In Good Health: ROC #207 - November 2022

U.S. Breast Cancer Death Rates Continue to Fall

Report: Despite drop, Black women much more likely to die from the disease

Breastcancer researchers and cli nicians have made tremendous progress in reducing death rates in the past three decades, yet a racial gap persists in the United States.

Even with the lower numbers of actual disease compared to white patients, Black women are still much more likely to die from the disease.

The American Cancer Society highlights these disparities in a new report.

“We found that despite contin ued progress in reducing the risk of death from breast cancer, there is an alarming persistent gap for Black women, who have a 40% higher risk of dying from breast cancer than white women despite lower inci dence. This is not new, and it is not explained by more aggressive can cer,” said report co-author Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society.

“We have been reporting this same disparity year after year for a decade. It is time for health systems to take a hard look at how they are caring differently for Black women,” Siegel said in a cancer society news release.

While Black women have 127.8

cancer cases per 100,000, versus white women with 133.7 cases, they have 40% higher death rates, the report says.

Moreover, for every 19.7 white women per 100,000 who die of breast cancer, 27.6 per 100,000 Black women will die. Among women younger than 50, the death rate is twice as high for Black patients.

Black women remain the least likely of any racial or ethnic group to be diagnosed while their breast cancer is at a localized, more easily treated, stage — at 57% versus 68% in white women, researchers found. They also have the lowest five-year survival rate of any racial or ethnic group for all breast cancer subtypes and stages, except stage 1. The largest gaps were between stage 3 and stage 4.

Gaps also exist for American In dian and Alaska Native women, who are 17% less likely to be diagnosed with breast cancer than white wom en, but 4% more likely to die from the disease.

The U.S. death rate from breast cancer dropped by 43% overall between 1989 and 2020, with 460,000 fewer deaths. The cancer society attributed that to earlier detection

through screening, increased aware ness and advances in treatment.

That pace of decline has slowed. While death rates dropped about 1.9% annually from 2002 to 2011, they dropped 1.3% annually between 2011 and 2020. That may, in part, reflect increased incidence.

“The slow decline in breast can cer mortality during the most recent period partly reflects stagnant screen ing uptake and suboptimal receipt of timely and high-quality treatment,” said study co-author, physician Ahmedin Jemal, senior vice president of surveillance and health equity science for the cancer society.

Jemal called for coordinated and concerted efforts by policymakers, health care systems and providers to

deliver the best breast cancer care to all populations. This includes ex panding Medicaid in the non-expan sion Southern and Midwest states, where Black women are dispropor tionately represented, he said.

“Also, increased investment is needed for improved early detection methods and treatments,” Jemal said in the release.

Cancer advocates called on law makers to provide funding for the National Breast and Cervical Cancer Early Detection Program, a program jointly funded by federal and state governments that helps improve ac cess to lifesaving breast and cervical cancer screenings.

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While Black women have 127.8 cancer cases per 100,000, versus white women with 133.7 cases, they have 40% higher death rates, a recent report says.

Meet Your Doctor

By Chris Motola

Saurabh, M.D.

Katie Couric Announces Breast Cancer Diagnosis

Former TV newswoman and TODAY show anchor Katie Couric has breast cancer.

Couric shared that informa tion late September on Insta gram, while also releasing an essay about the experience on her media website.

“Every two minutes, a woman is diagnosed with breast cancer in the United States,” Couric wrote on Instagram. “On June 21st, I became one of them.”

Couric, 65, received her cancer diagnosis in June, had a lumpectomy on July 14 at NewYork-Presbyterian/Weill Cornell Medical Center and then began radiation treatments on Sept. 7, TODAY.com reported.

The anchor’s name is often associated with cancer aware ness because her first husband, Jay Monahan, died from colon cancer at 42, when their children were young. Couric has long been a spokeswoman for getting colonoscopies to catch cancer early.

Couric wrote about sharing her cancer news with her daugh ters, Ellie, now 31, and Carrie, 26.

“Finally, four days after I was diagnosed, I FaceTimed each of them,” she wrote. “I tried to be as reassuring as Dr. Newman. Their faces froze in disbelief. Then shock. Then they began to cry. ‘Don’t worry,’ I told Carrie then Ellie, ‘I’m going to be fine,’ trying to convince myself as well as them.”

“They’d already lost one parent. The idea of losing an other was unfathomable,” she wrote.

Although Couric’s family has no history of breast cancer, the family has endured many cancer diagnoses and deaths. In addition to Monahan, Couric’s sister died at age 54 from pan creatic cancer. Her mother-inlaw died from ovarian cancer. Her parents also have a cancer history.

“Please get your annual mammogram,” she wrote. “I was six months late this time. I shudder to think what might have happened if I had put it off longer. But just as importantly, please find out if you need addi tional screening.”

Q: You’re a relatively new arrival Up state New York, right?

A: Yes, we just relocated from Manatee County in Florida.

Q: Good timing.

A: Yeah, I know. Florida was a good place to stay, but my wife and I had a desire to live in Upstate New York for sometime. She’s originally from New York, from Long Island, but her family has since moved to Niagara Falls. So we’ll be closer to the in-laws. And we enjoy all four seasons.

Q: What do you like about the area now that you’re here?

A: We used to come here every winter between November and De cember. So I’d been quite acquainted with this place. We’ve been here in the fall and seen all those beautiful colors. There are a lot of hiking trails here, which we love. And Thompson Hospital and my clinic is just across the lake. I have my lunch by the lake and de-stress. The weather here is so nice. In Florida I feel like I can’t breathe. It’s too hot and humid. You wake up and it’s already hot.

from 2019 to 2022, but before that I was teaching in Florida. Before that I was in the Caribbean for a good six or seven years as the dean of two medical schools. Before that I was in Mauritius, a small French island near Madagascar. I was teaching and practicing medicine there. Before that I was in India.

Q: So you’ve seen a lot of different med ical systems. What’s your broad take on the various medical systems? What did you like or not like about them?

A: It’s been awhile as I left India in 2008. But in India, the patient volume is too much. It’s a huge, expanding population, so it puts a lot of stress on the medical system. The only difference I noticed com pared to Western medicine, espe cially America, is that anyone who is board-certified takes patients in a guideline-based approach. It’s a very focused approach here, and the doc umentation is top notch. I remember back in the day having to go through pages of handwritten notes that you couldn’t always read; it was chaos. Things are much more regulated. I love it. Medicine doesn’t really change, but the ways of practicing it do. I learned a lot in the last three years. I’d been teaching it before that, but teaching and practicing aren’t

Q: What kinds of patients will you

A: I usually see patients who are 18 and above. I provide general family med icine care and preventive medicine, covering every thing from common colds to diabetes and heart fail ure. Preventive medicine is my favorite part: are they up-to-date on their vaccinations, colonos copies, blood work. And I do office-based proce dures as well.

Q: What are some of the most important factors to consid er with preventive care?

A: I personally believe, with the expe rience I have now, that patient education is the number one thing. The patient needs to be aware of what needs to be done and what’s

impact of that on their future health. If they understand it, they’re more likely to follow your recommenda tions. I’ve seen both sides of out comes. Patients who aren’t following advice starting to present with cancer or diabetes after many years. Pa tients who follow the advice and are well-informed are staying healthy. So I totally believe the impact we can make in preventive medicine is brought about by educating the com munity and educating the patient.

Q: Do you see opportunities to apply your previous subspecialty training now?

A: Toxicology and pharmacolo gy? I worked in India at the National Poison Center. I’d been curious about toxicology for a long time, and India it’s a three-year M.D. program. But I’ve used this in the hospital system here. In the hospital you see a lot of poisoning: organophosphate poison ing, alcohol poisoning, drug overdos es, unknown substance overdoses. I personally believe no education goes to waste.

Q: What is organophosphate poison ing?

A: It’s a poison farmers spray on the crops so that they’re not de stroyed by insects and that kind of thing. When they spray it, they can breathe it in, or it can be absorbed through the skin and cause poison ing.

Q: So I’ve got to ask about your name. You go by a single name, Saurabh, or Dr. Saurabh. Why is that?

A: It’s a common practice in some parts of India that the parents never use their last names for them selves. Society in India is divided into a caste system. With a last name, you can know which caste I belong to, which county I’m from, what religious practice I follow. You can pinpoint me down. So my dad never believed in that concept, so he told me and my brother, “You’ll just go by your first names.” Our family does have a last name, but none of my documentation, my passport, none of these had my last name. In the rest of the world I was able to fly by without that. But when I came to America, the USCIS said we’ll give you your only name as a last name, and we’ll give you another name: No Name Given (Nng). So people here will call me Dr. No, and I will respond to it. So my driver’s license, my bank account, everything has No Name Given. If somebody adopts me, I can choose a last name.

Lifelines

Name: Saurabh, M.D.

Position: Internist with Canandaigua Medical Group

Hometown: Niagara Falls (adopted). Current residence: Farmington Education: Himalayan Institute of Medical Sciences, Dehradun, India; medical degree in clinical pharmacology and toxicology at Lala Lajpat Rai Memorial Medical College in Meerut, India.

Affiliations: FF Thompson Hospital Organizations: American College of Physicians, American Academy of Family Physicians, American Heart Association

Family: Wife, son Hobbies: Hiking, golf

Globetrotting doctor settles in the Finger Lakes area, compares health systems here and abroad and explains why he uses only his first name

Riddle Wellness

HealthcareinaMinute

By George W. Chapman

Drug Costs Soar

Last year, we spent $603 billion on drugs. That’s about $1,800 per person in the US. Half of the $603 billion was spent on spe cialty drugs alone. Soaring prices, not increased utilization, drove up the overall drug spending. Specialty drug prices have increased a staggering 43% over the last five years. To reign in drug costs, the Inflation Reduction Act caps all Medicare Part D drug price increases at the inflation rate and out-ofpocket spending for Medi care members is limited to $2,000 annually. This went

Trinity Health Losses

The 88 Catholic hospital system lost $1.4 billion in the fiscal year just ended June 30.

St. Joseph’s in Syracuse and St. Peter’s in Albany are local members. Two other national Catholic hospital systems, CommonSpirit and Ascen sion (Lourdes in Binghamton), lost almost $2 billion each. Deficits were attributable to declining revenues and significant contract labor (mostly nursing) costs. In fairness to hospi tals, their fees are either predeter mined by Medicare and Medicaid or predetermined with commercial insurers. So, unlike drug manufac turers, they cannot arbitrarily raise prices to increase revenues.

Large national hospital systems have not fared much better than smaller local or regional hospital systems. Industry observers have speculated that the smaller systems (comprised of “across the street mergers”) may be more efficient because their proximity allows them to share clinical staff, consolidate overhead, and merge departments.

Industry experts Kaufman and Hall don’t see things improving for hospitals through next year. If hospi tals continue to lose money, they will

into effect Oct. 1, 2022. In addition, Medicare will finally be allowed to negotiate a handful of drug prices — but not until 2026. Seemingly in an ticipation of prices being controlled by Medicare, drug manufacturers increased the prices of some 1,200 products an average 31.6% from July 2021 to July 2022. In the meantime, physicians are lobbying Con gress not to cut their payments by almost 5% next year. With inflation at 8%, the 5% cut is tantamount to a 13% decrease in reimburse ment.

be forced to make painful staff cuts, mostly in non-clinical areas, to keep their doors open.

Medicare Open Enrollment

You are eligible for Medicare the month you turn 65. Open enrollment, which began this Oct. 15, allows peo ple to change their plan for 2023.

Medicare anticipates the trend to enroll in Advantage plans will continue with 32 million seniors, or more than half of all eligible seniors, enrolling. Advantage plans are oper ated by commercial carries like Unit ed, Humana, Aetna, Blues, Cigna and Anthem. As the popularity of Advan tage plans grows, so do the markets served by the carriers. These plans offer more services than traditional Medicare, often for no additional cost, such as dental, vision, hearing, transportation and even meals.

Incredibly, Advantage Plan premiums are expected to decrease 8% in 2023. Open enrollment for the Affordable Care Act and most employer plans began Nov. 1. The Kaiser Family Foundation estimates ACA premiums will increase 10% and commercial-employer premiums about 7%.

Nurse Practitioners in Mental Health

Prior to the pandemic, 11% of adults suffered from depression and anxiety. Since the pandemic, it is up to 40% of adults.

As the stigmatization associated with mental health declines, more and more people are seeking treat ment. But therapists are struggling to keep pace and meet the demand.

Adding to the problem, since 2011, the number of practicing psychiatrists (MDs) has declined 6%. Most don’t accept Medicare and many don’t accept any insurance. Psychiatric nurse practitioners are increasingly critical in providing mental health services. Their num bers have increased 162% since 2011. Since then, NPs have provided 30% of all mental health visits. Start-up companies are assisting these NPs with establishing and running their private practices by lowering over head and billing costs and contract ing with both Medicare and commer cial insurers.

Consumer surveys reveal 70% of respondents worry about their men tal health coverage. Many plans still restrict coverage or have expensive copays.

Out of Pocket Costs Concerning

A survey of 8,000 adults by the Commonwealth Fund revealed insurance does not provide enough financial protection against rising healthcare costs.

43% of those surveyed were inadequately covered and 9% had no coverage. 29% of those with employ er sponsored insurance and 43% of those with individual insurance were underinsured because of high outof-pocket expenses like deductibles and copays. Underinsured is defined as spending more than 10% of your income on out-of-pocket costs. 50% of those surveyed said they could not pay an unexpected medical bill of $1,000 within 30 days. Pollsters West

Health Gallup asked 5,000 adults to grade US healthcare for affordability, equity, accessibility, and quality. 44% of respondents graded US healthcare “F” and 33% graded it “D.” Only 22% of those taking the poll rated US healthcare either “A” or “B.”

Virtual Care Offering

Virtual care was growing VERY slowly in the several years prior to the pandemic.

The technology was there, but the acceptance by both providers and consumers was not.

The pandemic caused virtual care, by necessity, to rapidly prolif erate. It is now widely accepted by insurers, providers and consumers and it is integral to healthcare access and delivery.

The Massachusetts Blues have teamed up with the Carbon and Fire fly healthcare systems to offer their members virtual primary and mental health care by early 2023. The Blues are touting better outcomes, easier access, lower costs, less anxiety and improved outcomes. There will be no copays. You will be able to access your provider via laptop, desktop or phone. In addition to no commuting, waiting times will be minimal. There will be wellness coaching and sup port and specialists will be engaged, as necessary. The Blues will also provide free medical devices, such as blood pressure monitoring, to its members. United Healthcare, Aetna and Cigna are all considering similar products.

George W. Chapman is a healthcare busi ness consultant who works exclusively with physicians, hos pitals and healthcare organizations. He op erates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapman consulting.com.

1 in 7 U.S. High School Students Now Vapes

Teen vaping continues at con cerning levels, U.S. health offi cials reported in October. About 2.5 million middle school and high school students reported that they had vaped in the past 30

about 85% used flavored e-cigarettes. The brands they used were Puff Bar, with 14.5% calling it their usual brand, Vuse at 12.5%, Hyde at 5.5% and SMOK at 4%. More than half used disposable e-cigarettes. Most

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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.

: Wagner Dotto

George Chapman, Gwenn Voelcker, Anne Palumbo, Jennifer Faringer, Ernst Lamothe Jr. Naz Baecher (MD), Christine Walsh

• Advertising: Anne Westcott (585-421-8109) • Linda Covington

Are You Facing Thanksgiving Alone?

Ifyou are facing Thanksgiving alone for the first time, you may be anticipating a lonely and de pressing fourth Thursday of Novem ber.

But it doesn’t have to be so.

Whether you’re divorced, wid owed or just can’t make it home for Thanksgiving, this family-centered holiday can be an opportunity for personal growth and expression. Plus some fun, too!

Below are some tips and creative ways to manage and embrace what can be a challenging day in the life of those alone this time of year.

• Be thankful — And why not start with yourself? Consider making a list of all the things you are thank ful for this year: Your health? Your children? Good friends who have stood by you through thick and thin? A career or volunteer job you love? A beloved pet? Or perhaps even this opportunity now to experiment and learn new things about yourself?

• Take the long view — While you may be alone this year, it doesn’t mean you’ll be dining solo on left over turkey the rest of your life. This one day doesn’t dictate your destiny.

Who knows what the future holds? Over the next year, you may meet someone special or achieve a measure of inner peace and confi dence that enables you to enjoy a hol iday on your own or with a “family of friends.”

• Do good — Helping others this time of year can take your mind off

being alone and give you something worthwhile to do. Shel ters and food kitchens often welcome vol unteers, but, truth is, many of these agen cies fill up fast with regular volunteers. You may need to plan and be creative.

As an alternative, many local YMCAs host Turkey Trots and need volunteers to register and cheer on runners of all ages. Instead of serving stuffing at the shelter, you could be serving up smiles at the finish line.

• Throw your own little holiday dinner for fellow “strays” or “untethered” friends — Have some fun! It doesn’t need to be elaborate or even planned far in advance. Sometimes last-min ute dinner invitations can turn into the best, most memorable get-togeth ers.

Chances are you know others who may be alone this Thanksgiving. Extend a warm invitation and invite your guests to bring along a beverage or holiday side-dish to pass. This gives everyone a chance to make a meaningful (and delicious!) contri bution.

• Beware of “euphoric recall” — When you are feeling lonely, it can

be easy to glorify the past. Did last year’s Thanksgiving live up to the Norman Rockwell ideal? Or did all the bickering, bad blood, and woo zy, overstuffed relatives make you want to run for the hills? Maybe, just maybe, being with your own good company is a blessing.

• Rent a movie and indulge in a tasty guilty pleasure — Oh, why not? Rent a favorite “feel good” film and make a night of it. You might check out “Tootsie” or “On Golden Pond,” two of my favorite oldies, which never fail to warm my heart.

Or find a new movie you haven’t seen and enjoy the novelty of seeing something for the first time. Top it off with a favorite treat. I love every thing pumpkin this time of year: pumpkin soup, pie, ice cream and fry cakes!

• Pick up the phone — I’ve mod ified one of Abe Lincoln’s famous quotes for my own purposes: "Folks are usually about as lonely as they make up their minds to be." The difference between isolation and engagement can be as simple as sending a text or dialing a seven-dig it phone number.

My experience happily tells me that most folks welcome a call on Thanksgiving. Why not pick up the phone to connect with out-of-town friends and family members? Catch up and make their day, as well as yours, a little richer.

Or connect locally with a neigh bor or friend with an invitation to go for a walk around the block or see a matinee while the turkey is in the oven. Many folks welcome the diversion and chance to get out of the kitchen before or after the big feast.

• Decorate your home inside and out. — Do it for you. It may help put you in the spirit of the holiday. This past weekend, I recreated my annual stacked-pumpkin display for my front porch. It gives me a warm feel ing every time I pull up to the house.

Add harvest accents to your

home and feel the essence of Thanks giving in your heart.

• Nurture yourself — On your own, Thanksgiving can be a great day to do whatever you enjoy doing. Carve out well-deserved time to read, do some early online shopping for the holidays, give yourself a man icure or whatever tickles your fancy.

On Thanksgiving Day, I plan to nurture myself with a solo walk in the woods, where I find peace and feel connected to all living things: trees, birds, critters and insects — even creatures I can’t see within the ponds, underground and in the sky.

I never feel alone when I’m in na ture and use the time alone to count my blessings and be grateful.

So pamper yourself for at least 30 minutes and take a mini-vacation from your worries, doubts and fears. Then seize the day with a renewed outlook on life.

• Write “thank you” notes — Now here’s an idea that’s so obvious it of ten gets overlooked on Thanksgiving. “Build bridges the rest of the year, and cross them during the holidays,” said Craig Ellison, PhD, author of “Saying Goodbye to Loneliness and Finding Intimacy.” If you can’t be with friends or family this holiday, pick up a pen and thank them for their support and friendship.

Who wouldn’t love to receive a hand-written card after Thanksgiv ing that begins, “I’m sitting here on Thanksgiving morning thinking of you. On this day of thanks, I can’t help but be thankful for our (fill in the blank).”

In preparation for this kind gesture, purchase cards and stamps in advance.

There you have it: Survival tips for a single-serving Turkey Day. The good news? It will be Friday before you know it and you can look back and be proud of yourself for rising to the occasion and treating yourself to big helping of joy and gratitude this Thanksgiving.

Playing sports can benefit children in many ways, but all sports are not equal when it comes to their bones.

New research suggests children will have healthier bones if they participate in multidirectional sports such as soccer or basketball, rather than unidirectional activities such as running.

Mixing it up a bit with a variety of sports instead of focusing on just one is also less likely to lead to over use injuries, the researchers noted.

“Our data shows that playing multidirectional sports when young er versus specializing in one sport, such as running, decreased a per

son’s bone injury risk by developing a bigger, stronger skeleton,” said study author Stuart Warden. He is associate dean of research and pro fessor of health and human sciences at Indiana University-Purdue Uni versity Indianapolis.

“There is a common mispercep tion that kids need to specialize in a single sport to succeed at higher levels,” Warden said. “However, recent data indicate that athletes who specialize at a young age are at a greater risk of an overuse injury and are less likely to progress to higher levels of competition.”

While researchers have tra ditionally looked at bone mass to

determine skeleton health, previous studies by Warden’s team have found that bone mass and size are equally important.

For this study, they used high-resolution imaging to examine bones in the shins and feet of women who compete in college cross-coun try running. These athletes often suffer bone stress injuries, such as stress fractures.

The investigators found that the women who participated in both running and multidirectional sports when younger had 10% to 20% great er bone strength compared to their counterparts who only ran.

In addition, those who had played sports like soccer or basket ball when younger had better bone structure and strength than those who solely ran, swam or cycled, the scans revealed.

“We want to ensure people have better, stronger bones as they grow, become adolescents and go through life,” Warden said in a university news release. “Specializing in one sport at too young of an age means they are more likely to get injured and not make it at the collegiate and professional levels.”

Athletes should be given time to allow for proper growth and devel opment, not specializing until at least their freshman year of high school, Warden advised.

Those who already play multiple sports should take time off for rest and recovery during the year, he added. This can improve both bone strength and performance.

The findings were recently pub lished in the journal Medicine and Science in Sports and Exercise.

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Are We in the Midst of an Opioid Epidemic or Fentanyl Epidemic?

By Jennifer Faringer

Along with our colleagues in prevention, treatment, recov ery and harm reduction, the National Council on Alcoholism and Drug Dependence-Rochester Area (NCADD-RA) has worked to increase awareness of the opioid epidemic and its impact on our community and families. We continue to use a variety of evidence-based prevention environmental strategies along with educational sessions for professional and community groups.

In 2016, we invited a group of stake holders to join our collaborative efforts for what is now the Opioid and Other Drugs Task Force in Mon roe County. The robust membership has continued to grow and broaden, meeting bimonthly to identify service

delivery gaps across the continuum, share resources, network, and to combine efforts. We continue to meet virtually on a bimonthly basis with membership remaining strong and engaged. As a result of collaborative and collective efforts to reduce harm across the continuum of care:

• Narcan was made more widely available to emergency responders and then to the general public.

• Prescription monitoring pro grams were implemented state-bystate (I-STOP in NYS).

• Availability of and access to medication-assisted treatment was increased.

• Prevention providers and coalitions are distributing medication disposal pouches and lock boxes for

securely storing medications.

• Through recent grants, the NCADD-RA has increased media and community awareness campaign efforts focusing on both the risks of opioids and a call to stop the stigma that surround both affected individu als and their families.

• Prevention providers and coalitions have joined efforts with the Drug Enforcement Agency’s (DEA) Take Back efforts.

The results have yielded a drop in opioid medication availability and overprescribing plummeting 50 per cent nationally. Despite efforts and advances, opioid overdose deaths have continued to rise, more than tripling between 2010 and 2020.

According to the Centers for Disease Control (CDC), 107,622 Americans died of drug overdoses in 2021, with 66 percent of those deaths related to synthetic opioids like illegal fentanyl. More recent medi cal examiner reports have mirrored this, showing fentanyl at the top of their list, identifying substances as primary cause of death. In 2020, over 98.3 percent of overdose deaths were attributable to illicit fentanyl, com pared with 10.9 percent to prescrip

tion pain medication and 8.8 percent to heroin.

Street level drugs are almost cer tain to contain very high percentages of fentanyl or may even be 100 per cent fentanyl. The synthetic opioid fentanyl is 50 times more potent than heroin and 100 times more potent than morphine. Only two milligrams of fentanyl, equal to 10-15 grains of table salt, is considered a lethal dose. While there is no way to know how much fentanyl is concentrated in a pill or powder, harm reduction programs are distributing test strips to detect the presence of the synthetic opioid.

If you encounter fentanyl in any form, do not handle it and call 911 immediately. In Monroe County, we continue to receive reports of increas ing overdoses which are due primar ily to street drugs laced with illicit fentanyl. The prevalence of fentanyl in a range of street drugs that in cludes pills which may be of various colors, as well as the incidence of look-alike fake pills, remains high.

In NCADD-RA’s Spring 2022 Newsletter, the cover story refer enced DEA’s “One Pill Can Kill" public awareness campaign (www. dea.gov/onepill) to increase aware ness of the dangers around fake pills. Resources for parents and the com munity can also be found on DEA’s fentanyl awareness page (https:// www.dea.gov/fentanylawareness). Additional resources for parents and community members that include community referral directories, com munity awareness campaign materi als and much more may be found on the NCADD-RA’s website at https:// ncadd-ra.org.

Jennifer Faringer is the director of the National Council on Alcoholism and Drug Dependence — Rochester Area.

Laura

& Awith Beth Ciardi

Director of Golisano Autism Center talks about her nonprofit and its work

By Mike Costanza

The Golisano Autism Center brings 12 local nonprofits, in cluding AutismUp, CP Roch ester and the Al Sigl Community of Agencies, together under one roof to provide services for those who have autism and their families.

The neurological disorder, which is clinically referred to as autism spectrum disorder, can affect the mental, emotional and physical func tioning of an adult or child, resulting in a variety of symptoms. While some who have autism can live fully independently, others require fulltime care and support.

Though the GAC has but two full-time and one part-time employ ee, through its efforts 130 staff and volunteers collaborate to serve about 2,300 individuals and families each year.

In Good Health spoke to Beth

Ciardi, the Golisano Autism Center’s director, about her nonprofit and its work.

Q: What is autism spectrum disorder?

A: Autism spectrum disorder is a neurologically based develop mental disorder that can present with difficulties in social interaction, communication challenges, intel lectual disabilities, gross and fine motor delays, sensory impairments and medical issues. It varies widely in severity and symptoms and lasts throughout a person’s lifetime. The earliest signs of autism typically oc cur during the first three years of life and may develop gradually.

Q: What makes autism a spectrum dis order?

A: Autism being a spectrum disorder means people can have varying abilities and support needs.

One third of autistic people also have an intellectual disability. Some have high support needs, which may mean that they require full time care and support. Some people may need a bit of support with day-to-day activities, while others live fully inde pendent lives. With proper support and creative opportunities, most peo ple with autism live fulfilling lives.

Q: Does ASD present itself in other ways?

A: Those who have ASD often experience sensory sensitivities and medical issues, such as gastrointes tinal disorders, seizures, or sleep issues, as well as such mental health challenges as anxiety, depression, and attention and learning issues.

Q: How many adults and children are on the autism spectrum?

A: It is estimated that more than 10,000 individuals have an autism diagnosis in Monroe County and that one in 44 children in the US has been diagnosed with autism. It is more common in males than in females and occurs in all racial, ethnic, and socio-economic groups.

Q: How does GAC support people with autism and their families?

A: The Golisano Autism Center has transformed the delivery of au tism services in the region by provid ing a comprehensive, enriched and innovative model that co-locates and coordinates resources offered by mul tiple providers who are experts in their specific autism service areas. It is a national model for support and a gateway to high-quality, person-cen tered and sustainable supports and services.

Q: What kinds of clients does GAC serve?

A: We primarily serve individu als with intellectual and/or develop mental disabilities, particularly au tism, and their families. Autism is a lifelong disability and our collabora tive partner providers currently serve those ranging from children who are 12 months old to aging adults.

Q: Can you tell us of some of the ser vices that GAC provides through its col laborators for those with autism and their families?

A: GAC provides a continuum of services that span a lifetime and offer a full array of coordinated program options for infants, toddlers, youth, teens and adults. These include early

intervention, preschool and child care services, an outpatient clinic, behavioral and primary care sup ports, and respite services. GAC also offers care management, community habilitation, social, recreational and therapeutic services and transition age programs. Clients can also obtain assistance with housing and employ ment.

Q: GAC also has a family and peer nav igation program. Can you give us some details of that program?

A: GAC’s Family and Peer Navigation program is collaborating with AutismUp to empower autis tic individuals and their families to overcome the challenges and barriers they face to reach their full potential. The program provides individual support services, along with edu cational and training workshops specific to autism. Our family naviga tor is a parent of an autistic child and our peer navigator is an autistic adult. The support they provide is coming from a compassionate place of somebody who has knowledge of the systems that are navigated once receiving an autism diagnosis and the different types of services one can receive here inside of the GAC or out in the community.

Q: What kinds of challenges does GAC face right now?

A: There are still many who are unaware of what we do and that we are here to help. The autistic popu lation consists of people of all racial and ethnic backgrounds and people of diverse sexual orientations and gender identities. The intersection alities are vast and ensuring inclu sivity for all who are neurodiverse is crucial to social change.

Q: How will GAC solve that problem?

A: Opportunities for community outreach are essential to informing the public about us and is why we appreciate the feature in In Good Health. In addition, information about our Autism HelpLine is posted throughout Monroe County and is another way individuals and families can connect with us.

For more information on the Goli sano Autism Center, go to: https:// www.golisanoautismcenter.org

Is Peloton Worth It?

By Deborah Jeanne Sergeant

During the pandemic, Peloton exploded in popularity as homebound people explored ways to get fit and stay active.

The exercise equipment man ufacturer makes not only exercise bikes but also programs to keep users moving and motivated.

The combination of equipment and programming proved so suc cessful during the pandemic that the company struggled to keep up with demand.

But does Peloton live up to the hype?

For around $2,500, the bike comes with a rotating screen so that users can participate in cycling on the stationary bike and in non-biking classes. Peloton also makes a tread mill (around $3,500) and a rowing machine (around $3,100). In addition to the equipment, users can sign up for a separate membership for $44 a month to access all the Peloton programming, accessible to the entire household.

Kerri Howell, online personal trainer, nutrition coach and owner of Rochester-based fitprmomlife.com, owns a Peloton.

“It depends on the person, Howell said. “The membership is comparable to a gym, so the value is consistent with what you’d pay

but you don’t need to drive. For some, that 15- to 30-minute drive is a lot. If they don’t prefer to go to the gym, they can get a community and accountability.”

Tuning into a live session can offer real-time feedback and account ability. Or users can select pre-record ed sessions.

Howell said that programming includes classes in yoga, stretching, walk, running and resistance.

“It’s not just the bike,” she said. “You can see who else is in the course and connect with them. There’s a social aspect and community. Some people do better with a program but they’re not comfortable with the gym.”

Another layer of anonymity may provide a protective buffer, but it also forces users to rely solely upon themselves to feel motivated to par ticipate and to participate fully once involved. There’s no one to check in on them if they do not show up or to monitor form and progress as they participate.

“Peloton relies on self-disci pline,” Howell said. “You have to get on the bike or pick up the weights. At the gym, you might be in a class and you’ll be less likely to skimp. If some one wants a variety of fitness options in their own home, it’s worth it.”

Napping Linked with Higher Stroke Risk

By Deborah Jeanne Sergeant

Anewstudy released in a recent issue of the journal Hyperten sion indicates that daytime sleep sessions may increase risk of hypertension and ischemic stroke.

Local experts do not lay the blame with napping itself. The study included 358,451 UK participants. It found an association, but that does not establish a causal relationship between napping and higher stroke risk.

Many people with a sleep dis order nap to make up for their sleep deficit. For example, some people need to nap to make up for sleep lost because of sleep apnea, a condition for which obesity is a high-risk factor. Obesity is a risk factor for COPD, congestive heart failure and hyper tension. These issues also raise risk for stroke.

“Sleep affects many of our important faculties and functions: memory, blood pressure, cardiac rhythm, mood and overall physical good feeling,” said Robert Newman, night supervisor at the Sleep Disor der Center at St. Joseph’s Health. “If you don’t get enough sleep, you may suffer from poor memory, high blood pressure, arrhythmias such as atrial fibrillation — palpitations — bad moods, feeling flat, achy and lethar gic. Sleep well; live well.”

Napping is not directly related to

the increased risk for stroke. Some one who exercises and works hard but is overall healthy would have no reason to think naps lead to stroke instead of someone with medical problems that disrupt sleep and con currently raise risk of stroke.

“The study describes an asso ciation between frequency of naps and stroke and not a cause effect,” said Ali El-Solh, associate chief of staff for Research at Veterans Health Administration at Western New York Healthcare System in Buffalo. “First the study was based on self-reporting and not on an objective measure of naps and did not include duration of naps. So, is napping for 30 minutes, one hour, or two hours more likely to result in stroke? The article does not address this question.

“Second, napping could be indicative of another disease that could be linked to stroke. For exam ple, patients with congestive heart failure may nap more because they feel tired. Congestive heart failure is known to be associated with stroke. We assume that napping causes stroke while in reality it is a symptom of another disease linked to stroke. The bottom line is that the study raises more research questions but should not change practice or behavior yet.”

Napping can help people who

Dave Pfaff, a certified personal trainer with AMP Fitness in Penfield, said that some of his busy clients like the option of an at-home workout. While not as personalized as using a trainer, “moving is better than noth ing,” Pfaff said. “If you like it, use it.”

Peloton offers a rental option and month-by-month program option.

But Pfaff does not see the ne cessity of buying a Peloton to stay fit at home when family obligations or winter weather keeps one home bound.

“There’s so much stuff at home that you can do,” he said. “I feel it’s a piece of equipment that’s overpriced. But if you bought it, maybe you won’t just let it sit there. Yet, there are so many other things you can do if you have the motivation, like dumbbells, resistance bands, a yoga ball and medicine ball for a full body workout at your house.”

The numerous free videos on YouTube can also provide guidance for home-based workouts.

occasionally need more rest. People who cannot make it through the day without napping should contact a sleep specialist to determine the un derlying reason for their lack of rest.

Instead of replacing lost sleep with excessive napping, most experts agree that improving sleep hygiene can promote restful sleep at night. Sleep hygiene refers to creating the right context for sleep. Newman en courages clients to “keep a consistent sleep schedule. Go to bed at the same time and wake at the same time if your work schedule allows.”

The sleep environment also mat ters. A chaotic, busy sleeping place does not promote good rest.

“Try to keep outside stimuli such as light and noise out to a mini mum,” Newman said. “Light from phone and television screens emit blue spectrum light which suppress es melatonin, a key chemical that the body uses to induce sleep.”

What a person does directly before sleep also matters.

People should exercise earlier in the day, not directly before bed as that can raise their body temperature. Engaging in quiet activity before bed and avoiding screens can help promote a restful night’s sleep.

“Try not to eat and drink within four hours of going to sleep, reduc ing the need for middle-of-the-night bathroom breaks,” Newman suggest ed.

The bedroom should be dark, cool, and quiet. The bed should be used only for rest and intimacy, not watching television or other activ ities. The bedroom should be com fortably appointed and should not contain items that induce stress, such as a basket of unfolded laundry or stack of bills. By focusing on only in the bedroom, people can cue their body to relax and sleep.

Peloton bike: The company makes not only exercise bikes but also programs to keep users moving and motivated.

Things You Need to Know About Allergies

By Ernst Lamothe Jr.

Allergies

can be both unpredict able and inconvenient.

Whether you are dealing with seasonal issues or year around nuisances, there are various factors that affect your sinuses. Climate change will potentially lead to both higher pollen concentrations and longer pollen seasons, causing more people to suffer more health effects from pollen and other allergens, according to the Centers for Disease Control and Prevention.

Pollen are tiny seeds dispersed from flowering plants, trees, grass and weeds. The amount and type of pollen in the air depends on the sea son and geographic region. Though pollen counts are typically higher during the warmer seasons, some plants pollinate year-round.

“Multiple factors may contribute to environmental allergies occurring later in life. Factors such as moving to a different area in the world can trigger allergies, along with new pets and age-related immune system changes,” said physician Emily Weis, who holds dual appointment in the University of Rochester Medical Center’s department of pediatric al lergy and immunology as well as the department of allergy, immunology and rheumatology.

1.Myths

There are myths about aller gies ranging from the idea that you can’t outgrow allergies to the lack of awareness on treatment options. Weis said she has dealt with many others

including common myths about pets.

“There are myths that say ‘my dog has short hair, so it does not cause allergies.’ But in reality, we can be allergic to other components of the dog, including dander and saliva. A short-haired dog can still be allergen ic,” she said.

Another myth involves flu season. “In years past, patients with egg allergies may have been advised not to get their influenza vaccine. However, given our current evi dence-based information, patients with egg allergy can receive the influ enza vaccine,” said Weis.

Specific precautions may be advised depending on the patient history, so patients should check with their health care provider. Patients with a history of reaction to the in fluenza vaccine itself should have an allergy consultation.

2.Symptoms

Hay fever, also known as allergic rhinitis, occurs when aller gens like pollen enter your body and your immune system mistakenly identifies them as a threat. If you have allergic rhinitis, your body then responds to the allergen by releasing chemicals that can cause symptoms in the nose. Symptoms of allergic rhinitis can occur during certain seasons or year-round, depending on the allergen, and affect as many as 60 million people per year in the United States. Symptoms from allergic rhini tis include sneezing, runny nose and congestion.

“Regardless of concerns about the type of allergy which may be

How To Quit Smoking Today

By Naz Baecher, MD

Why should you quit smok ing?

Tobacco use is the most common cause of preventable death. But it isn’t easy to quit; many people try several times. Every quit-smok ing attempt brings you closer to a success.

A good place to start is with your healthcare provider and the New York State Quitline. You can receive free nicotine patches or gum by calling the Quitline (866-697-8487) or visiting them online at www. nysmokefree.com. URMC also offers a free smoking cessation program, including counseling over text-mes saging (English or Spanish) and 12 weeks of nicotine patches, gum and lozenges sent to your door. Interested persons can sign up for the program by calling 585-504-9461 or emailing quitcenter@urmc.rochester.edu

But why is it so hard? Just like

experiencing grief, there are stages a person goes through when quitting smoking. Understanding the stages will bring you more success.

If you feel you are in denial of needing to quit or not willing to talk about it, this is the precontemplation stage. It might not feel helpful at this stage to learn about all of the harms and dangers of smoking. A more ef fective approach to help someone in the precontemplation stage would be to lend an ear and slowly talk about concerns they have about smoking.

The next stage is contemplation Here you are starting to think about quitting and you are starting to ask some questions. Think about what might be holding you back from quit ting cigarettes, or what might be hard about it once you start. Make a list of your top reasons to want to quit, then think of past attempts as successes: when you quit last time what worked well?

It is important to have strong

food, drug or environmental, pa tients should first consult with their primary care physician. If input from an allergist is needed, a referral to a board-certified allergist is the best course of action,” said Weis.

3.Allergies and COVID-19

A runny or stuffy nose, cough, tiredness, even shortness of breath and a lack of smell and taste can occur in both allergies and COVID-19. But a cough from COVID-19 is typically dry, whereas in allergies, a cough is wet and usual ly more sneeze-like.

“If a patient with underlying environmental allergies contracts COVID-19, their baseline nasal congestion, eye symptoms and post nasal drip may be amplified in the setting of the infection,” said Weis. “Additionally, it may sometimes be hard to discern mild COVID-19 symptoms from allergic symptoms. So it is important to contact your health care provider with concerns.”

4.Diagnosis and treatment

Various allergy diagnosis and treatments can lead to many different diagnoses. Environmental allergies are diagnosed by proper history taking, examination, and al lergy testing. Treatments may include medications such as non-sedating antihistamines, steroid nasal sprays and allergy shots.

Food allergies are diagnosed with proper history taking, examina tion and allergy testing. Treatments include avoidance, and certain types of food allergies may necessitate carrying an epinephrine auto injec tor pen and having an allergy action plan. For patients with particular types of food allergies, there are also newer treatments, including oral immunotherapy.

Drug allergies are diagnosed with proper history taking, examina tion, and allergy testing.

“For patients with multiple drug allergies on their allergy list, we rec ommend they meet with a board-cer tified allergist to determine if there

motivations to quit. This next stage involves preparation and planning. In the preparation stage, you can go over obstacles and triggers before hand and choose a good strategy to overcome them.

You will then want to talk to your doctor again and get started on a treatment option. There are six FDA-approved smoking cessation treatments, plus at least two pre scription medications you might try.

Nicotine gum is great but it is intended for short-term use as you get used to not having cigarettes. Nicotine patches come in three stag es, and your provider can help you choose which stage to start at and then wean to lower doses until you are done completely. Nicotine loz enges, a nasal spray, and even a nico tine inhaler that could be prescribed are other options. Your doctor may talk to you about Chantix (vareni cline) or Wellbutrin (bupropion); pill options that cause your body to “dislike” smoking.

The next stages involve action and maintenance. You might feel like “I’m not smoking but I’m thinking about it a lot.” Support is key and al lowing someone to talk about “close calls” and giving feedback is import ant at this stage. They may also need

Physician Emily Weis currently practices clinical allergy & immunology for pediatric and adult patients. She holds dual appointment in the URMC’s department of pediatric allergy and immunology as well as the department of allergy, immunology and rheumatology.

are medications that may not need to be avoided, or could be tested and safely re-introduced,” said Weis.

5.Consult experts

Allergy experts believe the field and symptoms are growing exponentially so they advocate for allergy sufferers to consult a pro fessional. Simply pointing to your family history or self-diagnosis can lead to unnecessary trial and error.

“The field of allergy is rapidly expanding,” added Weis. “There are new methods for evaluation and new treatments available. We recommend that patients who have not had their current allergies evaluated or have developed new allergies discuss referral to a board-certified allergist with their primary care provider.”

help altering or refining methods of coping, or may need to learn a new self-image as a nonsmoker.

The last stage could be relapse This can be common. Most people will go through relapse before per manently quitting. Pointing out your past successes can be useful here.

Overall, every try counts and it is possible to successfully quit smok ing. Do: ask your healthcare provider about quit options and counseling. Do: call the NYS Quitline or another resource like the URMC program. Don’t use other nicotine sources like chewing tobacco or dissolvables. These can be like poison to your body and are not approved for use to quit smoking.

I encourage everyone to make that try to quit using tobacco today. I know you can do it.

Physician

Naz Baecher is a preventive medicine resident at University of Rochester Medical Center.

Tips to Deal with the High Cost of Prescription Medications

Nearly one in five adults (18%) reported that they or a family member skipped prescribed medicine at least once in the prior 12 months to save money, according to a recent survey from Gallup and West Health.

“Although higher costs may be causing many to make concessions, that doesn’t need to be the case when it comes to many prescription med ications,” said Mona Chitre, chief pharmacy officer and vice president of clinical strategy for Excellus BCBS.

“There are several ways to save money on prescription medications without jeopardizing your health and safety.”

The first step in saving money, according to Chitre, is to start with a talk with your physician, pharmacist or health care provider who pre scribed the medication.

“Having a trusting relationship with your health care team is critical so you can work together to deter mine the best treatment for you. Ask why the prescribed medication is

needed and how it works. It’s im portant to let them know if you have financial limitations so that they can identify lower cost options that work just as well or other interventions to meet your budget.”

Chitre recommends these money saving tips:

• Generics. Generic equivalents have the same active ingredients and therapeutic effects and can save as much as 80% off the cost of brand name medications.

• Know your health plan’s formulary and research your copays or coinsurance. Many health plans have tiered costs for covered medications: lowest cost for generics to highest cost for select brand name drugs. You can access most insurance company drug formularies (list of covered drugs) on their websites to see what your medication may cost.

• Take as prescribed. Not filling prescriptions or taking medication less frequently than directed can end up costing more money down the road by delaying your recovery — or worse, resulting in a hospital stay or ER visit.

•Mail service 90-day supply. In addition to the convenience of filling your prescriptions by phone or online and having them delivered to your home, you may also save mon ey when you fill one 90-day supply of your medication instead of three 30-day supplies.

• Regularly review your medications. At each provider visit, review your prescribed medications and ask if they are still needed or if lower-cost options have become available.

• Prescription discount programs: If you’re paying full price for med ications that are outside of your pharmacy plan or if you don’t have

Mona Chitre

insurance, these programs are free to join and can be an easy way to save on prescription medications at par ticipating pharmacies. Excellus BCBS offers the Inside Rx discount card to help the community access discounts at more than 60,000 pharmacies.

• Drug assistance programs: New York state offers the Elderly Pharma ceutical Insurance Coverage (EPIC) program to seniors to help supple ment out-of-pocket Medicare Part D drug plan costs.

• Manufacturer assistance programs: Pharmaceutical companies may offer an assistance program on the medica tions they manufacture.

Whether you’re insured or not, there are many ways to help save money on prescription medications. Become a smart shopper and always talk with your provider or pharma cist before making any changes to your medications.

SmartBites

By Anne Palumbo

The skinny on healthy eating

Bushels of Nutrition in Green Beans

Every early November, my fam ily has the most absurd conver sation. We talk about Thanks giving sides as if they were open for discussion. Who are we trying to kid? Like most Americans, we would never switch up our cherished favor ites—our beloved stuffing, mashed potatoes and green bean casserole. Thanksgiving is about peace and togetherness, after all, not acrimony and war!

Green bean casserole is our favorite and that’s because, of all the sides, the nutritional chops of green beans somehow justify all those tempting seconds and thirds.

Green beans pack a decent fiber punch, delivering about a fifth of our daily needs in one cooked cup. Fiber promotes regularity, ferries bad cho lesterol out of our bodies and helps to stabilize blood sugars. What’s more, multiple studies suggest that increasing fiber reduces our risk of dying from heart disease, cancer, stroke and diabetes.

On the vitamin front, this tasty legume provides admirable amounts of vitamins K, C, A and folate. While vitamin K helps blood clot prop erly and maintain strong, healthy bones, vitamins C and A pro mote healthy immune systems, which is especially

important during flu and cold sea son. Folate, a critical B vitamin that prevents birth defects in newborns, also contributes to heart health by lowering an amino acid that can lead to hardening of the arteries.

Green beans are a good source of minerals, especially manganese. This essential mineral supports bone health, promotes wound healing, and has antioxidant abilities, much like vitamins C and A, that protect our bodies from disease and acceler ated aging by neutralizing toxic free radicals.

A versatile bean that can be eaten raw or cooked, green beans are natu rally low in fat, sodium, cholesterol, and calories: only 44 per cooked cup.

What’s more, fiber-rich beans take longer to digest, which helps us feel full longer, snack less, and may be, just maybe, reach for only two helpings this Thanksgiving instead of three!

Healthy Green Bean Casserole

Adapted from slenderkitchen.com

2 pounds fresh green beans

2 tablespoons butter, divided

1 cup shallots or onions, thinly sliced

½ cup whole-wheat panko bread crumbs

¼ cup sliced almonds

1 pound mushrooms, sliced

3 garlic cloves, minced

2 tablespoons white whole-wheat flour

2 cups reduced-fat milk

2 vegetable bouillon cubes (or chicken)

1 teaspoon dried thyme

½ cup grated Parmesan cheese (optional)

Salt and pepper to taste

Preheat oven to 400 F.

Bring a large pot of water to a boil. Add the green beans and cook 3-4 minutes until bright green and tender crisp. Immediately add to an ice bath to stop the cooking. Strain and dry.

Melt 1 tablespoon of butter in a pan over medium heat. Add the shallots or onions and cook 5-7 min utes until tender. Transfer to a small bowl. Add the breadcrumbs to the

Can Coffee Perk Up Your Heart and Life Span?

Folkswho drink two or three cups of coffee daily appear to live longer than people who don’t care for the beverage, new research shows.

Coffee lovers also seemed to have healthier hearts, which might contribute to the longevity boost, said the team of Australian investi gators.

The findings were published Sept. 27 in the European Journal of Preventive Cardiology.

“Ground, instant and decaffein ated coffee were associated with equivalent reductions in the inci dence of cardiovascular disease and death from cardiovascular disease or any cause,” study author physi cian Peter Kistler, of the Baker Heart and Diabetes Research Institute in Melbourne, said in a journal news release.

While other studies have sug gested that the

might be a healthy one, Kistler’s team said there’s not been much investigation into the health effects of various forms of coffee.

To try to find out, they analyzed data from the ongoing UK Biobank database, looking at data on people aged 40 to 69. In this study, the av erage age was 58 and the Australian researchers focused on levels of daily coffee intake and life span, as well as heart disease, heart failure and stroke.

Overall, data on almost 450,000 Britons was included in the research.

daily coffee intake, partic ipants were divided into six groups:

less than a cup a day; one cup per day; two to three cups per day; four to five cups per day; and over five cups per day.

Helpful tips

Purchase fresh when possible. Look for firm beans that are bright green and free of black spots. Fresh green beans should be refrigerated in a plastic bag and eaten within a week or less, since they lose their fresh flavor quickly. Since cooking green beans may cause a reduction in some nutrients, such as vitamin C, cook them for the least amount of time necessary, whether boiling, steaming, sautéing or roasting. Steaming beans is better than boil ing, since it uses less water and pre vents the beans from overcooking.

pan, toast for 1-2 minutes until light brown, and transfer to the cooked onions. Stir in the sliced almonds. Set aside.

Wipe out the pan with a paper towel. Add the remaining tablespoon of butter. Once melted, add the mushrooms and cook 6-8 minutes until tender. Add the garlic and cook 1 minute more. Add the flour, along with a splash of water, and stir well. Cook for 1 minute. Add the milk and bouillon cubes. Bring to a simmer and cook for 6-8 minutes, stirring often, until thick and creamy. Turn off the heat and stir in the thyme and Parmesan cheese (if using). Season with salt and pepper to taste.

Lightly oil a 9 x 13 inch baking pan. Add the green beans and mush room gravy, Stir to combine. Top with the onion mixture.

Bake for 20-25 minutes until browned and bubbly.

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

Rochester’s

Brighten Spirits by Becoming a DePaul Holiday Helper

With the holiday season steadily approaching, DePaul, a nonprofit health and human service agency based in Gates, is seeking the community’s support for its annual holiday helpers program.

Individuals, businesses, schools, and service and faithbased organizations can “adopt” clients from DePaul’s mental health residential programs who may not have family support during this meaningful time of year.

Participants can select from items on a wish list or choose to donate generic gifts such as hats, gloves, personal care items or socks for adults. Past client wishes have included items as simple as a piece of chocolate cake, boots or basic articles of clothing.

If you are interested in adopting actual gifts from an individual’s holiday wish list, arrangements can be made to ship adopted wishes from online retailers directly to DePaul. If you wish to purchase gifts and personally deliver them, specific appointment times will be avail able for in-person drop-offs at a convenient location. Donations of gift cards and financial contri butions can also be made instead of purchasing gifts. Please know we are dedicated to safety and social distancing as needed.

For over 20 years, generous members of the community have made the season special for those less fortunate by taking part in DePaul’s holiday helpers program.

DePaul serves some 5,000 people annually in programs that encompass mental health residential and support services, senior living residential services, addiction prevention and sup port programs, vocational pro grams and affordable housing.

For more information about the holiday helpers program, contact Amy Cavalier via email at acavalier@depaul.org or by calling 585-426-8000, ext. 3102.

Learn more about DePaul by visiting the DePaul website at www.depaul.org.

Tax-deductible financial con tributions can be made by check and mailed to “DePaul Holiday Helpers Program,” 1931 Buffalo Road, Rochester, NY 14624, or made online on DePaul’s web site at www.depaul.org/donate/ donation-form.

Golden

Top Issues Affecting Seniors

By Deborah Jeanne Sergeant

Aging brings its own rewards— wisdom, experience and sense of accomplishment—along with a few challenges.

With planning and a few com munity resources, older adults can mitigate the effects of these challeng es as they age.

1. Lower muscle tone

Losing muscle is not merely a vanity issue. It can contribute to falls and frailty. It begins gradually in middle adulthood but can occur more rapidly if an older adult has been laid up because of sickness or injury.

“It’s really important for seniors to do resistance training,” said Kerri Howell, online personal trainer and nutrition coach at www.fitprmomlife. com. Howell is based in Rochester but serves clients wholly online.

“They should consume enough protein to support muscle growth,” she added.

She said that maintaining muscle tone does not have to mean lifting weights, but engaging in bodyweight exercise, swimming and walking are examples of exercise that can help. She recommends starting with walk ing a few more minutes daily.

3. Nutritional deficiencies

Poor eating in older adults can stem from food inaccessibility, lack of ability or motivation to cook, depres sion or medication that suppresses appetite or the senses of smell and taste. Nutritional deficiencies can contribute to a host of health prob lems, including mental health.

“Get annual check-ups and blood work so they know nutritionally what you need,” Howell said. “Most people are deficient in vitamin D and some are deficient in B complex. You wouldn’t know unless you have blood work done.”

Numerous community resourc es can help ensure good nutrition. Melissa Goddeau, registered dieti tian nutritionist at Nutrition Care of Rochester, PLLC in Pittsford, rec ommends checking into congregant meal sites, grab-and-go meal boxes, Meals on Wheels and other resources listed on the Monroe County Office for the Aging site, www.monroe county.gov/aging. The NY Connects program at 585-325-2800 can also offer tips on area supports.

5. Inaccessibility to healthcare

Lack of transportation represents one barrier to healthcare. Relying on others for transportation has helped bridge that gap, whether informally from friends and family to senior ride programs and public transportation. In recent years, telehealth has made lack of technology aptitude another barrier to healthcare.

“We see seniors at our practice and we’re exclusively telehealth right now,” Goddeau said. “Not everyone is OK with that. Some enlist the help of family members to get set up.”

6. Mental health issues

Overall, the percent of local older adults with depression and anxiety has remained at nearly the same as what it was 15 years ago, 30%, ac cording to data gathered by Lifespan of Greater Rochester.

2. Poor hydration

Drinking enough fluids is vital to good health—and that does not nec essarily mean chugging eight glasses that are 8 ounces each. Howell said that the current rule is drinking half the body weight in ounces daily, such as a 150-pound man would drink 75 ounces each day.

Fluids other than water count too, such as soup broth.

“This is something a lot of older people have trouble with,” she said. “Don’t just have a cup of coffee and leave it until dinner. Fill a water bot tle and determine you’ll drink it.”

She tells clients that adding cu cumber, mint and fruit to their water can keep them drinking more.

4. Polypharmacy

According to Georgetown University Health Policy Institute, people aged 50 to 64 take an average of 13 prescription medications. That shoots up to 22 by age 80. Some of these medications may be attributed to polypharmacy: taking unnecessary mediation. Goddeau feels concerned about the issue.

“They may need help in nav igating polypharmacy,” she said. “There’s possible drug interaction. They may have interactions with the food they eat.”

Polypharmacy also causes un necessary side effects and expenses to patients. Consulting with a phar macist or primary care provider can help reduce unnecessary and outdat ed prescriptions.

“I don’t want to dismiss the effect the pandemic has had on older adults,” said Christine Peck, licensed master social worker and associate vice president of programs at Lifes pan. “It increased the number of old er adults who were isolated. When you look at our older adult popula tion and depression, we’re seeing a very steady rise in older adults.”

She believes that many cases of depression and anxiety among this population go unreported and untreated, as primary care providers focus on physical health and few older adults actively seek mental healthcare. But Peck sees some im provement.

“I feel regionally, we’re doing a much better job at screening for de pression than we used to,” she said.

The same barriers exist for men tal healthcare as physical healthcare, along with stigma for seeking help. Normalizing screening at primary care visits has helped reduce stigma, especially among older adults.

Meet Your Provider

CarePatrol of Rochester-Syracuse

Local business helps seniors find care and living options at no cost

By Julie Whitbeck-Lewinski

The expert team at CarePatrol has not let the pandemic get in the way of helping seniors find the best care and living options. CarePatrol provides a no-cost service for seniors and their families navigating the complexities of care transitions when more help is needed.

CarePatrol helps explore in-home care, independent living, assisted living and memory care options available locally and nationally.

The options are overwhelming

Senior living is not one size fits all. Whether a senior is looking to age in place at home as long as possible, needs skilled medical care daily, needs memory care supports or just wants more amenities, there are a variety of options to fit the bill. It’s not just a nursing home. Options range from various types of inhome care and supports to agein-place and independent living communities with or without

care supports. Independent living communities offer various amenities, making life easier and more enjoyable than one might have living on their own. These communities can offer the opportunity for couples with different care needs to reside together. Beyond independent living communities, the next level of care is in assisted living communities. These communities can offer various levels of care, memory care and enhanced care services. Assisted living communities come in many different styles: room style, studio

and apartment styles with unique amenities and services to meet care needs.

Navigating the options

CarePatrol offers an in-depth care discovery process where they take a person-centered approach to understand the senior’s needs, desires, geographic preferences and budget. The CarePatrol team uses their decades of legal, healthcare, social work, life enrichment and senior living experience to identify a handful of curated options to meet their specific care and living needs. They walk families through the appropriate options and facilitating the option of choice. CarePatrol educates families regarding options for paying for care such as reviewing all of their available assets, exploring the availability of Veterans’ benefits, selling a home, reversing a mortgage, other government benefits and more. CarePatrol is able to connect families to a variety of elder care services to support every step of their journey.

Now is the time

CarePatrol can help at any time, day or night, weekday or weekend. Planning ahead for long-term care should be a priority for any senior. However, most families reach out when concerns or challenges arise:

• When hospitalization occurs and it is no longer safe to go home;

• When a senior ends up in subacute rehab and needs to have a safe discharge plan to go home or to a senior living community;

• When a caregiver is overwhelmed and unable to continue providing all the care for the senior;

• When memory impairments become a safety concern;

• When multiple falls are occurring.

Don’t wait for a crisis situation. Reach the team at CarePatrol today to begin your no-cost senior living journey.

Julie Whitbeck-Lewinski, OTD, OTR/L, CDCS, CFPS, is the owner-senior care consultant of CarePatrol of RochesterSyracuse.

Vaccines That Are Recommended for Older Adults

By Jim Miller

There are three different types of senior-specific flu shots (you only need one) that the CDC is now recommending to people age 65 and older. These FDA-approved annual vaccines are designed to offer extra protection beyond what a standard flu shot provides, which is important for older adults who have weaker immune defenses and have a greater risk of developing dangerous flu complications.

Here’s more information on these three vaccines.

• Fluzone High-Dose Quadrivalent: Approved for U.S. use in 2009, the Fluzone High-Dose is a high-potency vaccine that contains four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protec tion. According to a study published in the New England Journal of Med icine, this vaccine was proven 24% more effective than the regular dose shot at preventing flu in seniors.

• Fluad Quadrivalent: First avail able in the U.S. in 2016, this adju vanted vaccine contains an added ingredient called adjuvant MF59 that also helps create a stronger immune

response. In a 2013 observational study, Fluad was found 51% more effective in preventing flu-related hospitalizations for older patients than a standard flu shot.

You also need to be aware that both the Fluzone High-Dose and Fluad vaccines can cause more of the mild side effects that can occur with a standard-dose flu shot, like pain or tenderness where you got the shot, muscle aches, headache or fatigue. And neither vaccine is recommend ed for seniors who are allergic to chicken eggs, or those who have had a severe reaction to a flu vaccine in the past.

Also note that the CDC does not recommend one vaccination over the other.

• FluBlok Quadrivalent: For old er adults who are allergic to eggs, FluBlok, which is a recombinant vaccine that does not use chicken eggs in their manufacturing process is your best option. This vaccine is proven to be 30% more effective than a standard-dose influenza vaccine in preventing flu in people age 50 and older.

All of these vaccines are covered

100% by Medicare Part B as long as your doctor, health clinic or phar macy agrees not to charge you more than Medicare pays.

Pneumonia Vaccines

Another important vaccination the CDC recommends to seniors, especially this time of year, are the pneumococcal vaccines for pneumo nia. Around 1.5 million Americans visit medical emergency departments each year because of pneumonia, and about 50,000 people die from it.

The CDC recently updated their recommendations for the pneumo coccal vaccine and now recommend that everyone 65 and older who has not previously received any pneumococcal vaccine should get either PCV20 (Prevnar 20) or PCV15 (Vaxneuvance). If PCV15 is used, this should be followed by a dose of PPSV23 (Pneumovax23) at least one

year later.

Or, if you’ve previously received a PPSV23 shot, you should get one dose of PCV15 or PCV20 at least one year later.

Medicare Part B also covers two different pneumococcal shots the first shot at any time and a different, second shot if it’s given at least one year after the first shot.

COVID Booster

If you haven’t already done so, you should also get a COVID-19 booster shot this fall. Both Moderna and Pfizer have developed new bi valent booster vaccines that adds an Omicron BA 4/5 component to the old formula, which provides better protection.

Jim Miller is the author of Savvy Senior, a column that’s published monthly in In Good Health.

Partner in

Talking to a Loved One About a Move to Assisted Living

Itcan be hard to talk to your loved ones about moving into assisted living, so don’t push them too hard and make sure they feel safe and comfortable with the idea, one expert advises.

“Start the conversation as early as possible, and focus on what matters,” said Angela Catic. She’s a geriatrician and associate professor in the Roy M. and Phyllis Gough Huffington Center on Aging at Bay lor College of Medicine in Houston.

“Think about if an assisted living environment could not just support, but enrich things that really bring joy to that individual’s life,” Catic said in a college news release.

As people age, it gets harder to take care of a house and yard. Adult children often start talking about assisted living when they see their parents are struggling, Catic said. After the death of a partner, a person may feel alone and lose their social connections. This is where transition ing into assisted living could benefit an older person, as such facilities often provide various social activities for their residents.

When starting a conversation with a loved one, consider covering these topics:

• Mention a few facilities you

have already researched prior to the conversation. Whether you visit them in person or do online research, keeping a few facilities in mind can ease any nervous feelings about the process.

• Present a few options close to your loved one’s home or facilities near the home of a family member. This could remind them that they won’t be completely alone and will still have access to their family.

• Stay mindful of their feelings, as they could feel anxious or sad about having such a conversation. These emotions may prompt them to resist the move altogether.

• Mention any of their friends that you have heard from or ask them if they know anyone who has already moved into an assisted living facility, to normalize the idea.

• Make sure they feel involved in the process so they feel like they have control over what happens.

• Encourage them to come with you to tour a few facilities so they can visualize what their stay would be like there.

“Find a place they feel good about, too, and bring some of their belongings,” Catic said. “It’s typical ly a major downsizing of space, but it is important to bring things that

What You Need to Know About Macular Degeneration

By Deborah Jeanne Sergeant

have meaning to them and make it feel like home as much as possible. This may include items like a favorite chair, items they need to engage in a favorite hobby or family photo graphs.”

If your loved one says no to the idea of moving to an assisted living facility, don’t keep pushing the idea unless you’re truly worried about their safety. Hospitalization due to an accident or other health issues can also be a good reason to bring up the idea of assisted living again.

If they decline initially, you can always return to the conversation later, as their initial hesitation could be due to other factors that change, Catic said. When bringing the topic up again, ask them if they had time to reconsider the idea. Welcome their thoughts on the subject and offer ways you can make the process more comfortable for them.

Catic advises prioritizing finding

monoxide, such as a woodburning stove.

“That can potentially accelerate the condition,” he said. “If you’re outdoors, even in winter, put on sunglasses as UV exposure can accel erated.”

your loved one a place that fits their needs and learning as much about it as you can so you know exactly what you are signing them up for. Even if a place looks nice in the lobby or on the tour, finding out more about what they have to offer can be an important part of finding the best fit for your loved one.

Additionally, learn about the staff and how often people move in and out. On another note, some facilities might have connections to different social groups such as veterans or other interesting people with whom your loved one could socialize.

“Go beyond the beautiful, fresh flower bouquet in the lobby because this is going to be someone’s home, not a hotel they’re staying in for a couple of nights,” Catic said. “You’re looking for a feeling of home and fitting in with other residents and a staff that feel like family.”

Macular

degeneration is one of the nation’s leading causes of blindness and low vision, affecting 1.8 million Americans, according to the Centers for Disease Control and Prevention.

Age-related macular degenera tion or “dry” macular degeneration is more commonplace, 70%-90% of cas es, than wet macular degeneration.

Either type of macular degenera tion affects the central vision, which is important for reading, filling out paperwork and driving.

Patients may see fine in their pe ripheral vision, but not in the center. For example, they may see a person’s clothing and hair, but not the face.

WMD occurs when blood vessels grow abnormally under the macular and leak blood and fluid. This vision loss is rapid, and typically presents with straight lines appearing wavy. AMD is a slower process as the macula thins, which eventually blurs vision. Patients have a 10% chance of progressing into WMD.

Although there is no cure for AMD, doctors can treat WMD to reduce its effects with anti-VEGF injections to decrease the bleeding in the back of the eye and photodynam ic therapy, a less common treatment sometimes used with anti-VEGF injections.

The injections “are generally very effective,” said Luca Zatreanu, MD, ophthalmologist with Reed Eye As sociates in Pittsford and Irondequoit. Reed Eye also operates an office in Newark.

“Patients need to realize that these are treatments, not cures.”

They will need to return to the office for injections to prevent further damage. Even a week’s delay can negatively affect vision. With effective treatment, WMD can be managed for years—even decades— thanks to current protocols with a much lower risk of losing vision.

Photodynamic therapy uses a cold laser to target a light sensitive medication in the eye to break down blood vessels that cause the vision loss. Patients may need repeated treatments to maintain the effect.

Zatreanu tells adult children of someone with macular degeneration to regularly undergo a dilated eye exam of the back of the eye “even if they don’t have problems with their vision,” he said.

He also advises patients in lifestyle modifications for those with macular degeneration that can reduce their risk for further vision loss, including avoiding exposure to smoking and other sources of carbon

Supplements can also help, in cluding brands such as Preservision and Ocuvite.

Early diagnosis can help patients make lifestyle changes that can slow macular degeneration progress. In addition to smoking, the greatest risk factors for macular degeneration include age, family history, gender (women are more prone), high blood pressure, high cholesterol and poor diet.

Melissa Goddeau, registered dietitian nutritionist with Nutrition Care of Rochester, PLLC in Pittsford, recommends improving the diet by including more healthful foods to prevent further degradation for eye health and in general to promote eye health and reduce the risk of eye issues. She recommends improving intake of vitamins C and E.

“Some examples vitamin C-rich foods include oranges, strawberries, raspberries, cantaloupe, red peppers, cauliflower, broccoli and Brussels sprouts,” she said. “Vitamin E sourc es include nuts, seeds, sunflowers, peanut butter, shrimp, fish, wheat germ and spinach.”

Phytochemicals lutein and zeaxanthin can also help. Goddeau noted that leafy green vegetables like spinach and dark-leaf lettuce, cruciferous vegetables like kale and

broccoli, and eggs and peas are good sources.

“Omega 3 fatty acids are an anti-inflammatory,” Goddeau added. “That will help combat oxidative stress that contributes to macular degeneration. “Eating fatty fish like salmon or tuna a couple times a week is helpful or taking, fish oil supple ment if they don’t eat fish. Ground flaxseed and walnuts are also good sources.”

For people watching their sodi um intake, shopping for walnuts in the baking aisle can make it easy to avoid added salt since these nuts are typically sold plain, unlike nuts sold from the baking aisle.

“Nuts improve symptoms of depression and other mental health disorders,” Goddeau added. “They can reduce the tendency for the blood to clot. It also can help lower elevated triglyceride levels."

Meet Your Provider

Kirkhaven

Kirkhaven, with its partner Preferred Therapy Solutions, provides a team of rehabilitation professionals committed to guiding patients through successful rehabilitation after a hospital stay. The goal is to inform, educate and provide the quality care patients need to regain their strength after a hospitalization and return home.

Patient-centered care is the key to meeting each patient’s specific needs. Therapists’ treatment plans include a one-to-one approach, which allows the therapist to build a personal rapport with the patient and their loved ones, gaining insight into the patient’s lifestyle while working with them on their individual goals. That is what makes rehabilitation at Kirkhaven different from other providers. Kirkhaven focuses on a patient’s recovery for a successful return home.

Kirkhaven provides the care necessary to bridge the gap from hospital-to-home. Every therapy program is guided by a profound and lasting commitment to the patient. Their comprehensive model delivers personalized care, which

is a powerful element in healing, recovery and rehabilitation. Their systematic approach is disciplined and efficient, keeping the unique needs of patients in mind.

Rehabilitation therapy is available six days a week in Kirkhaven’s state-of-the-art therapy center.

Learn how their exceptional model in rehab therapy can help you or your loved ones get back to your

life at home.

Here is what some of Kirkhaven patients say about the services they received here:

I spent two weeks at Kirkhaven for rehab after back surgery. I was very pleased with the level of care and the dedicated staff members. If I ever need rehab again, I will only consider Kirkhaven. They are the best!”

-JoAnne L.

Everyone is great! They instructed me on how to get better and provided positive encouragement which was the motivation I needed. When I first arrived, I couldn’t move my right side and was doubtful that I would ever walk. Now, I can do everything on my own. I can dress myself, walk without a cane, and go up and down steps. When I was able to do all that, I had confidence I could get back home.”

-Alcenius H.

Even though therapy was hard and I didn’t want to go all the time, the therapists at Kirkhaven listened to my concerns and gave me the emotional support that I needed. They held me accountable for my actions. I was able to push through the pain and negative thoughts to finish each session. They always encouraged me to reach my goals so I could walk again and go home.”

-Pamela T.

Kirkhaven: 254 Alexander St., Rochester, NY 14607

$12,000. That’s How Much an Average Funeral Costs

By Jim Miller

It definitely pays to know what charges to expect when pre-plan ning a funeral. Most people don’t have a clue and can often be upsold thousands of dollars’ worth of extra services they may not want or need.

Here’s a breakdown of what you can expect.

Funeral Prices

The first thing you need to be aware of is that funeral costs will vary considerably depending on your geographic location, the funeral home you choose and the funeral choices you make. With that said, here’s a breakdown of what an average funeral costs, nationwide, according to the most recent data from the National Funeral Directors Association.

• Professional services fee: This is a basic non-declinable fee that covers the funeral provider’s time, expertise and overhead: $2,300.

• Transfer of the remains: This is for picking up the body and taking it to the funeral home: $350

• Embalming and body preparation: Embalming is usually mandatory for open-casket viewing, otherwise it’s not required unless the body is going to be transported across state lines. Embalming costs $775. Other body

preparations, which includes hair dressing and cosmetics runs $275.

• Funeral viewing and ceremony: If the viewing and funeral ceremo ny is at the funeral home, you’ll be charged for use of the chapel and any necessary staff. Costs: $450 for view ing, and $515 for funeral ceremony.

• Metal casket: This is a big money maker for funeral homes, with mark ups of up to 300 percent over the wholesale price: $2,500.

• Funeral transportation: Use of hearse and driver; $325 to transport the body to the cemetery. Use of a service car or van: $150.

• Memorial printed package: This includes printed programs and me morial guest book: $183.

In addition to these costs, there are also a number of cemetery costs like the plot or mausoleum fee, the vault or grave liner that most ceme teries require, and the opening and closing of the grave, all of which can run between $2,000 and $3,000; and the gravestone, which typically runs between $1,000 and $3,000.

You’ll also need to budget for related expenses like flowers for the funeral ($200 to $400), the newspaper obituary fee ($100 to $800 or more), the clergy honorarium ($200 to $300) and extra copies of the death certif icate ($5 to $35 per copy depending

on the state).

All told, the average cost of a total U.S. funeral today with view ing and cemetery burial is around $12,000.

Ways to Save

If this is more than you’re willing or able to pay, there are ways to save. For starters, you should know that prices can vary significantly by funeral provider, so it’s wise to shop around. If you need some help, there are websites you can turn to like Parting.com that lets you easily compare prices online based on what you want.

When evaluating funeral provid ers, be sure you get an itemized price

list of services and products so you can accurately compare and choose what you want.

The most significant way to save is to request a “direct burial” or “di rect cremation.” With these options the loved one would be buried or cremated shortly after death, which skips the embalming and viewing. If you want a memorial service, you can have it at the graveside or at your place of worship without the body. These services usually run between $1,000 and $3,000, not counting cem etery charges.

Jim Miller is the author of Savvy Se nior, a column that runs every issue in In Good Health.

New Alzheimer’s Drug Slows Progression of the Disease

By Deborah Jeanne Sergeant

Currently, more than six mil lion people in the US live with Alzheimer’s disease and 410,000 of those live in New York. By 2050, those figures are anticipated to double, according to the Alzheimer’s Association.

Eisai and Biogen’s lecanemab, in phase 3 of its clinical trial, has been shown to slow the rate of cognitive decline caused by Alzheimer’s by 27%. The anti-amyloid monoclonal antibody drug is meant for people with mild cognitive impairment.

“It’s quite a substantial percent age,” said Teresa Galbier, executive director of the Alzheimer’s Associa tion Rochester Finger Lakes Region chapter. “It’s a positive treatment. This is historic and exciting for those of us in the field to have this type of report in an Alzheimer’s clinical trial. Our hope is families will have more opportunity to have more time at or near full ability to participate in daily life.”

Time is not on the side of people with Alzheimer’s and their families. With lecanemab slowing the dis ease’s progression, they will have more time.

“They’ll be able to remain in dependent longer and make more healthcare decisions. It’s a hopeful, positive exciting time for people who live with Alzheimer’s and those who care about them,” she said. “We need value treatments that extend the lives of those with Alzheimer’s and other dementias.”

Current medication for Alzhei mer’s disease only treats symptoms. Lecanemab works by combating the excessive accumulation of amyloid proteins in the brain, which is be lieved to be the cause of Alzheimer’s.

Galbier noted that although Alzheimer’s affects each race, Blacks have double the risk and Hispanics are at 1.5 times the risk compared with whites. Twenty-five of the par ticipants in the Lecanemab research were Black and Hispanic.

“We believe this is a good step in the right direction,” Galbier said. “The disparity exists in the disease it self and it’s important to have clinical trials that represent the population we’re serving.”

More detailed results yet forth coming will give indicator as to much time tients will have near their baseline cognition while using Lecanemab. It is also not yet clear as to the side effects.

“We look for ward to seeing the safety data from the phase 3 trial so we can more accurately compare safety profiles between this drug, others in its class, as well as treatments for other diseases like cancer,” Galbier

said.

Contraindications are not yet available. They are especially im portant for older adults who may be taking other medications for unrelat ed health conditions.

The full results on lecanemab “we believe is happening in the com ing months,” Galbier said. “It could be as early as this calendar year.”

After FDA approval, health insurance coverage for the new drug depends upon whether Medicare and Medicaid services provide coverage.

Most health insurance compa nies follow their lead. Galbier said that the only other anti-amyloid treatment, Aduhelm (aducanumab), would have cost $56,000 per month out-of-pocket. In a similar class as lecanemab, Aduhelm was also an infusion drug, but wasn’t approved by the FDA.

“The association will continue to support the development of more medication,” Galbier said. “One thing we advocate very strongly for is that this gives an opportunity for people to make those choices. They can ensure their voices are heard and of course the safety and wellbeing of all people living with Alzheimer’s our highest priority. They have the right to make these choices. We need to listen to people with the disease. We don’t want to take away the option of an informed choice.”

Support and information from the Alzheimer’s Associa tion are available for free anytime, day or night for individuals with Alzheimer’s dis ease and their caregiv ers at 800-272-3900.

Teresa Galbier, executive director of the Alzheimer’s Association Rochester Finger Lakes Region chapter.

Tips for Selecting a Medicare Plan

By Deborah Jeanne Sergeant

Manypeople feel confused when choosing a Medicare plan. The numerous options and industry jargon can make plan selection challenging.

Fortunately, area Medicare experts can help guide those new to Medicare or those changing plans during the current open enrollment period, which ends Dec. 7.

“The first thing they should consider is their current health,” said Terry W. James, broker at Medicare Made Easy in Rochester. “What does their health look like historically? Someone getting Medicare at 65 is likely relatively healthy and goes to the doctor once or twice a year will have different needs than someone with a chronic condition, knee re placement pending or a lot of physi cal therapy.”

Beyond the basic Medicare, the additional plans vary depending upon company and type of plan. In addition to medical needs the plans cover, James encourages clients to consider their comfort level with health conditions. Some want to see their doctor for every twinge. Others are more wait-and-see types who seldom want to use their medical coverage.

“You can have a MediGap plan,” James said. “That’s the higher premi um plans, but will result in maybe no co-pays at all, with the exception of Medicare B deductible if you’re new to Medicare. Advantage Plans have a low monthly premium and you have a level of protection with a maximum out-of-pocket. And it usually in cludes prescriptions.”

Some people stuck on a certain company. Although brand loyalty may seem like a money-saver, James warned it often is not. Some compa nies’ prescription plans may not cov er a policyholder’s medication at the same level as another’s for example.

“Company X might have your prescription cost 10 times Company Z,” James said. “One thing not to do is say, ‘I want Company X because I’ve always had it.’ Or ‘My friends love Company X.’ It may be the best plan for them, but we need to find the best plan for you.”

One of his clients nearly made an $11,000 mistake by wanting to stick with a company that would not cover his medication at the same level as the company James recommended. That was an exceptional case. Typi cally, the difference is about $1,000 a year.

James also looks at whether a policyholder’s doctors will be cov ered with the plans they consider. Most people want the comfort of con tinuity of care. It is also vital for those who travel to ensure that they will receive coverage for non emergency healthcare needs away from home.

“Snowbirds may be better suited if they have coverage that’s a PPO,” James said. “Some have national networks. You could be with a carrier with a national network. Understand whether a carrier has a national net work or is just regional.”

Typically, HMOs will not cov er routine issues addressed out of network.

Some policyholders stick with the same plan for years and years despite changes in their healthcare needs.

“It would be a mistake to not get professional guidance, especial ly since it doesn’t cost anything,” said Rick Grossmann, chartered life underwriter and president of ROC Insurance Services in Rochester. “Brokers don’t charge an additional fee to give advice.”

He said that insurance plans continually change and upgrade their products and many grandfather in clients with outdated plans.

“Oftentimes, people are reluc tant to give up their plan because it’s worked in the past,” Grossmann said. “People fear making change. The newer plans are better as they in corporate more benefits. The compa nies receive subsidies from Medicare to enhance the new plans.

“If someone comes to us and we recognize they’re on an older plan, we always bring to light the newer plans. It’s almost always that they want to move to a newer plan.”

Merely discussing what is new does not place policyholders under obligation to change their plans.

How to Stay Fit During Retirement

By Deborah Jeanne Sergeant

Doesretiring from work mean retirement from working out?

It may seem that way for people whose fitness activities linked to their employment. Once they are no longer in a workaday routine, it’s easy to let fitness slide. For example, perhaps they took a morning run before leaving for work. Or maybe they walked with a group of cowork ers on their lunch break. Perhaps the employer offered a fitness center, dis count on a gym membership or their health insurance benefits included a gym membership reimbursement.

When fitness endeavors closely align with employment, it takes plan ning to stay fit as a retiree.

“Retirement is a blessing as you have more time to focus on yourself,” said Kerri Howell, online personal trainer and nutrition coach and own er of www.fitprmomlife.com, based in Rochester. “I fit fitness in at 5 a.m. View retirement as an opportunity. You can align your fitness with other scheduled things you’ll do.”

She offered eating as an exam ple. Most people don’t forget to eat meals. So, if they plan to work out after breakfast and take a long walk after lunch, it is easy to build fitness into the day.

Workplace workouts often in volve others. But retiring pares down the social circle. Establishing a new social circle around activity can help people meet those fitness goals.

“It’s a good time to engage with other adults, which will hold you ac countable,” Howell said. “You’re less likely to say, ‘I won’t walk today’ if the neighbor is waiting outside with the dog.”

Joining a fitness group or class can also help keep retirees connect ed and accountable. Many fitness organizations offer lower rates for people 65-plus and provide regimens that can accommodate people with limitations from past injuries.

There is no reason a bum knee or painful shoulder should eliminate activity. Community-based walking

Transportation Vital to Senior Health

By Deborah Jeanne Sergeant

Obtaining a driver’s license as a teenager represents a step towards autonomy and inde pendence. The inverse is also true: giving up driving as an older adult can mean more reliance on others.

In addition, it can affect health, as adults often need more medical care from their primary care provid ers and specialists as they age. Delay ing medical and dental appointments can worsen health problems. Lack of transportation can prove a barrier for timely appointments.

Transportation is also important for obtaining prescriptions and food and maintaining social involvement. Of course, public transportation can help provide rides. The costs of these services can add up for people visiting a different specialist each week or completing rounds of preop, post-op and rehabilitative visits. Plus, there’re also trips to the grocery store, hairdresser, house of worship and social gatherings. Unfortunately, some older adults pare their trips down to the medical necessities to save money.

“Transportation is important so that seniors in the area can get to these main needs,” said Michelle Marlow, clerk typist with Wayne County Department of Aging & Youth in Lyons.

Some local transportation op tions are for the general public, such as RTS, taxis, Uber and Lyft. Some in clude special considerations for dis ability, such as wheelchair-accessible vehicles, assistance to the door, and help in carrying bags such as after a shopping trip. The transportation options include fee-based, reduced fee-based and free (for those who qualify). Typically, transportation options do not cross county lines,

which can make it difficult for people living in one county who must see a specialist in another.

“It’s very hard to get transpor tation between counties,” said Neeci Packard, Give a Lift coordinator and mobility specialist for Lifespan of Greater Rochester which organizes a consortium of 16 volunteer driver programs throughout the Roches ter area. These programs transport people only within Monroe County. Department of Transportation fund ing requires each county program to transport only that county’s resi dents, even if people live right on the county line near their primary care provider on the other side of the line.

Give a Lift relies upon volun teers, typically newer retirees who still drive. Packard said that the pandemic has halved the number of volunteers, which has caused many of the programs to reduce their trips to medical appointments only.

Most transportation programs for older adults require two weeks’ advanced notice, as the slots fill quickly. This can prove problematic for a patient whose medical appoint ment must be rescheduled because of an issue in the office.

Packard said that the shortage of drivers has cause many families to get creative about meeting their needs.

“A lot of people’s kids use Insta cart,” Packard said.

Grocery delivery through Insta cart’s app provides a convenient way to eliminate trips to the store. It may help to request that shoppers pack age items in separate bags so that seniors are not burdened with a huge box or bag full of cans. Also note to place the parcels on a bench on the porch, for example, if lifting from the

clubs, hiking groups or other ac tivity-based groups can help keep retirees moving.

Dave Pfaff, certified personal trainer at AMP Fitness in Penfield, recommends starting with shortterm goals of 30 minutes of moderate activity three to five times per week and working up towards a more intense regimen.

“You have to make a plan and follow through with it,” he said. “De cide, ‘These are the days I’m going to work out’ and make a commitment to yourself. If it’s hard, find a trainer to make yourself accountable. I’ll teach you how to do it and why you do it.”

He encourages clients to use more resistance training, especially as they lose muscle as they age. Build ing more muscle reduces the risk of chronic health conditions and falls and improves the chances of being able to carry out activities of daily living well into old age.

Like Howell, he encourages retir ees to join a club or take fitness-ori ented lessons to stay accountable and consistent. Going it alone often results in engaging in activity that is not intense enough and offers min imal results. Going too intense can lead to quitting or, worse, injuries.

“I have a few clients who are retired,” he said. “One comes in three

floor is too challenging.

For older adults who want to select their own groceries such as produce, scheduling regular de livery of all of their bulk or heavy items through a standard website can reduce the amount of items se niors need to pick up. Most of these sites offer free shipping at a certain minimum total. By paring down the shopping list, they need to carry only a bag or two each week. Most public transportation options do not provide assistance with carrying packages.

Using an online pharmacy or a brick-and-mortar pharmacy that delivers can eliminate another trip. Many health insurers cover prescrip tions filled through online pharma cies. Some traditional pharmacies that deliver will also add a few small items to the order if requested.

The Gogograndparent.com site allows older adults an easier means of obtaining groceries, takeout deliv ery and rides. Ideal for people who do not use smartphones, gogogrand parent employs phone operators to act as a concierge to connect older adults with services such as Grub hub, Lyft, Uber and Instacart. After signing up, all users need to do is call and ask for what they want from a live operator. Updates on the request are texted to the user’s emergency contact such as “Delores has been picked up by Lyft” and “Delores has arrived at her destination.”

“It is a transportation option for people,” Packard said. “They text the emergency contact, so she has peace of mind.”

Seniors can maintain more in dependence by arranging their own rides and deliveries through Gogo grandparent instead of relying on their adult children.

RTS offers transportation for peo ple who need wheelchair access and service on demand in urban and sub urban areas. In more rural areas, rid ers will need to call well in advance to schedule a ride. RTS drivers do not go down driveways, help riders to the door or with carrying packages. The service is strictly curb-to-curb.

times a week and twice a week does Silver Sneakers. It depends on the person. You have to find out what works for you.”

Many senior center programs provide discounted transportation for older adults to go to the senior center for socializing. That often includes a hot meal.

It may also help to contact a house of worship. Some of these provide a ministry of free or low-cost transportation to appointments and other places. Neighbors and friends may be willing to help as well.

Transportation Options for Senior

The senior transportation options in the area include:

• Monroe County: www. lifespan-roch.org then type “medical trans portation” in the search menu.

• Ontario County: www. ontariocountyny.gov, then type “senior trans portation services” in the search menu.

• Wayne County: https:// web.co.wayne.ny.us then type “transportation for seniors” in the search menu.

For more help, call New York Connects team at 585-325-2800.

Kerri Howell, online personal trainer and nutrition coach and owner of www. fitprmomlife.com, based in Rochester.

Neeci Packard.

By Jim Miller

Free Online Hearing Tests You Can Take at Home

Dear Savvy Senior,

Can you recommend any good online hearing tests? My husband has hearing loss, but I can’t get him to go in and get his hearing checked, so I thought a simple online test could help him recognize he has a problem. What can you tell me?

— Loud Talking Linda

Dear Linda,

There’s actually a growing number of very good online and app-based hearing tests available that will let your husband check his hearing on his own. These tests are a quick and convenient option for the millions of Americans that have mild to moderate hearing loss but often ignore it, or don’t want to go through the hassle or expense of visiting an audiologist for a hearing exam.

Who Should Test?

Hearing loss for most people develops gradually over many years of wear and tear, which is the reason many people don’t realize they actu ally have a hearing problem.

Anyone who has difficulty hear ing or understanding what people say, especially in noisier environ ments or over the phone. Or, if you need a higher volume of music or TV than other people, should take a few minutes to test their hearing.

Self-Hearing Tests

Online and app-based hearing tests can serve as a great screening tool. They are not meant to be a diag nosis, but rather to give you an idea of how bad your hearing loss is and what can be done about it.

For most do-it-yourself hearing tests, you’ll be advised to wear ear headphones or earbuds and sit in a quiet spot.

You also need to know that there are two different types of tests avail able. One type is known as pure-tone testing, where tones are played in de creasing volumes to determine your specific level of hearing loss. And the other type is known as speech-innoise or digits-in-noise (DIN) where you’ll be asked to identify words, numbers, or phrases amid back ground noise.

Where to Test

If your husband uses a smart phone or tablet, two of my favorite app-based hearing tests are the hearWHO app created by the World Health Organization, and the Mimi Hearing Test app. Both apps are free to use and are available through the

HearWHO allows users to check their hearing status and monitor it over time using a DIN test, while Mimi uses pure-tone and masked threshold tests to give you a detailed picture of your hearing abilities.

There are also a wide variety of online hearing tests your husband can take on a computer.

Some top online tests — all offered by hearing aid manufacturers — for speech-in-noise or DIN tests can be accessed at ReSound (resound. com/en-us/online-hearing-test) and Miracle Ear (miracle-ear.com/on line-hearing-test).

And some good online hear ing tests for pure-tone testing are available by Signia (signia.net/en/ service/hearing-test); Ergo (ergo. com/hearing-health/hearing-check); and MD Hearing Aid (mdhearingaid. com/hearing-test).

All of these hearing tests are completely free to use and take less than five minutes to complete.

What to do with Results

If the tests indicate your husband has hearing loss, it’s best to think of that as a starting point. He should take results to his doctor or an audi ologist for further evaluation.

Many insurance providers and Medicare Advantage plans cover rou tine hearing exams, however original Medicare does not.

If his hearing loss is mild to moderate, he should look into the new over-the-counter (OTC) hearing aids, which are available this fall online and at retailers like Best Buy, Walgreens and CVS.

OTC hearing aids don’t require a prescription or medical examination for purchase and they’re much more affordable than traditional hearing aids you buy through an audiologist or a licensed hearing instrument specialist.

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

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Ask St. Ann’s

By Christine Walsh

Facing Down Those Holiday Desserts

Ask

been eating right all year, making healthy choices and keeping the extra pounds at bay.

You’ve

Suddenly, everywhere you look there are cookies of every descrip tion, pies of all kinds, cakes of inde scribable beauty.

Welcome to the holiday season!

It’s the time of year when des serts seem to have us surrendered.

Well, here’s an early gift from a registered dietitian: It’s OK to par take.

It is unrealistic to expect yourself to avoid sweets during the holidays. They’re simply part of the celebra tion, adding to the feeling of good cheer we’re all entitled to enjoy. Un real expectations (“I will not eat any sweets”) will only cause resentment and disappointment, and that’s not how any of us should go through the holidays.

A more realistic approach?

Arrive at the holiday party with a plan. Make an agreement with yourself to follow these steps so you can enjoy without overdoing.

1. Allow yourself some goodies. (The key word is “some.”) Limited indulgence on special occasions will not derail your healthy lifestyle un less you let it.

2a. Scan the dessert table and decide on a few items you really want. Use a small plate and take only the items you decided on. When the plate is empty, call it quits.

2b. Don’t sit next to the dessert table! Why create unnecessary temp tation?

3. Take advantage of the fes tive occasion to engage with those around you. Enjoy the time together to socialize and converse, rather than making eating your central mission.

4. Drink plenty of water. This will keep you hydrated while also helping you feel full and avoid over eating.

5. Bring a healthy dish to pass (roasted vegetables, a salad, the recipe below) so you have something good to fall back on. Enjoy the veg gies and fruits on the hors d’oeuvre tray.

6. Listen to your body. Are you eating because you’re hungry or be cause the cookies just look so good? It takes about 20 minutes for your stomach to tell your brain you’ve had enough. Take a time out and let that message get through.

Alzheimer’s Walk Raises

Nearly $250,000

Rochester and Finger Lakes area residents participated in this year’s Rochester Walk to End Alzheimer’s, raising nearly $250,000 to help fund the care, support and research programs of the Alzheimer’s Associ ation.

Donations for this Walk and the chapter’s additional two Fin ger Lakes Walks will be accepted through Dec. 31.

7. Take a short walk after eating. This can help with digestion and maintain a healthy blood sugar level after a high-carb meal. And be sure to keep up with your normal fitness routine throughout the season.

The holidays are a special time of year, one we all deserve to enjoy. The key is to keep your goals in mind, your urges in check, and your healthy habits in place when the party’s over.

Bonus Recipe: Healthy (and Tasty!) Green Bean Casserole

Ingredients:

1/2 cup whole wheat panko breadcrumbs

1/4 cup freshly grated parmesan cheese

2 tbsp. chopped fresh parsley

4 tbsp. extra-virgin olive oil

2 1/2 lbs. green beans

1 medium onion, thinly sliced

8 oz. baby bella (crimini) mush rooms, sliced

3 tbsp. all-purpose flour

2 cups 2% milk

7 oz. Greek yogur

1 tsp. kosher salt, 1/2 tsp. black pepper, 1/8 tsp. ground nutmeg

Topping: Stir the breadcrumbs, parmesan, parsley, and olive oil together.

Casserole: Blanch the green beans, pat dry. In a sauce pan, saute onion and mushrooms in oil. Add the flour and stir. Add milk and spices. Stir, then let sauce reduce. Remove pan from heat, add yogurt.

Spread half the green beans into a baking dish, then layer half the sauce on top. Finish with the remain ing green beans and sauce. Top with breadcrumb mixture. Broil for 1 to 3 minutes until browned then let sit for 10 minutes. Serves 10.

Christine Walsh, a registered dietitian, is nutrition services manager for St. Ann’s Community. She can be reached at cwalsh@ mystanns.com.

“Our Walk to End Alzheimer’s is our largest fundraiser each year,” said Teresa Galbier, executive direc tor of the Alzheimer’s Association Rochester Finger Lakes Chapter.

“Thousands of people from across our nine-county region come out to help raise awareness and funds for our robust research and our full complement of free programs and services. We couldn’t be happier with the turnout at our second Walk of the season and we are so grateful for the support we receive from the commu nity.”

If

From the Social Security District Office

New Start Dates for Medicare Part B Coverage Coming In 2023

What is not changing:

you are eligible at age 65, your initial enrollment period (IEP):

• Begins three months before your 65th birthday.

• Includes the month of your 65th birthday.

• Ends three months after your 65th birthday.

If you are automatically enrolled in Medicare Part B or if you sign up during the first three months of your IEP, your coverage will start the month you’re first eligible. If you sign up the month you turn 65, your coverage will start the first day of the following month. This won’t change with the new rule.

What is changing:

Starting Jan. 1, 2023, your Medi care Part B coverage starts the first

The Social Security Office Q&A

Q.: When a person who has worked and paid Social Security taxes dies, are ben efits payable on that person’s record?

A.: Social Security survivors ben efits can be paid to:

• A widow or widower—unre duced benefits at full retirement age, or reduced benefits as early as age 60.

• A disabled widow or widow er—as early as age 50.

• A widow or widower at any age if he or she takes care of the deceased’s child who is under age 16 or disabled, and receiving Social Security benefits.

• Unmarried children under 18 or up to age 19 if they are attending high school full time. Under certain circumstances, benefits can be paid to stepchildren, grandchildren, or adopted children.

• Children at any age who were disabled before age 22 and remain disabled.

• Dependent parents age 62 or older.

Even if you are divorced, you still may qualify for survivors ben efits. For more information, go to www.ssa.gov.

Q.: I plan to retire soon. When are So cial Security benefits paid?

A.: Social Security benefits are paid each month. Generally, new re tirees receive their benefits on either the second, third or fourth Wednes day of each month, depending on the day in the month the retiree was born. If you receive benefits as a spouse, your benefit payment date will be determined by your spouse’s birth date.

day of the month after you sign up if you sign up during the last three months of your IEP.

Before this change, if you signed up during the last three months of your IEP, your Medicare Part B coverage started two to three months after you enrolled.

If you don’t sign up for Medicare Part B during your IEP, you have another chance each year during the general enrollment period (GEP). The GEP lasts from Jan. 1 through March 31. Starting Jan. 1, 2023, your cover age starts the first day of the month after you sign up.

You can learn more about these updates on our Medicare webpage at www.ssa.gov/medicare and our Medicare publication at www.ssa. gov/pubs/EN-05-10043.pdf.

Please pass this information along to someone who may need it.

Here’s a chart showing how your monthly payment date is deter mined:

Day of the Month You Were Born Social Security Benefits Paid On

1st-10th Second Wednesday

11th-20th Third Wednesday

21st-31st Fourth Wednesday

For a calendar showing actual payment dates, see the Schedule of Social Security Benefit Payments at www.ssa.gov/pubs.

Q.: Will my Social Security disability benefit increase if my condition gets worse or I develop additional health problems?

A.: No. We do not base your Social Security benefit amount on the severity of your disability. The amount you are paid is based on your average lifetime earnings before your disability began. If you go back to work after getting disability bene fits, you may be able to get a higher benefit based on those earnings. In addition, we have incentives that al low you to work temporarily without losing your disability benefits. For more information about disability benefits, read our publications “Dis ability Benefits and Working While Disabled — How We Can Help.” Both are available online at www.ssa. gov/pubs.

Medical society recognizes healthcare professionals

The Monroe County Medical So ciety has recognized two healthcare professionals who, according to the group, have gone above and beyond the usual call of duty.

They are • Physician Thomas L. Mahoney,

50-plus professional and technical publications.

Excellus selected as one of NYS’s best employers

Excellus BlueCross BlueShield has been recognized by Forbes as one of the best employers in New York state.

In New York state, Excellus BCBS was ranked 19th overall.

• Accreditation— New this year, a score was added for facilities ac credited by the Joint Commission In ternational, an independent, nonprof it healthcare standards organization which has been accrediting facilities since 1951.

the highest rating possible from Medicare. For the seventh consec utive year Excellus BCBS’s Medi care Part D prescription drug plan received a 5-star rating. Additionally, the health plan’s Medicare PPO plans earned 4 stars.

For more than a decade Excellus BCBS Medicare plans have consis tently received above average quality ratings (4 stars or higher).

Excellus BCBS also finished as the:

• Highest ranked company head quartered in the Rochester region

• Highest ranked insurance com pany in the state.

Dr. Tom Mahoney

who earned the 2022 Edward Mott Moore Physician Award. Mahoney served as chief medical officer for Common Ground Health from 2010 to 2021, oversee ing all aspects of clinical data and analytics for the regional health planning organi zation. He was instrumental in securing a $26.6 million community wide grant from the Center for Medicare and Medicaid Innovation for transforming primary care by integrating home and communi ty-based services.

Prior to joining Common Ground Health, Mahoney served as CEO of the Rochester Individual Practice As sociation and was a clinical assistant professor of medicine at the Univer sity of Rochester School of Medicine and Dentistry.

Mahoney serves on several statewide and regional committees, including the New York State Depart ment of Health’s State Health Inno vation Plan-State Innovation Models (SHIP-SIM) steering committee, the NYeC policy committee and the exec utive steering, IT, and clinical quality committees for the Finger Lakes Performing Provider System.

• Louise Woerner, founder of

“We’re proud to be recognized as a great place to work,” said President and CEO Jim Reed. “As a large Up state New York employer, we’re com mitted to engaging and supporting our employees through our strong mission, inclusive culture, flexible work environment and comprehen sive employee benefits.

“Last year, we also raised the minimum wage for all employees from $15 to $18 an hour given this commitment to our employees,” he added.

Forbes, and its market research partner Statista, surveyed 70,000 individuals nationwide who worked for companies with at least 500 em ployees. Forbes divided its list into 51 rankings — one for each of the 50 states and the District of Columbia.

Jewish Home ranks among best nursing homes

The Jewish Home of Rochester, an affiliate of Jewish Senior Life, has been recognized by Newsweek’s Best Nursing Homes 2023 list. Only 4% of nursing homes nationwide received this distinction.

“We are honored to be ranked among the best nursing homes in the nation. Finding the right place for a loved one is an incredibly important decision for families,” said Michele Schirano, administrator of the Jewish Home of Rochester. “Providing high quality care for our residents contin ues to be our first priority. We pride ourselves on the care and compas sion our staff provides every day, and this award provides external valida tion of our efforts.”

Thompson names new nutrition services director

UR Medicine Thompson Health

recently named Rhashard Wat kins of West Henrietta its director of nutrition ser vices.

“Our ratings are a testament to our health plan’s commitment to the health and experience of our Medi care members,” said Sharon Palmiter, vice president for population health strategic programs at Excellus BCBS.

Star ratings measure a variety of health benchmarks, including how a Medicare member’s chronic condi tions such as diabetes and high blood pressure are being managed; whether Medicare members are receiving their preventive screenings and vac cines; and whether the plan is teach ing members about correctly taking their medications as prescribed. Member satisfaction and experience with the health plan and its provid ers are also important measures in the overall quality ratings.

Louise Woerner

HCR Home Care, who earned the 2022 Edward Mott Moore Layperson Award. Woerner is known as an entrepreneur, philanthropist, creative power house, feminist, trailblazer and compassionate thought leader.

She founded HCR Home Care and serves as president of HCR Cares, a 501(c)3 nonprofit.

Woerner has been at the fore front of the evolving Rochester area healthcare community for many years. She has served on numerous boards including two terms on the New York Federal Reserve. She is also the founding director and first president of the Friends of the Na tional Institute of Nursing Research. She is the first living woman induct ed into the Rochester Business Hall of Fame, recipient of multiple honors and nursing awards and the first non-nurse inducted into the Ameri can Academy of Nursing.

Woerner has spoken and written widely, having been published in

In New York state, of the over 600 nursing homes, only 42 were recognized on the Newsweek Best Nursing Homes list.

This award is presented by Newsweek and Statista Inc., the world-leading statistics portal and industry ranking provider. This year’s ranking identifies the na tion’s top facilities awarded by state. Nursing homes in the 25 states with the highest number of facilities were included. The rankings are based on four criteria:

• Performance—Staffing, quality measures, and health inspections data provided by the U.S. Centers for Medicare and Medicaid Services (CMS) were used to create a perfor mance score.

• Reputation— Over 10,000 medical experts including physicians, nurses and nursing home leaders were invited to participate in an online survey to recommend quality nursing homes. Self-recommenda tions were excluded.

• COVID-19 management— Re sponses and protocols during the pandemic were evaluated based on resident impact; facility capacity; staff and personnel; supplies and personal protective equipment; as well as ventilator capacity and vacci nation rates.

Rhashard Watkins

For the past four years, Watkins has served as director of food service operations for Elderwood of Lakeside at Brockport, a 120-bed nursing home. He previously was in leadership roles within nutritional service at the Hurlbut Nursing Home in Rochester. Since 2016, Watkins has also served as chief operating officer of the Roch ester-based Kron Insurance Services, Inc.

Watkins will oversee a nearly 80-person department providing meals to patients of F.F. Thompson Hospital and residents of the adja cent M.M. Ewing Continuing Care Center.

Watkins received an Associate in Applied Science degree in computer information systems at SUNY Alfred, where he later obtained a bachelor’s degree in technology. He received his executive Master of Business Admin istration degree from the E. Phillip Saunders School of Business at the Rochester Institute of Technology in 2019. He is treasurer of the Rochester Alumni Chapter of Kappa Alpha Psi Fraternity, Inc., as well as a board member for the nonprofit Baden Street Settlement in Rochester.

Excellus BCBS receives high ratings from Medicare

The Centers for Medicare and Medicaid Services (CMS) announced its 2023 quality ratings. Excellus BCBS again achieved some of the highest ratings in the state and the nation for quality performance in clinical care and outstanding service to its Medicare members.

CMS awarded Excellus BCBS’s Medicare Advantage HMO plans a 5-star rating. This is the second year in a row Excellus BCBS has received

“No health plan can reach this level of quality care without a real commitment to partnering with local health care providers,” said physi cian Stephen Cohen, senior vice pres ident and corporate medical director for Excellus BCBS.

Nurse at Thompson Health gets DAISY Award

Registered nurse Melissa Hoff

man of the Birthing Center at F.F. Thompson Hospital was recently honored by UR Medicine Thompson Health with The DAISY Award For Extraordi nary Nurses. Hoffman is a resident of Pitts ford and was the first to receive the award at Thompson.

Melissa Hoffman

The nonprofit DAISY Foundation was established in memory of J. Pat rick Barnes by his family members. Barnes died at the age of 33 in 1999 from complications of idiopathic thrombocytopenic purpura (ITP), a little known but not uncommon au to-immune disease. The care Barnes and his family received from nurses in Seattle while he was ill inspired this unique means of thanking nurses for making a difference in the lives of their patients and families.

Hoffman was celebrated during a small ceremony where she received a certificate, a pin, and a hand-carved sculpture called A Healer’s Touch. In addition, she and her colleagues enjoyed cinnamon rolls, Barnes’ favorite treat during his illness.

Thompson Health Vice President of Patient Care Services/Chief Nurs ing Officer Hazel Robertshaw noted during the ceremony that often when a nurse receives a DAISY Award, the response is, “I didn’t do anything special. I was just doing my job.”