Golf Tee-Up devices.

These are long-handled tools (1.5 to 3 feet long) that have trigger-style handgrips and a jaw that holds the ball and tee for easy placement. They cost between $69 and $72 and are

available at NorthcroftGolf.com. For other tee-up solutions, see the Tee Pal ($55, TeePalPro.com) and Joe’s Original Backtee ($15, UprightGolf. com).

NorthcroftGolf.com and UprightGolf.com also offer a variety of stoop-proof ball pickup accessories, divot repair and magnetic ball marker products ranging between $5 and $12.

Or, if you just want a great all-around golf picker-upper, consider the Graball GrabAll Jaw — sold through Amazon.com for $10 for a package of two. It attaches to the handle end of your putter and chipper and is designed to pick up golf balls, flagsticks, putters and green side chippers.

Gripping Aids

To help alleviate your golf club gripping problem, there are specially designed golf gloves and grips that can make a big difference.

The best gloves are the Bionic Golf Gloves (BionicGloves. com) that have extra padding in the palm and finger joints to improve grip. And the Power Glove (PowerGlove.com) that has a small strap attached to the glove that loops around the club grip to secure it in your hand. These run between $20 and $30.

Another option is to get oversized grips installed on your clubs.

This can make gripping the club easier and more comfortable, and are also very good at absorbing shock.

Oversized grips are usually either one-sixteenth-inch or one-eighth-inch larger in diameter than a standard grip, and cost around $10 per grip.

You can find these grips and have them installed at your local golf store or pro shop.

Or, for a grip-and-glove combination fix, consider the Quantum Grip (QuantumGrip.com) that incorporates Velcro material recessed in the golf club grip and a companion golf glove that has mating Velcro material in the palm. Cost: $20 per grip, plus $35 per glove.

Vision Helper

If vision problems make finding the ball difficult, Chromax golf balls (ChromaxGolf.com) can make a big difference. These are reflective colored golf balls that make them appear larger and brighter.

Cost: $10.50 for a three-pack.

Ergonomic Carts

There are also ergonomically designed golf carts that can help you transport your golf clubs around the course. If you like to walk, the Sun Mountain Sports Micro-Cart, V1 Sport Cart or Reflex Cart are great options. These are three and fourwheeled, lightweight push carts that that fold into a compact size for easy transport. Available at SunMountain. com for $200, $210 and $230.

Or, for severe mobility loss, the SoloRider specialized electric golf cart (SoloRider.com) provides the ability to play from a seated or standing-but-supported position. Retailing for $9,450, plus a $550 shipping fee, this cart is lightweight and precisely balanced so it can be driven on tee boxes and greens without causing any damage. Federal ADA laws require that all publically owned golf courses allow them.

In the Market for an Adult Day Care Service?

By Jim Miller

A

dult day care services can be a great option for caregivers who work or for those who just need a break during the day.

Here’s what you should know, along with some tips to help you find and choose one.

Adult Day Services

The business of adult day care services has grown rapidly in recent years. According to the National Adult Day Services Association, there are around 5,700 programs operating in the United States today.

As the name implies, adult day care provides care for elderly seniors who cannot care for themselves at home. While services will vary from center to center, they typically provide personal care, meals and snacks, various activities and social interaction in a safe supportive environment. Additionally, many centers also provide health services such as medication management, various Page 16

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therapies, exercise and transportation to and from the facility.

Adult day care centers generally operate programs during normal business hours five days a week.

However, some centers may offer services in the evenings and on weekends, too.

Costs for care will vary as well, usually between $25 to more than $100 per day (the national average is $65 per day), depending on where you live.

Unfortunately, in most cases original Medicare (Part A and B) does not pay for adult day care, but some Medicare Advantage (Part C) plans, and many long-term care insurance policies do. But, most seniors or their families pay for care out-of-pocket.

If your mom is lower income and can’t afford this, many states offer Medicaid waiver programs, and some have PACE programs that provide financial assistance. Contact your state Medicaid office (see Medicaid.gov) for more information.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

The VA even provides adult day care to eligible veterans enrolled in their medical benefits package. See VA.gov/geriatrics to learn more.

How to Choose

Your first step in shopping for an adult daycare center is to determine the kinds of services your mother and you need. After you do that, here are some tips to help you locate and choose a good provider.

Start by contacting the county’s office for the aging (call 800-6771116 to get your local number) to get referrals to adult day service programs in your area. You can also search online at the National Adult Day Services Association (NADSA) website at NADSA.org/locator, or check your phone book yellow pages under “Adult Day Care” or “Senior Services.”

Once you have a list of a few centers, call them to find out their eligibility criteria, if they offer the types of services your mother needs, if they

are accepting new clients, their hours of operation, if they’re licensed or registered with a state agency (this is not required in all states) and what they charge.

After you identify a few good centers, go in for a visit. Find out about the staffing ratio (at least one staff member for every six participants is recommended) and what kind of training they have. While you’re there, notice the cleanliness and smell of the facility. Is it homey and inviting? Does the staff seem friendly and knowledgeable? Also be sure to taste the food, and consider making an unannounced visit.

To help you rate your visit, the NADSA offers a helpful checklist of questions to ask at NADSA.org — click on “Choosing a Center.”

Then, after your visit, be sure to check their references. Get names and phone numbers of at least two or three families who have used the center you are considering and call them.

Golden Years

Good Food on a Tight Budget

By Deborah Jeanne Sergeant

Experts offer senior strategies on how to eat healthfully on a tight budget

I

f you’re a senior with a fixed income, it may seem difficult to eat a well-balanced diet. Food prices increase, but your grocery budget doesn’t. With some planning, you can eat healthfully, stretch your dollars and find the most affordable nutritious food.

Saving money on your overall grocery bill can help you better afford healthful foods, such as lean sources of protein, and a variety of whole fruits, vegetables and grains. Ask about a senior discount.

Think big to save. Susan Branning, registered dietitian and clinical nutrition manager at St. Joseph’s Hospital Health Center, recommends purchasing in bulk.

“That’s a great way to save money if the up-front cost is affordable,” she said. “The discounts can be up to 40 percent.”

She recommends shopping with a friend to split bulk purchases and also the gas to drive to the store.

When buying bulk meat or meat near the sell-by date, cook it all at once and freeze it in portion-sized packages. Then, all you need to do is take it out of the freezer and place it in the fridge the night before you plan to heat it and eat it.

Choose inexpensive cuts of meat and slow cook or use a meat mallet to tenderize. Lentils and beans provide a good source of economical protein, plus fiber. Branning recommends rinsing canned beans to reduce the sodium.

Eggs, canned fish and nut butters can also offer versatile and inexpensive sources of protein, especially if dental issues make meat difficult to chew. Cottage cheese and Greek yogurt also provide protein and calcium inexpensively.

“Shopping the perimeter of the supermarket is where consumers will find some of the healthiest and least-processed foods,” Branning said.

For produce, Branning advises clients to shop for seasonal fruits and vegetables to help save money. Yearround, bananas and potatoes offer low-cost nutrients.

“They’re a great source of potassium which benefits seniors who may need extra potassium in their diet if taking medications like diuretics, commonly called water pills,” Branning said.

Frozen produce can help trim costs and Branning said that it’s just as nutritious as fresh.

She added that staples such as fortified, whole grain cereal can provide a good portion of your day’s vitamins and minerals, plus fiber and

complex carbohydrates.

Plan meals for the week based on what’s on sale. Compare prices of generic items versus the price of a name-brand item on sale or with a coupon. Always compare the unit price, not the general price. Most stores indicate the price per weight or volume on the shelf tag in smaller print in a small orange or yellow square. That way you can know you truly have the best price.

Cooking at home offers the highest nutrition and best savings since you’re in control of what goes into your meals and you’re not paying anyone else to cook for you.

Onondaga County offers the Farmer’s Market Nutrition Program which provide coupons for free produce to seniors who financially qualify.

Eating away from home can perk up a flagging appetite and provide a variety of foods with a different nutritional profile. Instead of dining out at restaurants, consider joining community meals. Many churches host free meals or dish-to-pass meals open to the community and advertise them in the shopping flyers and newspapers.

Jad Kurtzworth, a 67-year-old Minoa resident, saves money by dividing bulk packages of food and freezing them. She also freezes produce.

"Anything I can freeze, I do, like you-pick blueberries," Kurtzworth said. "I pick enough I can have a cup a day every day through the winter."

To cut help control her intake of cholesterol, Kurtzworth uses little meat and the strategy also saves her money.

She used to use coupons and store-hop to hit all the sales, but to save gas and time, she now prefers shopping at Aldi and Wal-Mart for their consistently low prices.

She relies on lists to reduce impulse purchases.

August 2016 •

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

ho is 90, looks 70 and has the energy of someone half her age?

Marilyn Ribyat is a petite dynamo who is constantly active — whether it’s taking fitness classes through the town of Dewitt Parks and Recreation, walking the Erie Canal, attending classes at OASIS, playing bridge, lunching with friends, or participating in a book club.

She’s always on the go, according to Joan Harkulich, an instructor with the town of Dewitt’s exercise program.

“It’s a lot more fun being in good shape than being in bad shape,” Ribyat said with a chuckle.

She has been involved in the town’s exercise programs for nearly 15 years and is now taking the weights class and Pilates.

As Ribyat stands to do a series of squat exercises with weights, she grabs the 10-pound free weight, the heaviest of those available to her, to do the arm exercises. On nice days, she walks approximately six miles on the Erie Canal trail, and during bad weather, she makes good use of a treadmill at her home.

“I was a runner for many years.

Now I’m just a fast walker,” she said.

Fitness has always been important to Ribyat, and her husband of 68 years, Seymour, is now 91.

Because Seymour was a marathon runner, Marilyn decided to take up running in her 30s.

“It was either that or never see him,” she said.

Ribyat was also a musician, at one time playing in the Onondaga Civic Symphony Orchestra, taking part in the Syracuse Chorale and playing the piano.

While she may no longer play, she and Seymour still enjoy attending concerts and musical programs.

Ribyat has the distinction of having been in the first class at Syracuse University’s School of Nursing, which is now defunct. She earned her nursing degree in 1946 and a year later got her bachelor’s degree in science.

She went on to marry and raise a daughter and two sons.

But in 1960, seeing more career opportunities at the time in education than nursing, she returned to school and got a degree in teaching.

She taught for 21 years in the Syracuse City School District — at Prescott, Lincoln and Sumner schools, all of which have since closed.

“Soon as I walked in, the next year they closed the doors,” she said.

Ribyat’s quick wit comes through in any conversation with her.

“I can remember every joke that I’ve ever heard. I can’t remember somebody’s name, but I can remember jokes my father told me 80 years ago,” she said.

Her activities — and perhaps her knack for telling jokes — have enabled her to make new friends, which she said is important to do as one ages.

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Isolation, loss of friends and loved ones are some factors that contribute to depression among seniors, say experts

By Deborah Jeanne Sergeant

B

ecoming a “grumpy old man” or a “crabby old lady” isn’t a natural part of the aging process. Aging does increase the likelihood for certain risk factors for depression; however, older people can reduce their chances of depression. And those with depression can find relief.

Most older adults don’t suffer from depression, according to geriatrician Sharon Brangman, SUNY Upstate Medical Center.

The incidence of depression is the same as in the general population but it is often underdiagnosed.”

“Many grew up in a time where there was a taboo against Brangman any mental complaint. They had a grit-yourteeth-and-deal-with-it approach.

Many older adults wouldn’t consider going to a counselor or therapist to talk about their problems.”

Ignoring depression affects quality of life and has been linked to chronic pain and heart attacks.

Brangman added that just as someone should seek medical attention for high blood pressure, he should seek it for depression.

And older adults have plenty of risk factors for depression, such as declining health, personal loss, untreated pain conditions, social isolation, and difficulty engaging in activities of daily living. They may also experience loss of hobbies and employment. These factors would negatively affect people of any age, but are likelier in older adulthood.

Older people also may experience more directly age-related complications from health conditions such as thyroid disease.

Many seniors take more than one prescription.

“Many drugs can interact and cause greater risk of depression,” said Douglas Goldschmidt, PhD and licensed clinical social worker practicing in Syracuse. “Many drugs aren’t tested on or designed for people above 40. The body isn’t as good at filtering these and the drugs stay in the body longer.”

Like Brangman, he contends that depression isn’t a natural side effect of aging, since a person of any age facing the same challenges would be prone for depression.

Goldschmidt said that depression differs from a bout of the blues in that the feelings run deeper, include hopelessness and possibly physical manifestations, and last longer.

He added that people who are mildly depressed may find relief through lifestyle modification, such as more aerobic exercise, eating better and finding positive ways to spend time. Many derive pleasure from volunteering, too, “You’re not at home alone all day, thinking about being alone,” Goldschmidt said as he refer to volunteerism. “You have people to share things with. It gives you a whole sense of life that you don’t otherwise get.”

He added that talk therapy can prove helpful as well.

Seeking unhealthy coping mechanisms such as alcohol only temporarily blunts emotional pain, but it won’t offer lasting relief.

Don’t count on a primary care physician to spot depression, especially if the visit is about a different malaise. Goldschmidt said that many primary care physicians miss it or mistakenly believe it’s a natural part of aging.

“Many GPs don’t know enough about it to properly treat their [older] patients,” he said. “They do their best, but it’s not taught much in medical school.”

Look for signs such as persistent sadness, unexplained fatigue, losing interest in activities previously enjoyed, isolation, low self worth, contemplating death or suicide, lack of mental focus, feeling hopeless, anxiety, unexplained body aches, irritability, unexplained changes in weight, sleeping, grooming and eating patterns.

If you see these signs in yourself, bringing it up during a medical visit, talking with a minister trained in mental health counseling, or seeking help from a mental health therapist directly may be the only way to obtain professional help. If someone you care about exhibits signs of depression, talk about what you’re observing and ask if the person needs to discuss this with his doctor.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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ho doesn’t love sharing a summer picnic with friends and family? Whether you plan one for everyone on your block or a quiet afternoon for two, you’ll need to bring a basket full of delectable goodies. When you’re sharing dishes with loved ones, whether you’re at home or away, you’ll be sure to make everyone happy with a variety of treats.

In the service of securing today and tomorrow, Social Security has a full picnic basket of services. Our table is ready to serve millions of Americans online, by phone and in person in our network of field offices.

It’s easy to pick the method that’s best for you from the comfort of your home or on the go.

The quality service you expect from us is easy, secure, and convenient to access when you go online.

Signing up for a My Social Security account will give you a secure and efficient way to interact with us and accomplish various tasks, including estimating your future benefits or managing your current benefits. You can sign up for your own account at www.socialsecurity.gov/myaccount and join the more than 25 million Americans who already conduct business with us online using My Social Security.

Another way you can contact us is toll-free at 1-800-772-1213 (TTY 1-800-325-0778). Of course, you can

www.seniorshelpingseniors.com

Q: Can I refuse to give my Social Security number to a private business?

A: Yes, you can refuse to disclose your Social Security number, and you should be careful about giving out your number. But, be aware, the person requesting your number can refuse services if you don’t give it.

Businesses, banks, schools, private agencies, etc., are free to request someone’s number and use it for any purpose that doesn’t violate a federal or state law. To learn more about your Social Security number, visit www.socialsecurity.gov/ssnumber.

Q: I prefer reading by audio book. Does Social Security have audio publications?

A: Yes, we do. You can find them at www.socialsecurity.gov/pubs.

Some of the publications available include What You Can Do Online, How Social Security Can Help You When a Family Member Dies, Apply Online for Social Security Benefits, and Your Social Security Card and Number. You can listen now at www. socialsecurity.gov/pubs.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

also use the field office locator at www.socialsecurity.gov/agency/ contact to find your local field office, where you can speak with a Social Security employee face-to-face.

What true summer picnic is complete without ice cream? When it comes to great flavors, there’s vanilla, mint, chocolate chip, rocky road … who can choose just one? Likewise, Social Security offers all the different types of benefits you’ll need at any stage of your life.

Social Security has retirement benefits and the tools to help you plan for your retirement and apply for benefits online. But that’s not all.

We also provide disability benefits to individuals with medical conditions that prevent them from working.

If the disabled individual has dependent family members, they can also receive payments. There are also survivors benefits for widows, widowers, and deceased workers’ dependent children. When you create your my Social Security account, you can view your Social Security Statement to see estimates of the future retirement, disability, and survivors benefits you and your family may be eligible to receive.

It’s a great day for a picnic! Social Security is opening up its picnic basket to share our great services and benefits, and you’re invited! Visit www.socialsecurity.gov today, and we’ll save you a place.

Q: I’m reaching my full retirement age and thinking about retiring early next year. When is the best time of year to apply for Social Security benefits?

A: You can apply as early as four months before when you want your monthly benefits to begin. To apply, just go to www.socialsecurity. gov/applytoretire. Applying online for retirement benefits from the convenience of your home or office is secure and can take as little as 15 minutes. It’s so easy!

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.

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By Jim Miller

Who’s Eligible for Social Security Survivor Benefits?

Dear Savvy Senior,

Who is eligible for Social Security survivor benefits? My ex-husband died last year at the age of 59, and I would like to find out if me, or my two kids – ages 13 and 16 – that we had together are eligible for anything?

Divorced Widow Dear Divorced,

If your ex-husband worked and paid Social Security taxes, both you and your kids may very well be eligible for survivor benefits, but you need to act quickly because benefits are generally retroactive only up to six months. Here’s what you should know.

Under Social Security law, when a person who has worked and paid Social Security taxes dies, certain members of that person’s family may be eligible for survivor benefits including spouses, former spouses and dependents. Here’s a breakdown of who may be eligible.

• Widow(er)’s and divorced widow(er)’s: Surviving spouses are eligible to collect a monthly survivor benefit as early as age 60 (50 if disabled). Divorced surviving spouses are also eligible at this same age, if you were married at least 10 years and did not remarry before age 60 (50 if disabled), unless the marriage ends.

How much you’ll receive will depend on how much money (earnings that were subject to Social Security taxes) your spouse or ex-spouse made over their lifetime, and the age in which you apply for survivors benefits.

If you wait until your full retirement age (which is 66 for people born in 1945-1956 and will gradually increase to age 67 for people born in 1962 or later), you’ll receive 100 percent of your deceased spouses or ex-spouses benefit amount. But if you apply between age 60 and your full retirement age, your benefit will be somewhere between 71.5 — 99 percent of their benefit.

To find out what percentage you can get under full retirement age visit ssa.gov/survivorplan/survivorchartred.htm.

There is, however, one exception.

Surviving spouses and ex-spouses who are caring for a child (or chil-

dren) of the deceased worker, and they are under age 16 or disabled, are eligible to receive 75 percent of the worker’s benefit amount at any age.

• Unmarried children: Surviving unmarried children under age 18, or up to age 19 if they’re still attending high school, are eligible for survivor benefits, too. Benefits can also be paid to children at any age if they were disabled before age 22 and remain disabled. Both biological and adoptive children are eligible, as well as kids born out of wedlock. Dependent stepchildren and grandchildren may also qualify. Children’s benefits are 75 percent of the workers benefit.

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• Dependent parents: Benefits can also be paid to dependent parent(s) who are age 62 and older.

For parents to qualify as dependents, the deceased worker would have had to provide at least one-half of the parent’s financial support.

But be aware that Social Security has limits on how much a family can receive in monthly survivors benefits — usually 150 to 180 percent of the workers benefit.

You also need to know that in addition to survivor benefits, surviving spouses or children are also eligible to receive a one-time death benefit of $255.

Maximizing Strategies

Social Security also provides surviving spouses and ex-spouses some nice strategies that can help boost your benefits. For example, you could take a reduced survivor benefit at age 60, and could switch to your own retirement benefit based on your earnings — between 62 and 70 — if it offers a higher payment.

Or, if you’re already receiving retirement benefits on your work record, you could switch to survivors benefits if it offers a higher payment.

You cannot, however, receive both benefits.

You also need to know that if you collect a survivor benefit while working, and are under full retirement age, your benefits may be reduced depending on your earnings.

For more information, visit ssa. gov/survivorplan or call 800-7721213.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Officials from local nonprofit participating in the awards program organized by Excellus. Seated are Louise Thurlow and Najah Zaaeed, both of InterFaith Works; standing are Kim Dill, SAGE Upstate; Jim Reed, Excellus BlueCross BlueShield, Beth Broadway, InterFaith Works, and Ruth Troy, Canton Woods Senior Center.

Nonprofits Receive Community Health Awards from Excellus Excellus BlueCross BlueShield recently presented grants of up to $4,000 each to the Canton Woods Senior Center in Baldwinsville, InterFaith Works in Syracuse and SAGE Upstate, also in Syracuse.

According to Jim Reed, regional president, Excellus BlueCross BlueShield, the three Central New York nonprofits were among those selected from a pool of 185 Upstate New York applications to receive its 2016 Community Health Awards.

• Canton Woods Senior Center will use the funds to install a hydration station (including a water fountain and bottle filling station) and provide educational information on the health benefits of proper hydration to help improve the health of senior participants.

• InterFaith Works will use its award to create a refugee wellness program that addresses depression, loneliness and health imbalances among refugees who are experiencing post-traumatic stress disorder

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

as a result of the war, violence and oppression they have experienced.

• SAGE Upstate will use grant money to offer cultural competency training and resources for health professionals who provide services for older gay, lesbian, bisexual and transgender individuals in Cortland, Onondaga and Oswego counties.

Funds will also be used to produce a resource guide of supportive services for older GLBT county residents.

Excellus BlueCross BlueShield presents its Community Health Awards as part of its mission to improve the health and health care of the residents of the communities it serves.

The company’s Community Health Awards are granted to Central New York institutions that positively influence the health of the community. Awards are based on scope of need, goals of the program, number of people expected to benefit from the program and positive impact on the community’s health status.

Health News Auburn hospital, one of most wired in the nation Auburn Community Hospital has been named as one of America’s most wired hospitals, according to results of the 18th Annual Health Care’s Most Wired survey, released recently by the American Hospital Association’s (AHA) Health Forum.

HealthCare’s Most Wired survey, conducted between Jan. 15 and March 15, is published annually by Health & Hospitals Networks. The 2016 Most Wired survey and benchmarking study is a leading industry barometer measuring information technology (IT) use and adoption among hospitals nationwide.

The survey of 680 participants, representing an estimated 2,146 hospitals — more than 34 percent of all hospitals in the U.S. — examines how organizations are leveraging IT to improve performance for value-based health care in the areas of infrastructure, business and administrative management; quality and safety; and clinical integration.

“Auburn Community Hospital’s continued implementation of stateof-the-art information technology is central to our mission of providing critical health information to the providers and patients of our community,” said Christopher Ryan, the hospital’s chief information officer.

Acknowledging receipt of this recognition, ACH President and CEO Scott Berlucchi, stated “We are pleased to be nationally recognized as a leader, along with 23 other New York state hospitals, in advancing healthcare excellence.”

Detailed results of the survey and study can be found in the July issue of Health & Hospitals Networks.

For a full list of winners, visit www. hhnmag.com.

Dr. Ryan Magnuson joins Crouse’s ICU Physician Ryan Magnuson, the newest member of Critical Care Associates, joins Crouse Hospital’s intensive care unit from the University of Rochester Medical Center, where he completed his fellowship in critical care medicine.

Magnuson previously served as medMagnuson ical director of the acute medical care inpatient unit at Strong Memorial Hospital and has served as senior instructor in the department of medicine, University of Rochester Medical Center.

Magnuson received his medical degree from the University of New England College of Osteopathic Medicine in Biddeford, Me., and completed his internship and residency at University of Connecticut Health Center in Farmington, Conn.

RMS Healthcare adds new professionals Two professionals have recently joined Research & Marketing Strategies, Inc. (RMS), based in Baldwinsville.

Peter Johnson joined as healthcare transformation specialist.

Johnson comes to RMS with 10 years of information technology experience and a vast knowledge of the healthcare industry.

"Peter's skills and extensive experience in healthcare Johnson information technology will prove to be a tremendous addition to the RMS Healthcare team," said Susan Maxsween, senior director of healthcare operations and compliance.

In his new role, Johnson will be responsible for assisting RMS Healthcare clients with individual project needs in preparation for NCQA approval. He will also assist clients in achieving Patient-Centered Medical Home (PCMH) recognition, as well as being involved in quality improvement initiatives relating to the PCMH model and patient-centered care. Johnson's demonstrated abilities in communication, customer service and administrative abilities will be instrumental in coaching practices through their healthcare transformation journey.

Johnson currently resides in Baldwinsville.

• Christine Benn joined as business development coordinator.

Benn previously worked at the Alzheimer's Association Central New York chapter. She holds a bachelor's degree in business marketing from Le Moyne College.

In her new position, Benn Benn cultivates client relationships to better understand and facilitate their marketing and research needs. She also coordinates client relations between the analytics and healthcare teams. Benn is also the main contact and liaison for RMS' CAHPS. products and services.

Benn is passionate about fitness and the outdoors, and enjoys travelling in her spare time.

Cheryle Nieset earns CRCP-P certification Cheryle Nieset, manager of billing and patient services at Nephrology Associates of Syracuse PC, has recently achieved certification as a certified revenue cycle professional (CRCP-P) through successful

completion of the American Association of Healthcare Administrative Management (AAHAM) examination.

AAHAM is the premier professional organization in healthcare Nieset administrative management and its mission is to provide education, certification, networking, and advocacy for healthcare revenue cycle professionals.

Nieset has an associate’s degree in computer science from Bryant and Stratton and oversees the front desk/reception area, billing, medical assistants and medical records staff at Nephrology Associates. She is also certified thru the American Medical Billing Association (AMBA) and has been with the practice since 2006.

Surgeon Evan Dentes joins St. Joe’s Physicians St. Joseph’s Physicians welcomes physician Evan Dentes to its team of surgeons. St. Joseph’s Physicians offers comprehensive surgical care for ambulatory, elective and critically ill patients. In his role, Dentes will provide general surgical services addressing a wide variety of medical conditions.

An accomplished physician and surgeon, Dentes earned his medical degree at SUNY Health Dentes Science Center in Syracuse, where he completed residencies in both medicine and surgery. He has been a member of the St. Joseph’s Health medical staff since 1981.

“We are so pleased to have such an experienced surgeon join our team,” said Julianne Himes, chief operating officer for St. Joseph’s Physicians. “Dr. Dentes brings a wealth of talent to the office; and having been a part of the St. Joseph’s family for nearly four decades, his commitment to our mission speaks for itself.”

Kate Rolf appointed to national health committee Kate Rolf, president and chief executive officer at VNA Homecare, has been appointed to a four-year term on the National Advisory Committee on Rural Health and Human Services (NACRHHS) of the Health Resources and Services Administration.

NACRHHS is comprised of a group of 21 nationally recognized rural health experts who advise the secretary of the Department of Health and Human Services on ways to address health care issues across August 2016 •

rural America.

Committee members offer first-hand experience dealing with rural issues in fields ranging from medicine, nursing and public health to law, finance and research.

As a committee Rolf member, Rolf will be responsible for helping to analyze key rural issues and for submitting recommendations for possible solutions.

Rolf brings a wide range of health policy experience to the committee. She has more than 20 years of leadership experience, complemented by a master’s in business administration, a home care executive certification (CHCE), a fellowship from the American College of Healthcare Executives (FACHE), and licensure as a New York State Nursing Home Administrator, among other affiliations and accolades.

“I am excited to have this opportunity to contribute to such an important body,” Rolf notes. “The potential to influence federal policy as it relates to rural America is an honor, especially given that approximately 1.5 million New Yorkers live in areas designated as rural by the United States Department of Agriculture.”

Oswego Health welcomes two psychiatrists Oswego Health welcomes two psychiatrists to its Behavioral Health Services (BHS) Department. They are: • Omar Colon, who recently completed a four-year psychiatry residency program at Bergen Regional Medical Center, the largest psychiatric hospital in New Jersey, which has 323 psychiatric beds and 1,070 nursing beds.

He was named chief resident of the center’s outpatient clinic during his third year of residency, which is an honor as it is a year earlier than most chief Colon residents are named. Also in his fourth year of residency he was named chief resident of academics where he was involved in providing teaching to the residents and medical students from accredited medical schools.

Colon, a native of Puerto Rico, has extensive training in child and addiction psychiatry as well as in different psychotherapy modalities. He is also certified in Suboxone maintenance treatment for patients suffering from opioid addiction.

He earned his medical degree from the Universidad Iberoamericana, located in Santo Domingo, graduating magna cum laude. Colon

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Distinctive Maternity Care.

At Crouse.

A

s the region’s premier provider of maternity care, Crouse is proud to be designated as one of the first hospitals in the nation to receive Excellus BlueCross BlueShield’s Blue Distinction Center+ for Maternity Care designation.

We thank our entire Kienzle Family Maternity Center team for this special recognition. We’re proud of the highly trained, experienced clinical staff and physicians who care for our mothers and their newborns — over 4,000 last year alone.

See why more babies are born here than at any other hospital in Central New York.

Visit crouse.org/babies

CROUSE

Kienzle Family Maternity Center

Blue Distinction Centers (BDC) met overall quality measures for patient safety and outcomes, developed with input from the medical community. A Local Blue Plan may require additional criteria for facilities located in its own service area; for details, contact your Local Blue Plan. Blue Distinction Centers+ (BDC+) also met cost measures that address consumers’ need for affordable healthcare. Each facility’s cost of care is evaluated using data from its Local Blue Plan. Facilities in CA, ID, NY, PA, and WA may lie in two Local Blue Plans’ areas, resulting in two evaluations for cost of care; and their own Local Blue Plans decide whether one or both cost of care evaluation(s) must meet BDC+ national criteria. National criteria for BDC and BDC+ are displayed on www.bcbs.com. Individual outcomes may vary. For details on a provider’s in-network status or your own policy’s coverage, contact your Local Blue Plan and ask your provider before making an appointment. Neither Blue Cross and Blue Shield Association nor any Blue Plans are responsible for non-covered charges or other losses or damages resulting from Blue Distinction or other provider finder information or care received from Blue Distinction or other providers.

Health News obtained his undergraduate degree from Pennsylvania State University.

At Oswego Health’s BHS division on Bunner Street, Colon will provide care to both inpatients and those utilizing outpatient services. In addition, he will be available to provide consults in the Oswego Hospital emergency room.

• Bentley Strockbine, who recently completed a fellowship in forensic psychiatry at Upstate Medical University and fulfilled his fouryear residency in psychiatry at Stony Brook University.

He earned his medical degree Strockbine at St. George’s University School of Medicine, located on the island of Grenada.

Along with earning a medical degree, Strockbine has a doctorate of philosophy in molecular and cellular pharmacology from Stony Brook University. His undergraduate degree in pharmacology was also earned at Stony Brook.

While studying for his degrees, he was presented with several awards and honors, including the Max Fink Award, for outstanding achievement in research, from Stony Brook University’s Medical Center, Department of psychiatry.

Strockbine said he was looking forward to providing care locally to those who suffer from anxiety, mood disorders and other general behavioral health concerns. He will provide outpatient care to residents aged 18 and older at Oswego Health’s BHS facility on Bunner Street in Oswego An avid runner, Strockbine will compete in several triathlons this summer, one in the Syracuse area and another in Buffalo.

Pomeroy College of Nursing Announces New 18 Months to RN Evening/Weekend Option

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rouse Hospital’s Pomeroy College of Nursing has announced a new option that will make it possible for students to attend classes and clinical experiences offered in an evening/weekend format, culminating in an associate degree in applied science with a major in nursing in just 18 months.

The New York State Department of Education recently approved the college’s 18 Months to RN Evening Track. Applications are being accepted now for the January 2017 start date. To learn more, visit crouse.org/ RNevening or call 315-470-7481.

“We are pleased to be able to offer a wonderful educational opportunity to students who may want or need a course of study outside the typical workday schedule,” says Rhonda Reader, DNS, RN, CNE, dean of the Pomeroy College of Nursing. “The 18 Months to RN Evening Track will particularly benefit those who need to balance the demands of work and family, while attending a nursing program.”

Students in the evening/weekend option will be able to take advantage of the same curriculum,

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dedicated faculty and access to the college’s state-of-the-art simulation lab that full-time day students experience. They will also begin clinical rotations at Crouse Hospital early in the first semester, Reader and be able to take both nursing and general education courses required to graduate.

Another advantage of the 18 Months to RN Evening Track is that while it is a full-time, continuous program, short breaks are provided between semesters.

“Students who complete our new 18 Months to RN Evening Track will transition to the workforce, or continued education, sooner than a traditional associate degree format,” says Dean Reader. “This timeframe is especially beneficial to those raising families or wanting to continue on in their nursing education.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

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Upstate Oncology Practice Selected For Initiative To Promote Better Cancer Care

he oncology practice at the Upstate Cancer Center has been selected by The Centers for Medicare & Medicaid Services (CMS) as one of nearly 200 physician group practices and 17 health insurance companies to participate in a care delivery model that supports and encourages higher quality, more coordinated cancer care. The Medicare arm of the oncology care model includes more than 3,200 oncologists and will cover approximately 155,000 Medicare beneficiaries nationwide.

Health

“We are pleased to be selected for this important transformation project, and welcome the opportunity to further embrace Upstate Cancer Center’s commitment to quality care and practice efficiency that help strengthen and enhance the care patients receive,” said Richard Kilburg, administrator for the Upstate Cancer Center.

“The oncology care model encourages greater collaboration, information sharing and care coordination, so that patients get the care

in good

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they need, when they need it,” said Health and Human Services Secretary Sylvia M. Burwell. “This patient-centered care model fits within the administration’s dual missions for delivery system reform and the White House Cancer Moonshot Task Force—to improve patient access to and the quality of health care while spending dollars more wisely.”

Practices participating in the five-year oncology care model will provide treatment following nationally recognized clinical guidelines

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for beneficiaries undergoing chemotherapy, with an emphasis on person-centered care. They will provide enhanced services to beneficiaries who are in the oncology care model to help them receive timely, coordinated treatment. These services include coordinating appointments with providers within and outside the oncology practice to ensure timely delivery of diagnostic and treatment services; providing 24/7 access to care when needed; and arranging for diagnostic scans and follow up with other members of the medical team such as surgeons, radiation oncologists, and other specialists that support the beneficiary through their cancer treatment The Upstate Cancer Center, which opened in the summer of 2014, brings much of Upstate’s ambulatory cancer care under one roof with some of the newest technology available in the fight against cancer, such as the Vero SBRT (stereotactic body radiotherapy system) for advanced treatment of lung, liver, panaceas and many other cancers, and TrueBeam with RapidArc, an advanced radiotherapy option that lessens treatment time, improving patient convenience. Add these new technologies to Upstate’s existing arsenal of cancer-fighting technology, including Tomotherapy and Gamma Knife Perfexion—and the Cancer Center provides the widest breadth of therapy options in the region.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 25

From left, Terry Spooner, Debbie Tyler, Adah Vaughn (RN with Madison County Health Department) and Terri Russo.

Three Madison County Practice Recognized for HPV Immunization Efforts

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hild Health Associates in Oneida, Family Health Center of Hamilton and Family Health Center of Morrisville have been recognized by the Madison County Health Department with its immunization champion award. The three practices showed increased vaccination rates to protect boys and girls between the ages 13 and 17 from HPV (human papillomavirus).

The driving force behind the campaign the New York State Department of Health and local health departments kicked off in early 2015, is “HPV vaccine is cancer prevention.” Madison County Health Department worked with 12 healthcare provider practices to increase the HPV vaccine series completion rate for 13 to 17 year olds. Health Department staff provided baseline vaccination rates to each practice, along with

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016

strategies and educational materials recommended from the Centers for Disease Control (CDC). Health Department staff continued to check in with each practice over the course of the year, providing an update on their practice rates in September, offering additional materials and assistance, and seeking feedback.

As a result, the Madison County report showed a 6 percent increase in the HPV vaccine series completion rate among 13 to 17 year olds in one year. This roughly triples the initial goal set. “We are proud of our healthcare providers, who have worked diligently to educate parents on the importance of their children receiving the HPV vaccine,” said Cheryl Geiler, director of community health for Madison County Health Department.

CDC Warns of Dangers of Plastic Surgery in Dominican Republic

Farnham Family Services Celebrates 45 years!

U.S. health officials are warning about the dangers of “medical tourism” after at least 18 women from the East Coast became infected with a disfiguring bacteria following plastic surgery procedures they had in the Dominican Republic.

The infections, caused by a type of germ called mycobacteria, can be difficult to treat. At least several of the women had to be hospitalized, undergo surgery to treat the infection and take antibiotics for months, according to the report from the U.S. Centers for Disease Control and Prevention.

“It’s a very mutilating infection.

They’re going for cosmetic surgery, and they will be scarred. It’s a terri-

ble scenario for people to go down there, get surgery and come back worse than they imagined they could be,” said physician Charles Daley, based in Denver.

According to the CDC, 21 women from six Northeast and Mid-Atlantic states appear to have been affected by mycobacterial infections after visiting five plastic surgery clinics in the Dominican Republic, a nation in the Caribbean.

F

arnham is a New York state-licensed, private, nonprofit organization that helps people with substance use and behavioral health disorders by providing high quality, recovery oriented, strength-based outpatient treatment and prevention services to all residents of Oswego and surrounding counties. There has been a lot of growth to get to this point.

In December 1970, The Crisis Center of SUNY Oswego opened in an abandoned dormitory, Farnham Hall. In June 1971, the project incorporated as Farnham Youth Development Center offering crisis hotline services, information, referral and counseling. Farnham continued to grow through the 80s providing a variety of services before discontinuing the hotline services and turning focus to clinical treatment for drug abuse in 1990. The first clinical state operating license was obtained in 1993. Prevention services began to develop evidence-based practices and student assistance counseling in school based sites. By 2001, Farnham was a fully integrated, state-licensed outpatient clinic serving people dealing with both alcohol and drug addiction and was also providing a comprehensive suite of community and school based prevention services.

Today, these services continue with the support of 28 staff and a $1.9 million budget.

Going forward, Farnham is adapting to meet emerging community needs through the development of an opiate treatment program.

This service will provide Medicated-assisted treatments, including Suboxone, Vivitrol and Methadone. We are hopeful to be operational in early 2017.

Farnham is also pursuing the development of Home and Community Based Services, Peer Supports, Continuing Treatment and In Community Services to better meet the needs of those dealing with addiction.

At Farnham Family Services, we work to uphold the highest degree of professionalism and to promote a caring atmosphere where those who are adversely affected by alcohol and other drugs can achieve their recovery goals.

We are pleased to have supported the community for 45 years and look forward to many more. If you need help there is no need to wait.

Treatment openings are available and we strive to get people in for assessments as quick as possible, usually within a few days. Do not hesitate, hope starts today!

Submitted by Farnham

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2016