HEALTH EXPO BODY - MIND • SOUL Presented by
The Berkshire Eagle January 5, 2019 • Free event from 2-5 p.m. Berkshire Plaza Hotel, 1 West St., Pittsfield, Mass
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Saturday, January 5, 2019 | Body, Mind & Soul The Berkshire Eagle | BerkshireEagle.com 2
TABLE OF CONTENTS
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Making the world right again Vestibular therapy eases dizziness from inner ear disorders
Keeping area athletes healthy and active for life BHS Sports & Wellness provides comprehensive care for Berkshire athletes, from competitive players to weekend warriors
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Deciding on joint replacement surgery Advances in pain management and surgical technology are making the decision easier
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New tool at BMC assesses a woman’s lifetime risk for developing breast cancer Knowing your risk leads to more strategies for prevention and early detection
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Overcoming crisis with resiliency How to weather the storm with your health intact
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Home is where better health can be achieved and maintained The Berkshire Visiting Nurse Association provides health and wellness services that enable people to live to their fullest potential
Making the world right again Vestibular therapy eases dizziness from inner ear disorders By Berkshire Health Systems The symptoms seem to come from out of the blue. You roll over in bed and suddenly feel like you’re dropping off the face of the earth. The intense spinning sensation may only last a matter of seconds, but the experience is unforgettable. Or, your symptoms might be a lot less dramatic, such as a persistent woozy feeling that doesn’t seem quite right. Either situation should prompt an immediate visit to your primary care physician to rule out something serious, noted Berkshire Medical Center Physical Therapists Jessie DeLuca, MPT, and Mary Ann Racette, MPT. But chances are, you just experienced the first episode of vestibular disorder - a condition that affects the inner ear and brain, causing a range of symptoms that can jeopardize balance and quality of life. Both DeLuca and Racette are certified vestibular therapists at BMC’s Center for Rehabilitation, where they help make the world right again for people with vestibular disorders. Beginning with a 90-minute patient evaluation, the therapists isolate the specific
vestibular disorder and create a customized plan of therapy. “The vestibular system is a sensory organ that is housed in both the right and left inner ears,” DeLuca said. “Vestibular disorders can be caused by aging, traumatic head injuries, a virus, other illnesses, and even chemotherapy.” The condition unleashes a wide range of symptoms that include extreme spinning, dizziness, unsteadiness, nausea, and cognitive deficits to memory and concentration. Organizations that provide information and support to those with vestibular disorders say that 35% of all adults over the age of 40 have experienced the condition at some time in their lives. “Left undiagnosed and without vestibular rehabilitation therapy, people who are dizzy or unsteady tend to move around less,” added Racette. “This can lead to an additional range of health problems associated with deconditioning that puts them at a greater risk of falling.” Yet, in a majority of cases, vestibular rehabilitation therapy can ease the symptoms, resolve the disorder and restore most, if not all, quality of life. Not all rehab facilities provide this specialized care so it’s important to make sure a certified vestibular therapist is on staff. Vestibular disorders are typical-
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Body, Mind & Soul | Saturday, January 5, 2019
PHOTO COURTESY OF BHS
From left: Jessie DeLuca, MPT; Eileen Hunter, MPT; and Mary Ann Racette, MPT, vestibular therapists at Berkshire Medical Center’s Center for Rehabilitation.
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ly classified as peripheral, which means the disorder is located in the inner ear, or central, which means the disorder originates in the brain. If peripheral, the inner ear is not giving the brain correct information. If central, the inner ear is providing the right info, but the brain is not processing it correctly. The vast majority of vestibular disorders originate in the inner ear, including Benign Paroxysmal Positional Vertigo (BPPV), which is the most common and most treatable vestibular disorder. In this case, crystals located in the inner ear break free from the vestibular system. When the head is put in certain positions – like when you are rolling over in bed the free-floating crystals trick the brain into thinking it’s spinning out of control. Therapy involves identifying what ear canal is involved and then manipulating the crystals back where they are supposed to be. This condition is 90% treatable, usually in three visits. Another common vestibular disorder that responds very well to therapy is called Bilateral Vestibular Hypofunction (BVH), which occurs when the vestibular nerve in one ear has somehow been damaged, causing a feeling of imbalance. Specialized therapy encourages the other healthy ear to pick up the slack, restoring your sense of balance. Years ago, vestibular disorders were hard to diagnose and people suffered, often with frightening physical symptoms that gradually caused them to be more sedentary, isolated and anxious, the BMC therapists said. Today, physicians are far more likely to refer patients to vestibular rehabilitation for relief. “In addition to easing symptoms and restoring a sense of balance and safety, vestibular therapy enables our patients to take back control of their lives,” the therapists said.
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Keeping area athletes healthy and active for life BHS Sports & Wellness provides comprehensive care for Berkshire athletes, from competitive players to weekend warriors By Berkshire Health Systems
Not so long ago, only elite athletes had access to physicians who were specially trained to help them avoid or recover from injuries and maintain peak performance. Today, athletes of all ages and abilities in the Berkshire are visiting BHS Sports & Wellness – a collaboration of Berkshire Medical Center and Berkshire Orthopaedic Associates – to get the care and guidance needed to stay active and healthy for life. "The Berkshire community has a very active population," said Mark Sprague, MD, an orthopaedic surgeon who is one of the leaders at BHS Sports & Wellness. "Whether it's school sports, organized ball or individuals who enjoy outdoor activities, thousands of people are out there every day. Our goal is to help these athletes enjoy their sports without overextending themselves or suffering injury that prevents them from remaining active." Also leading the team at BHS Sports & Wellness is Orthopaedic Surgeon Mahlon Bradley, MD, who was a national competitive figure skater from 1969 to 1978,
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at Tufts, Harvard and Northeastern University. Serving as Program Coordinator of BHS Sports & Wellness is Erica Baptiste, MA, ATC, LAT, who ďŹ rst learned about sports medicine when she was injured as a ďŹ eld hockey goal keeper in college. “That experience exposed me to a career path as a state certiďŹ ed athletic trainer, thanks to the unforgettable care and rehabilitation I received,â€? she said. “Now, our team at BHS Sports & Wellness is providing excellent treatment for athletes who are injured - just like I was – offering the kind of personalized care that ensures a healthy and safe return to the sport of their choice." The goal of BHS Sports & Wellness is to get injured athletes back into the game as quickly and safely as possible through careful diagnosis, treatment and care. The program offers comprehensive care for all sports injuries, including fractures, bracing and splinting. Programs focused on injury prevention, nutrition, concussion management and many other is-
PHOTO COURTESY OF BHS
Body, Mind & Soul | Saturday, January 5, 2019
and a member of the US International Figure Skating Team from 1976 to 1977. “I was always very involved in sports and wanted a profession that would ďŹ t into my life,â€? he said. “I’m fascinated by this always-changing ďŹ eld of sports medicine and the great impact it has on athletes of all ages and levels. It’s great that my day-to-day profession is so closely aligned with what I love to do.â€? Dr. Bradley is board certiďŹ ed in Orthopaedic Sports Medicine, while Dr. Sprague is fellowship trained in sports medicine. Both have strong links to the world of athletics. In addition to his own career in ďŹ gure skating, Dr. Bradley served as the team physician for the US Olympic Team in the 2002 Olympics in Salt Lake City, and has been the team physician for US Figure Skating from 1989 to the present. Dr. Sprague serves as team physician for the PittsďŹ eld Suns and prior to joining Berkshire Orthopaedic Associates, he provided sideline medical expertise to the Boston Celtics and athletic teams
From left: Mark Sprague, MD, Erica Baptiste, MA, ATC, LAT, Mahlon Bradley, MD. sues that challenge area athletes are also provided, as well as sports clinics to ensure that injured athletes are seen at the ofďŹ ce as soon as possible. Also part of the multidisciplinary team at BHS Sports & Wellness are physician assistants, physical therapists, coaches, trainers, and wellness experts.
“But at the center of this approach to sports medicine are the athletes,â€? Baptiste said. “Our goal is to get them back into the game as quickly and safely as possible through expert treatment and care.â€? To ďŹ nd out more about BHS Sports & Wellness, visit berkshirehealthsystems.org/sports
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Deciding on joint replacement surgery Advances in pain management and surgical technology are making the decision easier By Berkshire Health Systems
People have always weighed the benefits and risks of joint replacement surgery before deciding whether to undergo the procedure. Will the pain associated with surgery and recovery outweigh the pain they’re living with every day? For some people, the answer is a resounding yes. A deteriorating knee or hip can make every step excruciating, taking a lot of the joy out of life. But others hang on for as long as they can, hoping to avoid what they believe will be a very painful experience.
Over the last several years, dramatic changes in pain management for joint replacement surgery, improvements to the surgical procedure itself, and new technology designed to enhance accuracy and precision are all making joint replacement surgery a less difficult choice. “Joint replacement surgery is still painful - I don’t want to mislead anyone on this point,” said Daniel Sage, MD, an orthopaedic surgeon at Berkshire Orthopaedic Associates. “But generally, people are not suffering like they once did. Today, we attack pain from a variety of angles.” Beginning with the anesthesia used during surgery and on to a full arsenal of pain management modalities, orthopaedic surgeons now use intra-articular injections, nerve blocks, IV acetaminophen, anti-inflammatories and other
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non-narcotic medications to help their patients recover from surgery as comfortably as possible. And all of these options mean that patients, on average, require less narcotic medications. Good pain management enables patients to get out of bed and start moving their new hip or knee – often on the same day as surgery. Movement is an essential first step to recovering and the continued ability to keep moving will help speed the process. Adding to improvements in pain management are advancements in surgical procedures, including the advent of more reliable cementless knee implants over the last decade. “Traditionally, the gold standard in knee replacement surgery was the use of cement to bond the implant to the bone,” Dr. Sage continued. “Yet, cement could break down over a period of time, some-
times requiring additional surgery to revise the implant years later.” Today, cementless knee implants are performing very well – with growing evidence to support its use in many patients, he said. The great advantage to this technique is that the bone will grow into the implant and become part of the body. It also eliminates a potential cause of revision down the line. “In my opinion, one of the most encouraging advancements in joint replacement surgery is robotic technology, which supports greater accuracy in bone cuts and more precise placement of the implant,” he said. “Before surgery, a CT scan enables surgeons to plan how much bone will be removed to make way for the new implant. The image also guides the exact placement of the new joint. During surgery, the robotic arm makes sure that this plan is followed exactly,
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Body, Mind & Soul | Saturday, January 5, 2019
PHOTO COURTESY OF BHS
Daniel Sage, MD, an orthopaedic surgeon at Berkshire Orthopaedic Associates.
allowing us to consistently give a patient a perfectly balanced and aligned knee replacement.” Robotics in joint replacement surgery is relatively new and definitive studies to support its use are not yet available. However, early literature suggests improved pain scores, physical function scores, and overall patient satisfaction. Robotics also enable surgeons to accurately place implants in patients who are considered outliers – meaning the alignment of their legs fall outside of what is considered average. “Orthopedic surgeons diagnose when a patient reaches the point when joint replacement becomes necessary,” Dr. Sage said. “But only patients can decide when they’re ready. Hopefully, it’s an easier choice these days. And waiting on the other side of surgery is a better quality of life.”
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New tool at BMC assesses a woman’s lifetime risk for developing breast cancer Knowing your risk leads to more strategies for prevention and early detection
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By Berkshire Health Systems
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Mammography changed the course of women’s health care in 1976, when the screening test was first recommended for the early detection of breast cancer. Before then, cancer was typically diagnosed when a tumor could be felt by hand – often too late for effective treatment. “Many women are alive today because annual mammograms beginning at age 40 detect cancer at earlier and more treatable stages,” said Caitlin Lopez, MD, medical director of the Women’s Imaging Center at Berkshire Medical Center. “We now have an additional tool that can help assess a woman’s lifetime risk for breast cancer, providing greater opportunities for prevention and early detection.” Women checking in for their annual mammograms at the Women’s Imaging Center are now invited to take a risk assessment survey that calculates their esti-
mated lifetime risk. Just getting older places them at increased risk for breast cancer, but other factors contribute to lifetime risk as well. Thus, the survey asks about family history of breast cancer, the woman’s own medical history, at what age she started her period, whether or not she’s given birth, and more. “It is important to note that this risk assessment does not predict whether or not a woman will develop breast cancer,” Dr. Lopez continued. “Its value is in estimating her level of risk, which provides opportunities to take steps to reduce it. Both the woman and her primary care physician receive the results of the assessment survey and, depending on the level of risk, decide together what options are available to reduce risk.” For example, women who are found to be at high risk for developing breast cancer may be screened with MRI in addition to mammography. Women who are
PHOTO COURTESY OF BHS
Caitlin Lopez, MD, Director of the Women’s Imaging Center at Berkshire Medical Center.
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Early detection and better treatment options are improving the chances of surviving breast cancer. A breast cancer diagnosis can be a devastating blow. Upon receiving such a diagnosis, people may begin to ask questions about treatment and the impact cancer may have on their personal lives. Many people who are diagnosed with cancer also begin to wonder about their mortality. An estimated 266,120 new cases of invasive breast cancer and 63,960 new cases of non-invasive, or in situ, breast cancer are expected to be diagnosed among women in the United States this year, according to Breastcancer.org. According to the latest statistics presented by the Canadian Breast Cancer foundation, 26,300 women and 230 men had been diagnosed with breast cancer in Canada in 2017. The good news is that breast cancer incidence rates began decreasing in 2000 after increasing for the previous two decades. In addition, death rates from breast cancer have been decreasingly steadily since 1989.
lifetime risk for developing breast cancer is one way for women to make more informed decisions about their breast health and care.” In addition to letters sent to patients and their physicians, nurse navigators at BMC follow up by phone to answer questions and provide more information if requested. “We understand that knowing you are at high risk for breast cancer may be daunting, but our patients are eager to learn more, meet with their primary care physicians, and develop a strategy that emphasizes prevention and early detection,” Dr. Lopez said.
The National Cancer Institute says that the change in age-adjusted mortality rates are an indicator of the progress being made in the fight against breast cancer. The most recent SEER Cancer Statistics Review released in April 2018 indicates cancer death rates among women decreased by 1.4 percent per year between the years of 2006 and 2015. The American Cancer Society says that decreasing death rates among major cancer types, including prostate, colorectal, lung, and breast cancers, are driving the overall shift in survival. The ACS says breast cancer death rates among women declined by 39 percent from 1989 to 2015. That progress is attributed to improvements in early detection and treatment protocols. For anyone doing the math, over the last 25 years or so, 322,000 lives have been saved from breast cancer. A similar scenario has unfolded in Canada. Breast cancer mortality rates in Canada recently decreased to 21.4 percent, down from 21.8 percent in 2011, states data from the Canadian Cancer Society. Currently, the five-year survival rate for breast cancer among Canadians is 87 percent, and the five-year net survival in the United States is 85 percent. Increased knowledge about breast cancer, early detection through examinations and mammography and improved treatments are helping to drive up the survival rates of breast cancer. Although this does not make diagnosis any less scary, it does offer hope to those recently diagnosed. METRO CREATIVE
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at high risk may also benefit from genetic testing and/or hormonemodulating medications. Although some additional tests are for use only in the high-risk population, all women, including those with intermediate or average lifetime risk levels, can reduce their risk for developing breast cancer by maintaining a healthy weight, exercising, breastfeeding, limiting alcohol, and not smoking. “One of the difficult aspects of breast cancer screening is that women with calculated high risk don’t always develop breast cancer, and most breast cancers are diagnosed in average risk women,” Dr. Lopez said. “Knowing the
Body, Mind & Soul | Saturday, January 5, 2019
Breast cancer survival rates soar
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Saturday, January 5, 2019 | Body, Mind & Soul
Overcoming crisis with resiliency How to weather the storm with your health intact By Berkshire Health Systems
The world can be a wonderful place. It can also be wildly unpredictable. In the midst of what seems to be a steady and happy period in life, an event suddenly happens that feels like a catastrophe. A good example is the loss of a job. Adrenaline starts pumping as people consider the financial uncertainties ahead. Hearts beat faster. People feel sick, and wake
up frequently at night worrying about the future. “Some people can take this kind of punishment without a risk to their health. No matter how harshly life treats them, they can’t be broken,” said Alex N. Sabo, MD, Chairman of the Berkshire Medical Center Department of Psychiatry and Behavioral Science. “But for most of us, catastrophes that go on for too long can threaten our health and leave us vulnerable to illness.”
PHOTO COURTESY OF BHS
Alex N. Sabo, MD, Chairman of the Berkshire Medical Center Department of Psychiatry and Behavioral Science.
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These feelings are normal. Transform the catastrophe into a challenge. Being resilient does not mean having the ability to tough it out on your own. Assemble a team of people who care about you and leverage their various skills to help solve the challenge. Your team can include family, friends, your church group, therapist or others. The importance of social bonding—spending time with supportive people — cannot be overemphasized during a catastrophe. Break the challenge into pieces. Some you can solve and some you cannot. Accept those that you can’t control and don’t waste time trying to change the impossible. Instead, work relentlessly and tenaciously on those you can control. This step is very important. Sometimes, despite the best efforts to follow the principles of healthy coping, a pro-longed stress reaction can set in. “Typically, it begins with the inability to sleep eight hours a night,” Dr. Sabo said. “You may begin to feel anxious and worried all the time. If this continues for
“For most of us, catastrophes that go on for too long can threaten our health and leave us vulnerable to illness.” — ALEX N. SABO, MD
two to eight weeks, you may lose your appetite, lose pleasure in the things that you once enjoyed, develop a persistently sad or irritable mood, and have poor concentration and fatigue. Depending on how severe the stress reaction, some may even begin to think that ending their life is the best or only option.” Dr. Sabo advises reaching out for help from a physician, minister, pastor, rabbi or imam, therapist, or local mental health agen-
cy. And just as important, he said, is helping those who are suffering through a crisis. “A prolonged stress reaction which has evolved into a major depression is treatable by psychotherapy and/or medication. Help is available and things will get better,” he said. “Having resiliency will not make the catastrophes in life disappear. However, being resilient will help you weather the storm with your health intact, ready to face what comes next in life.”
Body, Mind & Soul | Saturday, January 5, 2019
When faced with life’s misfortunes, people become pre-occupied with the immediate stress of the moment and neglect the basics that keep them healthy. Yet, it is precisely during the most difficult periods in life when self-care is most beneficial. According to Dr. Sabo, attention to sleep, exercise and good nutrition are all extremely important yet frequently overlooked when it feels like the world is falling apart. “It’s always a good idea during a crisis to make a checklist that will remind you to drink enough water, eat something healthy, get a little exercise, and sleep on a daily basis,” he continued, adding that the following four steps are simple yet powerful ways to harness the inner strength and resiliency needed to recover from a major setback: Be compassionate to your mind and body. Acknowledge what you are feeling and thinking. As people weather devastating situations, they need validation for their experience, the emotions they are feeling, and the serious life predicaments they must begin to solve.
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Body, Mind & Soul | Saturday, January 5, 2019
Home is where better health can be achieved and maintained The Berkshire Visiting Nurse Association provides health and wellness services that enable people to live to their fullest potential People who are sick enough to be hospitalized begin their recovery in the hospital, and maybe even spend time in a short-term rehabilitation facility to regain their strength and mobility. But many of them find the most enduring path back to health and wellness comes from caregivers at Berkshire Visiting Nurse Association, who are skilled at helping them overcome an acute illness or injury, while also preparing them for better health and wellness in the future. “We see our role as guiding our patients from a more restrictive facility like a hospital to continuing their recoveries at home,” said Mary Hagarty, RN, MSN, Director of the BVNA. “Our niche is help-
ing people make a successful connection back to their community.” The BVNA is the largest certified home health provider in the area. They are fully integrated with Berkshire Health Systems, which means all caregivers associated with each patient collaborate to provide a seamless transition of care from the hospital, to short-term rehab, and on to the BVNA and home. The BVNA serves everyone – from newborns and their mothers to people of all ages who are recovering from an illness or injury. PHOTO COURTESY OF BHS
Christine Frydel, RN, and Janet Stone, RN, nurses at the Berkshire Visiting Nurse Association.
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BCArc Adult Family Care (AFC) Program A caregiving program for individuals needing assistance with daily living Who We Are: Berkshire County Arc’s Adult Family Care program was founded in 2009. The program currently serves more than 125 qualified individuals receiving quality services in their own homes, or the homes of their caregivers. Our Members: Our members are individuals age 16 and up who cannot live safely on their own, due to medical or physical disabilities or cognitive impairments. Our Caregivers: An AFC caregiver can be any family member or non-family member who is not currently the member’s legal guardian or spouse.
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46 Elm Street, Pittsfield MA 01201 413-464-7262 ext 15 • www.bcarc.org
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They are known for providing skilled nursing care – whether it’s managing diseases like diabetes and high blood pressure, to caring for patients with heart failure, chronic wounds and ostomies; those needing infusion services and more – all at a patient’s home. And home is the differentiator that enables the BVNA to expand the limits of their care from an injury or illness to a patient’s future health and independence. “Home visits enable BVNA caregivers to see what challenges may exist that will prevent their patients from recovering and living the kind of life they want, despite a change in their health condition,” Hagarty said. For patients with mobility issues, stairs to get in and out of the house present a barrier to independence. For patients with severe chronic wounds or diabetes, the wrong food in the fridge won’t provide the kind of nutrition needed to regain and maintain their health. For people with respiratory or cardiac issues, evidence of smoking is a red flag for the BVNA caregivers.
“Our challenge is not just resolving the acute issue that caused the illness or injury in the first place, it’s also about working with our patients to make lifestyle changes that will keep them at home and out of the hospital,” Hagarty said. The BVNA caregivers include RNs, LPNs, speech, physical and occupational therapists; medical social workers and certified home health aides. They work in teams that revolve around a patient’s diagnosis, so that experts in caring for those with congestive heart failure, for example, are on the right team for the right patient. They coordinate with other community agencies for resources not provided directly by the BVNA. All departments work together to offer the combination of health and social services that patients may need, Hagarty said. BVNA caregivers will provide a comprehensive assessment of their patient’s health, as well as assess the home environment and speak with close family members. “Our service is very patient-centered. We ask during the first visit or two what their expectations
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and goals are, and we help achieve them,” Hagarty continued. “Our role starts at the post-acute time, but we don’t stop there. Most of our patients have other factors that will impact their health and wellness that we need to address. We ask our patients how willing they are to manage their health and extend their lives. This is crucial to getting the best patient outcomes.” Thus, the BVNA caregivers have frank conversations with their patients about their health and all other necessary issues that will enhance their long-term goals. Do they have enough heat in the home; enough nutritious food? Can they afford their medications and do they know how to take them? Are they having trouble adhering to a diabetic diet? In addition to skilled nursing care, the BVNA also serves as patient educators. For the typical patient, the entire process takes about two months. “Before we discharge a patient from our services, we want to make sure they’ve made as much progress as possible, and we have provided all that we can for them,” Hagarty said.
Educa ng and Promo ng Healthy Communi es in the Berkshires since 1979 x x x
Con nuing Educa on for Health Care Professionals Medical Interpreter Training
Tobacco Free Community Partnership
(413) 443-3577 • www.drschagen.com
x x
...because home is where the heart is!
PHOTO COURTESY OF BHS
Mary Hagarty, RN, MSN, Director of the Berkshire Visiting Nurse Association.
MA Food Allergen Awareness Training
Conference Management
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Offering: Live-In Service, Personal Care, Medication Reminding, Homemaking, Companionship, Shopping and Errands, Pet Sitting/Care
Tolearnmorecontactusat:(413)236-4500
152 North Street, Suite 40, Pittsfield, MA 01201 413-464-7524 • mtviewhomecare.com
www.berkshireahec.org
c/o BCC,1350West Street, K213HPittsfield,MA01201
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