IGH - WNY 67 May 20 by In Good Health: WNY's Healthcare Newspaper

BFOHEALTH.COM

MAY 2020 • ISSUE 67

On the

Frontline

The role of nursing has taken on even greater significance, as nurses and other healthcare providers are front-line responders in the battle against COVID-19. As nurses celebrate their month in May, we profile three of them. Coronavirus Special Issue Inside

WHERE HAVE ALL THE SICK PEOPLE GONE? ER visits at hospitals managed by Kaleida Health have slowed to about 50% of the normal volume. What happened? P. 2

MENTAL HEALTH Chairman of psychiatry at University at Buffalo, Dr. Steven Dubovsky, discusses how coronavirus pandemic is affecting psychiatric patients.

More People in the Region Seek Animal Interactions Fava Beans Promote Good Health P. 12

The New Normal: Face Masks, Social Stigma P. 7

The Case of the Missing Patients Kaleida Health: ‘Where have all the sick patients gone?’

cross the country, emergency departments previously bursting at the seams and hospitals that were operating at capacity have seen a significant reduction in patient volumes due to the coronavirus pandemic. At Kaleida Health — Buffalo General Medical Center/Gates Vascular Institute, DeGraff Memorial Hospital, Millard Fillmore Suburban Hospital and Oishei Children’s Hospital — emergency room visits have slowed to about 50% of the normal volume. But where have all the sick patients gone? Physician David Hughes, chief medical officer for, Kaleida Health, said fear is causing people to not seek care for urgent conditions, which could lead to an even greater threat to the health of our community. “We are still seeing people coming in with chest pains and stroke symptoms,” said Hughes. “Just not the sheer volume that we had before. And there are some national statistics to show that people are staying away. We want people to seek care immediately if they are experiencing any signs or symptoms of a serious condition.” The number of visits for other critical medical issues, like inflamed appendixes, infected gall bladders and bowel obstructions, has decreased significantly at Kaleida Health’s hospitals. This trend has

Kaleida Health: ‘Hospitals still safest place to receive health care.’ medical professionals worried that patients are putting themselves at greater risk by not seeking the appropriate care in time. “The longer these patients delay treatment, the sicker they may become,” added Hughes. “Trying to avoid COVID-19 exposure could put their health at serious risk for other preventable conditions and complications.” Hughes hopes to reassure the public about the safety of visiting Kaleida Health’s hospitals and clinics

during the COVID-19 crisis. “We understand the public’s apprehension to visit emergency departments because of the risk of COVID-19 exposure,” said Hughes. “At this point, the hospital is among the safest places to be right now with the extreme precautions that we have taken to protect patients and staff and to limit the spread of COVID-19.” Kaleida Health has instituted universal masking, requiring all providers and staff as well as any

patients and anyone coming into the emergency department to wear a mask. In addition, Kaleida Health implemented even more frequent and rigorous cleaning protocols to ensure facilities and high-touch areas are sanitized and safe. Staff caring for COVID-19 patients are wearing personal protective equipment like N95 masks, gloves, gowns, face shields/and eye protection to protect themselves and prevent spreading the virus to other patients. If you’re feeling ill, Kaleida Health’s emergency departments and outpatient clinics now offer the option of being seen by a doctor for medical issues from the safety of your own home by scheduling a video or telephone visit. “For some medical issues, like potentially broken bones, lacerations needing stitching or more serious medical needs, an in-person visit will be necessary,” Hughes said. But for other medical issues, a video visit using a smartphone, tablet or computer eliminates an individual’s exposure to germs and reduces the risk of getting or transmitting illness from or to others. By utilizing telehealth video or phone visits, patients will get the same great care without leaving their house. Video visits are fast, easy, and safe. “Ultimately, we want the community to know that we are still available both in person and virtually to provide the safest, highest quality care whether you are having a baby, need emergency surgery, or are experiencing symptoms of a heart attack or stroke,” added Dr. Hughes. “We are ready to provide the same great care our community expects and deserves.”

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May 2020 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 3

Meet

Your Doctor

By Chris Motola

Steven L. Dubovsky, M.D. FDA Pulls Heartburn Drug Zantac From Market All versions of the heartburn drug Zantac (ranitidine) have been pulled from the U.S. market due to possible contamination with a probable cancer-causing chemical, according to the U.S. Food and Drug Administration. This is the latest step in an ongoing investigation of N-Nitrosodimethylamine (NDMA) in ranitidine medications, the agency noted. In some ranitidine products, NDMA increases over time and when the drugs are stored at higher temperatures, which may result in people being exposed to unacceptable levels of the chemical, according to the FDA. The agency’s order for immediate withdrawal of all ranitidine products means they won’t be available either by prescription or over-the-counter (OTC) in the United States. “Today’s action requesting companies to withdraw all remaining ranitidine products the U.S. market is being taken out of an abundance of caution,” Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, said in an agency news briefing dearly April. “Even though these products when they come off the factory line don’t contain unacceptable levels of (NDMA), we don’t know if they’re stored under various conditions what will end up at the end of the day,” she explained. According to Woodcock, storage temperature appears to be key to the accumulation of NDMA in ranitidine. “With ranitidine, the NDMA does not appear to be formed during manufacturing, but instead appears over time in storage, especially when stored at higher than room temperature,” she said. Packaging or specific formulations of the drug might play a role, too. All of that means that the buildup of NDMA in stored Zantac “may be a fixable problem,” she told reporters. “We’re open to companies demonstrating that they’ve reformulated their product in a way that is stable.” But for now, consumers taking OTC ranitidine should stop taking any tablets or liquid they have, dispose of them properly and not buy more. Those who want to continue treating their condition should consider using other approved OTC products, the FDA recommended. Page 4

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Chairman of psychiatry at University at Buffalo discusses how coronavirus pandemic is affecting psychiatric patients Q: What kind of an impact is COVID-19 having on psychiatric departments? A: There are a number of contrasting things we’re seeing. First of all, we’re seeing fewer people coming to the emergency room for psychiatric emergencies. Part of that is we get a lot of people in the psychiatric emergency room who aren’t really having a psychiatric emergency. Those individuals by and large are staying out of the hospitals. They’re staying in; they’re afraid to come to the hospital. Q: And the ones who are having psychiatric emergencies? A: The number of acutely ill psychiatric patients coming into the hospital has been about the same. The content of those acute illnesses, a lot of it is a lot more focused on things related to the COVID virus. They’re afraid of it. But the illness itself hasn’t really changed things much. For outpatients, it depends. By and large people are doing pretty well, but there’s a group of people with chronic illnesses who rely heavily on what we call “the clubhouse” for social interaction. These are places people go for group activities, have lunch with people in similar circumstances, take classes. For a large group of chronically ill people, it’s the only social interaction they have. They can’t get to many places because they lack transportation. So with those places closing because we don’t want people congregating in one area, a lot of those individuals are becoming increasingly isolated. Q: What can be done about that? A: What we do for them is try to provide more availability. To a certain extent

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2020

you can do it by video conferencing, but some of them don’t have a smart phone, they don’t have a computer, they don’t have internet. For those people you can stay in touch by phone. In my own practice, I’ve had to increase the number of contacts I make by phone just because there’s no other social contact they have. Q: How do psychiatric patients seem to be handling the pandemic broadly speaking? A: There are a variety of responses, some of which are excessive. People are extremely anxious, fearful and isolated. They don’t have as much of a chance to do reality testing, so they may feel more catastrophic about things. The only information you’re getting is from the news media, which is telling you this is the worst thing that’s ever happened, everyone’s going to die. You have the governor of New York saying 80% of people are going to get this virus, there aren’t enough ventilators, there aren’t enough beds, there’s not enough this, there’s not enough that, with very little opportunity to really look at the data. You have people making statements in the media with no data, and if they say they don’t know, they get yelled at. You see very little about how the majority of people who get the virus recover from it. The actual mortality rate is actually quite low. On the one hand, you see a story about a 100-year-old war veteran recovering from it, and then you see one about a newborn dying from it. All of this is intensifying people’s fears. So you have a lot of anxious people looking for information and the information they do find is feeding their fears. Q: How do you address that?

A: What we try to do is teach people how to relax, and behavioral approaches to reducing anxiety. We teach mental exercises to avoid catastrophic thinking and being able to tolerate uncertainty. Q: What can the broader population do, if they’re struggling with isolation? A: For people who have a social network, who have a family, you can stay in touch with things like FaceTime. It’s not the same, but it keeps you in touch. People who have an existing social network will probably be in much better shape, to the extent they stay in touch with each other. Whether or not you’re being mentally active is another factor. If you’re just sitting there taking in the news and not engaging in mental or physical activity, it’s going to be a lot harder. But for people who are mentally active and in touch with their social network, they’re doing pretty well. For people without a social network who depend on a therapeutic environment, may not be able to access them, it’s harder. It’s not even about having a therapist; we can give you that over the phone or through Zoom. A lot of patients even like that better. It saves time, money and effort. But it’s not the same as being in that environment, and that’s hard to replace in this kind of situation. I haven’t seen them going virtual, and they may not be able to in many cases. The best you can do is try to make up for that by providing a therapist to talk to the patient briefly every few days to keep them feeling connected to something. Q: What role is telehealth playing in your practice. A: At least 90% of our regular outpatients are receiving care delivered through telemedicine. This has been greatly facilitated by the relaxation of HIPAA law. A lot of the platforms being used now like Zoom aren’t compliant with HIPAA law, but the federal government has waived enforcement during the pandemic. Many patients really like it. It’s much more convenient. We don’t have good data on outcomes on this versus in-person therapy, but everyone’s impression is that it works very well. Some patients even do better with it. For in-patients, obviously we’re not using telehealth, but with COVID-positive patients, we may use it in-facility to conserve protective equipment when we’re doing evaluations. This is only with clearly infectious patients, and even then in some cases we’re just not going to be able to do the diagnosis over the monitor. There’s no other way to provide that care.

Lifelines Name: Steven L. Dubovsky, M.D. Position: Professor of psychiatry at University at Buffalo; chairman of psychiatry department for University at Buffalo Hometown: Pueblo, Colorado Education: NYU School of Medicine Affiliations: Erie County Medical Center Organizations: American Psychiatric Association; American College of Psychiatry; Group for Advancement of Psychiatry; Eggertsville Hose Company Family: Two children; three grandchildren Hobbies: Climbing, cross-country skiing

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 5

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Alone in the Time of Corona

t’s been said that too much of a good thing can be too much of a good thing. While I love living alone, this concerning, confusing and, for some, depressing time of self-isolation and social distancing has taken “alone time” to a whole, new level. Solitude by choice is one thing; solitude by necessity is another. In the first week under the stay-at-home order, I managed just fine. I cleaned, I cleared out the clutter, and I took care of minor repairs and maintenance projects inside and outside my home. I was fine. So I thought. By week two, I found myself walking in circles with too much time on my hands. I was flitting from one thing to another, unable to focus. Still, I thought, I’ve got this. Alone time is my wheelhouse. But then reality set in. So did self-awareness and reflection. I was not fine. I felt lonely and unmoored. My empty calendar became a source of anxiety. Gone were my weekly touchpoints: the fitness classes I led at the YMCA, my band rehearsals, my volunteer job at the fair-trade shop, and my get-togethers with friends and family. My home and life were quiet. Too quiet. And so I did what I usually do when confronted with a challenge: I went into problem-solving mode. I knew I needed to create a new normal for myself — a new daily routine in which I could find fulfillment and joy. I started by making a list of things I wanted to accomplish each day and then created a schedule in one- and two-hour increments. Do I stick to my timetable religiously? No. Do I leave plenty of room for spontaneity, incoming

phone calls/texts, invitations to walk, and most every interruption? Yes! Below, I’ve shared my daily schedule in the hope that it might inspire you to embrace this unique time in our lives and to make the most of our collective solo experience.

Today and Every Day 5:30 a.m. Wake up on the dot before sunrise with no alarm clock. Even in retirement, I can’t break this habit. Before I get out of bed, I do a series of stretches and repeat my morning affirmation: “I am filled with gratitude and positive energy.” 6 a.m. I make a pot of coffee and carry my cup into the living room, where I light a candle in the darkness and prepare to meditate. Sitting comfortably on my couch, I concentrate on my breathing, focus on the present and center myself for the day ahead. In this soothing, safe and contemplative space I feel surrounded and uplifted by a universe of caring souls. I feel connected and so blessed to be a part of it. Abundant compassion, love and kindness are shared in this tranquil moment. I am not alone. 7 a.m. After enjoying yogurt and a banana, I move to my desktop computer to read digital copies of the local newspaper and “New York Times.” Then, I send and answer emails with friends and family with the aim to support, cheer up, console and commiserate. Humor always seems welcome! Following that, I check out COVID-19 stats and updates, and glance at my go-to websites for breaking news, movie/book reviews, cat videos (kidding!), spring gardening tips, and — drum roll — 30% off

s d i K Corner

All That Social Media Hasn’t Hurt Kids’ Social Skills: Study

oday’s youngsters are as socially skilled as previous generations, despite concerns about their heavy use of technology, like smartphones and social media, new research shows. The researchers compared teachPage 6

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er and parent evaluations of more than 19,000 U.S. children who started kindergarten in 1998 — six years before Facebook appeared — with more than 13,000 who began school in 2010. That’s when the first iPad came on the market.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2020

sales with free shipping. Woo-hoo! Can’t wait for my new pair of wellies to arrive. 8 a.m. Time to shower and make myself presentable. I want to look pretty under my face mask. Ha! Then I make my bed, fold laundry and do a little ironing (one of my cherished “Zen” activities). 9 a.m. I devote this hour to my music. I play percussion in a local community band and like to practice my pieces and double-stroke rolls in the morning when I’m feeling fresh. I also tried something new just for the fun of it: I subscribed to a learn-to-play piano app and decided to start from scratch. I know how to play the piano, but I’m rusty, so I thought what better time than now to revisit the rudiments. 10 a.m. I need a change of scene and, more importantly, human contact (even at six feet apart). Every day around this time, I take a long walk. Alone or preferably with my sister Anne or a friend, I walk for over an hour. I believe that — at a safe distance — in-person companionship is vital to my emotional well-being. And perhaps to my immune system, too. I love nature, so walking in a park, re-purposed railroad trail or canal path does my heart good. I try valiantly to smile at passers-by with my eyes, above my mask. 12 p.m. Time for lunch. This may be my favorite time of day. I’ll prepare something healthy to eat and take it outside to enjoy on my back patio. On the bistro table, I create a nice place setting and “equip” it with a pen, paper, and notecards. In this peaceful oasis, I write handwritten get-well wishes, sympathy cards (sadly) and heartfelt thankyou notes to friends, family and even perfect strangers, e.g., frontline caregivers at our local hospitals. I wish I could do more. 1 p.m. Catch-all time — so much to do, so much time! I make a list of household chores and knock them off in half-hour increments. I use my oven timer to stay on track. It works. 3 p.m. Time to exercise. Working out has always been a huge part of my life. With no fitness classes to lead or attend, I created an exercise studio

in the hayloft of my barn. In this rustic, fragrant space I am producing homemade workout videos for my friends and neighbors who want to stay in shape. On YouTube, it’s called “Workout at Home with Gwenn.” It’s one way I can help. Together, we can stay strong. 4 p.m. Nap time. I like to kid myself and refer to it as “reading time,” but, well, you know how it goes ... 6 p.m. I watch the local news, followed by the national news. On commercial breaks, I pop into the kitchen to experiment with new recipes. Last night it was homemade pizza with slices of hot sopressata, instead of pepperoni. It was delicious, if I do say so myself. I’ll be happy to share the recipe. 7 p.m. Hunkering down for the evening. After checking my inbox one last time, I watch a Netflix or Amazon Prime movie or original series, a PBS special or reruns of a favorite childhood TV show. I can’t get enough of “The Andy Griffith Show!” At 9 p.m. I switch over to watch Rachel Maddow on MSNBC for a news recap and then call it a night. So, there you have it, a recipe for living alone in the time of Corona. Make it your own! And know that what initially might seem like too much of a good thing can turn into a great thing — a time to slow down, to make new connections with yourself and others, to pitch in and help, and to remind yourself that you can do this. You can create a wonderful life, make a meaningful contribution, and find contentment on your own.

“In virtually every comparison we made, either social skills stayed the same or actually went up modestly for the children born later,” said study lead author Douglas Downey, a professor of sociology at Ohio State University. “There’s very little evidence that screen exposure was problematic for the growth of social skills,” he added in a school news release. Both groups of youngsters had similar ratings on interpersonal skills — such as the ability to form and maintain friendships and get along with people who are different — and on self-control, such as the ability to control their temper. The only exception to the overall findings was that social skills were slightly lower for children who accessed online gaming and social networking sites many times a day. “But even that was a pretty small effect,” Downey said. “Overall, we found very little evidence that the time spent on screens was hurting social skills for most

children,” he added. While he was initially surprised to discover that time spent on screens didn’t affect children’s social skills, Downey said he shouldn’t have been. “There is a tendency for every generation at my age to start to have concerns about the younger generation. It is an old story,” he noted. “The introduction of telephones, automobiles, radio all led to moral panic among adults of the time because the technology allowed children to enjoy more autonomy,” he explained. “Fears over screen-based technology likely represent the most recent panic in response to technological change.” New generations are learning that having good social relationships means being able to communicate successfully both face-to-face and online, according to Downey. The study was recently published online in the American Journal of Sociology.

Gwenn Voelckers leads Alone and Content empowerment workshops for women held in Mendon and is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about workshops, to purchase her book, or invite her to speak, call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com.

COVID-19

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

he alarming rate at which COVID-19 has swept the world has left researchers little time to discover all we need to know about the illness other than that it’s both highly contagious and deadly. Researchers, doctors and governments as of mid April recommend we all stay home and avoid mingling with anyone who doesn’t live in the same household. When we must go out, we should keep at least six and a half feet away from others to prevent the spread of the illness. Unfortunately, we must still leave our homes for essentials. So how can we keep ourselves and others safe? The CDC and Gov. Cuomo now recommend wearing a cloth mask whenever we leave our home and are around others. Many cities have joined in and are making efforts to enforce wearing masks in public. Even many stores now require employees and customers to wear masks or cover their faces while in the establishments.

How masks help Current studies indicate COVID-19 spreads mainly between people in close proximity through respiratory droplets from coughing, sneezing and even talking. The incubation period between exposure

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

ou’ve been told over and over not to touch your face during the coronavirus pandemic, but that’s easier said than done. Most people touch their face up to 23 times an hour and don’t even realize they’re doing it, a psychologist says. “Typically, we’ll do something like shaking someone’s hand and then failing to wash our hands properly, followed by touching our faces and then we’re off to the races with an infection and symptoms that will show up in two to 14 days,” said Jim Pomerantz, a professor of psychological sciences at Rice University in Houston. “It’s much better to prevent an

and showing symptoms can range between two to 14 days. A significant number of people are also asymptomatic or have mild symptoms. Yet they can still spread the disease to others who may be affected more severely. The primary purpose of wearing a cloth mask is to prevent spreading the virus to others since it’s transmitted through respiratory droplets, keeping our noses and mouths covered helps contain the droplets preventing the spread to others.

each make responsible choices that are not only in our own best interest but also for the safety of those around us. Each of us can do our part by following the CDC guidelines. At the same time, whether someone around you is wearing a mask or not, try not to pre-judge, since you don’t know their situation. Because wearing a mask is so new, it may feel strange at first, especially if others aren’t wearing one. In all likelihood, though, you won’t be the sole person wearing a mask when you’re out. Plus, the more people wear them in public, the more that’ll join in the battle to eradicate the virus, until it becomes the new norm.

Social Stigmas Both those who wear masks and those who don’t may experience social stigma related to the covers. Earlier recommendations that only those who are symptomatic wear masks may lead some people to assume anyone wearing a mask is infected with the virus. As a result, those wearing masks may be treated differently by some individuals. On the other hand, many people are following the latest guidelines that everyone wears masks to prevent the spread of the virus. Those who are wearing masks may, therefore, see those who aren’t as either irresponsible or lacking regard for the welfare of others. It’s impossible to control how others think and behave. So we must

Recommended protocols Currently, there’s a severe shortage of N95 respirators and surgical masks for healthcare workers and first responders who are regularly being exposed. So the CDC does not recommend the general public wear

infection than to try to deal with it after the fact, and that’s the purpose of our work here,” he said in a university news release. Here are Pomerantz’s tips to keep your fingers off your face. Ask a partner to alert you when you touch your face. Wear perfume or bracelets to remind you not to touch your face, and write down how many times you touch your face each day. Remind others when you see them touching their face to stop. Keep your hands busy. Put them in your pockets, hold a ball or a deck of cards, or make fists for one minute if you bring them near your face. Keep your elbows off the table, sit in chairs without armrests or in the middle of the couch. If you find it is hard not to touch your face, sit on your hands. Practice relaxation by focusing on long, slow, deep breaths and on relaxing muscles that feel tense. Sit in a quiet place and dwell on the present moment, not the past or future. Spend time in nature, but keep a safe distance from others. “Many of us have taken a course in introductory psychology where we learned about conditioning and the laws of behavior, and how we can establish and change behavior,” Pomerantz said. “We know that this works. And if people put these ideas into practice immediately, we’re going to see, we hope, some flattening of the curve much more quickly than otherwise,” he added.

2. 3. 4. 5.

these medical-grade masks. Cloth masks, however, are easy to make at home. Tutorials and videos are available on the CDC website, among many other websites and social media pages with instructions on how to make various designs. You can also buy masks online from the many companies and individuals now selling premade cloth masks. When making or buying masks, make sure they: • snugly cover your nose and mouth • are secured with ties or loops • have multiple layers • are easy to breathe through • can be machine washed after each use It’s also vital to wash your hands immediately after removing your mask and machine wash it after each use to remove viral droplets that may have landed on the mask.

Will Warmer Weather Curb COVID-19?

oth the U.S. National Academy of Sciences and a report out of China are dampening hopes that — as happens with colds and the flu — COVID-19 might begin to fade with hotter weather. “Given that countries currently in ‘summer’ climates, such as Australia and Iran, are experiencing rapid virus spread, a decrease in cases with increases in humidity and temperature elsewhere should not be assumed,” according to experts at the National Academy of Sciences (NAS). And a new study conducted between early January and early March in 224 coronavirus-endemic cities across China supports that notion. It found that coronavirus transmission did not seem to change with fluctuations in daily temperature or humidity. “Our study does not support the hypothesis that high temperatures and UV radiation [sunlight] can reduce the transmission of COVID-19,” said a team led by Ye

May 2020 •

Yao, of Fudan University in Shanghai. “It might be premature to count on warmer weather to control COVID-19.” Physician Robert Glatter, an emergency medicine specialist working at the heart of the U.S. COVID-19 outbreak in New York City, agreed. The new findings run “contrary to claims in early February that the virus will ‘miraculously’ go away by April as temperatures rise,” said Glatter, who practices at Lenox Hill Hospital in New York City. Still, there is some reason for hope. As the Chinese team noted, it’s long been known that upper respiratory infections tend to cluster in colder seasons. The exact reasons for that aren’t clear, but Yao’s group said a number of factors are probably at play.

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COVID-19

Tips for Safe Grocery Shopping

Safer Shopping for Seniors By Deborah Jeanne Sergeant

ustling crowds during coronavirus-fueled panic shopping may have presented an annoyance to some shoppers. But for an older adult with balance issues, going to stores during a time like this can increase the risk of falling and a subsequent broken bone. Of course, during the pandemic, it’s important to follow health and safety protocols about going places in public; however, in general, a few strategies for shopping can make it safer to reduce the risk of falling for older adults. Julie Mayeu, social work supervisor with Landmark Health in Buffalo, recommended shopping at less busy times. “Early in the morning is less crowded,” she said. Grocery stores are least busy before 8 a.m., according to InMarket, a company that analyzes retail shopping patterns. Once it’s noon, the store likely will stay busy until 7 p.m. As a plus, the store will likely be its cleanest and best-stocked early in the morning. Weekends, especially Saturday morning and early afternoon on Sunday (the post-church crowd) are very busy times, as are the day before a holiday or food-oriented event, such as the Super Bowl. Shopping on weekdays — especially during morning working hours — is a much better bet for experiencing thinner crowds. Mayeu encouraged older adults to bring along their cane or walker or use any assistive devices the store might have, such as a motorized shopping car. If possible, bringing along the cane in the cart can help if the shopper needs to step away from the cart. Planning the route through the store can make the trip easier by reducing the need to backtrack. For

example, grouping all the dairy items on the list can save backtracking to that department. To save steps, shop online. Amazon Prime Pantry, for example, can deliver shelf-stable goods free with orders of $35 or more. That can whittle down the shopping list to fewer items. Or, shop with a store such as Wegmans or Tops, which offer curbside pick-up or delivery through the Instacart app. This includes a store’s perishable goods, too. “A lot of stores let you pick your groceries and they have everything ready for you,” Mayeu said. “They bring everything out to your car. They’re really good about making sure if there’s a specific item that the person needs and the store doesn’t have that item, they’ll reach out and say, ‘Is it okay if I substitute this instead?’ I’ve had several patients use this and they’ve had good feedback with it.” She also wants more people with balance concerns to get assistance while shopping or to send by others for what they need. “Don’t be afraid to ask your family, friends or neighbors if you’ve had someone offer to go grocery shopping,” she said. “Use those resources.” She added that many church groups offer grocery drop-off or other errand assistance for older adults who may be mobile, but struggling with performing extended shopping excursions. “Driving from store to store is huge,” Mayeu said. “It can take multiple days to recover physically and emotionally from driving all around.” Daniel Jones has a certificate in gerontology and owns Daniel Teaches based in Rochester. He teaches technology lessons specializing in

helping older adults access technology. Lately, he’s been developing online tutorials on apps such as Grubhub and Instacart. “If you take your time and go through them, both are very straightforward,” Jones said. Grubhub and DoorDash, a similar app, deliver restaurant food based upon ZIP code. Just enter the ZIP and see what restaurants use the delivery services. “By default, it brings up menus for your area,” Jones said. “They may charge more because you live far away. There’s a point where the app itself is not going to work for you. But that will be pretty rare.” Instacart works in a similar fashion, linking users to the stores nearest to the user, including grocery stores, mass merchandisers and drug stores. While having someone else pick out your food may be an adjustment, “for the most part, when we all go shopping, we usually buy the same things,” Jones said. “I don’t need to check the back of the Ritz crackers every time. It’s a staple.”

You’re in lockdown, yet you still have to go grocery shopping, but how do you stay safe and avoid catching the coronavirus? The American Medical Association has some timely tips. When you go to the store: • Stay at least six feet away from other shoppers. • Don’t shake hands, hug or have any physical contact. • Wipe down grocery carts or basket handles with disinfectant wipes if you have them. • Don’t touch your face. • Wear a cloth face mask. • While waiting and after leaving the store, use hand sanitizer if you have it. • If you’re sick, don’t go shopping. But if you must, wear a mask, wash your hands often and keep a safe distance between you and others. When you get your groceries home: • Although it’s unlikely you’ll be exposed to the virus from the items in your shopping bag, wash your hands after unpacking your groceries. • Wipe surfaces with a household disinfectant. Take precautions when preparing food: • Wash your hands before eating. • Do not share plates or silverware with others. • Rinse fruits and vegetables before eating them. If you’re 65 or older: • Ask a neighbor or friend to pick up groceries and leave them outside your house or bring them in while keeping at least six feet apart. • Check with your local market and go during store hours reserved for older shoppers. • See if your grocer delivers and shop online. These tips were published online recently in the Journal of the American Medical Association.

Jim Millard Rejoins Catholic Health to Support COVID-19 Incident Command

im Millard, former president and CEO of Kenmore Mercy Hospital, has come out of retirement to rejoin Catholic Health to support the health system’s COVID-19 initiatives. He is serving as executive leader and incident commander of the system staffing center, which has been established in response to the COVID-19 crisis. Millard, who retired in 2018, was at the helm as Kenmore Mercy was increasingly recognized for its innovative

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2020

approach, excellent safety profile and exceptional quality. Prior to that, he served as president and CEO of St. Joseph Hospital and spearheaded the fight to save the hospital from closure, as well as led efforts to support its consolidation into Sisters of Charity Hospital in 2008. He was instrumental in bringing together associates, physicians and the entire community to advocate for the hospital, which is now in the process of being transformed into a COVID-19 treatment facility. “Jim’s connection to Catholic Health and his love of community run deep, so he is a natural fit for this new role,” said Mark Sullivan, pres-

ident and CEO at Catholic Health. “His knowledge of our system and expertise will be invaluable as we diligently work to address this public health crisis.” Millard is responsible for the overall leadership and strategy of the staffing command center, working directly with ministry leadership to assess, project, and implement changing staffing needs for all facilities and disciplines. He also leads the core team who will ensure each location is properly, effectively, and expeditiously staffed as the COVID-19 pandemic places fluctuating demands on the system as a whole.

COVID-19

Old School Tips for Caretakers of Quarantined Persons

By Karla Thomas

here is more to quarantining than simply isolating, especially if there are others in your home. Whether you live with a spouse, significant other, small children or even in-laws, COVID-19 poses a threat to your family’s health. Ensuring their safety and your own is the single-most important thing in our lives today. Here are a few old-school methods our grandparents used whenever someone was sick with something contagious. They will work great for the current COVID-19 outbreak. Isolate infected persons. Absolutely no visitors. They should only leave the area to use the bathroom. Husbands and wives — one in the bed, the other in the spare bedroom or on the couch, please! Make sure to clean and sanitize the bathroom after every use to prevent contamination or infection of others in the household.

Handwashing with soapy water thoroughly and frequently for at least 20 seconds, is the single most important thing you can do to remain COVID-19-free. Add a capful of bleach to dishMake sure the person in isola3. water when handwashing dishes. 8.tion has access to a thermometer Automatic dishwashers use hot and track their temp several times steam to sanitize. Wash the clothes and linen of the isolated person separately. Whenever possible, use paper plates, disposable cups and cutlery. Use gloves when giving or receiving anything from the isolation room. It should all go straight to the trash or be sanitized. Make sure the isolated person is warm and comfortable — cell phone, charger, clean linen, snacks, cough drops, music, movies, books and plenty of TLC. Keep children and seniors away from the isolation room. They can FaceTime or Skype.

4. 5. 6.

per day. This info should be kept in a log and available to medical personnel should the patient’s condition worsen. Keep the patient hydrated. Water, orange juice and hot tea with lemon, honey and a dash of black pepper will help keep mucus from forming. Maintain whatever diet is tolerable for them but especially keep those fluids coming. If temperatures spike, coughing becomes worse or the patient becomes extremely fatigued, call their primary care doctor. If they experience tightening in their chest or have difficulty breathing, go to the nearest emergency room.

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Karla Thomas is director of marketing at Community Health Center of Buffalo, Inc. She holds a bachelor’s degree in human resources and a masters degree in organizational leadership, both from Medaille College. Caretakers who follow this quarantine regimen will help significantly reduce opportunity for the transmission of COVID-19 to others in the house.

Family Therapist: ‘Turn Off Your TV’ Kathleen Calabrese, CEO of nonprofit Brain-Body Technology Institute, offers nine tips to keep stress in check during the coronavirus pandemic By Kathleen Calabrese

Severely curtail the intake of the news. I never listen to the news; rather, I read it online. Over these past weeks, I have learned that taking in too much news, no matter how compelling it is, effects me like that fifth cup of coffee. It creates anxiety and interferes with sleep. Talk to as many family members and friends via FaceTime, Zoom, Skype or any other way to see your loved ones. Hearing their voices and faces is in itself, comforting. Be honest about how you are feeling. We no longer can pretend to ourselves or others. Expressing the truth of how you are feeling gives people a chance to support and comfort you, and you them. Create a schedule for each day and then fully participate in each

3. 4.

out the day. It is OK to do that and you will feel great. Breathe, breathe, breathe. This is so important to calm yourself down when looking at bleak financial numbers, wondering about your job and career, concerned about sick relatives and friends and the list goes on. Just stop, sit down, close your eyes and take a slow, deep breath, hold for the count of four, and exhale slowly. Do this three or four times at a time several times a day and especially before you go to bed at night. Be positive and pray. While it may look bleak all around us, remember this too shall pass and you have so much to look forward. Remember, positive thoughts equal positive results and say a prayer to whom you worship.

endeavor so, at the end of each day, you feel good about how you spent your day. Each day is precious. Include some kind of exercise into your daily schedule. I have learned thousands of people want us to keep moving and they have created ways for us to connect with movement online. I am so grateful to those who are working to support each of us. Keep a journal to track how you are feeling each day and note how it shifts as the day progresses. Note what lifts your spirits and what does not and vow to change so you can feel better. If you love music, listen as much as you can. If you love to laugh, find some really funny YouTube videos, watch funny movies, and feel free to just laugh out loud through-

5. 6.

Is It Allergies or COVID-19?

ith allergy season and the coronavirus pandemic overlapping this spring, one allergist offers some advice on how to tell which one may be making you miserable. “This spring allergy season has been especially challenging because of the pandemic of COVID-19, and a lot of my patients, and a lot of allergy sufferers, can have a hard time distinguishing between what is an allergy and what are symptoms

of COVID-19,” said Rachna Shah, an allergist at Loyola Medicine in Maywood, Illinois. Typical symptoms of seasonal allergies include itchy eyes, itchy nose, sneezing, runny nose and post-nasal drip. Symptoms of COVID-19 include fever, cough, shortness of breath, fatigue, muscle aches, diarrhea and, sometimes, a sore throat. “The big differentiating factor between allergies and COVID-19 are

Kathleen Calabrese, Ph.D., is a licensed marriage and family therapist and CEO of Brain-Body Health Technology Institute, a 501©3 corporation (www. bbht-institute.com).

those itchy symptoms — itchy eyes, itchy nose and sneezing. If you are experiencing these, they are most likely due to environmental allergies and not COVID-19,” Shah said in a Loyola news release. Many people with allergies also suffer from asthma. “Asthma can also make you more susceptible to having more severe symptoms of COVID-19,” Shah said. “So, it is really important to have an up-to-date action plan for both your allergies and for your asthma.” Shah noted that often, “when people are feeling well, they will become more lax about following their

treatment plans.” Patients must be “vigilant” in taking all medications as prescribed and having additional inhalers and refills, Shah urged. To minimize spring allergy symptoms, try to avoid allergens. For example, keep windows closed, and rinse off or change clothes after being outside. Many of the current restrictions for preventing the spread of the coronavirus — such as staying at home — can also help minimize allergy and asthma symptoms this spring, according to Shah.

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COVID-19

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

o wonder about 85 million American households in the U.S. have animals, according to figures from Human Animal Bond Research Institute. Whether it’s a pleasure horse or a pet poodle, an animal brings companionship, activity and a few health benefits, like lowered blood pressure and reduced risk of stroke and heart attack, according to numerous studies. More people than ever have tapped into the benefits of emotional support animals and therapy animals, which can help with anxiety, post-traumatic stress disorder, and many other mental health issues. But outside those concerns, many people crave connections with animals and find them relaxing. “During this COVID thing, my dogs are keeping me sane,” said Tricia Korzelius, case manager and outreach coordinator at Buffalo CARES, an organization that fosters dogs and occasionally cats surrendered by owners or shelters. “I can’t go into work, but the dogs are keeping me on a schedule,” she added. “They get me out of bed and out of the house every day. I read reports about people who have been depressed but feel so much better because they’re getting out and hiking.” She believes that the reason pets make such a difference is that animals offer unconditional love and trust.

“It doesn’t matter if you screwed up at work or you made a fool of yourself or if you have trouble in your relationship,” Korzelius said. “Your animal always loves you. You can’t do anything wrong in their eyes. We see dogs who were abused who still missed their owners. We had a 15-year-old dog whose owner overdosed and she missed him so much.” Especially when coming from a difficult background, it can take animals some time to trust new people in their lives. Once that bridge of trust is built, “you become their world and it gives you a feeling of adequacy,” Korzelius said. Because humans crave physical connections, experiencing social isolation has been particularly tough on people who live alone. Korzelius said this is a time where pets can make a big difference. “It’s so nice to have my animals I’m cuddling with and petting,” Korzelius said. Suzanne Vullers operates Mountain Horse Farm in Naples, a B&B operation that provides guests with “cow cuddling” and a “horse and cow experience” with her six horses and two cows. Vullers wants to “give them the same experience I get from it: connecting with nature and animals,” she said. “In this time, we’re so focused on being inside and in front of screens. Everything you can do

Are Ventilators Helping or Harming COVID-19 Patients?

echanical ventilators have become a symbol of the COVID-19 pandemic, representing the last best hope to survive for people who can no longer draw a life-sustaining breath. But the ventilator also marks a crisis point in a patient’s COVID-19 course, and questions are now being raised as to whether the machines can cause harm, too. Many who go on a ventilator die, and those who survive likely will face ongoing breathing problems caused by either the machine or the damage done by the virus. The problem is that the longer people are on ventilation, the more likely they are to suffer complications related to machine-assisted breathing. Recognizing this, some intensive care units have started to delay putting a COVID-19 patient on a ventilator to the last possible moment, when it is truly a life-or-death decision, said physician Udit Chaddha, an interventional pulmonologist with Page 10

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Mount Sinai Hospital in New York City. “There had been a tendency earlier on in the crisis for people to put patients on ventilators early, because patients were deteriorating very quickly,” Chaddha said. “That is something that most of us have stepped away from doing. “We let these patients tolerate a little more hypoxia [oxygen deficiency]. We give them more oxygen. We don’t intubate them until they are truly in respiratory distress,” Chaddha said. “If you do this correctly, if you put somebody on the ventilator when they need to be put on the ventilator and not prematurely, then the ventilator is the only option.” Experts estimate that between 40% and 50% of patients die after going on ventilation, regardless of the underlying illness, Chaddha said. It’s too early to say if this is higher with COVID-19 patients, although some regions like New York report as many as 80% of people infected with the virus die after being placed on ventilation.

virtually.” She wants to offer guests a reprieve from screens and the companionship of farm animals, such as lying in a pasture against one of her placid cows or grooming friendly horses. Vullers is certified by the Equine Assisted Growth and Learning Association, an organization for mental health and equine professionals that incorporates horses to address mental health and personal development. She has worked with horses all her life. “I know what they do for me,” she said. “It’s always been the relationship, not competing and winning prizes. It’s always been about getting that connection and forming that friendship.” When visiting family in the Netherlands, she observed similar work with cows and realized she needed to add bovines to her herd. “We work with them differently, as cows like to lie down,” Vullers said. “They’ll lie down for long periods of time. Horses, they don’t really interact that way with people they

don’t know. They may lie down, but that’s rare.” By offering experiences with both animals, Vullers can meet the needs of more guests who crave animal interactions. To meet her animals’ needs, she limits the opportunities for guests to visit with the animals to one to two sessions up to four days a week and hosts the interaction in a space where the animals are free to move around. “You see the animal relax,” Vullers said. “That’s where the benefits of your heart rate and blood pressure going down and you relax and can breathe. All that good stuff happens because it comes from mutual desire to connect.” Of course, bringing home an animal without being ready can increase stress. Would-be owners should make sure they have the resource in place to care for the animal for life. Anyone seeking a farm animal “fix” can find it volunteering with animals at local shelters or walking a busy or elderly neighbor’s dog or offer to pet sit at a friend’s home.

These critically ill patients die because they are so sick from COVID-19 that they needed a ventilator to remain alive, not because the ventilator fatally harms them, said physician Hassan Khouli, chairman of critical care medicine at Cleveland Clinic. “I think for the most part it’s not related to the ventilator,” Khouli said. “They’re dying on the ventilator and not necessarily dying because of being on a ventilator.”

Lat survived, and he thanks the ventilator but he also is struggling to recover his ability to breathe. “I experience breathlessness from even mild exertion,” Lat wrote. “I used to run marathons; now I can’t walk across a room or up a flight of stairs without getting winded. I can’t go around the block for fresh air unless my husband pushes me in a wheelchair.” Mechanical ventilators push air into the lungs of crucially ill patients. The patients must be sedated and have a tube stuck into their throat. Because a machine is breathing for them, patients often experience a weakening of their diaphragm and all the other muscles involved with drawing breath, Chaddha said. “When all these muscles become weaker, it becomes more difficult for you to breathe on your own when you’re ready to be liberated from the ventilator,” Chaddha said.

‘People don’t come back from that’

However, mechanical ventilators do cause a wide range of side effects. Those complications, combined with lung damage from COVID-19, can make recovery a long and arduous process, Chaddha and Khouli said. New York City lawyer and legal blogger David Lat spent six days on a ventilator last month, in critical condition at NYU Langone Medical Center after he was diagnosed with COVID-19. “This terrified me,” Lat wrote in an opinion piece in the Washington Post. “A few days earlier, after my admission to the hospital, my physician father had warned me: ‘You better not get put on a ventilator. People don’t come back from that.’”

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2020

COVID-19

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

he world is learning more about how certain viruses spread in speed and how long they can linger. Virus-laden droplets may infect an area for several hours, depending on where they fall. Viruses generally remain active longer on stainless steel, plastic and similar hard surfaces than on fabric and other soft surfaces, according to the Mayor Clinic. Other factors, such as the amount of virus deposited on a surface and the temperature and humidity of the environment, also determine how long viruses stay active outside the body. “When you think of what we are going through now, people really need to do their research on what happened in the 1918 pandemic,” said physician Shauna Zorich, clinical assistant professor of epidemiology and environmental health at the University at Buffalo. “That was unprecedented, and we are currently living in those times now. We are using similar solutions such as closing bars, restaurants and limiting social interaction. The 1918 pandemic was extremely devastating, but they were successful in decreasing the spread so that is why we need to take everything seriously now.” Zorich discusses five key elements of viruses.

Social distancing is essential to stop some viruses Social distancing is deliberately increasing the physical space between people to avoid spreading illness. Staying at least six feet away from other people lessens the chances of catching COVID-19. “There are some viruses that are spread via the airborne route. This means the virus can remain in the air for several hours and can travel distances. A good example of an airborne virus is measles, which is why it is so contagious,” said Zorich. “Other viruses will only be transmitted in close quarters, which is the case with the novel coronavirus. If an infected individual remains six feet or more from another person, the less likely the infected person is able to transmit the virus to the next person. That’s the reason it makes sense to shut down schools, restaurants and have people work from home.”

Viruses cause a wide range of illness Viruses can cause a wide range of illness in humans. They can be anything from subtle to deadly. Various viruses can cause headaches, chills, vomiting or more serious problems. “Viruses can cause mild diseases like the common cold but also more serious disease such as smallpox,

polio and Ebola,” said Zorich. “Poliovirus causes paralysis in about one of every 200 people infected. Ebola kills on average one of every two people infected. The bottom line is that some viruses can cause very serious disease.”

Viruses can live on objects The length of time a virus can survive on a surface will be dependent upon the type of virus and the surface involved. “For example, the flu virus has the potential to live on infected surfaces for up to 48 hours. This means that the flu virus could live on inanimate objects that others may be touching as well,” she added. “Viruses can live on objects like doorknobs, sink faucets and computer mouses so that is why we have to make sure to constantly disinfect these surfaces.”

Viruses are different from bacteria One important distinction between bacteria and viruses is that antibiotic drugs can be used to kill bacteria, but they aren’t effective against viruses. Infections caused by bacteria include strep throat, tuberculosis and urinary tract infections. Diseases caused by viruses include chickenpox, AIDS and the common cold. “Viruses are made up of genetic material and are surrounded by a coat of fat and proteins. They are not cellular like bacteria,” said Zorich. “It is important to note that viruses can only survive inside a host cell. If you have a viral infection, antibiotics will not help you recover.”

Finding a vaccine Many have wondered, with COVID-19 being an issue first overseas for months, why

ECMC to Fund Community Testing With DSRIP Program Funds

ECMC funds inner-city testing, additional healthcare support services

rie County Medical Center Corporation (ECMC) recently announced a community-based, inner-city healthcare initiative designed to support Buffalo’s vulnerable, at-risk residents during the COVID-19 pandemic. ECMC has been able to expand its testing capability and the effort is in concert with Kaleida Health’s recently announced effort to expand its laboratory testing capability for the coronavirus.. The new testing at ECMC and Kaleida will be able to provide anyone in the general public who has been deemed symptomatic by their primary care doctor and have received a prescription to obtain testing. ECMC expects that more com-

munity testing will be supported by the federal government in the future. Through Delivery System Reform Incentive Payment (DSRIP) Program, NYS Medicaid Waiver funding will be used in vulnerable communities to increase testing and link individuals with primary care. The coronavirus. pandemic is disproportionally affecting minority and economically challenged areas due to social determinates of health that have created underlining health conditions in these communities. Organizations that have existing agreements under the DSRIP Medicaid program in these vulnerable communities will be able to apply for COVID-19 testing sites and apply for grant funding for up to $2,500/

day for up to 100 days. These organizations will have specific deliverables and reporting requirements to meet DSRIP goals. $1.125M funds will also be provided to the African American Health Equity Task Force, to facilitate the Task Force’s work with inner-city churches and other community-based organizations to reach out to vulnerable individuals and educate them on COVID-19-related health issues and identify barriers to care and link individuals with primary care and COVID-19 testing sites. Also with support of the New York state, ECMC, through the DSRIP program, will also release $7.24 million as early distribution of funds to outpatient community

Physician Shauna Zorich, clinical assistant professor of epidemiology and environmental health at the University at Buffalo. hasn’t an established vaccine been created and distributed to the public? Well, it is not that easy. There is a process through the U.S. Food and Drug Administration that involves different scientific trials before it is given to the general population. It first starts with bench research to identify the correct components of the vaccine. Then there are tests on animals and then you start the first phase on a few dozen people. “Then if all goes well, you do a second phase on hundreds of people and then a third phase on thousands of people,” said Zorich. “We can’t offer a vaccine to millions of people without first identifying potential side effects. We must make sure that vaccine is safe and that takes time.” Vaccines have been pivotal in helping illnesses such as Hepatitis B, polio, measles, mumps, rubella and HIV.

partners, including primary care and behavioral health partners, as well as organizations who are engaged in three areas of activity: 1) Expanding healthcare capacity to reach Medicaid and vulnerable populations (e.g. telehealth); 2) Address social determinants of health (e.g., food, food pantries, rent assistance, housing); 3). Provide COVID-19-related care. “ECMC, as a safety net hospital, is committed to working with our community partners, including faithbased organizations, to provide the vitally important healthcare resources to vulnerable communities,” said ECMCC President and CEO Thomas J. Quatroche Jr., Ph.D. “I would like to commend the African American Health Equity Task Force members for their efforts to raise awareness of the impact of the COVID-19 virus on the inner city. We look forward to working with them and all of our community partners to advocate for additional public and private support to address the needs of vulnerable individuals during this crisis.”

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

new study adds to a growing pile of evidence that suggests losing your sense of smell and taste is an early sign of COVID-19. While there has been anecdotal information about this link, these are the first empirical findings that make a strong connection, according to the researchers at the University of

California, San Diego. Other known symptoms of coronavirus infection include fever, fatigue, cough and difficulty breathing. “Based on our study, if you have smell and taste loss, you are more than 10 times more likely to have COVID-19 infection than other causes of infection. The most com-

mon first sign of a COVID-19 infection remains fever, but fatigue and loss of smell and taste follow as other very common initial symptoms,” said study author Carol Yan, an otolaryngologist and head and neck surgeon at UC San Diego Health. “We know COVID-19 is an extremely contagious virus. This

May 2020 •

study supports the need to be aware of smell and taste loss as early signs of COVID-19,” Yan said in a university news release. The study was published April 12 in the journal International Forum of Allergy & Rhinology.

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SmartBites

The skinny on healthy eating

Immune-Boosting Fava Beans Promote Good Health

onger days, singing birds, the fresh scent of cut grass: spring is here and nothing heralds the season quite like rhubarb, asparagus, peas and pale green fava beans. While fava beans look a bit like lima beans, they’re less starchy and fuller in flavor: nutty and slightly sweet. First-of-the-season favas, coveted for their buttery, melt-inyour-mouth quality, are worth the preparation time. Like most legumes, fava beans brim with healthy nutrients. Low in fat, cholesterol and sodium, they stand out for their folate, fiber, protein, manganese and immune-boosting antioxidants. Why do we need folate? An essential B vitamin, folate is needed to make red and white blood cells, convert carbs into energy and produce DNA and RNA. Adequate intake

of this vital nutrient is extremely important during periods of rapid growth such as pregnancy, infancy and adolescence. A good intake is equally important beyond adolescence as folate helps to maintain a healthy heart, plays an important role in brain function and mental health and may even have protective benefits against certain cancers. One cup of cooked fava beans dishes up 44% of average folate needs. A good source of dietary fiber, fava beans may help lower cholesterol in both healthy adults and those with elevated levels. The soluble fiber, in particular, promotes healthy bowel movements by softening your stool and can also bind to and remove cholesterol from your body. In addition, several studies have shown that a diet rich in fiber may improve

Helpful tips

By Anne Palumbo feelings of fullness, which can then result in lower calorie intake and weight loss. One cup of cooked fava beans has 9 grams of fiber. Fava beans are rich in two nutrients that may prevent bone loss: manganese and copper. Although their exact role in bone health is unclear, some studies suggest that these two essential minerals are crucial to bone strength. Research has also suggested that manganese may help postmenopausal women maintain normal bone density, which may then lower the risk for osteoporosis. Looking to boost your immune system? Fava beans are loaded with compounds that may enhance antioxidant activity. Antioxidants are vital to your body’s immune defense, as they fight free radicals that may lead to cell damage and disease. Bone-strengthening manganese also plays a key role in forming a specific antioxidant enzyme that is one of the body’s most powerful antioxidants.

Fava Beans and Asparagus with Toasted Almonds Adapted from Martha Stewart Serves 8

1½ pounds fresh fava beans, shelled 1 pound asparagus, tough ends removed and cut into 2-inch pieces 4 tablespoons olive oil, divided 2 cloves garlic, minced 3 tablespoons fresh lemon juice; 1 teaspoon lemon zest salt and pepper, to taste ½ cup slivered almonds, roasted Blanch fava beans in a pot of salted boiling water just until tender, about 1 minute. Transfer to an ice bath; drain after 5 minutes. Pat dry and remove loose outer skin. Heat 1 tablespoon olive oil in a

How to Avoid Unwanted Weight Gain During COVID-19 Pandemic

eware of your fridge, pantry and couch during the coronavirus pandemic. Being cooped up at home with easy access to food can lead to overeating. Couple that with routine housekeeping, working from home, homeschooling your kids and tending to loved ones, and it’s a sure-fire recipe for weight gain, experts at the University of Georgia in Athens warn. “These tasks have been added to our many other responsibilities,” said Emma Laing, director of dietetics in the College of Family and Consumer Sciences. “So if something has to give as we strive to find our new normal, routines surrounding eating and physical activity might go out the window.” To stay on track, get up off the couch. Try to set times during the day for physical activity you enjoy, and to eat regular meals and snacks that provide adequate energy and hydration. “In creating this schedule, do so while maintaining flexibility,” Laing said. “It’s important to trust our bodies’ cues for hunger, so listen to Page 12

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those first.” Try to avoid mindless snacking. Social distancing during the coronavirus pandemic doesn’t mean you have to stop exercising. In fact, physical activity is a crucial stress management strategy. Ali Berg, a Cooperative Extension nutrition and health specialist, pointed out that «physical activity is good for maintaining immunity, in addition to adequate nutrition. Being active is also good for mental health.” Even though gyms and yoga studios are closed, you can find other ways to be active, said Tracey Brigman, a clinical assistant professor. “I start each day with a 2-mile walk,” said Brigman. “Anytime I cook, I dance (and embarrass my kids). Music also lifts my spirits so I don’t stress eat. If I have down time waiting for a timer, I jog around the rooms in my house while I wait.” Other simple ways to stay active include playing with your pets, finding workouts online or through free apps, playing games with the family -- and even cleaning the house.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2020

When buying favas, choose plump pods with a grassy-green color and few brown spots. Select small to medium pods, which are more tender and sweeter than the larger, starchier beans. Avoid burst pods: this means they’re old. Unshelled fava beans, stored in a plastic bag, last about 10 days in the fridge; cooked favas last about 5 days. Favas also come canned, dried, and frozen. large skillet over medium-high heat. Add asparagus and cook, stirring frequently, until asparagus is crisp-tender, about 3 minutes. Remove from heat; transfer to a large bowl; set aside. In same skillet, heat 1 tablespoon olive oil over medium-high heat. Add garlic and fava beans and cook, stirring frequently, until garlic is softened, about 2 minutes. Remove from heat and add to asparagus. Whisk together lemon juice and remaining 2 tablespoons olive oil, adding salt and pepper to taste. (Add more oil if dressing is too tart.) Add to bowl mixture and gently toss to coat. Combine almonds and lemon zest in small bowl. Transfer asparagus-fava bean mixture to a platter. Sprinkle with almond-zest mixture and serve.

Anne Palumbo is a lifestyle colum-

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

Nurses on the Frontline

They and other healthcare providers are front-line responders in the battle against COVID-19. Thank a nurse — May is Nurses Month. By Deborah Jeanne Sergeant

urses perform tasks that few other people could do as they care for patients who are sick and hurt. Currently, the role of nursing has taken on even greater significance, as nurses and other healthcare providers are frontline responders in the battle against COVID-19. The nature of their work places them in direct contact with infected and possibly infected patients every day. Nurses provide the physical and emotional care patients need, especially while isolation prevents loved ones from visiting. While recent events have drawn the public attention to nursing as they work long hours — sometimes with insufficient supplies and equipment — caring for COVID-19 patients, the industry has long experienced staffing difficulty. As of May, 209, 178,320 registered nurses work throughout the State of New York. Of those, 12,280 work in the Buffalo area. Even outside of the pandemic, nurses often work under circumstances unlike most other positions in healthcare and stressors not known in many other industries.

It’s commonplace for nurses to care for eight or nine patients at a time on a particular shift. This problem has prompted the New York Nurse’s Association to promote the statewide Safe Staffing for Quality Care Act, which supports nurse ratios, staffing for acuity, publicly disclosed staffing levels, maximum number of patients assigned to an RN, and more. Most of the ratios are 1:1, such as trauma and surgery to 1:3, such as newborn nursery. Rehabilitation and subacute nurse-to-patient ratio is 1:5 and the highest is the well baby nursery at 1:6. Nursing education began as much less formal than now. Caring women learned the folk remedies and wisdom passed down from

experienced elders. While the standard now is two years’ education to become a registered nurse and four years to earn a bachelor’s (BSN), the industry in New York has moved toward a required four-year degree as the standard. As of 2020, New York students beginning their studies may complete an associate’s degree and then have 10 years after they receive their RN credential to complete their BSN degree. The goal is to improve patient outcomes through improving nurses’ critical thinking skills. New York is the only state to pass such a measure — and it took a decade for New York to pass the law. It’s likely that the nationwide nursing shortage plays into other states’ decisions so far to resist laws such as this. According to the National Nursing Workforce Study, half of current RNs nationwide are 50 or older. In addition, the Health Resources and Services Administration estimates that within the next decade, over a million RNs will retire from nursing. Historically, women have dom-

inated nursing; however, in recent decades, men have become more commonplace in the field. In New York, 157,439 women were working as nurses as of 2017. Male nurses numbered 11,048, according to Kaiser Family Foundation. Nationwide, about 12% of RNs are male, up from 2.7% in 1970, states the Bureau of Labor Statistics. Part of the reason may lie in the fading stereotype of nursing as “women’s work” and the sharp increase in the need for nurses. With more nurses retiring and the aging baby boomer population increasing the demand for healthcare, nursing represents one career path with a guarantee of available employment. While the $76,120 annual mean salary in the Buffalo area is a good salary, nursing is taxing work which often involves long shifts, unpredictable hours (depending upon the place of employment) and heavy responsibility. Despite this, many nurses refer to their occupation as a “calling” that they feel privileged to perform. Since May is Nurses Month, take time to thank a nurse you know.

Volunteering Shifted Educator to Nursing

Susan Roeser, RN: ‘I love taking care of people. It just gives me joy.’ By Deborah Jeanne Sergeant

elping with a volunteer ambulance corps encouraged Lancaster resident Susan Roeser to shift her career from education to nursing. Now an RN and the nurse care manager at Landmark Health in Buffalo, Roeser had completed a bachelor’s degree in education in 1990 at Buffalo State College. While at Buffalo, she volunteered with the ambulance because she had always like watching medically oriented television shows as a kid, such as “M*A*S*H” and “St. Elsewhere. “ “I thought I’d join to see what it was all about,” she recalled. “It completely changed my life. I loved it.” The excitement of life-or-death situations seemed more meaningful to her and spoke to her in a way education never had. She enrolled at Erie Community College and earned her associate degree in nursing and earned her RN credential in 1994 while working a paid position with Lasalle Ambulance Corps. Initially, Roeser worked as a nurse at what is now known as Sisters of Charity St. Joseph’s Campus in Cheektowaga. For the past five years, she has worked at Landmark. While she enjoyed the fast pace of the hospital’s emergency room, she wanted a personal connection with patients and a long-term relationship, where she could see her influence make a lasting positive change in patients’ lives. She found that providing home health nursing through Landmark.

The agency’s patients tend to be high risk and elderly, the kind of people Roeser believes fall through the cracks and end up returning to the hospital. “I enjoy the problem solving of keeping them at home and out of the hospital,” she said. “We go into the patients’ homes and we get to see how they live. Sometimes, they don’t have food and their medications aren’t organized. They may be outdated. Sometimes they take the wrong dose. They have throw rugs and they’re tripping and falling. They don’t have equipment to keep them safe.” She added that aspects of patients’ lives such as these remain unseen from clinicians working in the hospital setting. “A lot of these things can be taken care of to keep them home,” Roeser added. Though unintentional, Roeser’s teaching background has proven very helpful in educating patients and family members on what can keep patients safer at home. She finds among her biggest challenges is “getting people to change their habits, like their diets,” she said. Whether it’s steering patients with congestive heart failure away from the salt shaker or encouraging and streamlining medication compliance, “nursing is a lot of education,” Roeser said. “A lot of people don’t think about it that way, but it’s a big part of my job. Sometimes patients

are receptive to change and some it takes a while.” She relies on her interdisciplinary team at Landmark, which includes professionals in behavioral health, dietitians and more to address patients’ needs. “I have a lot of resources to use, which really helps with the challenges of taking care of these people,” Roeser said. In light of the COVID-19 crisis, she has noticed an upswing in behavioral health challenges. “People are more anxious,” she said. “There’s depression. Being sensitive to those kinds of things right now is important for everyone, myself included. A lot of times, I’m the only one to call them and see them. That’s why I want to say ‘happy birthday’ or something personal to connect with patients that way.” That personal connection is the thing she enjoys most about nursing. Roeser said she treats her patients like family and they often reciprocate. “I love taking care of people,” she said. “It just gives me joy.” She tells others interested in nursing as their career that because it’s a tough job and many challenges, “you have to be creative and use your resources and do the best you can to better the health and lives of these patients. They depend upon you. Sometimes, we’re all they have.” She believes that the reason behind why someone chooses nursing will determine success.

May 2020 •

“You have to have a passion for what you’re doing,” she said. “Anyone can be book smart, but the people who really have a passion for what they’re doing and they care about what they’re doing and the patients, those are the ones who make the impact. The bedside manner is so important. “I hope to continue to do it as long as I can,” Roeser said. “You’re never not a nurse. I have patients who are retired nurses and they say the same thing.” In her free time, she likes to spend time with her family, listening to music and watching movies.

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Family Example Drew Man to Nursing West Seneca RN currently working with COVID-19 patients in New York City By Deborah Jeanne Sergeant

hile it’s human nature to flee from danger, West Seneca resident Ron Oakes, a registered nurse, volunteered for the frontlines of the fray against COVID-19 by taking a temporary job as a bedside nurse at New York University Langone. He works for Aya Healthcare, a Joint Commission-approved nurse staffing company based in San Diego. Oakes’ willingness to work in America’s COVID-19 epicenter represents his dedication to nursing, which was inspired by watching his cousin, Wendy Eygnor become a licensed practical nurse in the 1990s. This influence exposed Oakes to the consideration of nursing as a career. He also felt drawn to nursing because of “the values that I grew up with and I always wanted to help people,” Oakes said. Eygnor, now an RN, works at Fiddler’s Green Manor in Springville. Oakes followed suit in pursuing a healthcare career. He earned his nursing degree at Erie Community College in 2006, a Bachelor of Science in Nursing degree at Daemen College in 2012 and a master’s in nursing leadership from University at Buffalo in 2016. He’s also the current president of the Professional Nurses Associa-

tion Western New York Chapter. “When I was doing bedside nursing, I realized I loved critical care,” Oakes said. “I love that the interventions you do as a nurse can have almost immediate impact and influence on patients’ health. I love seeing that immediate response.” He has also enjoyed leadership roles in nursing that have involved coaching a team of nurses in the emergency room. Though a restructuring at Catholic Health ended his previous employment, it also opened him up to possibilities that can help him protect healthcare workers. He has applied to law school. “The more that I have been in nursing leadership, the more I see the impact of the legal system on our practice,” he said. “I have had a lot of experience working with risk management attorneys, having to evict a patient who wouldn’t leave and supporting nurses who were assaulted by patients. I have helped them through the waters of pressing charges. I think there is a need for attorneys out there that have the perspective of the bedside nurse who has their interests in mind. It’s a way to better represent the nurses in our community. “Nurses are punched, thrown

against the wall. They’re putting their lives on the line to help people because they’re attacked.” He hopes to represent nurses and “work toward the betterment of the health of our community, whether involving myself in legislation or representing nurses,” he said. In the meantime, he continues to nurse through Aya Healthcare and, perhaps once he’s back in Buffalo, as a per diem critical care nurse. He views the biggest challenge facing nursed today as “the amount of work that needs to be done and being able to provide the care that you yourself want to provide to your patients. Down deep, all of us have real connections to people and patients and we want to connect to them on a personal level and sometimes it’s not possible.” He tries to meet that challenge by developing an “intentional presence when I’m with patients and family, making direct eye contact and trying to connect as much as I can.” Oakes enjoys the human aspects of nursing the most. “The gratitude that you hear from patients and families, or sometimes, you just see it in their eyes, is one of the most rewarding things,” Oakes said. “Being that person who

has helped them through a difficult recovery or eased suffering during end-of-life is profound. I enjoy being that person who can provide that comfort and care.” He views nursing as a career with many opportunities for people who have “a deep desire to care for people and the compassion to set aside the distractions and make your patient your priority.” In his free time, he works with the Professional Nurses Association. Oakes is also a foster parent and takes care of rescue dogs.

Employment Whim Turned into Loved Career For Dylan Deabold, nursing requires more than a diploma: “Your heart has to be into it” By Deborah Jeanne Sergeant

uffalo resident Dylan Deabold is a registered nurse who works at Erie County Medical Center and teaches part-time at Trocaire College. His dedication to healthcare might lead one to imagine he had always wanted to work as a nurse; however, that’s not the case. At age 18, he began his first job — not in healthcare — which lasted four years. “I could not get interested in doing network marketing,” Deabold said. “It was not for me.” He spotted an interesting employment ad about working with people with developmental disabilities. He had never worked in healthcare but on a lark, applied and was hired as a direct care worker. To his surprise, he warmed to helping people and “fell in love” with the job. His enjoyment of that job prompted him to apply for nursing school. He graduated from Trocaire College in 2016 with his Bachelor of Science in Nursing and has since worked at Erie County Medical Center and part-time teaching at Trocaire. Though Deabold loves his work, he feels staffing is a big issue. “Nurses are often forced to work short. There’s such a shortage of nurses now. California has mandated nursing ratios, which I think would be beneficial to nursing everywhere.” Page 14

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As a nursing instructor, he likes feeling he’s part of the solution as he’s teaching new nurses. Erie County Medical Center is part of the New York Nurse’s Association, which promotes staffing ratios. “Sometimes, it’s pretty difficult,” he said. “Nurses could have six to seven patients at a time and we can be spread only so thin. It becomes pretty difficult.” He thinks the reason the industry lacks nurses is that affordable twoyear colleges lack sufficient capacity to accept all of those interested in nursing and the larger capacity fouryear schools tend to have more costly tuition. “Different grants would be helpful to students who are pursuing nursing careers and for those in the healthcare professions,” Deabold said. “It gets super expensive. With everything going on with COVID-19, thank God they’re deferring student loans for everyone.” He likes that at least the pandemic is giving healthcare workers some much-deserved recognition, and he hopes that it also draws more people to healthcare careers. “But this is what happens on a daily basis,” he added. “We are always there for your family members and the patient lying there in the bed. Families are not always able to be

involved.” The patient care and interactions are what he enjoys most about nursing. “When you’re in the hospital [as a patient], it’s one of your most difficult times,” Deabold said. “To be comforting for them —I really enjoy that.” He hopes that anyone interested in nursing will consider why they want to pursue it as a career option. “If you want to get into it for the money, don’t do it,” he said. “You have to have a passion for nursing. It’s a hard, thankless difficult job. Your heart has to be into it.” Beyond the educational requirements, he believes that nurses must possess compassion, caring and understanding. “This is the most vulnerable time for people and they’ll lash out because they’re sick and scared,” he said. “Especially with the patients in palliative care at end of life, it gets pretty tense. You have to be there for the family members and the patient.” “I love nursing,” he added. “I got into it on a whim at first and I think if you feel in your heart you’re a compassionate person and you want to help people, it’s probably for you. It’s still a female dominated, but there’s an increase in the number of male nurses. I think patients

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2020

have really started to like that. I get complimented all the time for being a male in the field. It’s a nice changeup for patients.” He hopes to advance his career by obtaining additional education to become a nurse practitioner focusing on palliative care. When he’s not working, Deabold enjoys spending time with friends and family, activities he’s not able to do during quarantine, but he’s looking forward to when he can.

Dedicated. Caring. Exceptional.

In Celebration of In Celebration of Nurse’s National Nurse’s National Month Month

In Celebration of National Nurse’s Month

At UBMD Obstetrics & Gynecology, we’ve always found these words to describe our nurses, but this year, they carry a different meaning. This year, they’ve been redefined. During the public health crisis COVID-19 has brought to our community, we’ve seen our nurses rise to challenges we haven’t seen before in healthcare. While adjusting to new norms and changes at home, our nurses continued to take care of our patients throughout the pandemic each and every day. Nurses Day has always been important to us as a team, but celebrating it this year has come to mean something different. This year, we celebrate not only the care they provide and how crucial they are to our team, but we now also celebrate how our nurses have gone above and beyond during this time. With these new circumstances, it became imperative we increase accessibility to our providers. Within a matter of days, our nurses transitioned to UBMD CareConnect, our telemedicine platform, so that while we’re social distancing and some of our patients are unable to come into the office, we can continue to provide essential care to our patients in need. At the same time, we’ve seen our nurses quickly adapt our offices to new regulations that keep our patients and team members safe, and our office a safe environment to provide care.

Dr. LaVonne Ansari, CEO Community HealthAnsari, Center ofCEO Buffalo, Inc. Dr. LaVonne

“In a ‘normal’ year, our nurses are vital members of our care team, but in these times, I’ve seen a resiliency that cannot be matched,” said Dr. Vanessa Barnabei, president of UBMD OBGYN. “We are thankful to have this group of nurses’ part of our organization. They have remained steadfast in their commitment to our patients, to the WNY community and to our team.”

Community Health Center of Buffalo, Inc. Congratulations to Rudo Mushonga, Director of Nursing and the entire Nursing Staff of the Community Health Center of Congratulations to Rudo Mushonga, Director of Nursing and the entire Nursing Buffalo, Cheektowaga, Niagara Falls and Lockport. Dr. LaVonne Ansari, CEO Staff of the Community Health of Buffalo, Cheektowaga, Niagara Falls and WeCenter Appreciate You All! Community Health Center of Buffalo, Inc. Lockport.

716-636-8284

We Appreciate You All!

A Special Thank You to ALL Nurses...

Congratulations to Rudo Mushonga, Director of Nursing and the entire Nursing Staff of the Community Health Center of Buffalo, Cheektowaga, Niagara Falls and Lockport.

On the frontline and beyond!

We Appreciate You All!

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

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

May 2020 •

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Page 15

Special Time for Nurses at a Critical Period in Medical History By Nancy Cardillo

he World Health Organization has declared 2020 as the International Year of the Nurse and Midwife in a nod to the 200th birthday of Florence Nightingale, the founder of modern nursing (also known as the “Lady With The Lamp”). Wednesday, May 6 is National Nurses Day and kicks off National Nursing Week, which culminates on May 12, Nightingale’s actual birthday. Commemorative events and activities recognizing the important role nurses play in our lives are (now, tentatively) scheduled all over the world throughout the year under the overall theme as designated by the International Council of Nurses of “Nurses: A Voice to Lead — Nursing the World to Health.” Perfect timing. With the advent of the novel coronavirus crisis, health care workers have been thrust into the spotlight as they work desperately and diligently to care for those afflicted with the virus — as well as other health crises — all the while risking their own health and possibly the health of their family members. This group includes the more than 3.8 million registered nurses who represent not only the largest segment of the health care profession, but also one of the largest segments of the nation’s workforce as a whole. Nurses are an integral part of the health care system as they encompass the promotion of health, prevention of illness and care of those who are physically or mentally ill or disabled. As part of patients’ interdisciplinary teams, nurses are there 24 hours a Page 16

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day, every day of the year, and are the continuous link or lifeline – the “eyes and ears” – between patients and physicians, ensuring patients get the best care possible. “Nurses are the point of entry for patients, and the closest to the bedside, wearing multiple hats to ensure patient care is met,” says Shari McDonald, an RN and vice president and chief nursing officer at Mercy Hospital of Buffalo. “We collaborate with providers on a care plan and act as advocates for the patient to ensure the plan of care is met, not just while a patient is in the hospital, but after discharge as well.” The men and women who are licensed practical nurses and RNs perform an array of duties in a variety of settings. In hospitals, they’re involved in critical and acute care in specialized areas such as the emergency room, intensive care unit, maternity and cardiovascular floors. Depending on their degree level, nurses can also work in community-based clinics, patient-centered medical homes, home care services, private practices, schools and with vulnerable populations, such as the homeless. “Nursing isn’t a job, it’s a profession and a calling,” says McDonald. “It’s extremely important and hard work done by very dedicated, caring people. It’s a difficult profession, but the reward comes when you see the difference you’ve made in the delivery of care to a patient and see them improve.” Just how vital are nurses? According to the Bureau of Labor Statistics, registered nursing is among the top occupations in terms

of job growth, with a projected need for an additional 203,700 new RNs each year through 2026.

Shortage looming

However, the American Association of Colleges of Nursing says the nation is projected to experience a shortage of RNs that is expected to intensify as baby boomers age and the need for health care grows. Compounding the problem is the fact that nursing schools are struggling to expand capacity to meet the rising demand for care, given the national move toward health care reform. Denise Dunford is the assistant dean and interim director of the Doctor of Nursing Practice and Nursing Education Programs at the Patricia H. Garman School of Nursing at D’Youville College in Buffalo, where approximately one third of the school’s 3,000-student population are nursing students. Last year, the school was awarded a $401,000 Health Resources and Services Administration grant to address the nursing shortage. “We’re using that money to enroll students in our master’s and doctoral programs to address the shortage and graduate students who are then fully qualified to work in a variety of positions in multiple industries,” she said. Dunford says D’Youville’s graduate nursing programs have an employment rate of 97 percent. “Before they even have their license, one-third of our graduates have job offers, the need is that great,” she says. What does it take to become a

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2020

nurse? “First and foremost is the ability to possess a sense of service to others,” says Dunford. “Kindness, compassion, intelligence, flexibility, innovation and the ability to be a good listener are also attributes of a good nurse. “Nurses provide a much-needed service for people ‘from womb to tomb’ as we say,” says Dunford. “There’s nothing more rewarding than helping someone achieve optimal health at any life stage.” D’Youville offers several nursing degrees at various levels. “The higher your degree, the more chance for advancement and the more opportunities available,” says Dunford, who says the average cost for a master’s-level degree at D’Youville is around $40,000. “For that price you’ll get upward mobility in terms of nursing management and outlets available to you throughout your career.” Dunford added that nurses qualify for loan forgiveness plans at state and national levels. McDonald says nurses in Western New York are a bit above the national average when it comes to compensation and benefits. There is also a huge need — particularly now — and there are a variety of available jobs. Both McDonald and Dunford agree that while the technological capabilities in medicine have improved greatly over the years, the one thing that has never changed is the connection between nurses and their patients, particularly in times of crisis, such as we are experiencing now.

Erasing the Stigma Mental health comes front and center as significant priority during pandemic By Michael J. Billoni

or the past four decades, Ken Houseknecht has been associated with the Mental Health Advocates of Western New York, the last nine as its executive director. During that time, one of its primary goals has been ending the stigmas associated with mental illness. In a way, Houseknecht said the COVID-19 pandemic is helping to do just that. “One of the good things to come from this pandemic — and there are some good things — is the lowering of ‘stigma,’ the barrier to getting help,” Houseknecht says. “Everyone is experiencing some degree of anxiety, depression and stress and for many, it’s acute. Fortunately, discussing mental health is commonplace right now. If you need help, get help. It’s not a sign of weakness. It’s a sign of humanity.” Houseknecht, who received the organization’s Lifetime Achievement Award at its 58th annual dinner recently, one day before large gatherings were banned, says the mental health system in America was in trouble well before the pandemic. Spending on mental health was the single-largest health care cost, by far, and expenditures there were growing twice as fast as other areas, he points out. “Sadly, all of the trends — even with all of this money being spent — were not moving in the right direction,” he explains. “Now, in the wake of this pandemic, an already stressed and inadequate system is enduring challenges that no one ever envisioned. How can — how must — we

respond? “Let’s start with the obvious. It’s always better — from a human and financial perspective — to keep people mentally strong and resilient. Like never before, we need to increase the emphasis on awareness, education, prevention, early detection, and early intervention. It is far better to keep people healthy than wait until they are ill,” he adds.

Helping oneself “We know there are specific — and very easy and often free — things that folks can and must do to preserve and promote their mental health, especially now. Proper sleep, exercise, good nutrition, mindfulness, strong relationships, limiting technology, and spirituality are some sure steps,” Houseknecht said. During this pandemic, he has seen the mental health community — from clinicians to mental health advocates — find creative ways to address today’s unprecedented challenges and mounting needs. From telehealth to creative uses of technology, people are finding ways to both provide and get help. “Every aspect of society is being tested right now,” he says. “Outmoded ways of thinking and acting are giving way to innovative ideas and solutions. Necessity, as always, is the mother of invention. Stay focused. Stay strong. Focus on what you can control and we will all get through this. And — if we stick with these simple steps — we’ll come out stronger on the other side.” Houseknecht, who annual dress-

“One of the good things to come from this pandemic — and there are some good things — is the lowering of ‘stigma,’ the barrier to getting help.” Ken Houseknecht, Executive director at Mental Health Advocates of Western New York

es as Superman for MHA’s annual Superhero Walk & Run for Children’s Mental Health, donned his costume and arranged for other superheroes to join him in early April at the Erie County Medical Center to greet nurs-

es at their shift change. “These are the real heroes,” he said. The MHA website is www. mhawny.org.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Social Media: Mental Health Friend or Foe?

By Deborah Jeanne Sergeant

hether it’s to alleviate boredom from quarantine, connect amid social isolation or get the latest news on COVID-19, social media seems to be a busy place these days as the world turns more and more virtual. In general, and in light of current events, the effects of social media on mental health are mixed. “Facebook is a hedonic treadmill,” said Corey Leidenfrost, Ph.D., research assistant professor and associate training director, department of psychiatry at Jacobs School of Medicine and Biomedical Sciences. “You watch other people and what they’re doing and think you should be doing it and you want to keep up.” Posting can help one stay motivated to drop 40 pounds or finish a remodeling project. While the accountability is good, it can also give others a skewed view of the poster’s life. For example, the do-it-yourselfer who renovated the kitchen may not show that his lawn is overgrown and his family has not been able to use the kitchen for several weeks. Or the dieter showing off a tremendous weight loss doesn’t share about the social outings missed to ensure sticking with the new eating plan. It’s easy for social media to turn into a showcase of perfect moments that can leave others feeling like they don’t quite measure up if they haven’t fixed up their home or lost the weight they want to lose. “Social media can be a facade because you don’t know what really is going on,” Leidenfrost said. “That pressure to put up a particular image. Part of it is that reappraisal that what other people portray isn’t reality. Knowing that can take pressure off. Focus on what’s meaningful for you.”

While superficially connecting with others online may offer diversion, Leidenfrost said that real-life relationships are what’s more important. Especially during isolation, social media can help reach out to people one actually knows — not “friends” who never met in person. Shira Gabriel, social psychologist with University at Buffalo, specializes in the human need for social connection. She wants people who use social media to “use it as a way to connect with others and have conversations,” she said. “Research says people who do that are happier and healthier. Social media isn’t good or bad, but can be used in ways good or bad for mental health.” Only “lurking” — reading others’ posts but not participating in posting and commenting — can result in feeling down, since it’s not a give-and-take conversation. The one lurking isn’t sharing anything. “We focus in on others’ best moments, not what their real life is like,” Gabriel said. “If you use it to inter-

act, comment and post, if you share recipes and ask for them, and share your highs and lows and comment on others highs and lows, that can be a positive way in connecting with others, especially when we’re limited in our real world connection.” She likes the community-building posts that share how others are positively coping with COVID-19 isolation, such as trading recipes, placing a teddy bear or rainbow in the window for children to count while on a walk or writing positive messages on a sidewalk with chalk to encourage others. “If you can find creative ways to find ‘collective effervescence’, a connection of sacredness and community, that is helpful,” she said. As the coronavirus pandemic continues, many people turn to social media for news; however, since any person can post anything on social media, the information may not be accurate. Instead, stick with sources such as the World Health Organization and the Centers for Disease Con-

Technology Beats COVID-19 Isolation for Nursing Home Residents By Deborah Jeanne Sergeant

xperts agree that suspending social visits to nursing homes represents an important way to reduce breakouts of COVID-19. While this can help slow the spread of COVID-19 within this vulnerable population, it severely limits the scope of social interactions available to nursing home residents. Family members are prohibited from stopping in but that doesn’t mean that residents cannot connect with loved ones. At Park Creek Senior Living Community in Buffalo, Facetime and Skype have helped residents to stay in touch with their family members. Page 18

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Geri Robinson, administrator at Park Creek, said that since some of the community members have macular degeneration or hearing impairment, using technology that includes both visual and audio components helps. “I’m glad to use the technology, but my staff wasn’t as up on technology before,” Robinson said. “We’re learning to use it.” Another example is lchurch services for residents of faith. “Residents have been very happy with that,” Robinson added. She said that Park Creek sends weekly updates to family members to

keep them in the know. Some family members have “visited” by stopping by to see their relatives through their window. “It’s frustrating for families because it’s been a long time and it appears we have another month,” Robinson said in mid-April. “But the families are happy because we haven’t had any cases. Technology may be a new trick for us old dogs.” To help residents feel closer to their families, care facilities are using technology. For example, St. Ann’s, Rochester’s largest nursing home, encourages family members to call residents anytime they wish.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2020

trol and Prevention — and limit time looking at news stories promoted through social media. Accurate news can still focus too much on negativity. Look at social media for entertainment and connection and not as much as a news source. Shawn Marie Cichowski, life and energy coach, certified mindfulness and meditation instructor, and owner of the WNY Life Coaching Center in Williamsville, said that using social media for news limits the news only to the preferences of the user. “There’s not a broad scope of what you’re seeing,” she said. “It opens the door to everyone’s opinion which sometimes isn’t helpful. With COVID-19, it’s a perspective, but not a full perspective. What we focus on is what we give our life to. What does news usually cover? A lot of times, it’s not always the positive.” Following someone who consistently posts positive content may help improve the social media feed.

“We understand this is a difficult time for families, loved ones and guardians who are unable to visit our residents during the COVID-19 pandemic,” said Triciajean Jones, director of life enrichment at St. Ann’s Community. Participation in the buddy program can help residents feel more connected. The program links residents with employees who volunteer to visit with them multiple times weekly as an informal, non-clinical check-in. It’s just a time for casual conversation. “These volunteers also help the seniors contact their families via video chat, phone, or other means,” Jones said. “It’s a friendly visit for both residents and staff.” The facility also purchased more tablets so residents can video chat with their buddies to reduce feelings of isolation. The tablets are disinfected after use for safety.

Q A &

with

Valerie Nowak

Chief executive officer of Harmonia Collaborative Care says organization strives to help those with mental health issues, support seniors in need in community By Michael J. Billoni

alerie Nowak, chief executive officer of Harmonia Collaborative Care in Derby since 2019, has been with the organization as a New York statelicensed mental health counselor for 14 years. She holds a Master of Arts in mental health counseling, a master’s degree in public administration and is a health leaders fellow of the Health Foundation for Western & Central New York. Harmonia Collaborative Care has 40 employees and an annual budget of more than $2.5 million. For more information, visit www. harmonia-care.org or call 716-9475025. Western New York In Good Health newspaper recently interviewed Nowak about Harmonia Collaborative Care. Q.: What is Harmonia Collaborative Care’s mission? A.: Formerly Community Concern of WNY, we are a nonprofit organization providing behavioral health, health home and senior care services to foster individuals’ independence and improve their quality of life. We all strive to find harmony in our lives and to find concordance between family, passions, work and our homes. There are many challenges to a harmonious existence: sickness, addiction, the realities of aging and the burdens of life. Harmonia’s mission is to help harmonize our clients’ lives again, so they can move to a melody that supports healthy balance. Harmonia is the Latin word for harmony, and

can also mean melody, consonance and concordance. It speaks to disparate pieces working together to create something whole. Q.: How does Harmonia Collaborative Care help harmonize lives? A.: Our professional staff, working at our two beautiful facilities in Derby and Hamburg and from individuals’ homes across Western New York, prides itself in providing empathic care to help establish balance in our clients’ lives. We strive to enable people to attain their highest level of well-being and independence through our integrated mental health, senior and health home services while reducing the cost of care for individuals and funders alike. Q.: Why was the organization rebranded? A.: For years, people have struggled to understand the services our organization provides. The word “concern” was especially troubling for people to define as it related to a human service agency. Broad, sweeping images of “concerning” community issues (political, socioeconomic, legal) often jumped into people’s minds. Following our acquisition of Hamburg Counseling Services in late 2017, which substantially increased our service capacity and geographic diversity, the time was right to look introspectively and objectively at our structure, goals, and potential as well as the perception we help in the minds of our many constituents. Q.: Whom do you serve? A.: Our mental health counseling

provides services to people aged 13 and up, as well as seniors and families in need of support through our programs. Our CarePanion program provides in-home housekeeping and companionship to seniors to support keeping them in their homes. We accept Medicaid, Medicare and most health insurance plans. Some of our senior programs are supported by a contract through Erie County Senior Services, which means some people may qualify because of financial need. Caregivers who need help have chosen this option because it is an affordable way to support their loved ones. Q.: Tell us about the growing mental health and seniors’ needs in WNY? A.: We have all heard the challenges individuals with mental health needs undergo due to stigma and access to help. The number of people in need in our community is growing. In a rural setting, access to care is challenging because of the isolation brought about by lack of transportation. We are working to bring quality

tele-behavioral health to those shutin or isolated. The same is true for our seniors. They are isolated physically and emotionally. Our programs strive to meet them where they are, supporting their needs and elevating their quality of life. The COVID-19 crisis escalated the temporary need to connect with people by alternative means. We have transformed our behavioral health clinic to a “virtual” clinic, providing services by phone or video in a temporary capacity. Our senior services case managers are connecting with their clients by phone. Q.: How can the public support Harmonia? A.: Harmonia Collaborative Care is a New York state-licensed nonprofit. In order for the organization to continue to provide these services to the community of those in need, we need financial contributions. Small investments from our fellow WNYers in need add up. Donations can be made at www.harmonia-care.org.

ECMC Launches “Brave” Program to Fight Violence

rie County Medical Center (ECMC) Corporation and its community partners recently introduced Buffalo Rising Against Violence at ECMC, or BRAVE. Funded through the New York State Office of Victims Services, BRAVE aims to go beyond treating injured bodies to heal the whole person. BRAVE workers will connect patients and families to culturally sensitive, comprehensive, and multifaceted interventions at ECMC and in the community. Violence is a public health problem that impacts the entire commu-

nity. ECMC is committed to serving a vital role in an effort to reduce community violence in Buffalo. As the region’s Level 1 adult trauma center, most victims of violence are treated at ECMC. BRAVE will provide care and services from the initial trauma and continue when the patient returns to the community. Through BRAVE while the patient is in the hospital: a professional follows the patient during their journey to recovery; a liaison is provided to the patient/family and ECMC staff to ensure medical and

communication needs are met; referral is made to spiritual care providers and trauma chaplains; the patient is visited by an experienced representative who understands the patient’s circumstances; help is offered to the victim of violence to make changes in desired areas of their life; a safety plan is created to enable the patient to return to the community for recovery; patient transportation is secured; safety planning is offered; links to mental health and substance abuse services are provided; and family support services are also offered. May 2020 •

Upon discharge, BRAVE in the community provides on-going case management and community resource assistance; referral to primary care physicians; financial assistance with applying for victim’s compensation, food stamps, and SSDI; housing application assistance; legal support assistance; links to education and job training programs, life skills training, recreational and wellness programs. Those individuals interested in obtaining additional information about the BRAVE program can call 716-898-6461.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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

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

Plans (AHIP), the industry trade association. The report, by the Wakely Consulting Group, modeled healthcare utilization and costs on the basis of published studies for infection rates ranging from 20% to 60% of the population. The researchers also calculat-

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

— could exceed $30,000, according to an AHIP news release. The researchers modeled the costs and utilization of COVID-19 patients on data for patients who had been treated for seasonal influenza and pneumonia. To estimate inpatient costs, they used the 75th percentile of admission costs for patients with ICU admissions and the 25th percentile of admission costs for non-ICU cases. Other cost figures came from claims databases. The researchers assumed that 75% of total costs would be incurred in 2020, and 25% of costs would occur in 2021, after the pandemic waned. It’s notable, however, that such a high cost was projected for the second year of the disease. While experts disagree on how long the pandemic might last, there is a consensus that only a vaccine will knock it out completely. Such a vaccine may be available in a year to 18 months, but it may take longer, some experts say.

tions they need to treat the virus and other respiratory diseases. President Trump may have to use the Defense Production Act to force drug manufacturers to step up. About half of our U.S. population lives in an area where an uptick in the virus would overwhelm the number of ventilators available in local hospitals.

has been available for years, but providers and consumers alike have been slow to incorporate it into practice. COVID-19 may be the catalyst for the widespread acceptance and use of the virtual visit, especially as both consumers and providers adapt over the next several months. Medicare is also relaxing physician supervision of nurse practitioners and physician assistants, granting these two advanced practitioners more independence. Physicians will also be allowed to provide virtual care across state lines regardless of in which state they are licensed.

Healthcare in a Minute

By George W. Chapman

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

arious computer models have attempted to predict U.S. deaths from the coronavirus pandemic. The earliest estimates were upwards of one million deaths. These early predictions were based on spurious data from China, very little experience with the virus in the U.S., no established federal game plan or preparation, and no change to everyday life. A few months into this, we have more experience, we have a federal game plan and CDC guidelines are in place to mitigate the spread of the virus like distancing, hand washing and isolation. As of mid-April, models are predicting less than 100,000 deaths. In any event, life as we know it will be altered for

months (years?) until a vaccine is discovered. However, it is important to keep things in perspective. Far more of us die every year due to other diseases and illnesses. Here are the major causes of death for 2018: Heart disease, 655,381; cancer, 599,274; Alzheimer’s and dementia, 267,311; emphysema/COPD, 154,603; stroke, 147,810; diabetes, 84,946; drug overdose, 67,367; pneumonia/ flu, 59,690; liver disease, 55,918; renal failure, 50,504; car crash, 42,114; septicemia, 40,718; guns, 39,201; falls, 37,558; hypertension, 35,835; Parkinson’s, 35,598; digestive diseases, 31,015; arterial diseases, 24,808. In 2018 the U.S. population was 327 million.

Hospital Beds in NYS

the fact that we do not have a unified healthcare system in the U.S. For hospitals, it has always been “every man for himself.” The pandemic has decimated already fragile operating margins. The $2 trillion plus stimulus package contains $100 billion for providers.

Currently, New York state has 214 hospitals with about 35,000 beds. About 3,000 of those beds are equipped for intensive care, which is where patients on ventilators end up. Contrary to what some critics have said, Gov. Cuomo does not determine or control the number of beds in the state. Twenty years ago, in 2000, we had thousands more beds. The reduction of hospital beds over the last two decades is a reflection of what has happened across the U.S. Hospital closures and mergers, shaky bottom lines, wonder drugs, better technology and the proliferation of procedures now performed as outpatient have contributed to the reduction of, or need for, inpatient beds. Hospitals simply can’t afford to keep open enough beds for a pandemic every 20 years or so. Most budget for 90% occupancy. About one third of hospitals operate in the red; one third breakeven; one third make a modest profit. Even large hospital chains, both for profit and nonprofit, struggle financially. The COVID-19 has highlighted Page 20

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Ventilators

A hospital-style vent costs from $25,000 to $50,000. If the typical hospital is somewhere around breakeven, just as it can’t afford to stockpile unused beds, it can’t afford to stockpile ventilators for the every 20 year or so pandemic like COVID-19 let alone a smaller scale epidemic. Again, the U.S. does not have a healthcare system that would be prepared to deal with a pandemic or an epidemic. Most hospitals plan on using up to 90% of their vents on any given day. So, considering the thin operating margins of hospitals, it begs the question: “Who should finance an expensive and rarely used stockpile?” The next shortage facing hospitals will be the medica-

PPE

Highly infectious COVID-19 has drastically increased the need for personal protective equipment like masks, gowns and gloves in hospitals and medical practices. Hospitals are going through their supplies 17 times faster than under normal conditions where typically only staff in the operating suite or treating patients in isolation wear PPE. Now everyone that comes into contact with any patient must wear PPE, since every patient is assumed to be a carrier, given the high number of asymptomatic COVID patients. To make matters worse, healthcare workers that wear PPE must also remove their clothes before entering their homes to avoid contaminating their homes and families.

Telemedicine

Most likely, because of the highly infectious virus, your provider has either postponed your upcoming routine office visit or has offered to “see” you via telemedicine. Medicare has relaxed privacy and billing requirements for providers, (MDs, NPs, PAs, social workers, therapists, mental health providers) making it far easier for them to offer and bill for virtual visits. Smart phones and personal computers are acceptable for virtual visits. Medicare will waive office copayments, but the 20% coinsurance and deductibles still apply. The virtual visit cannot be related to a prior visit, usually a follow up, that occurred within the prior seven days and does not lead to a personal visit within 24 hours or next available appointment. You must agree to the virtual visit verbally. Commercial insurers typically, but not always, mimic Medicare. If you are uninsured, Medicare will pay your provider normal Medicare rates. Telemedicine

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2020

Testing

As of this writing, in mid-April, about 2 million of us have been tested for SARS 2/COVID-19. That is a start, but still not even 1% of the U.S. population of 330 million. There are plenty of labs to perform the tests including 4,900 CDC labs and 228,000 public health labs. The overwhelming problem right now is the inability for most of us to get tested. The shortage of testing presents another problem in that physicians cannot verify that a patient died of the virus if they were never tested. Consequently, fatalities due to the virus are probably somewhat understated, as scarce tests are being saved for the screening and diagnosis of the more ill patients. To get back to “normal,” if we ever do, it is imperative that all of us have immediate access to testing. Social distancing is working but until there is universal, or just better, testing epidemiologists believe it won’t be safe to “open up the country” again. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

Our Family, Focused on Yours.

Why Choose CBD BioCare: • • • • • •

By Jim Miller

Medicare Expands Telehealth Services to Help Keep Seniors Safe at Home Dear Savvy Senior,

Yes! Due to the coronavirus (COVID-19) pandemic, Medicare recently announced that it will be expanding coverage for telehealth services to help keep vulnerable seniors safe at home. Here’s what you and your mom should know.

Telehealth Services If you’re not familiar with telehealth or telemedicine services, they are full visits with a health care provider (who isn’t at your location) using telephone or video technology device — i.e. smartphone, tablet or computer. Telehealth services allow Medicare beneficiaries to take care of ongoing medical problems as well as new concerns, while following public health advice to stay home during the coronavirus outbreak. Medicare patients with chronic health conditions now don’t have to postpone a regular follow-up visit with the doctor to keep safe. They can do it via Skype or FaceTime. And people concerned they may have the virus could see their doctor or nurse practitioner virtually to find out how to get tested. Nursing home residents will also be able to have telehealth consultations with their doctors. If your mom isn’t familiar or comfortable with technology, you or another relative or friend can assist her. You may need to go over to her house to help her do this. Bring your smartphone, tablet or laptop – but remember, don’t visit if you’re feeling sick. Risk of serious illness from the coronavirus is much greater for older people and those with underlying health problems such as lung conditions, diabetes or heart problems. Many seniors are also managing chronic health issues that put them at heightened risk.

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Until recently, telehealth coverage under original Medicare has been limited to beneficiaries only in rural areas, and patients often need to go to specially designated sites for their visits. The expanded telehealth coverage, which will remain in effect during the coronavirus outbreak, now allows doctors and hospitals to bill Medicare for visits via telemedicine that previously had to take place in person, at a medical office or facility. If your mom happens to get her Medicare benefits through a private Medicare Advantage plan, they will also be expanding their telehealth services. For coverage details, contact her plan directly.

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Other Medicare Coverage In addition to the expanded telehealth services, Medicare will also be covering all coronavirus testing costs Changing Lives One Bottle at a Time Lives...... One Bottle at a Time to see if your mom has been infected,Changing and medically necessary hospitalizations, so if her doctor recommends that she remain in quarantine at the hospital rather than self-isolating at home, she will not have to pay for these costs. And if your mom has a Medicare Part D prescription drug plan, it will cover the coronavirus vaccine when it becomes available and will waive prescription refill limits so she can have extra medication on hand ________________________________________ during the pandemic. For more information on how Medicare is covering the coronavirus _______________________________________ see Medicare.gov/medicare-coronavirus. And for the latest information on the coronavirus, visit Coronavirus.gov. ________________________________

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Ask The Social

Security Office

From the Social Security District Office

Social Security Honors Our Military Heroes

Lucy Connery is associate director at Wellness Institute of Greater Buffalo.

Healthy Communities 2030! Addressing People’s Health Amidst Crisis

n Memorial Day, our nation honors military service members who have given their lives for our country. Families, friends and communities pause to remember the many great sacrifices of our military and ensure their legacy lives on in the freedoms we all enjoy. We recognize these heroes who, in President Lincoln’s words, “gave the last full measure of devotion.” The benefits we provide can help the families of military service members. For example, widows, widowers, and their dependent children may be eligible for Social Security survivors benefits. You can learn more about those benefits at www. ssa.gov/survivors. We also offer support to our wounded warriors. Social Security benefits protect veterans when an injury prevents them from returning to active duty or performing other work. Wounded military service members can receive expedited processing of their Social Security disability claims. Are you a veteran with a 100% permanent and total compensa-

By Lucy Connery

he modern era Healthy Communities revolution is a global, quality of life improvement movement that began to spread worldwide in the 1980s through the World Health Organization (WHO). The Healthy Communities approach to positive community culture change was unique in that it strategically addressees both human behaviors and the social, economic and environmental factors that impact our health and quality of life. The movement is driven by the social capital-building public, private, nonprofit and citizen collaboration in creating their community’s better future. In 1989, the U.S. Department of Health & Human Services partnered with the National Civic League (www.NCL.org) to launch the Healthy Communities Movement in America. In that same year, the newly founded Wellness Institute of Greater Buffalo, inspired by the U.S. Healthy Communities initiative, adopted its mission of “creating healthy communities.” Fast forward 30 years, in response to the recent Robert Wood Johnson Foundation’s 10th Annual County Health Rankings (released March 2020), the Wellness Institute team launched a decade-long strategic initiative to more aggressively address the health behaviors and social/ecological determinants of health that together impact the Page 22

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quality of life in the Erie and Niagara counties. The Healthy Communities 2030! Initiative is an ongoing, year-round comprehensive approach to quality of life improvement that addresses four of the major health behaviors and the social, economic and environmental factors that contribute to people’s health. The WNY WALKS! Initiative works underneath the Healthy Communities 2030! umbrella to address regular physical activity in the form of walking, as it is the most accessible, affordable, and easy-to-do form of physical activity. Walking an accumulated 30 minutes a day can bring health benefits such as decreased stress, improved mobility and flexibility, improved cardiovascular health, and even improvements in physical health like muscle toning. We partner with organizations like Explore Buffalo, GoBike Buffalo, the Sunset Striders, Hamburg Moves!, and others to promote and facilitate improved walkability and increased regular physical activity. The Healthy Communities 2030! initiative addresses health as a metric for quality of life. We collaborate with our local leaders and communities to strengthen and empower us to achieve the progress we all want! To get involved in this health-enhancing initiative, take the first step by contacting us at BeActive@ City-Buffalo.org or CreatingHealthyCommunities.org.

Q&A : I went back to work after retiring, but now the company I work for is downsizing. I’ll be receiving unemployment benefits in a few weeks. Will this affect my retirement benefits? A: When it comes to retirement benefits, Social Security does not count unemployment as earnings,

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2020

tion rating from the U.S. Department of Veterans Affairs? We will expedite your disability claim. Both the Department of Veteran Affairs and the Social Security Administration have disability programs. You may qualify for disability benefits through one program but not the other, or you may qualify for both. Depending on your situation, some of your family members, including your dependent children or spouse, may be eligible to receive Social Security benefits. Want more information? Visit www.ssa.gov/woundedwarriors for answers to commonly asked questions or to find information about the application process. Thinking about retirement? Military service members can receive Social Security benefits in addition to their military retirement benefits. For details, read the Military Service page of our Retirement Planner, available at www.ssa.gov/planners/ retire/veterans.html. Please share this information with the military families in your community. To the veterans who bravely served and died for our country, and to the military service members who serve today, we honor and thank you.

so your retirement benefits will not be affected. However, any income you receive from Social Security may reduce your unemployment benefits. Contact your state unemployment office for information on how your state applies the reduction to your unemployment compensation.

Serving Western New York A monthly newspaper published by Local News, Inc. Distribution: 32,500 copies throughout more than 1,500 high traffic locations in the region In Good Health is published 12 times a year by Local News, Inc. © 2020 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 • P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Michael J. Billoni, Ernst Lamothe Jr., Kimberly Blaker, Karla Thomas, Nancy Cardillo, Kathleen Calabrese, Ph.D. • Advertising: Anne Westcott, Amy Gagliano Layout & Design: Dylon Clew-Thomas • Office Manager: Nancy Niet No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

WITH GRATITUDE You have been caring for the community since 1890 — you were with us then; you are with us now and we know we can count on you always because your commitment is unrelenting. You are compassionate. You care. You work hard and always put others first. You accomplish the impossible and people’s lives are better because of you. In celebration of National Nurses Week, we thank nurses everywhere. And, to the 162 nurses that are part of the Nascentia Health Family, remember that you are valued for the people that you are, and we thank you for everything you always do.

888-477-HOME • nascentiahealth.org May 2020 •

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ECMC-18108-InGoodHealth_January_Ad | TRIM: 9.75” x 13.75” | No Bleed | CMYK

If ECMC wasn’t there, we wouldn’t be here. In the face of the worst accidents and traumas, ECMC has always been on the front line of our community’s most critical injuries. As Western New York’s only Level 1 Adult Trauma and Emergency Department, we know firsthand the level of dedication and excellence ECMC’s caregivers bring to every patient they serve. For too long, these doctors, nurses, and support staff have provided lifesaving care in a cramped, outdated facility designed for far fewer patients than the over 70,000 individuals who are treated there annually. But with a new, state-of-the-art Trauma and Emergency Department opening in spring 2020, more lives can be saved, more families can celebrate their loved ones, and more stories of hope and healing can be shared throughout our region.

Give to the place where there’s no giving up, and donate today for hope and healing in WNY. SUPPORTECMCTRAUMA.ORG

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2020