OurHealth Lynchburg & Southside Aug/Sep 2013 Edition

INSIGHT ON MEMORY CARE

BLUE RIDGE BEST OF

2013 Retirement Living Awards

A UGUS T

•

THE ABCs OF BACK TO SCHOOL HEALTH

NUTRITION: THE HARVEST RECIPES

S EPTEM BER 2013 | LYNCHBURG AND SOUT HSIDE VIRG INIA E DIT ION | OURHE ALT H V IRGIN IA . C O M

table of contents | august • september

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COVER STORY The New Face of Retirement: Retirement is no longer MEDI•CABU•LARY.....................10 Local experts define healthcare related terms

about resting on your laurels. Our local seniors can attest to this.

JUST ASK!..................................12 A variety of health questions answered by local professionals

THE LATEST...............................14 A listing of new physicians, providers, locations and upcoming events in Lynchburg and Southside Virginia

HEALTH AND FITNESS ON THE GO..................................17 Health-focused apps you can download to your smartphone or tablet

2013 blue ridge best of:

RETIREMENT LIVING AWARD

WINNERS

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[SPECIAL ADVERTORIAL SECTION]

RETIREMENT LIVING HIGHLIGHTS...............................24

RETIREMENT LIVING AWARDS This year, nearly 10,000 votes were cast by people in our communities for their favorite senior services. FIND OUT IF YOUR FAVORITE MADE THE CUT!

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BASIC | our health

• A Holistic Approach

49

• Fast Facts About Dementia from the Alzheimer’s Association

The ABCs of Back-to-School Health

MEMORY CARE...........................37

BACK TO SCHOOL HEALTH

COMFORT AND PEACE..............42 Becoming a Conduit of Comfort

44

NUTRITION Healthy Eats! Preparing for the Harvest

MEDICAL EDUCATION ADVANCEMENTS........................58 •L ynchburg and Southside and Southwest Virginia colleges and universities are answering the call for needed medical care •L ynchburg College plans to create area’s first physician assistant program

MEN’S HEALTH...........................65 PROSTATE CANCER • A controversial issue with no one right answer

www.ourhealthvirginia.com | 7

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CONTRIBUTING MEDICAL EXPERTS Becky Bowman, Ed.S Allison L. Brooks, MSN, FNP-BC, AACC

Jennifer Claiborne, DDS Jodi V. Ettare, PharmD Tricia Foley, MS, RD Cory Passman, MD Geeta Rakheram, MD, FACP Matthew J. Tompkins, MD CONTRIBUTING PROFESSIONAL EXPERTS AND WRITERS Sarah Cox Rich Ellis, Jr. Anika Imajo Laura Neff-Henderson, APR Rick Piester Jennifer Romeo Edwin Schwartz ADVERTISING AND MARKETING Cynthia Trujillo P: 434.907.5255 F: 540.387.6483 cindy@ourhealthvirginia.com

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COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher: 305 Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.355.3071 Information in all print editions of Our Health and on all Our Health’s websites, including: www.ourhealthvirginia.com is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions.

Copyright © 2013 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. The Our Health Lynchburg and Southside Virginia edition is published bi-monthly by McClintic Media, Inc. 305 Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. www.ourhealthvirginia.com. Advertising rates upon request.

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our health | MEDI•CABU•LARY & JUST ASK

me d i • ca bu • l ar y

T H E L A N G U A G E O F H E A LT H C A R E E X P L A I N E D

What are orthodontic retainers and why are they necessary?

Retainers are used for two reasons: first, to allow bone to rebuild after your teeth are moved and second, to keep individual teeth from drifting back towards their original positions. In other words, retainers preserve and stabilize the results you and your orthodontist achieved through your orthodontic treatment. There are many types and designs of both upper and lower retainers. Most retainers are removable, but sometimes a fixed retainer is recommended in certain situations. Movement is most common in the lower front teeth and this is particularly true if the teeth were extremely crowded prior to treatment. Changes in tooth position are a lifelong and naturally occurring phenomenon for all of us even if braces are never worn. The best way to keep teeth from shifting is to wear your retainers as prescribed by your orthodontist.

Jennifer Claiborne, DDS Central Virginia Orthodontics Lynchburg | 540.385.GRIN (4746)

Are angina (chest pain) symptoms different in men and women?

What are my options for a Pelvic Prolapse (dropped bladder)?

Heart disease is the leading cause of death in both men and women as approximately 600,000 Americans die of heart disease each year. Although typically thought of as a problem for men, more women than men die of heart disease. Heart attack symptoms are typically thought of as an elephant sitting on the chest with discomfort radiating to his/her arms and associated symptoms of sweating and nausea.

While these particular symptoms may be present in both men and women; women often have atypical symptoms which can often be ignored and attributed to other conditions. Women may exhibit generalized fatigue, weakness/ dizziness, an uncomfortable sensation in the chest, jaw/neck or back. Other associated symptoms may include of shortness of breath, sweating, and nausea. If you are having any of these symptoms it is important to seek medical attention.

Pelvic prolapse is caused by a weakness in the support of the vaginal wall and/or uterus. The two main options for this problem are the use of a pessary or surgery.

A pessary is a flexible ring that your physician inserts vaginally that acts as a brace to support the bladder and/or uterus. The surgical options depend on your exam, but repairs can often be performed vaginally or with the da Vinci robot. This allows physicians to perform the repair without a large incision.

Allison L. Brooks, MSN, FNP-BC, AACC Stroobants Cardiovascular Center Lynchburg | 434.200.5252

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Matthew J. Tompkins, MD Lynchburg Gynecology Lynchburg | 434.385.7818

our health | MEDI•CABU•LARY & JUST ASK

ju st a sk!

T H E L A N G U A G E O F H E A LT H C A R E E X P L A I N E D

What type of blood tests are normally requested during my yearly physical?

Can I throw unused prescription and over-the-counter medicines in the trash?

What’s the best way to help my child prevent picking up an illness at school?

The following blood tests are normally recommended for an adult wellness exam:

Yes, but not always. Ideally, you would take your unwanted medications to one of the DEAsponsored drug take-back days at your local police department or a pharmacy licensed to take back non-controlled, donated medications. Otherwise, the Environmental Protection Agency requests that most medications be placed in the trash, but in a very specific way. They should be taken out of the original container, placed in a sealed container (like a baggie or something with a lid) along with an inedible substance like coffee grounds or kitty litter, and then placed in the trash can. Certain narcotics, such as oxycodone tablets and fentanyl patches, have labeling that tells you to flush them down the toilet. Bottom line is this: if it doesn’t say “flush it” on the medication handout, throw it in the trash, or return it to police or a pharmacy permitted to accept it and save our drinking water.

If you’re not sure, call your local pharmacist for advice.

Of course, keep your child up to date on immunizations and seasonal flu vaccines. Most importantly, educate your child that the most common way for kids to pass around a “bug” is for them to touch germy surfaces then rub their nose or eyes or put fingers or items in their mouths. Help them recognize top germ spots like the water fountain, pencil sharpener— any shared area that many others touch. Encourage them to politely steer clear of other children who are coughing or sneezing and not share pencils, lip balm, etc.

• A complete blood count (CBC), which is a blood test used to evaluate your overall health and detect a wide range of disorders, including anemia, infection and leukemia.

• A blood test to check cholesterol levels — called a lipid panel or lipid profile — which typically reports: Total cholesterol; LDL cholesterol; HDL cholesterol; Triglycerides — a type of fat in the blood.

• A blood test to measure the amount of Vitamin D in your blood.

• Metabolic Panel (Blood Sugar, Kidney, Liver function) Based on results of CBC, lipids, metabolic panel and Vitamin D, further testing may be indicated based on your risk assessment, age, and new/presenting symptoms.

Geeta Rakheram, MD, FACP Medical Associates of Central Virginia Lynchburg | 434.947.3944

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Jodi V. Ettare, PharmD Rustburg Family Pharmacy Rustburg | 434.332.1730

Show them how to properly wash their hands with soap, warm water, and good scrubbing and encourage them to do this often. Make certain hand sanitizer or wipes are readily available.

Becky Bowman, Ed.S Timberlake Christian Schools Forest | 434.237.5943

our health | THE LATEST

the l atest

N E W P H Y S I C I A N S , P R O V I D E R S , L O C AT I O N S A N D U P C O M I N G E V E N T S

New Therapy Gym, Space-Age Equipment at Lynchburg Health & Rehabilitation Center Lynchburg Health & Rehabilitation Center unveiled its new therapy gym in June, providing an airy, open facility filled with updated equipment to help restore health and mobility to patients recovering from accidents, illness or surgery.

Nearly a year in planning and construction, the therapy gym doubles the space of the former gym, and is staffed by a team of physical therapists who are expert in returning people back to their best possible states of health. The new gym also includes a redesigned area for occupational therapy, where patients can regain skills they need for everyday tasks when they return to life in their homes or at work.

Rehab Therapists Demonstrate the AlterG Anti-Gravity Treadmill MFA employees in the photo from left to right: Rachel Ewers, Rehab Therapist; William Fralin, President and CEO of Medical Facilities of America; Paul Saks, Administrator of Lynchburg Health & Rehabilitation Center; Drew Gowen, Rehab Therapist; and Al Abaidoo, Rehab Therapist.

The crown jewel of the new gym is the addition of a piece of equipment that defies gravity by reducing body weight to make it easier for patients to exercise and return to their normal lives that much earlier.

The AlterG Anti-Gravity Treadmill is especially helpful for people who are recovering from hip or knee replacement or who have suffered serious lower body injuries. It is also used for overweight people who are beginning an exercise program.

Rehab Therapist Demonstrates Dynamic Stair Trainer

The Dynamic Stair Trainer simulates the stairs, inclines, Originally developed by and rails that may be present in a home environment.

NASA to make it possible The MFA employees in the photo from left to right: Ed for astronauts to exercise Apuya, Rehab Therapist; Brian Anderson, Administrator of Stanleytown Health & Rehabilitation Center; and in space, the equipment Jonathan Calloway, Rehab Manager at Stanleytown involves an inflatable Health & Rehabilitation Center. chamber around the patient’s lower body. The chamber uses air pressure to reduce body weight by as much as 80 percent, making it much easier and safer for patients to get the exercise they need.

Lynchburg Health & Rehabilitation Center is at 5615 Seminole Ave. in Lynchburg. More information is at www.lynchburghealthrehab.com.

Centra Backs Lynchburg College’s Doctor of Physical Therapy Program

New Doctor

Three years ago, Lynchburg College and Centra began a partnership, designed to address the shortage of physical therapists, by helping to fund the doctor of physical therapy program now located on Monticello Avenue.

In 2010 Centra donated $250,000 to help pay for the facility and equipment and had pledged another $250,000 when the program received its full accreditation. After graduating its first class of 44 students this May, Lynchburg College was granted full accreditation status from the Commission on Accreditation in Physical Therapy Education (CAPTE).

Fulfilling their promise, Centra presented Lynchburg College with $250,000 in a check presentation on Tuesday.

“I am most grateful to Mr. E.W. Tibbs for this financial assistance and for the tremendous leadership that Centra and Centra administration and personnel have shown in the development of Lynchburg College’s Doctor of Physical Therapy (DPT) program,” said Dr. Kenneth Garren, president of Lynchburg College. “I am so pleased that the College has completed the requirements for receiving this final gift of support from Centra. I receive this gift with deep gratitude, for it is clear to me that Centra’s strong support has been critical to the success of our program,” said Garren.

From left to right: Deb Shipman, Centra Vice President of Rehab and Senior Care Services, Dr. Ed Polloway, Dean of Graduate Studies Lynchburg College, Kristina Jones, Centra Managing Director of Rehabilitation, Dr. Ken Garren, President of Lynchburg College, E.W. TIbbs, Centra President and CEO, Rusty” Smith, PT, EdD, OCS, Program Director of the DPT program.

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The doctor of physical therapy (DPT) program is a three-year graduate program that prepares students desiring to enter the physical therapy profession. Established in partnership with the regional healthcare community, the DPT program is designed to meet the growing demand for physical therapists.

“Historically, physical therapists have been hard to recruit,” said E.W. Tibbs, president and CEO of Centra. “It is a very demanding occupation, and this program allows us to be involved in their training and mentoring.

We are excited to be a part of this program with Lynchburg College.”

Brent Carothers, MD Centra Medical Group Stroobants Cardiovascular Center Lynchburg | 434.200.5252

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HEALTH AND FITNESS ON THE GO | our health

Health and Fitness

On the Go

Having information at your fingertips - that’s what mobile apps are all about. Empowering users to effectively manage their healthcare and a healthy lifestyle is important to everyone.

In our Health and Fitness on the Go section, we recommend a variety of health-focused apps you can download to your smartphone or tablet.

iTriage iTriage, founded by two emergency medicine physician, helps users answer the two most common medical questions: “What could be wrong?” and “Where can I go?” iTriage helps you take charge of your health with simple tools to research problems, take action and live healthier.

Android

This app features loads of training tools to help you stay on track: »» »» »» »» »» »» »» »»

Check symptoms Learn about possible causes Research medications Determine appropriate action Locate and compare nearby care options Choose a medical provider Manage your personal health Free for iPhone and Android

iPhone

Noom Walk

SHARE YOUR FAVORITE HEALTH AND FITNESS APP!

Our new favorite pedometer! Noom Walk is better than your average pedometer. With this app, connect with your Noom friends and cheer each other along in your daily, weekly, or all-time step count! If you’re Android not wild about the social features, just use Noom Walk privately without uploading any information. Not only does it count all your steps, it does it without killing your battery! This is probably our favorite feature. Noom Walk uses less than 2% of your battery in a 24 hour period. You can leave it on all day! Challenge yourself to get a few more steps every day. »» Free for Android »» Not yet available on iphone, but coming soon

Share your favorite health and fitness app! Scan this QR code with your smartphone or tablet to visit and “Like” Our Health’s Facebook page, then post a “Comment” with your favorite health and fitness APP!

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the new face of retirement Jackie Asbury

the NEW FACE of RETIREMENT | our health

Jacqueline (Jackie) Asbury didn’t grow up “as a Southern lady serving tea and smiles,” as she puts it. “I grew up on a farm where you didn’t have to find ways to exercise. We all worked and I did physical labor as a fairly young child. Girls worked as well as boys.”

That propensity for staying active, and a strong work ethic instilled at an early age, didn’t end when Asbury left the farm, nor has it disappeared as she nears her 76th birthday. If anything, it’s growing stronger.

Asbury, who lives in Lynchburg and holds a doctorate degree, worked at Lynchburg College for 43 years in several capacities, including as a professor and an administrator.

For the last decade of her career, she was the dean of the college.

“I was lucky to work in a setting that was totally devoted to helping people improve their lives and make better lives,” she explains.

ACTION ORIENTED words | RICH ELLIS, JR.

Her list of hobbies and activities might make a person half her age tired just reading about it. The year after her retirement, she took a master gardener course offered by Virginia Tech and the Cooperative Extension Office and today belongs to the Hill City Master Gardeners Association (HCMGA). In addition to helping support gardening education in local schools and Boys and Girls Clubs through HCMGA, Asbury tends to her flowers at home and works in her brother’s garden in Pittsylvania County.

She also enjoys cooking, which she calls one of her “more special private activities,” and has an extensive cookbook collection that she rarely uses because now she just goes online for recipes. She also has, at various times throughout her life, knitted, sewed and embroidered.

“I don’t do all those things all the time,” Asbury says. “But exercise is my one consistency.”

She works out at a local Snap Fitness location, where her favorite machine is the elliptical. “I had a hip replacement in 2000 and the elliptical is kind to artificial hips — much more so than a treadmill or bike,” Asbury says. For the past several months, she’s also been serving as a personal trainer — to her 13-year-old grandson. www.ourhealthvirginia.com | 19

our health | the NEW FACE of RETIREMENT

Her reasons for staying active are many, and include the fact that during her professional life she taught various physical education activities, including yoga for 25 years.

“One thing I know that most people have trouble learning is that you have to keep exercising whether you feel good that morning or not,” Asbury explains. “Exercise and health have to be habits like eating breakfast or drinking coffee. If you say I’m going to go at 9:00, you go. When you don’t go, you don’t feel good. You have to make it a habit. That’s probably the hardest thing for people.”

Another thing that Asbury thinks people often don’t put together is that so many things are tied to being active, such as being able to eat certain foods that you enjoy. “If you exercise, you still can’t eat like a pig, but you can enjoy your food and how you feel after exercising,” Asbury says.

Genetics also appear to be in Asbury’s favor when it comes to health and longevity.

Her mother lived to 99 and she had a grandmother who lived into her mid-90s. “I think my health is probably phenomenal,” Asbury exclaims. “No heart problems, no blood pressure problems.”

She recommends that other people find a way to be active and that there are several ways to do it.

“The most important thing is to have a plan and start slowly. For example, if I want to run a marathon but I’ve been doing nothing and then go boom, boom, boom, that’s too much, too soon. It needs to be progressive and one should always make sure their doctor says it’s a good idea. Most physicians will tell patients to exercise and watch their food intake. It’s mostly commonsense advice and evidently it’s the hardest advice to follow.”

As a final piece of advice, Asbury says that people just have to decide before age 60 that health is important. “At any age, you can start slowly and make positive changes. I’m not going to be in the Olympics, but I want to be able to feel good when I get up in the morning and be able to sleep.”

“There’s no need to live to 95 if you’re going to be miserable between 80 and 95.”

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the new face of retirement

A FULL LIFE words | RICH ELLIS, JR.

(AND SCHEDULE!) words | RICH ELLIS, JR.

Cooking. Yard work. Travel. Bingo. Zumba. Walking. Pitching horseshoes.

Swimming. Working out. Playing golf. And pickle ball. Yes, pickle ball (it’s all the rage in Florida — think of a tennis and badminton combination played with paddles on a smaller court).

That’s a brief rundown of Pat Cash’s hobbies and recent activities. A Madison Heights resident who gives her age as “over 60 years,” Cash says she just “enjoys doing things.” But it wasn’t always that way. After her husband passed away in 2003, Cash said there was a period of a couple of years during which she didn’t want to do much of anything. “Then I came back to reality and started doing things,” Cash recalls.

There was also a devastating shoulder injury at work that slowed her down, but certainly didn’t keep her down. As a production manager for a cellphone manufacturer, Cash was in the shipping area when she slipped on a piece of plastic and fell to the floor, her elbow bearing the brunt of the impact. The force of that fall resulted in a severe injury to the ball in her shoulder socket joint — an injury that would eventually require seven surgeries to correct.

“After the surgeries and therapy for two years or so I said, I can’t deal with this,” Cash explains. “So I went to the downtown YMCA in Lynchburg, got in the water and practiced moving my arm. I could go no more than six inches from my side.

Now I can do whatever I want to with that arm, although it is still a little weak. But I don’t let it hold me back.”

When she first started going to the Y, Cash says she couldn’t even get on the machines. Now she uses the cardio machines and strength-training machines, in addition to the pool.

“My outlook on it is ‘enjoy life,’ ” Cash explains. “There’s other stuff besides watching TV. That’s okay, but enjoy every minute of life.”

When she isn’t globe-trotting, Cash enjoys cooking at home and tending to her five-acre yard. In April she was in Jamaica, Cancun last year, the Outer Banks in two weeks, just returned from Florida and already has plans for Memphis in September.

As if that weren’t enough, Cash also keeps up with her three daughters, six grandchildren and three great-grandchildren. When asked how she stays so active and what advice she might have for others, Cash provides a simple and straightforward answer. “Enjoy every day that you can. Try to eat well.”

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Bentley Commons at Lynchburg Bentley Commons at Lynchburg is a state-of-the-art community that offers a full range of amenities and supportive services designed to maximize independence and encourage healthy, active lifestyles. Each resident enjoys several living and amenities options that provide everything needed for comfortable, gracious living.

Residents of the 108 rental retirement living apartments take pleasure in the comforts of community living, such as concierge services, housekeeping, scheduled transportation, chef-prepared meals, and cable and internet access.

Across campus, each resident is encouraged to visit the exercise gym and activity rooms, library, pub, gift shop and beauty and barber shops.

With so many services and amenities offered on campus, each resident delights in the special level of convenience that enables him or her to enjoy an independent lifestyle, while friends and family are reassured knowing Bentley Commons provides the finest assisted living services and healthcare options for their loved ones.

At Bentley Commons, highly experienced, caring staff members are devoted to ensuring residents receive treatment with respect and dignity and that they receive the personal attention they deserve. Through customized care programs, residents experience a range of assisted living services, such as help with the challenges of daily living as they grow older and even an ear to listen as a resident recounts a treasured story.

The Bentley Commons community is designed for independent-minded seniors. An extensive menu of programs and activities offers residents a variety of options to enrich their lifestyles and take an active role in the daily life of the community. The highly social environment lifts the spirits of residents, family, friends and staff, alike.

The 24-hour access to staff, 24-hour security and 24-hour emergency response from carefully trained professionals ensure assistance is available any time — day or night.

Bentley Commons looks to make the transition to community life as smooth as possible. A conversation with the Bentley Commons financial concierge can help future residents plan everything from real estate solutions to veteran benefit options.

Future residents, family and friends are invited to schedule a tour of Bentley Commons at Lynchburg, during which each can enjoy a complimentary meal and learn even more about all Bentley Commons has to offer.

Bentley Commons at Lynchburg 1604 Graves Mill Road | Lynchburg, VA 24502 | 434.509.0036 http://www.kapdev.com/senior_living/Lynchburg_VA/zip_24502/kaplan_development_group/1592

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Our Lady of Peace Retirement Community What defines the incredible lifestyle at Our Lady of Peace? It is the difference between ordinary and extraordinary. It is what you feel when you meet our residents – welcomed. It is what you experience every day – intellectual and vocational programs and fun excursions. From our wonderful dining, caring professionals and neighbors to the life enriching programs, at Our Lady of Peace life is lived, inspired, interesting and most of all incredible.

Our Lady of Peace is a nonprofit, nondenominational senior living community sponsored by the Catholic Diocese of Richmond. Since 1993, we’ve provided comfortable and affordable independent apartment living and a full-continuum of care. Our assisted living and nursing care services are customized for each resident to allow everyone to live life to their fullest potential. Our memory care neighborhoods provide specialized care and security for seniors who have been diagnosed with dementia or Alzheimer’s.

With a registered nurse on-site 24-hours a day, every day, residents and their families have confidence knowing that assistance is always available.

Maintenance-free, choice and style are what you will discover when you are looking for an apartment home at Our Lady of Peace. With several floor plan options from which to choose, you are sure to find one that fits your personal style, for singles and couples alike. Each floor plan features full kitchens, oversized bathroom, several large closets, and individually controlled heating and air conditioning. So you will never be in the dark, a new, full-community generator has recently been installed to provide an extra level of safety, security, and peace of mind.

One of the nicest features is affordability. With no buy-in and reasonable marketrate monthly payments, customized care, and other a la carte services from which to choose, you will be able to preserve your nest egg for the future.

We are conveniently located off of Hillsdale Drive, near Interstate 29 on a wooded campus. Peaceful privacy is around every corner. From your own apartment, to one of the lounges, the library, chapel, outdoor deck, or the shady walking paths, finding a quiet retreat is easy to do. But if it is fun, laughter and socialization that you crave, we have that too. Meet friends for a cooking or fitness class, take in a movie in our theater or get ready for a competitive card game of poker or bridge. The many concerts, dances, cultural excursions, educational programs, worship services, will give you plenty of options to be entertained and engaged.

Delicious, nutritious, and delightful all describe our dining experience. Our Chef and experienced culinary team are focused on creating a variety of menu options that appeal to different tastes and appetites. Every day they are proud to showcase their homemade favorites that are made with local produce, meats and seafood.

Our Lady of Peace Retirement Community 751 Hillsdale Drive | Charlottesville, VA 22901 | 434.973.1155 | www.our-lady-of-peace.com

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Heritage Green The Lynchburg area is home to two Heritage Green Assisted Living Communities.

Located in the foothills of the Blue Ridge Mountains, Heritage Green offers both assisted living and memory care accommodations.

Heritage Green Assisted Living Community caters to seniors who require assistance with the activities of daily living, ranging from a variety of needs from very independent to aging in place with hospice care. The 48-unit, community encourages residents to maintain maximum independence by providing a unique mix of support services and privacy. With both private and semi-private accommodations, Heritage Green offers 24-hour personal care assistance managed by a Clinical Care Director with an onsite Medical Director.

Heritage Green shares its campus with DayBreak, which offers programs for residents with Alzheimer’s and other dementias. For those who desire memory care, DayBreak offers a 32-unit, fully secured community that caters to seniors with various degrees of memory impairment. The unique facility features selfcontained neighborhoods, each with a living room, dining room, and outside courtyard. The staff is highly trained to assist in all activities of daily living, including bathing, dressing, and managing health and wellness. A consulting Geriatric Psychiatrist and monthly Alzheimer’s Support Group attend to the resident’s and families’ needs.

DayBreak’s memory care program, overseen by a Clinical Care Director and a Life Enrichment Director, incorporates clinical, personal, and social needs into an individualized yet interactive approach by promoting sensory activities, reminiscence techniques, physical exercises, motor skills therapy, and social engagement.

Residents of both communities look forward to three delicious meals per day and nutritious snacks. Meals prepared in consultation with a nutritionist are cooked from scratch, and menus are adjusted seasonally to meet the preferences of each resident. In the elegant dining room, holidays and special events are particularly festive. Heritage Green encourages residents to invite family and friends to experience special events, as well.

At Heritage Green Assisted Living Communities residents enjoy the benefits of weekly laundry and housekeeping services, therapeutic and social activities, safety features, care assessment, ongoing case management, and wellness programs.

Staff members delight in providing respect, care, and compassion to residents, family, and guests, alike.

We are Growing a Tradition of Care at Heritage Green Assisted Living and Memory Care!

Heritage Green Assisted LIving Communities 200 Lillian Lane | Lynchburg, VA 24502 | 434.385.5102 | www.heritagegreenal.com

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Runk & Pratt

Senior Living Communities Runk & Pratt offers individualized care, including assisted living, Alzheimer’s care independent living and respite care, with the mission of providing the highest quality of life for residents living as independently as possible. In an effort to meet this goal, Runk & Pratt encourages residents to offer input into their medical care, activity planning and social engagements.

Personalized medical care begins upon admission, at which time medical team members develop an individualized service plan with resident, family and doctor input. Everything from physical therapy sessions, lab services and weekly physician appointments are performed on-site for expeditious and convenient care. Other services that are available include physical, speech and occupational therapy; in-house physician, full activities program, special diets and support services as needed.

In addition to quality medical care, residents enjoy a range of entertainment options and amenities. The social calendar regularly includes birthday parties, movie screenings, seminars, pet visits, trivia games, worship services, holiday celebrations and local outings. Residents are also encouraged to take advantage of the activity center, library, outdoor gardens and wellness functions on site.

Three convenient locations offer residents, family and friends flexibility in their choices of care, specialized needs and living accommodations.

The Forest facility is designed specifically for those with Alzheimer’s and dementia.

The homelike atmosphere features color-coded hallways that give residents visual cues, allowing them to move about freely and independently. Measures like this provide families and friends with the peace of mind that their loved ones are living in an environment that fosters independence and maximizes quality of life.

The Smith Mountain Lake location offers 14 private two-bedroom cottages for independent living and a 60-bed assisted living facility with an additional 20 beds for residents with Alzheimer’s or dementia.

The Lynchburg facility provides assisted living for those who require assistance with some of the activities of daily living but who do not need around-the-clock skilled nursing care. Each room includes individual heating and cooling units, cable television and telephone services.

Runk & Pratt recently celebrated the groundbreaking for their newest Liberty Ridge development, planned to open in April of 2014. The proposed site will include 179 units for independent living, assisted living and Alzheimer’s care. . The facility will feature upscale interiors, three dining rooms, a café, wellness center, theatre, salon and spa and well as a two lane duck pin bowling alley. There never are visiting hours, meaning families can visit loved ones at any time.

One of the many characteristics setting Runk & Pratt Senior Living Communities apart is its local ownership. With more than 20 years of experience serving the Lynchburg area, family-owned and operated Runk & Pratt prides itself on understanding the local culture and the needs and desires of the people in the area.

Runk & Pratt Senior Living Communities www.runkandpratt.com

Westlake Towne Center | 115 Retirement Drive | Hardy, VA 24101 | 540.719.1300 Forest | 208 Gristmill Drive | Forest, VA 24551 | 434.385.8506 Lynchburg | 20212 Leesville Road | Lynchburg, VA 24502 | 434.237.7809

advertorial

Valley View Retirement Community For 25 years, seniors from the Lynchburg community and across the country have delighted in Valley View Retirement Community’s gracious amenities and joyful home like atmosphere. Valley View provides a unique blend of independent and assisted living, offering each resident the flexibility to make each living arrangement feel like home.

Across Valley View’s community, residents enjoy luscious, mature trees, walking trails, and raised gardening beds, and each apartment offers a private balcony, allowing residents to further enjoy the natural beauty surrounding each home.

In this quiet, park-like community, Valley View also offers dining, housekeeping, and a wellness center, each maintained by an outstanding, experienced staff.

With two full-time activity coordinators, Valley View looks forward to entertaining residents with a variety of social events. Valley View prides itself on hosting a rich calendar of social activities, including fitness classes, outdoors activities, crafts, outings, games, volunteer opportunities, and more. In addition, the community’s free transportation service provides each resident with access to his or her favorite medical facilities, shopping, and entertainment in the Lynchburg area.

Because the community is fully staffed and can provide residents with extra help, even assisted-living residents can take part in community life.

When residents would like to introduce guests to this rich experience, Valley View encourages family, friends, and even pets to visit. There are no restrictions on overnight or other visits, and Valley View offers access to private dining rooms and catering for residents’ special occasions.

While residents can look forward to experiencing the independence and freedom they want, family and friends are put at ease knowing the campus is staffed by 24-hour personnel, and monthly rental fees include emergency pull cord and response system services for an added level of security.

Because Valley View offers both independent and assisted living care, residents can stay on site as needs change; residents interested in moving to a higher level of care can do so without losing contact with the staff and fellow residents they have come to know well and value as family.

Month-to-month leases are available for flexibility, and Valley View offers these amenities and others without long-term commitment, entrance fee, and buy-in expense, providing excellent senior living value.

Valley View Retirement Community 1213 Long Meadows Drive | Lynchburg, VA 24502 | 434.237.3009 | www.valleyviewretirement.com

advertorial

Blue Ridge Best of:

Retirement Living Awards

www.ourhealthvirginia.com | 29

our health | BLUE RIDGE BEST OF RETIREMENT LIVING AWARDS

Independent Living

Real Estate Services

Skilled Nursing Facilities

GOLD

GOLD

The Summit 1400 Enterprise Drive Lynchburg, VA 24502 434.582.1500 www.summitlynchburg.com

Blickenstaff & Company Realtors 4923 Boonsboro Road Lynchburg, VA 24503 434.384.8000 www.blickenstaffandcompanyrealtors.com

SILVER

SILVER

Heritage Green Assisted Living Communities 200 Lillian Lane Lynchburg, VA 24502 434.385.5102 www.heritagegreenal.com

REMAX 1st Olympic 20395 TIMBERLAKE Road Lynchburg, VA 24502 434.832.1100 www.1stolympic2.virginia.remax. com

SILVER

BRONZE

BRONZE

Runk & Pratt of Lynchburg 7806 Timberlake Road Lynchburg, VA 24502 434.237.7809 www.runkandpratt.com

Dawson Ford Garbee & Co. Realtors 3715 Old Forest Road Lynchburg, VA 24501 434.385.0015 www.dawsonfordgarbee.com

BRONZE

GOLD Lynchburg Health & Rehab 5615 Seminole Avenue Lynchburg, VA 24502 434.239.2657 www.lynchburghealthrehab.com Avanté at Lynchburg 2081 Langhorne Road Lynchburg, VA 24501 434.846.8437 www.avantecenters.com Riverside Health & Rehab Center 2344 Riverside Drive Danville, VA 24540 434.791.3800 www.riversidehealthrehab.com

Runk & Pratt of Lynchburg 7806 Timberlake Road Lynchburg, VA 24502 434.237.7809 www.runkandpratt.com

BRONZE The Summit Assisted Living 1400 Enterprise Drive Lynchburg, VA 24502 434.582.1500 www.summitlynchburg.com

Palliative Care GOLD Centra Health 1920 Atherholt Road Lynchburg, VA 24501 434.200.6085 www.centrahealth.com

SILVER

Comprehensive Rehab (Outpatient) GOLD Rehab Associates of Central Virginia 44 Clifton Street Lynchburg, VA 24502 434.528.1848 www.racv.hostcentric.com

SILVER Orthopaedic Center of Central Virginia 2405 Atherholt Road Lynchburg, VA 24501 434.485.8500 www.occva.com

BRONZE Danville Orthopedic & Athletic Rehab 174 Executive Drive Danville, VA 24541 434.797.1504 www.doarpt.com

Assisted Living GOLD Heritage Green Assisted Living Communities 200 Lillian Lane Lynchburg, VA 24502 800.362.1763 www.heritagegreenal.com

30 | www.ourhealthvirginia.com

SILVER

Gentle Shepherd Hospice 22667 Timberlake Road Lynchburg, VA 24502 434.846.6270 www.gentleshepherdhospice.com

BRONZE Bedford Hospice Care 1621 Whitfield Drive Bedford, VA 24523 540.587.6592

Medical Equipment GOLD Lincare 1200 Fenwick Drive Lynchburg, VA 24502 434.237.3712 www.lincare.com

SILVER Commonwealth Home Healthcare 479 Piney Forest Road Danville, VA 24540 434.797.2332 www.commonwealthcare.com

BRONZE Roberts Home Medical, Inc. 2010 Tate Springs Road Lynchburg, VA 24501 434.973.7847 www.robertshomemedical.com

BLUE RIDGE BEST OF RETIREMENT LIVING AWARDS | our health

Insurance Agents

Restaurants

GOLD

GOLD

State Farm – Francisco Mayo 3813 Wards Road, suite F | Lynchburg, VA 24502 434.847.1249 | www.franciscomayo.com

Millstone Tea Room 9058 Big Island Highway | Bedford, VA 24523 | 540.587.7100 www.millstonetearoom.wordpress.com

SILVER

SILVER The Blue Dahila 2200 Graves Mill Road | Forest, VA 24551 | 434.455.2895 | www.thebluedahlia.net

BRONZE Depot Grille 10 9th Street | Lynchburg, VA 24504 434.846.4464 | www.depotgrille.com

Nelles Insurance Solutions 2225-B Lakeside Drive, suite C Lynchburg, VA 24501 | 434.382.0332 www.nellesinsurance.com

BRONZE Hedges Insurance Agency 7713 Timberlake Road | Lynchburg, VA 24502 434.237.2021 | www.hedgesinsurance.net

Pharmacy GOLD Gretna Drug 108 Vaden Drive | Gretna, VA 24557 434.656.1251 | www.gretnadrug.com

SILVER Rustburg Family Pharmacy 925 Village Highway | Rustburg, VA 24588 434.332.1730 | www.rustburgpharmacy.com

BRONZE Kroger Pharmacy 4 locations in Lynchburg Visit www.kroger.com/pharmacy for addresses and phone numbers

Fitness Centers GOLD Snap Fitness 4119 Boonsboro Road | Lynchburg, VA 24503 434.384.6600 | www.snapfitness.com

SILVER Jamerson Family YMCA 801 Wyndhurst Drive | Lynchburg, VA 24502 434.582.1900 | www.lynchburgymca.org

BRONZE Curves 20722 Timberlake Road and 2842 Linkhorne Drive Lynchburg, VA | 434.237.7907 www.curves.com

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our health | BLUE RIDGE BEST OF RETIREMENT LIVING AWARDS

After Life Services GOLD Diuguid Funeral Service & Crematory 811 Wiggington Road Lynchburg, VA 24502 | 434.385.8900 www.diuguidfuneralservice.com

SILVER Tharp Funeral Home 220 Breezewood Drive Lynchburg, VA 24502 | 434.237.9424 www.tharpfuneralhome.com

BRONZE Heritage Funeral Service and Crematory 427 Graves Mill Road Lynchburg, VA 24502 | 434.239.2405 www.heritagefuneralandcremation.com

Lawn Care GOLD 4 Seasons Landscape & Tree Care 1080 Cedar Lane Court | Lynchburg, VA 24503 434.384.8361

SILVER Southern Landscape Group 192 Miles Lane | Evington, VA 24550 434.821.6004 | www.soscapes.com

BRONZE Lawn Doctor of Central Virginia P O Box 11153 | Lynchburg, VA 24506 800.845.0580 | www.lawndoctor.com

Financial Advisor GOLD HSC Wealth Advisors 1563 Crossing Centre Drive, suite 100 Forest, VA 24551 | 434.316.9356 www.hscwealthadvisors.com

SILVER Servus Capital Management 1149 Vista Park Drive, suite A | Forest, VA 24551 434.316.0246 | www.servuscm.com

BRONZE Genworth Financial – Tammy Fuller 700 Main Street | Lynchburg, VA 24504 434.845.0911 | www.genworth.com

Beauty Salon GOLD Body Works Day Spa & Salon 4925 Boonsboro Road | Lynchburg, VA 24503 434.384.9053 | www.bodyworkslynchburg.com

SILVER Anthony & Company Spa and Salon 701 Church Street | Lynchburg, VA 24504 434.846.2232 www.anthonyandcompanysalon.com

BRONZE Boonsboro Barber Shop 4925 Boonsboro Road | Lynchburg, VA 24503 434.384.4910

Jewelry GOLD Bowen Jewelry Company 829 Main Street | Lynchburg, VA 24504 434.845.3495 | www.bowenjewelry.com

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BLUE RIDGE BEST OF RETIREMENT LIVING AWARDS | our health

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our health | BLUE RIDGE BEST OF RETIREMENT LIVING AWARDS

SILVER Arthur’s Jewelry 111 North Bridge Street Bedford, VA 24523 540.586.8034 www.arthursjewelry.com

BRONZE Fink’s Jewelers Thomas Jefferson Crossing 16960 Forest Road Forest, VA 24551 434.237.6301 | www.finks.com

Grocery Store GOLD Kroger 4 locations in Lynchburg Visit www.kroger.com for addresses and phone numbers

Elder Law GOLD Ron Feinman, Esq. 801 Main Street, Suite 702 Lynchburg, VA 24504 434.528.0696 www.ronfeinman.com

SILVER Wanda Phillips Yoder 1011 Court Street Lynchburg, VA 24504 434.846.5470 www.wpyoderlaw.com

BRONZE Terrance J Dunn 1045 Cottontown Road Lynchburg, VA 24503 434.485.5126 www.freemandunn.com

SILVER The Well 1764 Patriot Lane Bedford, VA 24523 540.587.9000 www.wellofcourse.net

BRONZE Midtown Market 7 Chambers Street Danville, VA 24541 434.793.8211

Country Club GOLD Boonsboro County Club 1709 Boonsboro Country Club Dr. Lynchburg, VA 24503 434.384.2111 www.boonsborocountryclub.com

Speech Therapy GOLD Lynchburg Speech Therapy 1049 Claymont Drive Lynchburg, VA 24502 434.845.6355 www.lynchburgspeechtherapy.com

BRONZE Winton Country Club 599 Patrick Henry Highway Amherst, VA 24521 434.946.5134 www.wintoncountryclub.com

Blue Ridge Therapy Associates 1912 Memorial Avenue Lynchburg, VA 24501 434.845.8765 www.blueridgetherapy.com

BRONZE Centra Health Virginia Baptist Hospital Lynchburg, VA | 434.200.4668 www.vbh.centrahealth.com

Comprehensive Rehab (Inpatient) GOLD Westminster Canterbury 501 VES Road Lynchburg, VA 24503 800.962.3520 www.wclynchburg.org

SILVER The Summit Health and Rehabilitation Center 1300 Enterprise Drive Lynchburg, VA 24502 434.845.6045 www.centrahealth.com

34 | www.ourhealthvirginia.com

Riverside Health & Rehab Center 2344 Riverside Drive Danville, VA 24540 434.791.3800 www.riversidehealthrehab.com

Geriatric Care GOLD John Olmsted III, MD Centra – Rehabilitation and Geriatric Specialists 3300 Rivermont Avenue Lynchburg, VA 24503 434.384.1581

SILVER Verna Sellers, MD Centra Health, PACE 300 Rivermont Avenue 434.200.6516 www.centrahealth.com/paceprogram

BRONZE Anu Mehra, MD Lynchburg Family Medicine 2323 Memorial Avenue, suite 10 Lynchburg, VA 24501 434.200.5200 www.centrahealth.com

Hospice GOLD Gentle Shepherd Hospice 22667 Timberlake Road Lynchburg, VA 24502 434.237.7669 www.gentleshepherdhospice.com

SILVER Hospice of the Hills 1900 Tate Springs Road Lynchburg, VA 24501 434.200.3204 www.centrahealth.com

BRONZE Centra Hospice 2097 Langhorne Road Lynchburg, VA 24501 434.200.3204 www.centrahealth.com/hospice

Memory Care GOLD Heritage Green 200 Lillian Lane Lynchburg, VA 24502 434.385.5102 www.heritagegreenal.com

SILVER

SILVER

SILVER Oakwood Country Club 3409 Rivermount Avenue Lynchburg, VA 24503 434.384.8181 www.oakwoodcc.net

BRONZE

Nursing Home GOLD Guggenheimer Health & Rehab 1902 Grace Street Lynchburg, VA 24504 434.947.5100 www.centrahealth.com

SILVER The Summit Health and Rehabilitation Center 1300 Enterprise Drive Lynchburg, VA 24502 434.845.6045 www.centrahealth.com

BRONZE Avante at Lynchburg 2081 Langhorne Road Lynchburg, VA 24501 434.846.8437 www.avantecenters.com

Runk & Pratt of Forest 208 Gristmill Drive Forest, VA 24551 434.385.8506 www.runkandpratt.com/facilities/ forest

BRONZE The Summit Health and Rehabilitation Center 1300 Enterprise Drive Lynchburg, VA 24502 434.845.6045 www.centrahealth.com Carriage Hill 1203 Roundtree Drive Bedford, VA 24523 540.586.5982 www.carriagehillretirement.com

Medical Supplies GOLD GS Medical Supply Store 1032 Claymont Drive Lynchburg, VA 24502 434.455.6500 www.generationsolutions.net

BLUE RIDGE BEST OF RETIREMENT LIVING AWARDS | our health

SILVER

SILVER

Roberts Home Medical 2010 Tate Springs Road | Lynchburg, VA 24501 434.846.5381 | www.robertshomemedical.com

Godsend Cleaning 7917 Timberlake Road Lynchburg, VA 24502 | 434.485.0065 www.godsendcleaning.com

BRONZE Lincare 1200 Fenwick Drive | Lynchburg, VA 24502 434.237.3712 | www.lincare.com

Senior Centers

BRONZE All About Kleening 7917 Timberlake Rd # 4 Lynchburg, VA 24502 | 434.485.0450 www.lynchburgcleaningservice.com

Coffee House GOLD The Muse Coffee Company 1509 Enterprise Drive | Lynchburg, VA 24551 434.237.8878 | www.themusecoffeeco.com

SILVER Black Water Coffee Company 828 Main Street, suite 302 | Lynchburg, VA 434.455.1659 | www.blackwatercoffee.com

GOLD Templeton Senior Center 225 Wiggington Road | Lynchburg, VA 24502 434.455.4000 | www.lynchburgva.gov

SILVER Adult Care Center of Central Virginia 621 Court Street | Lynchburg, VA 24504 434.847.8111 | www.adultcarecenter.org

Home Health GOLD Centra Home Health 1920 Atherholt Road | Lynchburg, VA 24501 434.200.4111 | www.centrahealth.com

SILVER First Dominion Home Health 2808 Old Forest Road | Lynchburg, VA 24501 434.384.2800 | www.firstcare.biz

BRONZE Generation Solution 1032 Claymont Drive | Lynchburg, VA 24502 434.455.6500 | www.generationsolution.net

Place of Worship GOLD Thomas Road Baptist Church 1 Mountain View Road | Lynchburg, VA 24502 434.239.9281 | www.trbc.org

SILVER Heritage Baptist Church 219 Breezewood Drive | Lynchburg, VA 24502 434.237.6505 | www.hbclynchburg.com

BRONZE Family Life Christian Church International 294 County Road 1549 | Forest, VA 24551 434.832.5658 | www.flcci.org

Cleaning Service GOLD Seven Hills Cleaning Service 7917 Timberlake Road | Lynchburg, VA 24502 434.237.6050 www.ourhealthvirginia.com | 35

our health | BLUE RIDGE BEST OF RETIREMENT LIVING AWARDS

BRONZE

BRONZE

Starbucks Coffee Company 21054 Timberlake Road Lynchburg, VA 24502 434.239.6474 www.starbucks.com

Longwood Florist 1333 Longwood Avenue Bedford, VA 24523 800.585.5176 www.longwoodfloristbedfordva.com

Florist

Golf Course

GOLD

GOLD

Kathyrn’s Flowers & Gift Shop 3261 Fort Avenue Lynchburg, VA 24501 434.846.6494 www.kathrynsflowerandgiftshop.com

Boonsboro County Club 1709 BCC Drive Lynchburg, VA 24503 434.384.2111 www.boonsborocountryclub.com

SILVER

SILVER

Doyle’s Florist 2134 Langhorne Road Lynchburg, VA 24501 434.846.6581 www.doylesflorist.com

Goodyear Golf Club 245 Jenny Lane Danville, VA 24541 434.797.1909 www.goodyeargolf.com

BRONZE Ivy Hills Golf Club 1148 Ivy Hill Drive Forest, VA 24551 434.525.2680 www.ivyhillgc.com

36 | www.ourhealthvirginia.com

Companion Care GOLD Generation Solutions 1032 Claymont Drive Lynchburg, VA 24502 434.455.6500 www.generationsolutions.net

SILVER Home Instead Senior Care 2085 Langhorne Road Lynchburg, VA 24501 434.385.0321 www.homeinstead.com

BRONZE Personal HomeCare 2808 Old Forest Road Lynchburg, VA 24501 434.384.2412 www.firstcare.biz

Post Acute Rehabilitation Services GOLD Lynchburg Health & Rehab 5615 Seminole Avenue Lynchburg, VA 24502 434.239.2657 www.lynchburghealthrehab.com

SILVER Westminster Canterbury Lynchburg 501 VES Road Lynchburg, VA 24503 800.962.3520 www.wclynchburg.org

BRONZE Riverside Health & Rehab Center 2344 Riverside Drive Danville, VA 24540 434.791.3800 www.riversidehealthrehab.com

A Holistic Approach words | SARAH COX

FOR A COMPLETE LISTING OF MEMORY CARE FACILITIES IN THE LYNCHBURG AND SOUTHSIDE AREA, PLEASE VISIT WWW.OURHEALTHVIRGINIA.COM

Engage and involve: Those are the missions of the professionals at Heritage Green Assisted Living Communities and the Daybreak, the facility within Heritage Green that is devoted to memory loss patients. Heather Pippin, executive director, says that their program centers around cognitive, spiritual, social and creative activities done at certain times of day so that residents get used to the flow of the day and at the same time are engaged.

“This keeps them at a higher level of functionality and we see a slower decline in the disease process,” says Pippen. “Socialization and interaction are going to make a more positive person and keep them happier with less negative behaviors when they feel successful. Our programming is geared at a level where they can achieve success.”

Pippen says there has been a lot of progress in dementia care, especially with regard to both medication and therapies. Additionally, there has been more attention given to support for the caregivers and families. www.ourhealthvirginia.com | 37

our health | MEMORY CARE

“Our overall thinking of Alzheimer’s has improved. Patients are no longer shunned or embarrassed. It’s a disease. We keep up with the latest, and Dr. Peter Betz (a geriatric psychiatrist at Piedmont Psychiatric Center) comes in monthly to do staff training and see some of the residents for memory care issues,” says Pippen.

Pippen says there are three main stages of Alzheimer’s — early, middle and late, according to the Alzheimer’s Association. In the early stages, a person can still drive; it’s not so much that one loses one’s car keys, but that one starts struggling with things one was once able to do handily, such as put together Thanksgiving dinner.

In the middle and especially the later stages, the person starts not recognizing family members and has physical symptoms such as gait issues and swallowing problems.

Pippen says that as far as the latest drugs are concerned, Namenda works on the brain a little differently than Aricept, and that some doctors prescribe both. According to researchers at the Massachusetts General Hospital Memory Disorder Unit, who reported in the journal Alzheimer Disease and Associated Disorders, “combining two types of Alzheimer’s drugs works better than giving none or one of the drugs alone to slow cognitive and functional decline.”

It is not necessarily the person who has dementia who suffers the most. Pippen points out that in the early stages, memory issues are harder for the person who has them, but later they know less of what’s happening to them.

“They settle in to a happy place and can focus on what they can enjoy in life, and it is our job to provide them with many moments of joy,” she says.

Yvonne Staton, a speech pathologist with Centra Outpatient Rehabilitation at Centra Virginia Baptist Hospital, provides varied training to staff as well as support for those with memory issues. That support includes strategies for things they can do in their everyday lives to make their memories more efficient.

Some of these strategies are simple — writing things down, using a calendar, making lists and writing messages to oneself to help with recall. She suggests using household items — 38 | www.ourhealthvirginia.com

MEMORY CARE | our health

a timer, a medication holder, an alarm clock set for appointment times. Or, use a cellphone to put in appointments. Another thing to do is to reduce distractions in the home.

“If you can’t pay attention to something, you won’t remember it, and there are so many distractions that impact our memory, such as the TV, outside noises and the telephone. What I teach is to turn off the TV when you are fixing dinner, and put off conversations until dinner. Set aside a time of day when you are most alert to do those things that require a lot of attention, such as calling the doctor and paying bills,” says Staton.

She says that brain stimulation is important and follows the philosophy of “if you don’t use it, you will lose it.” This is particularly apparent during retirement, when you don’t have job stimulation. She suggests patients read the newspaper or a book, stay engaged socially with others, try a new recipe, play cards or board games, download applications for a smartphone or try new programs on the computer. She points out that AARP has recently approved a computer game that has shown success for people. BrainHQ has various exercises to enhance memory, both visual and auditory, and AARP members receive a reduced cost for this program.

“We are not going to restore your memory to the way it was when you were 16,” says Pippen. However, her approach is to impact the lives of her patients so that they are more organized and able to function with a positive attitude.

She says that exercising, eating a healthy diet and managing stress levels are all good ways to cope with early-stage memory loss. Additionally, getting adequate sleep is important. In the elderly, staying hydrated is also key.

“With any of these health issues, if you are not able to manage these yourself, you need to see a physician,” she concludes.

www.ourhealthvirginia.com | 39

our health | MEMORY CARE

FAST FACTS! ABOUT DEMENTIA FROM THE

ALZHEIMER’S ASSOCIATION »» According to the Alzheimer’s Association’s 2013 “Alzheimer’s Disease Facts and Figures,” Alzheimer’s disease is the most common type of dementia, which is a general term used to describe a variety of diseases and conditions that result when brain nerve cells die or no longer function correctly. When this happens, changes to memory, behavior and clear thinking occur. Alzheimer’s disease is ultimately fatal.

40 | www.ourhealthvirginia.com

»» Other types of dementia than Alzheimer’s include vascular dementia and Parkinson’s disease. »» New, as of 2011, diagnostic criteria for Alzheimer’s, proposed by the National Institute on Aging and the Alzheimer’s Association, include the three stages of Alzheimer’s — preclinical Alzheimer’s disease, mild cognitive disease and dementia due to Alzheimer’s disease. »» The two main treatments of Alzheimer’s disease are divided into pharmacologic and non-pharmacologic therapy. No drugs can slow or stop the death or malfunction of brain neurons, but five drugs can temporarily improve symptoms.

Non-pharmacologic treatment goals are to improve the quality of life and reduce symptoms such as depression, apathy, wandering, sleep disturbance, agitation and aggression.

»» About 5.2 million Americans have Alzheimer’s disease in 2013, and 5 million of those are people ages 65 and older. Consider, as well, that by 2030 an estimated 72 million older Americans will make up 20 percent of the total population, which would be up from 13 percent in 2010. »» Alzheimer’s disease is the sixth leading cause of death in the United States. »» More than 15 million Americans provide unpaid care for people with Alzheimer’s disease and other dementias. In 2012, these unpaid caregivers provided an estimated 17.5 billion hours of unpaid care, which is valued at more than $216 billion.

our health | COMFORT AND PEACE

The loss of a spouse is one of life’s most stressful events, especially for seniors. But in recent years research has recognized that older adults’ adjustment to widowhood varies considerably. The nature of the relationship, cause of death and available social support are all factors that can account for the range in recovery ability.

Although spousal loss can occur at any age, widowhood in the United States is mostly experienced by those 65 and older. Nearly three-quarters of the 900,000 people who become widowed annually in the United States fall in this category. Today life expectancy at birth for men is 76, compared to 80 for women. So women are much more likely to outlive their spouse.

Anne Jones of Hurt lost her husband in a car accident with a drunk driver on July 17, 2010. “The irony of Charles’s death was that we had traveled all over the United States and in 10 foreign countries,” says Jones.

“And he was killed five miles from home during his lunch hour.”

Becoming a Conduit of Comfort words | EDWIN SCHWARTZ

42 | www.ourhealthvirginia.com

“Charles was my best friend. He was my everything. We thought we would grow older together,” says Jones. “We were both 65 and had been married 43 years. I didn’t want to live one minute longer than he did, but that would have been hard on our children and grandchildren. After he died I wanted the Lord to take me home to be with Charles.”

In describing their relationship Jones says, “We helped each other on projects. I was involved with the Woman’s Missionary Union and he with the Lions Club and Chamber of Commerce. You would always see both of us together.”

Elisabeth Kübler-Ross, MD, a renowned psychiatrist who specialized in neardeath studies, identified the five common stages of grief as denial, anger, bargaining, depression and acceptance. While not everyone experiences every stage, others may endure one or more several times, or enter multiple stages simultaneously. But however a person grieves, Kübler-Ross believed most individuals experience at least two of these stages.

COMFORT AND PEACE | our health

“One of the things I’ve realized is I know how to do things,” says Jones. “Because we did so much together, like gardening and minor repairs, I’ve been able to do a lot. I’ve been grateful for that.”

“It’s difficult to imagine 10 or 15 years of not having him,” says Jones. Because he traveled so much, she was accustomed to his being away. But after three months the reality of his not returning settled in. “Realizing this was permanent was the most difficult thing. I had to adjust to a new normal,” she says.

anniversaries is more difficult than the actual day. Once the day arrives, it’s easier than you think.”

Another thing Jones likes to share is her favorite GriefShare quote, “We are to be conduits of comfort, not containers.” She says, “I have come to understand we experience many types of grief in our lives, and I believe this quote applies to every facet of them. Not every grieving individual can start a GriefShare ministry, but each of us can become a conduit of comfort.”

Although family, friends and her church family ministered to her faithfully, Jones found it wasn’t enough. A close friend who had lost her husband invited her to attend GriefShare, a bereavement group sponsored by Gentle Shepherd Hospice in Lynchburg. For the next 26 weeks she traveled to Lynchburg, where Candice McCann and other facilitators helped her deal with what GriefShare calls the “new norm” for those dealing with loss.

“GriefShare literally saved my life emotionally,” says Jones. “They met my needs and made me want to help other people.”

“After 26 weeks I felt I had graduated. But God wouldn’t let me stop,” adds Jones. After a Sunday morning worship service she asked Alice Bond, her church parish nurse and a recent widow, if she had considered leading a grief support group. “This was the beginning of a tremendous ministry for us at First Baptist Church, Altavista.

We began our ministry in March 2011, and the Lord has sent us many hurting souls to love and help,” says Jones. In addition to GriefShare and Bond, Jones owes a great deal of gratitude to her children and Dr. Michael Lee of First Baptist Church in Altavista.

“Alice helped so much emotionally,” says Jones. “She said I wasn’t going crazy. I couldn’t remember anything. People need to be told what you’re feeling is normal.” Bond gave her a composition book to help remember conversations. “Everybody needs to keep a book of every contact and decision that is made,” recommends Jones. “Write their name, date, time and what was said. It’s amazing how many people you have to deal with.”

Spousal loss will happen to nearly all married seniors. And many may experience symptoms of grief, loneliness, anxiety and distress. However, no two individuals grieve the exact same way.

For anyone dealing with the loss of their spouse, Jones says, “The week leading up to www.ourhealthvirginia.com | 43

HealthyEats AR P E PR

OR THE F G N I

HARVEST

Corn and Tomato Salsa: Makes 4 servings

Ingredients: One of the best things about summer is the fresh produce you can enjoy from your garden! If your garden is anything like mine

2 ears of fresh corn

Directions: 1.

Season the corn with olive oil, salt and pepper.

2.

Place the corn over a grill and cook for about one to two minutes on all sides.

Drizzle of olive oil

Sea salt to taste

3.

Remove and cool.

Freshly ground black pepper to taste

4.

Remove the kernels from the cob.

5.

Combine the corn, tomatoes, onions, peppers, cilantro, lime juice and lemon juice. Mix well.

6.

Season the salsa with salt and pepper.

during these dog days of summer, you are

4 ripe tomatoes, sliced and then diced

often left with a surplus of produce that

¼ cup minced red onions

you are unsure how to use. Here are some

1 teaspoon minced jalapeno peppers

delicious recipes, full of flavor, that are sure

2 tablespoons chopped fresh cilantro

to satisfy any palate.

Juice from 1 freshly squeezed lime

Juice from 1 freshly squeezed lemon

Tricia Foley’s

CORN & TOMATO SALSA Tricia Foley is Our Health Magazine’s resident nutritionist.

HealthyEats P

FOR TH G N I AR R EP

E HARVEST

Zucchini “Pasta” and Fresh Tomato Sauce:

4.

Using a spatula, push the zucchini to the side so a portion of the bottom of the pan is clear. Add the garlic, and cook for 15 to 30 seconds. Mix the garlic into the zucchini.

5.

Stir in the tomatoes, lemon zest, salt, pepper and Parmesan cheese. Cook until softened, about two minutes.

6.

Add ground turkey to mixture and divide into four servings.

Makes 4 servings

Ingredients: 16 ounces lean ground turkey

Directions:

¼ cup grated Parmesan cheese

1.

In a large skillet, coat with cooking spray and then brown turkey until no longer pink (about 10 minutes). Set aside.

2.

In another large skillet, heat the olive oil over medium-high heat.

3.

Add the zucchini and cook just until wilted, flipping them over occasionally with a spatula. (The zucchini will be soft and somewhat see-through.)

1 teaspoon grated lemon zest ¼ teaspoon sea salt ¼ teaspoon ground black pepper 1 tablespoon olive oil 6 medium (8-ounce) zucchini, peeled with potato peeler 2 garlic cloves, thinly sliced ½ pint grape or cherry tomatoes, halved lengthwise

Tricia Foley’s

ZUCCHINI “PASTA” Tricia Foley is Our Health Magazine’s resident nutritionist.

our health | NUTRITION HEALTH

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HealthyEats P

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Watermelon Spritzer: Makes 6 servings

Ingredients: 8 cups cubed seeded watermelon (about 6 pounds with the rind), divided 1 cup water, divided 1/3 cup stevia, divided 1/4 cup fresh lime juice 1 sparkling water (such as LaCroix, So Clear or Perrier), well chilled

Lime slices, for garnish

Directions: 1.

Combine half the watermelon, half the water and half the stevia in a blender; puree.

2.

Pour through a coarse strainer into a large container.

3.

Repeat with the remaining watermelon, water and stevia.

4.

Stir in lime juice.

5.

Refrigerate until well chilled, about four hours.

6.

To serve, stir in sparkling water and garnish with lime.

Tricia Foley’s

WATERMELON SPRITZER Tricia Foley is Our Health Magazine’s resident nutritionist.

BACK TO SCHOOL | our health

of Back-to-School Health words | LAURA NEFF-HENDERSON, APR

sponsored by:

It’s long been known that classrooms are meccas for germs. According to WebMD a 2005 study of germs in schools found that classroom water fountain spigots and plastic cafeteria trays were the germiest spots in school. While toilet seats get cleaned regularly, trays and water fountains do not.

So it’s no surprise that, for many children and their parents, as well as their teachers, backto-school often means spending more than a handful of weekends on the couch with a box of tissues and cough drops.

Learn more about some of the most common childhood illnesses:

Asthma and Allergies An estimated five million children have asthma, making it the most common chronic disease of childhood, according to the Asthma and Allergy Foundation of America. Asthma is a chronic (long-term) illness in which the airways become blocked or narrowed, causing shortness of breath, trouble breathing and other symptoms. Allergies, also a prevalent childhood illness, occur when the immune system overreacts to a substance that’s harmless to most people. This overreaction can leave children coughing and sneezing, with itchy eyes, a runny nose and a scratchy throat. In severe cases it can also result in rashes, hives, lower blood pressure, difficulty breathing, asthma attacks and even death. Although allergies have no cure, they can be managed with proper prevention and treatment.

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our health | BACK TO SCHOOL

Bronchitis Children who suffer from repeated lung infections often develop bronchitis, an inflammation of the lining of the bronchial tubes, the airways that connect the trachea (windpipe) to the lungs. Children who have bronchitis often have a difficult time breathing when air passes in and out of the lungs. The most common symptom is usually a cough.

Chickenpox Caused by the varicella-zoster virus (VZV), chickenpox used to be a common illness among kids in the United States, particularly among those under 12 years old. The telltale sign of the virus is the itchy rash of spots that look like blisters and can appear all over the body. The rash is extremely contagious and is generally accompanied by flulike symptoms. The Centers for Disease Control and Prevention (CDC) recommends that children receive the chickenpox vaccine at between 12 and 15 months old and between four and six years old. The vaccination is 98 percent effective at preventing chickenpox.

Diabetes Type 1 diabetes, often called juvenile diabetes, develops when the pancreas can’t make the insulin that the body needs to break down glucose/sugar necessary to have energy. Without insulin, too much sugar stays in the blood. Type 2 diabetes used to be called adult-onset diabetes, but is increasingly common in children and teens as a result of obesity. Children with type 1 diabetes may need to take insulin, while those with type 2 diabetes manage their illness with diet and exercise, medication and/ or insulin.

Ear Infection

In children, the signs of an ear infection often include ear pain, especially when lying down; tugging or pulling at the ear(s); difficulty sleeping; fussiness; difficulty hearing or responding to sounds; loss of balance; and a fever. For adults, the symptoms usually include ear pain, drainage of fluid from the ear, diminished hearing and a sore throat.

Flu Flu is highly contagious, particularly when people share close quarters, like children do in school classrooms. Flu is spread among children when a child either inhales infected droplets in the air or when the child comes in direct contact with an infected person’s secretions. This happens most often when children share utensils and cups. The symptoms usually start abruptly and cause kids to feel the worst during the first two or three days. The symptoms typically include a high-grade fever; chills; exhaustion; headache and body aches; a dry, hacking cough; a sore throat; vomiting; and belly pain. The number one way to prevent flu is to get an annual influenza vaccination.

Gastroesphageal Reflux Disease/GERD Like in adults with the condition, gastroesophageal reflux — GERD, for short — is the upward movement of stomach contents into the esophagus and sometimes into or out of the mouth. It is usually the result of an immature digestive system and most infants with the condition outgrow it by the time they are one year old. In older children, obesity, overeating, constipation, and certain foods, beverages, and medications can be the cause of the condition. The most common symptoms of reflux in kids are frequent or recurrent vomiting, frequent or persistent cough, refusing to eat or difficulty eating (choking or gagging with feeding), and heartburn, gas, or abdominal pain.

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BACK TO SCHOOL | our health

Hand, Foot and Mouth Disease The Hand, foot and mouth disease most often occurs in children under 10 years old and is characterized by a rash of small blister-like sores on the palms of the hands and soles of the feet and in the mouth. Symptoms include fever, sore throat and headache. The disease is spread from person to person through saliva, fluid from blisters or the feces of an infected person. Outbreaks occur most often in the summer and early fall in classroom settings, where large groups of children congregate. The illness typically lasts for about a week.

Impetigo Impetigo, one of the most common skin infections among kids, usually produces blisters or sores on the face, neck, hands and diaper area. This contagious, superficial skin infection usually affects preschool and school-age children. The infected areas appear in plaques ranging from dime to quarter size, starting as tiny blisters that break and expose moist, red skin. After a few days, the infected area is covered with a grainy, golden crust that gradually spreads at the edges.

Juvenile Idiopathic Arthritis Nearly 300,000 children in the United States have some sort of arthritis, an inflammation of the joints.

The most prevalent form of juvenile arthritis is juvenile idiopathic arthritis, also known as juvenile rheumatoid arthritis. It affects about 50,000 U.S. kids and is very different from adult rheumatoid arthritis. Arthritis can be short-term — lasting for just a few weeks or months, then going away forever — or it can be chronic and last for months or years. Symptoms include joint pain, swelling and stiffness, leading to irritability, refusal to walk or protecting or guarding of a joint. Children who suffer from this condition may have periods with no symptoms in between flare-ups.

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our health | BACK TO SCHOOL

Kawasaki Disease Kawasaki disease is an illness that involves the skin, mouth and lymph nodes, and most often affects kids under the age of five. Kawasaki disease occurs in 19 out of every 100,000 kids in the United States. It is most common among children of Japanese and Korean descent, but can affect all ethnic groups. The cause is unknown, but if the symptoms (a fever lasting at least five days, red eyes, a body rash, swollen, red cracked lips and tongue, swollen, red feet and hands and/or swollen lymph nodes in the neck are recognized early, kids with Kawasaki disease can fully recover within a few days.

Untreated, it can lead to serious complications that can affect the heart.

Lice Lice aren’t dangerous and they don’t spread disease, but they are contagious. Itching, the most common symptom of all types of lice infestation, is caused by an allergic reaction. Lice bite the skin to feed on a person’s blood. The saliva from these bites causes the allergic reaction and itching. Lice are a very common problem, especially for kids between the ages of three and 12 and are more common in girls than boys. Itching may occur right away in some people that are very sensitive to lice bites. Others build up a tolerance to the bites and have little or no itching, even with repeated infestations.

Mononucleosis Known to teenagers all over the country as the “kissing disease,” mononucleosis is caused by the Epstein-Barr virus (EBV), a type of herpes virus. Most people who get mono are between the ages of 15 and 25, but younger kids can get it too. The mono virus affects the lymph nodes, throat, salivary glands, liver, spleen and blood. Symptoms include extreme tiredness and an achy body, as well as a decrease in appetite.

Otitis Externa (Swimmer’s Ear) Otitis externa, also known as swimmer’s ear, is an inflammation and infection of the ear canal. It occurs when the protective film that covers the ear canal is removed. Swimmer’s ear often develops when excess water enters the ear canal. But other 52 | www.ourhealthvirginia.com

BACK TO SCHOOL | our health

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our health | BACK TO SCHOOL

conditions can cause swimmer’s ear, including allergies, forceful ear cleaning and skin problems.

Symptoms can include itching, pain and a feeling of fullness in the ear.

Pinkeye (Conjunctivitis) Pinkeye (also called conjunctivitis) is the most common problem children have. Symptoms include itching, inflammation or swelling and a clear, white, yellow or greenish gooey liquid collecting in the eyes. Adults, especially parents and teachers who spend a lot of time with kids, can get conjunctivitis too. The condition usually lasts about a week or less, and then goes away by itself or after treatment.

Query Fever Q fever, or Query fever, is an infectious disease transmitted from animals to humans that can affect the heart, lungs and other body parts and cause flulike symptoms.

Although rare, it can affect children and adults who drinking raw, infected, unpasteurized milk; come into contact with infected animals; or are bitten by ticks. In some people Q fever may not cause any symptoms. Symptoms that may appear include fever, headache, cough, joint and muscle pain, nausea, vomiting and diarrhea. In rare cases, symptoms can last for longer than six months. This form of the disease (chronic Q fever) can lead to serious complications if it goes untreated.

Reye Syndrome Reye syndrome is an extremely rare but serious illness that can affect the brain and liver. It occurs most commonly in children recovering from a viral infection and predominantly affects children between the ages of four and 14 years old. Common symptoms include frequent vomiting, lethargy or sleepiness, and irritability or aggressive behavior. Other symptoms include changes in vision, difficulty hearing and abnormal speech.

Strep Throat Strep throat is one of the most common childhood illnesses. It’s contagious and painful, and typically happens during the school year when children are in close contact with one another. A strep infection 54 | www.ourhealthvirginia.com

BACK TO SCHOOL | our health

can be spread through sneezing, coughing and shaking hands. Symptoms include a severe and sudden sore throat without coughing, sneezing or other cold symptoms, pain or difficulty swallowing, a fever above 101 degrees F, swollen lymph nodes in the neck, white or yellow spots or coating on the throat or tonsils and/or a bright red throat or dark red spots on the roof of the mouth at the back near the throat.

Tonsillitis Tonsillitis is an inflammation of the tonsils, tissue that sits on both sides of the back of the throat. They help in the immune system to protect the body from infections that may enter the body through the mouth. When the tonsils become infected they become enlarged and red and have a yellow or white coating. Tonsil infections may be contagious and can spread from person to person by contact with the mouth, throat or mucous of someone who is infected. Tonsillitis symptoms include a sore throat, fever, swollen glands in the neck and trouble swallowing.

Urinary Tract Infection Urinary tract infections (UTIs) are common in kids, especially girls and uncircumcised boys. According to ww.kidshealth.org, about 8 percent of girls and 2 percent of boys have had at least one UTI before their fifth birthday. These infections occur when the kidneys, ureters, bladder or urethra become infected.

Symptoms include pain when urinating; changes in frequency, appearance or smell of urine; fever; chills; loss of appetite; nausea; vomiting; lower abdominal pain; and lower back pain or discomfort.

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our health | BACK TO SCHOOL

Viral Pneumonia Pneumonia is a general term that refers to an infection of the lungs, which is most often caused by a virus. Often, pneumonia begins after a person has had an upper respiratory tract infection (an infection of the nose and throat). Symptoms vary depending on the age of the child and the cause of the pneumonia, but the most common include fever, chills, cough, nasal congestion and difficulty breathing, as well as vomiting, chest pain, abdominal pain and lethargy.

Whooping Cough (Pertussis) Whooping cough is a bacterial infection of the respiratory system, characterized by severe coughing spells, which can sometimes end in a “whooping” sound when the person breathes in. It primarily affects infants younger than six months old before they’re adequately protected by immunizations, and kids 11 to 18 years old whose immunity has started to fade. The first symptoms of whooping cough are similar to those of a common cold, including a runny nose, sneezing, mild cough and low-grade fever.

After a few weeks, the dry, irritating cough evolves into coughing spells that can last for more than a minute and leave the child red or purple in color. At the end of a spell, the child may make a characteristic whooping sound when breathing in or may vomit.

Xerophthalmia (Dry Eyes) Xerophthalmia, also known as dry eyes, is a medical condition that occurs when the eye fails to produce tears. It is caused by a vitamin A deficiency and is common in developing countries around the world. Symptoms include dry, itchy, painful eyes.

Yeast Infection Yeast infections usually occur in warm, moist parts of the body, such as the mouth and moist areas of skin. Vaginal yeast infections are particularly common in girls and boys during the summer months, when children spend an increased amount of time wearing wet bathing suits. Also, recent use of prescription antibiotics or steroid medication can cause yeast infections to develop in children. Infants and toddlers who use an infected pacifier or bottle nipple can develop a yeast infection. Symptoms vary wildly depending on the location of the infection.

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BACK TO SCHOOL | our health

Zoonotic Disease Zoonotic diseases are those that can be transmitted from animals to humans. These diseases are caused by bacteria, viruses, parasites, and fungi that are carried by animals and insects. Examples are anthrax, dengue, Ebola hemorrhagic fever, Escherichia coli infection, Lyme disease, malaria, Plague, Rocky Mountain spotted fever, salmonellosis, and West Nile virus infection.

People can get zoonotic diseases from contact with infected live poultry, rodents, reptiles, amphibians, insects, and other domestic and wild animals. A common way for these diseases to spread is through the bite of a mosquito or tick. People can get diseases in most places where they might have contact with infected animals and insects, including: animal displays, petting zoos, pet stores, nature parks, wooded and bushy areas, farms, county or state fairs and/or childcare facilities and schools. To help prevent zoonotic diseases, wash hands thoroughly and frequently, avoid direct contact with certain animals and their environment, closely supervise children to ensure they wash their hands properly and avoid hand–to–mouth activities (thumb– sucking, eating, and use of pacifiers) after animal contact, use EPA–registered insect repellents that contain 20% or more DEET (N, N–diethyl–m–toluamide) on the exposed skin for protection that lasts up to several hours, use products that contain repellents (such as permethrin) on clothing (treat clothing and gear, such as boots, pants, socks and tents), look for and remove ticks from the body and limit the number of places around your home for mosquitoes to breed by getting rid of items that hold water.

- Sources: Centers for Disease Control, the World Health Organization and WebMD

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FOR A COMPLETE LISTING OF MEDICAL EDUCATION PROGRAMS OFFERED THROUGH LOCAL COLLEGES AND UNIVERSITIES IN THE SOUTHWEST AND CENTRAL VIRGINIA COMMUNITIES, PLEASE VISIT WWW.OURHEALTHVIRGINIA.COM

MEDICAL EDUCATION ADVANCEMENTS | our health

Lynchburg, Southside and Southwest Virginia Colleges are answering the call for needed medical care words | ANIKA IMAJO

As pressure mounts on the nation’s thinly stretched healthcare workforce, educational programs throughout Southwest and Southside Virginia are stepping up in response to the increasing demands.

Area schools — both emerging and established — are training professionals to meet challenges at the intersection of a growing aging population, underserved rural communities and a shortage of primary care physicians.

Edward Via Virginia College of Osteopathic Medicine (VCOM), chartered in 2002, has already established itself as an effective training ground for primary care practitioners committed to treating areas of need.

According to William King, associate vice president for student services, VCOM boasts the nation’s largest number of scholarship awardees from the National Health Service Corps, a U.S. Department of Health and Human Services program that provides financial aid to students pursuing careers in primary care with the intention of practicing in underserved locales.

VCOM also placed ninth in the country on U.S. News and World Report’s 2013 ranking of schools with the largest percentage of graduates entering residencies in primary care.

Linda Frasca, MD, chair of VCOM’s Appalachian Medical Mission, credits the school’s success in these areas in part to its educational outreach efforts, which include volunteer opportunities at remote free clinics, a new partnership with AARP to provide health screenings at six area sites and a mentorship program that pairs students with rural family physicians. Four of the young college’s graduates, she points out, are currently practicing and teaching in the region’s underserved areas.

Poised to welcome its inaugural class in fall of 2014, Liberty University’s new College of Osteopathic Medicine (LUCOM) represents another step toward fulfillment of the institution’s historical mission to serve community, according to Dean Ronnie Martin, DO. Pointing out that 67 percent of Virginia’s regions are federally designated HPSAs (Health Professional Shortage Areas) — with www.ourhealthvirginia.com | 59

our health | MEDICAL EDUCATION ADVANCEMENTS

primary care physicians particularly scarce in the southern part of the state — Dr. Martin explains that LUCOM will both actively recruit candidates from underserved areas and train them in real-life environments, while demonstrating the value of primary care.

“If the only people who ever train you are specialists and subspecialists, and if the only place that you ever do your training is in a centralized academic healthcare center, the lesson you’re learning is that this is the only way you can be a real doctor,” he observes, noting that an ongoing relationship between physician and patient, rather than episodic care, is critical to general well-being.

Ronnie B. Martin, DO is the dean of the new School of Osteopathic Medicine.

Designing a new medical school, such as the Virginia Tech Carilion School of Medicine and Research Institute (VTCSOM), presents an opportunity to train tomorrow’s physicians and reevaluate their role in a changing healthcare landscape, according to VTCSOM’s founding dean, Cynda Johnson, MD, MBA. In VTCSOM’s inaugural class, which will graduate in May 2014, of its 42 students, 22 have already presented their research at the national level and, according to Dr. Johnson, all 42 passed Step 1 of the U.S. medical licensing exam on their first attempt and exceeded the national mean substantially.

“The whole idea of starting with a clean slate has really allowed us to stretch and do new and different things,” she explains, adding that a strong emphasis on applied research, interprofessionalism and cultivation of leadership skills to guide both treatment teams and policy will position graduates to successively navigate today’s complex healthcare waters.

“You can think about this as not just 42 doctors, but 42 extended healthcare teams, and that’s really the difference,” Dr. Johnson remarks. “These aren’t just people in isolation that will do what has been traditional for physicians. But rather, in our physician thought leader model, they will really be able to take care of a large population. I think that population health is really the major focus of where we need to be going, to understand how to take care — good care — of large groups of people.”

This growing reliance on teamwork to serve communities in need will require skilled professionals of all stripes. Through a host of initiatives, from adding or revamping relevant courses of study to facilitating rapid transitions to higher degree programs, area schools are responding to these related demands.

“As they begin to retire, we’re losing a great number of qualified nurses,” notes Anne Prucha, MSN, BSN, RN, head of the nursing department at Virginia Western Community College (VWCC). She counts aging, health insurance issues and national politics among the considerations that influence how and when people seek care and how progressed their conditions might be before they receive treatment.

Preparing nurses not only to treat but also to reach out to underserved communities is an important part of providing critical, timely intervention.

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MEDICAL EDUCATION ADVANCEMENTS | our health

“The Roanoke Valley is seeing more cultures come into the area in larger numbers annually. To meet this need, our nursing program has to infuse cultural teaching into each nursing class so students are prepared to work in rural areas with diverse patient populations. This is very important since preventive healthcare is so important.”

According to Prucha, the nursing school at VWCC has taken several measures to increase its number of nursing graduates. Expanding yearly admission to its associate’s degree program in nursing from 90 to 115, VWCC is also reaching out to high schools to identify and nurture potential nursing candidates at early ages, and is partnering with other institutions to facilitate their graduates’ advancement toward higher nursing degrees.

Jefferson College of Health Sciences (JCHS) is also introducing an intensive program through which candidates holding bachelor’s degrees in various fields can obtain a Bachelor of Science in Nursing in four consecutive semesters, says Dean Lisa Allison-Jones, PhD.

Students at Jefferson College of Health Sciences (JCHS)

“To help meet the shortage of primary care physicians, Jefferson currently offers a very successful physician assistant program and is opening a family nurse practitioner program in fall 2014. Graduates of these programs will work with their physician colleagues to address the growing healthcare needs of the region.”

Miller-Motte Technical College has recently established a five-week program to train nurse aides at its Roanoke campus. Darlene Jeffrey, program director for the certified nursing program, explains that this development resulted directly from a needs assessment that indicated a growing call for certified nurse aides, particularly in nursing homes.

Across the board, institutions offering healthcare education are placing greater emphasis on the needs of the aging population in training professionals ranging from physicians to paramedics and administrators.

According to Carole Graham, dean of health professions at VWCC, her department’s response to these needs includes the introduction of additional courses of study and the construction of an innovative facility.

“We’re just getting ready to move into a new state-of-the-art health science building and we feel like it’s allowing us the opportunity to look at our current programs and expand them,” she explains, noting that training in radiation sciences is becoming increasingly relevant, especially in caring for the aging.

In addition to launching a computerized tomography program this fall and a magnetic resonance imaging program in 2014, VWCC is developing a medical lab technician program, which they hope to offer in 2014.

American National University (ANU) will add health information technology/medical records to its wide selection of healthcare-related curricula this September.

“This is a huge area for healthcare for all of Southwest Virginia,” says Gail van Duursen, academic dean at ANU. “And with everybody going to electronic medical records, there’s a need for certified information technology people to input these medical records and keep them moving.”

Producing graduates trained in ICD-10, the new diagnosis coding system, will benefit healthcare providers and patients alike.

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getting the doctors paid faster and illuminating a lot of the questions about what’s covered,” she notes, pointing out that Medicare will use only ICD-10 coding going forward. “We’re trying to help the government to get a little easier to deal with.”

ANU’s paramedic program is also responding to the increased need by creating a new course of study, to begin this fall, which will accelerate EMT and paramedic certification among intermediary responders. Alan Brie, department chair of paramedic studies at ANU — whose 2013 class in the associate’s degree program had a 100 percent pass rate for the National Registry of Emergency Medical Technicians exam — explains that a course in geriatrics and a nursing home rotation have been added to the program’s curriculum.

And skilled paramedics are also critical to the frontline of rural healthcare, which presents its own set of challenges. People living in remote locales, Brie points out, may wait until their conditions are particularly acute before they seek medical help, and are often involved in severe farming accidents.

In addition, paramedics responding to remote sites are often called upon to administer extensive care as they carry patients long distances to medical centers.

“With rural medicine the acuity level is high, the transport times are long,” says Brie, “and they do an awful lot in the ambulance when they’re trying to get to the hospital.”

Dental hygienists are also among the specialists playing an important part in the region’s healthcare, particularly given the paucity of dentists moving into rural areas. However, because dental hygienists are generally required to practice under the supervision of dentists, this shortage has limited the impact they can make independently on a community’s oral health.

“So while we’re still continuing to graduate dental hygienists, there are no new dentists, or very few new dentists, coming into the Roanoke Valley and virtually none in the Southwest Virginia area, which is even more rural,” explains Marty Sullivan, program head of dental hygiene at VWCC. But the Virginia General Assembly has offered some relief, she says, by allowing hygienists working for the Health Department to function as independent practitioners in high-need areas. Remotely supervised, they can provide preventive services without a dentist present.

“That could be implemented throughout the state because it’s a working model that has 62 | www.ourhealthvirginia.com

MEDICAL EDUCATION ADVANCEMENTS | our health

worked very well,” she observes. “It’s a national model, and Virginia is only using it in the Cumberland Plateau and the Lenowisco Health District.”

According to Sullivan, VWCC is also developing more collaborative training between departments, recognizing that students in different fields may benefit greatly from each other’s specialized knowledge and ultimately address each patient’s care from a much broader perspective.

In general, healthcare educational programs are focusing more on these preventative and interdisciplinary approaches to the escalating challenges their graduates will face.

“The emphasis is on proactive and preventative care in family medical practices and centers and less dependence on reactionary or emergency care,” explains Dr. AllisonJones. “Together with Virginia Tech Carilion School of Medicine, Jefferson has recognized the need to educate our students in an atmosphere that encourages all of the healthcare disciplines to respect and to work together to meet our patients’ needs.”

Still, while evolving, the primary care physician’s role remains essential to each patient’s overall health. As innovative leaders and thinkers committed to serving their communities, they will adapt to the dynamic healthcare climate and tackle the issues of today and tomorrow.

Virginia Western Community College in Roanoke.

“For thousands of years, doctors were the keepers of knowledge,” reflects Dr. Martin.

“That’s not true today. You can get on the Internet and find out as much knowledge as I have. So we have to train doctors to be the interpreters of knowledge, the people that apply knowledge. It’s not so much the what today; it’s the why.”

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words | SARAH COX

Lynchburg College Plans to Create Area’s First Physician Assistant Program Lynchburg College (LC) has announced plans to develop a department of physician assistant medicine. Jeremy Welsh, DHSc, PA-C, EM-CAQ, the founding department chair, program director, and associate professor of physician assistant medicine for LC, says the first entering class is set for 2015, pending provisional accreditation from the Accreditation Review Commission on Education*.

“As healthcare reform continues to move forward, I believe graduates of our physician assistant (PA) program will help increase access and affordability to local healthcare,” explains Dr. Welsh. “The idea behind the PA program is to create healthcare providers that can be utilized within the workforce quicker,” he adds.

Elliot & Rosel Schewel Hall at Lynchburg College.

*Provisional accreditation is an accreditation status for a new PA program that has not yet enrolled students, but at the time of its comprehensive accreditation review, has demonstrated its preparedness to initiate a program in accordance with the accreditation standards.

Lynchburg College has applied for provisional accreditation from the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). The College anticipates matriculating its first class in June 2015, pending provisional accreditation in March 2015. Provisional accreditation is an accreditation status for a new PA program that has not yet enrolled students, but at the time of its comprehensive accreditation review, has demonstrated its preparedness to initiate a program in accordance with the accreditation standards. The program will not commence in the event that this provisional accreditation is not received.

LC is developing a curriculum that will ideally make the transition into the healthcare field as smooth as possible. This will be done with a mixture of didactic and clinical training, and the latter will be done at local healthcare sites.

“We want to get rid of the lecturer at the front of the room and create a PA student with critical thinking skills,” continues Welsh. “Anybody can learn an algorithm, but that’s not what we’re teaching. We want to make sure our students are familiar with cutting-edge medicine.”

LC is currently doing a nationwide search for professionals to be a part of the new program, and is specifically seeking those that are familiar with current medical techniques, have had their work published, and have hands-on clinical training.

Locally, the healthcare organizations are excited about helping to create the program. Dr. Welsh points out that the trend is for those who are happy with their program to stay in the area after graduation, and that is his aim. There is no other physician assistant program in Lynchburg.

“We are all advocates. We are doing this because we want to see PA education grow,” says Welsh. He predicts that the 30-seat class will get about 600 applications, and that the prerequisites are in line with what a pre-medical student has, with the exception of taking the Graduate Record Examination (GRE) as opposed to the MCAT for med school.

Additionally, the tuition is in line with the national average for a PA program, or slightly lower, at about $85,000. The program will be about 28 months long, but the curriculum has not been solidified yet.

Dr. Welsh says he hopes the program will distinguish itself by creating PA leaders, not just practitioners, and to that end will integrate the concepts of leadership, administration, global healthcare, and disaster management and medicine. He also anticipates students will work in local free clinics and go on overseas mission trips.

“As healthcare reform moves forward, the utilization of PAs will continue to increase. This is in the back of our minds,” concludes Dr. Welsh.

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MEN’S HEALTH | our health

Prostate Cancer

A Controversial Issue with No One Right Answer words | RICH ELLIS, JR.

Prostate cancer is the most common form of cancer in men and the third-leading cause of men’s cancer deaths, with nearly 239,000 men diagnosed with it in 2013, according to the American Urological Association. But when prostate cancer is detected early, the prognosis for long-term survival is excellent. The key is an early diagnosis, making screening for prostate cancer extremely important because there typically aren’t any symptoms in the disease’s early stages.

Corey Passman, MD, is a urologist with Centra Medical Group Urology in Lynchburg. “The usual sign of prostate cancer is nothing,” he explains. “People do not usually have a lot of signs. If someone’s having signs of having prostate cancer, it’s usually because it’s spread somewhere else. The most common way we’re diagnosing prostate cancer now is because of an elevated PSA.”

Screening Screening for prostate cancers includes a test to measure the amount of prostate specific antigen (PSA) in the bloodstream and a digital rectal exam (DRE) to feel the prostate for any abnormalities, such as tumors.

As for when to screen for prostate cancer, the answer has become a complicated one. Within the last year and a half a significant controversy has developed surrounding screening because of recommendations issued by the U.S. Preventive Services Task Force. “They recommended not screening for prostate cancer,” Dr. Passman explains, “and gave the PSA a failing test and are recommending against DREs.” The American Urological Association, on the other hand, came out in May of this year with modified recommendations and currently recommends a PSA test and DRE for someone with normal risk parameters at ages 55 through 59, every one to two years. Dr. Passman follows the American Urological Association guidelines.

If the rectal exam or the PSA screening, or both, are abnormal, the next step will be a prostate biopsy — an outpatient procedure to remove tissue samples from the prostate so cells can be examined to determine if prostate cancer is present.

Stages Prostate cancer is measured in four stages, and Dr. Passman says the goal is to find prostate cancer while it’s still confined to the prostate. “That’s the only time that we can actually cure prostate cancer,” he explains. “When prostate cancer spreads, then there are no good, easy cures. We have very good ways of treating people [with prostate cancer that’s spread] but no ways of curing them.”

Corey Passman, MD, is a urologist with Centra Medical Group Urology in Lynchburg

The most common stage of prostate cancer is stage one, and specifically t1c, Dr. Passman says.

A pathologic stage two — t2 — is a tumor seen in the prostate and confined to the prostate. In t3 the tumor has spread outside the prostate, either into the prostatic tissue or seminal vesicles, and in t4 the tumor has spread into the surrounding organs. Stages t3 and t4 represent a worse prognosis for patients than stages t1 and t2.

Treatments Treating prostate cancer depends on a wide variety of factors unique to each patient. Generally www.ourhealthvirginia.com | 65

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speaking, however, stage t1 prostate cancer might not involve any treatment.

“For a low-risk, low-volume disease, one of the major treatment options is just active surveillance,” Dr. Passman says. “Where we follow the prostate cancer but don’t actually treat it, trying to get a better sense of how aggressive that prostate cancer is and if we need to treat it in the first place. It’s a slow-growing, indolent cancer and sometimes the best thing is just to watch it. That is a treatment that is actually increasing in favor right now across the country. We probably are not doing enough of it.”

Dr. Passman said that the vast majority of men diagnosed with prostate cancer are going to die of other causes, in part because prostate cancer is usually so slow growing. To illustrate , he points out that the average patient diagnosed with prostate cancer probably will go a decade or more without experiencing any problems from the prostate cancer. So if it’s diagnosed in a patient in his 70s, he is nearing his life expectancy and in all likelihood will die from something other than the prostate cancer. Dr. Passman emphasizes that while it may seem easy to talk about this in terms of general population numbers, it’s much more difficult to talk about it one-on-one with an individual patient.

The other treatment options are surgery — robotic or open — to remove the prostate in a procedure called a prostatectomy, and radiation, which can involve external beam therapy or brachytherapy seeds implanted into the prostate.

Who’s at Risk Prostate cancer is definitely related to age, Dr. Passman says. “The older you are, the higher your chances of having prostate cancer. Somewhere between one in five or one in six men will be diagnosed with prostate cancer in their lifetime.”

African-Americans tend to be diagnosed earlier than Caucasians and have a more aggressive disease earlier on, until patients reach their late 60s, when statistics between the two races tend to even out, Dr. Passman explains. “There is also a very strong family connection with prostate cancer. Someone whose family member had prostate cancer is definitely at an increased risk for developing prostate cancer.”

Some potential developments on the horizon for treating prostate cancer include multiple new drugs to treat hormone refractory prostate cancer by minimizing symptoms and prolonging longevity. These drugs, however, also come with controversy because they increase life expectancy by only several months and have a very high financial cost.

Also on the horizon is the use of genetics. “People are looking toward genetic markers to try to help figure out who has more aggressive versus less aggressive disease,” Dr. Passman explains. “We (presently) use the way the cells look under the microscope, we use the PSA, we use the rectal exam to try to help stratify risk of somebody with prostate cancer and try to help them figure out if we need to be treating them or watching them. I think the next big jump will be some type of genetic marker that we can factor against.”

Dr. Passman wants people to understand that prostate cancer is a very controversial issue right now. “There is not one right answer for the treatment of prostate cancer,” he explains. “I go over three different options with my patients on treating their prostate cancer. When a doctor gives you lots of options, it means the doctor doesn’t know what the right answer is because there is not one right answer for any one individual. It is a very complex answer and I think that one of the reasons it really lends itself to being a complex answer is because one of the treatment options is just to watch it. There’s going to be a large group of men for whom the treatment may be worse than the disease itself. That’s what makes it difficult.”

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