In Good Health: WNY #110 - December 2023 by In Good Health: WNY's Healthcare Newspaper

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DECEMBER 2023 • ISSUE 110

THE HOLIDAYS AND OUR Mental Health

PAGES 9-11

Meet Your Doctor

THOMAS A. RUSSO, M.D. Chief of infectious diseases at UBMD discusses viruses, bacteria, antibiotic resistance P.4 ALSO INSIDE

U.S. MEN ARE DYING MUCH EARLIER THAN WOMEN, AS DEATH 'GENDER GAP' WIDENS

Q&A with

CARIBE

Bikers Against Child Abuse’s statewide public relations talks about the nonprofit mission. P.14

FITNESS: TRY BAR LEAGUE YOGA A unique league in Buffalo’s fitness scene offers new ways to stay in shape

U.S. Men Are Dying Much Earlier Than Women, as Death 'Gender Gap' Widens

he gap in life expectancy between American men and women is now the biggest it has been since the mid-1990s — almost six years. The pandemic and opioid overdoses are key factors in the gender difference in longevity, said researchers from the University of California, San Francisco (UCSF) and Harvard University T.H. Chan School of Public Health. "There's been a lot of research into the decline in life expectancy in recent years, but no one has systematically analyzed why the gap between men and women has been widening since 2010," said the first study author, physician Brandon Yan, a resident in internal medicine at UCSF. In 2021, the gender gap in life expectancy rose to 5.8 years, its largest since 1996, he and his colleagues report. In 2010, the gap was its smallest in recent history, 4.8 years. Life expectancy in the United States was 76.1 years in 2021. That's down from 78.8 years in 2019 and 77 years in 2020. Researchers cited the pandemic as the biggest factor in the widening gender gap; it took a heavier toll on men. Unintentional injuries and

poisonings (mostly drug overdoses), accidents and suicide were other contributors. Another factor in Americans' shrinking lifespan: so-called "deaths of despair." That's a nod to the rise in deaths owing to such causes as suicide, drug use disorders and alcoholic liver disease. These are often linked to economic hardship, depression and stress. "While rates of death from drug overdose and homicide have climbed for both men and women, it is clear that men constitute an increasingly disproportionate share of these deaths," Yan said in a joint news release from UCSF and Harvard. He and colleagues from around the country used data from the National Center for Health Statistics to zero in on the causes of death that were contributing most to shrinking life expectancy. After that, they examined how much different causes were contributing to the gap. For a number of reasons, men were more likely to die of COVID-19 during the pandemic. Researchers pointed to differences in health behaviors as well as risk of on-the-job exposure, reticence to seek medical care, being in jail and housing instability. Also factoring in were chronic

metabolic disorders, mental illness and gun violence. The findings were published online Nov. 13 in the journal JAMA Internal Medicine. "We have brought insights to a worrisome trend," Yan said. "Future research ought to help focus public health interventions towards helping reverse this decline in life expectancy." He said the findings raise questions about the need to develop specialized care, such as in mental

health, for men. Senior author Howard Koh, a physician and professor of public health leadership at Harvard, said follow-up will be needed to see if the trends change after 2021. "We need to track these trends closely as the pandemic recedes," he said. "And we must make significant investments in prevention and care to ensure that this widening disparity, among many others, does not become entrenched."

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December 2023 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 3

Meet

Your Doctor

By Chris Motola

Thomas A. Russo, M.D.

Chief of infectious diseases at UBMD discusses viruses, bacteria, antibiotic resistance Q: This tends to be the time of year when people start getting concerned about infectious diseases, your area of expertise. Tell us about what you do. A: I have significant educational role with educating infectious disease medical students, residents and fellows. I also have an administrative role as chief of the division of infectious diseases, which includes both administrative duties and, lately, answering questions from the media, often about COVID-19. I’m also involved in infectious disease research funded by the Veteran’s Administrative and National Institutes of Health to study and try to treat antimicrobial-resistant bacteria. Q: What’s your post-mortem analysis of the COVID-19 pandemic? What went well and what could have been done better? A: I think our greatest achievement was the rapidity with which we got an efficacious vaccine. Imagine if we got that vaccine a year or two years later. It was record time, less than a year. That was the good news. We were, of course, all hoping to have a vaccine that prevents infection, but that’s unrealistic for a respiratory virus vaccine, which is something we also see

with the flu vaccines. But it’s been very good at keeping people out of the hospital and having bad outcomes. We took a potentially lethal virus, made it closer to the common cold, and reduced the number of transmissions and infections. Mission accomplished. As for negatives: even though we have the tools, not just the vaccine but antivirals like Paxlovid, we’re not optimally utilizing those tools. It’s almost gotten worse with this season. People aren’t worried about COVID-19, even though it’s likely to get worse. Of course, there’s a stratification of risk to different groups, but no one’s without risk. Only about 14% of adults have gotten the updated COVID vaccine.

Q: What have you found to be the most effective approach to getting patients to consider taking it? A: I think there have been some misconceptions and, for argument’s sake, let’s stay away from the anti-vaxxer movement. This is just within the context of what’s true. I think people were expecting that vaccination would mean you wouldn’t get infected. What should be expected is prevention of emergency room visits, hospitalizations and deaths. It checks those latter boxes but it’s imperfect at preventing infection. I think that’s one of the issues. The other issue is people saying, “I’ve been vaccinated and-or been infected, I’ve got immunity, I’m safe.” But our immunity wanes over time and the virus continues to evolve. So for optimal protection, we need to go ahead and periodically get updated versions that are a better match to circulating variants. Now, we are still in better shape then we were during the pandemic when no one had any immunity, but individuals who are still at risk of developing significant disease include seniors, those with significant underlying disease and the immunocompromised. Having said that, even in low-risk groups there’s never zero risk of having a bad outcome. And the last point is there’s an increasing body of data that suggests the vaccine decreases your chance of developing long COVID. And that’s important for all age groups, even the ones statistically unlikely to end up hospitalized. Q: What, exactly, is long COVID? Is it damage resulting from infection? Failure to clear infection? Lingering symptoms? It doesn’t seem like there’s a fully agreed-upon definition. A: Long COVID is almost a discussion unto itself and you’re right that we don’t yet have a formal definition. Generally the definition is symptoms that persist 30 to 90 days after infection. It’s also more than that. It includes the systemic consequences of being infected. It increases your risk having cardiovascular events, central nervous problems like brain fog, autoimmune issues, clots. These are maximal over the first three months and then hazard ratios decrease over time but may remain elevated even two years out, which is where we are now. Q: Moving away from COVID-19 and viruses generally, I want to touch on antibiotic resistance. There were some headlines recently about gonorrhea becoming extremely resistant. A: I don’t specifically work with the bacteria that cause gonorrhea, but the principles of antibiotic resistance apply to all bacteria that cause infections in humans. We’ve been using more and more antibiotics both appropriately and inappropriately, and as a result they’ve become more and more resistant to these antibiotics, in some cases making them very difficult to treat. It’s an ongoing problem and really something that’s mostly on us as healthcare providers. We need to prescribe them only when appropriate and use

Page 4 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2023

what we call narrow-spectrum antibiotics against a given infection so we don’t encourage the evolution of resistance. From a personal responsibility side, patients sometimes expect to get a pill when they go to the doctor, even if they have a viral infection. We do have antivirals for things like COVID and the flu, but we don’t want to prescribe antibiotics for viral. Sometimes a patient will come in with a common cold and pressure the physician for antibiotics. Q: Can you explain narrow-spectrum antibiotics in lay terms? A: So let’s say you have an antibiotic that’s only effective against three bacteria versus one that’s effective against 10. If the infection you have is among those three, you want to use the first antibiotic rather than second so that you can reserve it for situations where you need something that’s effective against more bacteria and aren’t selecting for resistant bacteria that you aren’t targeting. Q: On the research side, what’s the strategy for dealing with bacterial infections that are already resistant? How are we keeping up in the arms race? A: There are multiple strategies. The first strategy what we discussed, using the ones we have more judiciously. The backend is development of new products. That takes a lot of time. There’s a lot of effort going toward that right now, including at our lab at the University at Buffalo, especially bacteria that are common to healthcare settings, which have become very problematic. Other approaches include innovative approaches which could include using them alone or in combination with antibiotics. One example is bacteriophage therapy. The bacteria equivalent of viruses that infect us is called a bacteriophage. So they’re viruses that infect bacteria. Other approaches are developing antibodies. You may remember monoclonal antibodies from the COVID pandemic. The variants eventually became resistant, but this is another area that’s being researched for bacteria. I would add to that that there are vaccination efforts. It’s harder to develop vaccines for bacteria, but in some cases it may be cost effective from a public health point of view for select bacteria that infects broad swaths of the population like gonorrhea, or if you can identify a high-risk population. With new RNA technologies it might get easier to develop efficacious vaccines against bacteria, but that’s still a work in progress.

Lifelines

Name: Thomas A. Russo, M.D. Position: Division chief, infectious diseases, UBMD Internal Medicine and the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo; SUNY distinguished professor of medicine, UB Hometown: Boston, Massachusetts Education: McGill Medical University Affiliations: Veteran’s Administration Healthcare System Organizations: Infectious Disease Society of America, American Association for the Advancement of Science Family: Wife, three children Hobbies: Reading, gardening

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U.S. Infant Mortality Rate Climbs for First Time in 20 Years

ollowing nearly two decades of decline, U.S. infant death rates edged up by 3% in 2022, new provisional government numbers reveal. “This was the first year we saw statistically significant increased rates of infant mortality in about 20 years,” said study author Danielle Ely, a statistician at the U.S. National Center for Health Statistics. Infant mortality measures how many babies die before they reach their first birthday. The study wasn't designed to say why more babies are dying, but at least one expert suggested that the pandemic, which put a strain on the health care system, could have played a role. “The U.S. was still in the throes of COVID in 2022, which had myriad and varied impacts across the U.S. and disparate impacts by race, ethnicity, maternal age and geographical region,” explained Deborah Campbell, a neonatologist at the Children's Hospital at Montefiore in New York City. “The impact of COVID on pregnancy and delivery care nationwide

was dramatic, affecting access to and utilization of maternity care, and pregnant people avoiding pregnancy care and hospital births," she noted. For the study, researchers looked at birth certificates and infant death data collected through the U.S. National Vital Statistics System for 2021 and 2022. They found that the infant mortality rate in 2022 increased for moms aged 25-29. In addition, the rate also rose for preterm babies, male infants and infants born in Georgia, Iowa, Missouri and Texas. Infant death rates climbed by more than 20%, from about 7.4 deaths per 1,000 births to more than 9 deaths per 1,000 births, for infants born to American Indian or Alaska Native women. Meanwhile, infant mortality rates for white women increased by about 3%. Death rates for infants of Black women did not increase by that much, but Black infants still experienced the highest overall rates of infant mortality, Ely noted. The findings were published in the November issue of Vital Statistics Rapid Release Reports.

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Writers: Deborah J. Sergeant, Chris Motola, Jim Miller, Gwenn Voelckers, Anne Palumbo, Brenda Alesii, Ernst Lamothe Jr., Jane Schmitt, Julie Halm, Kimberly Blaker Advertising: Anne Westcott, Amy Gagliano, Pam Roe Layout & Design: Angel Campos-Toro Office Secretary: Allison Lockwood 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.

December 2023 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 5

Healthcare in a Minute By George W. Chapman

The Big Squeeze: Physicians’ Fees Cut Again While Operating Costs Go Up

edicare is proposing to reduce physician payments in 2024 by 3.36%. That comes on the heels of a 2% reduction this year. The American Medical Association (AMA) figures that, adjusted for inflation, it is tantamount to a 26% cut in reimbursement over the last 20 years. If you factor in the fact that staff and overhead expenses increase at about 3% a year, physicians are getting squeezed from both ends. Medicare has offered alternative payment models to physicians which have basically made attaining their

fees more complicated, risky, expensive and frustrating. To use a hackneyed sports reference, the Centers for Medicare & Medicaid Services (CMS) keeps moving the goal post. To make matters worse, commercial payers mimic Medicare when it comes to establishing their physician and hospital fees. It seems like CMS is trying to kill private practice. Over half of all practicing physicians are now employed by either a hospital, gigantic health system or a corporation like CVS or Walmart. That number will go much higher as most physicians finishing their residency

opt for employment versus the hassle of private practice. Ironically, CMS determined reimbursement rates for physicians and hospitals are becoming less relevant as more and more seniors opt for Medicare Advantage plans which are administered by commercial insurers like the Blues, United, Aetna and Cigna. Sooner than later, large health systems with several hospitals and thousands of physicians will sit across the negotiation table with Advantage plans to negotiate fees rather than having to lobby Congress.

RxPass

employers to drop health insurance altogether for their workers. That never happened. The Employee Benefit Research Institute found that between 2014 and 2022 workers eligible for health coverage increased 5 percent. As of 2022, for all employers in aggregate, 81% of private sector workers are eligible to be covered by their employer’s plan. Eligibility is 99% among workers in businesses with more than 1,000 employees. It’s 97% for businesses with 100-999 workers; 80% for businesses with 25-99 workers and 25% for businesses with less than 10 employees. The ACA did away with denying coverage for pre-existing conditions and established basic coverage requirements for three levels of coverage: bronze, silver and platinum. Critics have tried to repeal the ACA more than 60 times.

authored a resolution to at least maintain neutrality, versus outright disdain, for a single payer system. It was narrowly defeated 53 to 47. But the shift in attitude is palpable. Coincidentally, those numbers (53-47) reflected the 53% of docs in private practice versus the 47% of employed docs. Today, 2023, more docs (over 50%) are employed than in private practice. Times have changed. Commercial insurers are earning billions of dollars annually on both their commercial and Advantage plans, while physician fees are slashed. The hassles of private practice, corporatization of medicine and the desire for better life-work balance among younger docs are driving the AMA ever closer to outright endorsing some sort of single payer or Medicare for All plan.

AMA “Leaning Into” Single Payer

AI in Claims Processing

The old-fashioned proprietary drug store on the corner was replaced decades ago by corporate chain stores operated by Rite Aid, CVS, Walgreens, etc. Now, the corporate chain stores are being replaced. Rite Aid recently filed for bankruptcy and pharmacists at CVS and Walgreens staged a three-day walk out over working conditions. To cut costs, the chains have understaffed their stores causing poor working conditions. Basically, brick and mortar drug stores are struggling. Who better to come to the “rescue” than Amazon, which has almost single handedly closed thousands of retail stores? Prime members will be issued their RxPass which guarantees twoday delivery in select cities so far: Austin, Seattle, Phoenix, Indianapolis and Miami. And it will someday be delivered via drone.

Impact of ACA When the Affordable Care Act became law in 2010, naysayers said the new minimum requirements for insurance coverage would cause

For almost a century, the American Medical Association was staunchly opposed to any kind of healthcare reform. Any. It lobbied to defeat reform efforts in the 1930s and 1940s. The AMA delayed Medicare for years and killed attempts by President Clinton (famously spearheaded by Hillary) to overhaul our expensive and disjointed healthcare system. But then….. it endorsed the ACA in 2009. In 2019, the proactive medical student section of AMA delegates

Providers are already experimenting with AI when it comes to electronic medical records and answering high volume inquiries from patients (ChatGPT). Congress is now concerned with Medicare Advantage plans using artificial intelligence algorithms and tools to deny claims. (This could also be an issue with commercial plans.) Con-

Page 6 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2023

gress is concerned Advantage plans will deny more claims than traditional Medicare. Again, Advantage plans are operated by for-profit commercial carriers. A committee is recommending CMS compare Advantage plans to traditional Medicare when it comes to elapsed time between care and denial, the diagnosis, the reason for denial and whether an algorithm is corrected once a certain denial has been reversed in most cases.

Medical Debt While medical debt can no longer affect your credit score, a survey conducted by the Commonwealth Fund of 6,100 INSURED adults revealed medical debt is still a problem. 27% reported medical debt more than $500 and 15% reported debt more than $2,000. Besides causing anxiety, respondents said the debt causes them to postpone care or cut back on prescriptions. And 43% of those covered by employer coverage reported they are struggling with debt. 57% with individual plans reported they are struggling. Also 45% covered by Medicaid and 51% covered by Medicare said they were struggling with medical debt. One can only imagine what the average medical debt is for people without health insurance.

Life Expectancy The good news is that US life expectancy has risen, moderately, from 78.93 years in 2020 to 79.11 in 2023. The bad news is, despite spending more per capita than ALL developed countries, 40 of them have better life expectancy than the U.S. The leaders are Hong Kong 85.29, Japan 85.03, Macao 84.68, Switzerland 84.25, Singapore 84.07, Italy 84 and Spain at 83.99. Most of the 40 countries ahead of us have universal plans or in our vernacular, Medicare for All.

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.

‘Many of the larger grocery stores have pharmacies and they [offer] vaccines. When you’re going out shopping or running around doing errands, swing by and get the vaccine.’

GET YOUR SHOT

Dr. Gale Burstein, Erie County health commissioner.

Play It Safe: Get Vaccinated “Everybody should get vaccinated,” says Erie County Health Commissioner Gale Burstein By Jane Schmitt

all and winter are prime times to get sick from respiratory viruses, but keeping up to date with the available vaccines may help prevent severe illness. That’s the message from Erie County Health Commissioner Gale Burstein, who urges people of all ages to protect themselves and those around them by getting the recommended vaccinations for COVID-19, flu and RSV or respiratory syncytial virus. “Last year we had a huge outbreak of respiratory illnesses that we referred to as the triple threat, with COVID, influenza and RSV. We want to do everything in our power to prevent that from recurring,” Burstein, who is a physician, said. “Fortunately, there are vaccines for all three viruses, so we should take it upon ourselves to get vaccinated not only

to protect ourselves but to protect the vulnerable people in our lives.” With regard to COVID-19, the landscape has shifted significantly since early 2020 when the coronavirus was spreading rapidly, causing the World Health Organization to declare a public health emergency of international concern and later classify the outbreak as a pandemic. Now, despite a sharp decrease in the number of virus-related deaths and hospitalizations, the battle continues against variant strains that are circulating. “Our COVID response is different now than at the peak of the pandemic,” Burstein said. “We are not seeing the type of numbers and the severity of cases to close down our community. However, we are still seeing COVID and flu and RSV. You could be that next case. One of

the effective interventions to prevent severe illness is to get vaccinated. Everybody should get vaccinated.” But that’s not happening, according to the Centers for Disease Control and Prevention. A recent survey found that just 13.9% of American adults have gotten the updated COVID-19 vaccine, which targets new variants. The reasons vary. Some people complied with an employer mandate in the acute phase of the pandemic but decided against additional shots as the global emergency subsided. Others may have completed the primary vaccination series and now consider themselves protected. For some, there is fear after reading or hearing about alleged negative effects of the vaccine and booster shots. It’s simple apathy that has slowed the vaccination track for Katie, a 58-year-old resident of West Seneca who asked that her last name not be used. She is quick to point out that she is not a vaccine denier or “anti-vaxxer.” She got the original two-dose vaccine plus boosters. But a busy personal life and work demands have her stretched to the max and although she likely will end up getting the next shot, she’s in no hurry. Burstein is looking to change that mindset. “It’s not necessarily an emergen-

Dr. Gale Burstein cy (anymore) that people are lining up around the block to get a vaccine, but it’s still something that is important for your health,” she said. “I hope that people would take that as a priority.”

Herd immunity The more people who are vaccinated and have immune protection, the less likely that a virus will take hold and spread in the community, Burstein said. “We refer to that as herd immunity. And we need to get as close to the herd-immunity level as possible to keep everybody healthy, including some very vulnerable people,” she said. Vaccines are widely available at myriad locations across Western New York. “Many of the larger grocery stores have pharmacies and they [offer] vaccines,” Burstein said. “When you’re going out shopping or running around doing errands, swing by and get the vaccine. You can shop during the 15-minute observation period [post-shot]. We are always going to places where the vaccine is available. Adding this one extra step could be a game changer for your life.”

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December 2023 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 7

Live Alone & Thrive

with positive energy. Say “yes” to invitations and show up for your happiness fix! Or become the initiator. Identify a holiday concert or event you’d like to attend and invite family and friends to join you. Take on the role of “social secretary” and you’ll gradually feel your holidays, social life, and social circle becoming more active and interesting.

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

school” and send season’s greetings by snail mail. I love getting an unexpected card from a long-lost friend and I delight in tracking down and sending holiday wishes to those who might be surprised to hear from me. Sure enough, good things happen when you reach out to others. I encourage you to address a few envelopes this season.

Say YES to being realistic

Say YES to creating a new holiday tradition

Be Happier This Holiday Season: Say ‘YES’ “Thank you so much for thinking of me. I would love to attend but have another commitment. So sorry.”

o you find yourself using this familiar refrain? When feeling overwhelmed with life after my divorce, my first line of defense was to say “no” to invitations and opportunities. This was especially true during the holidays when I was alone and coping with all the decisions and choices and shopping and schlepping. Saying “no” was my way of keeping life simple and more manageable during a hectic, emotion-laden time. I thought it would make life easier and, therefore, happier. But it didn’t. Experience has taught me that there’s a downside to “no.” Declining invitations, deciding not to send holiday cards and discounting the value of holiday traditions and gatherings didn’t make me any happier. In fact, the opposite happened. By not showing up I felt empty and lonelier than ever. One of the world’s longest studies on happiness (conducted by Harvard researchers) revealed that good, close relationships are what keep people happy and healthy throughout their lives. Saying “no” keeps us apart. Saying “yes” brings us together. And it’s the togetherness that contributes

to happiness. In the end, doing the things that nurture our relationships is what lifts our spirits. Whether you celebrate Christmas, Hanukkah, Kwanzaa or the December solstice, the holidays can be a real challenge if you’re newly divorced or widowed. They were for me until I took the reindeer by the horns and decided to say a resounding “YES” to life during this festive time of year. Consider the following:

This is especially important if you are bemoaning the loss of irretrievable traditions of a “past life.” Consider instituting your very own “signature” tradition of volunteering to help others. When you give of yourself, you reap two big rewards: First, you’ll develop connections with people who share your spirit of giving and second, you’ll nurture your soul. I love serving as a gift-wrapping volunteer at my local book store. The tips go to a good cause and I get to chat with patrons about their purchases and delight in finding just the right book for a loved one. The entire experience warms my heart.

Say YES to accepting and extending invitations It’s the most wonderful time of year to meet and greet old and new friends. This is a joyful time and people at holiday gatherings are typically in good moods and filled

Let go of the notion that you need to be married or in a romantic relationship to enjoy the holidays. The potential for happiness is all around you. You’ll find it in the personal connections with family, friends, neighbors, colleagues, even people you meet in passing. You have a choice. Choose to be with people rather than isolate. Choose to deepen and strengthen your ties with loved ones. Choose to appreciate what you have rather than focus on what you’re missing. Choose to say “yes” and be happier this holiday season!

If volunteering doesn’t fit into your schedule, bake some holiday goodies for your family and friends. Or leave a little something (maybe a pine-scented candle?) on a neighbor’s doorstep. When you are thinking about and doing for others, you “get outside” of yourself and feel less lonely – more a part of the world and of this season of giving.

Say YES to inviting people over It will give you an incentive to decorate, if you don’t feel motivated to deck the halls for yourself. No need to plan anything elaborate. Inviting a few friends over for brunch, to make wreaths or to watch a holiday special on TV can brighten your day (and theirs!). Consider including children in your planning. For years, I hosted a cookie-decorating party for my friends and their kids. The children’s silliness, curiosity and wonder added a magical (and messy!) dimension to the holidays.

Gwenn Voelckers is the founder and facilitator of Alone and Content empowerment workshops for women (now on hiatus) and the author of "Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own" To contact Voelckers or purchase her book, visitErie C Has ounty www.aloneandcontent.com

Say YES to sending out holiday cards

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Page 8 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2023 Nati tim onal N e to urse th s ded ank nu Week i i

Say YES to happiness

Say YES to random acts of kindness

Say YES to slowing down Better yet, stop what you’re doing altogether. Find a quiet moment to ask yourself what the holidays really mean to you. Rebirth? Hope? Generosity and goodwill? Love and connection? Revisit your most deeply held beliefs about the season and make a conscious decision to participate in the holiday rituals, traditions and activities that align with your values, views, and spiritual underpinnings.

For those who live alone, some degree of loneliness can be considered normal during the holidays. It’s a good time to remember that feelings of loneliness aren’t terminal, nor are they a “state of being” reserved for single people. Loneliness has very little to do with being alone. It has everything to do with your state of mind. Prayer, meditation, mindfulness and communing with nature can remind you of your intrinsic belonging to your inner self, to others, and to all of life. Embrace the felt experience of belonging to an all-encompassing universe.

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Meet the New Medical Chief at Oishei Children’s Hospital Among her priorities are improving access, broadening psychiatric care By Julie Halm

hysician Dori Marshall took over the role of chief medical officer at Oishei Children’s Hospital in late August. She came to the position armed with plenty of experience, empathy and a love for the community

that she is now serving. Marshall moved to the Buffalo area as a small child and considers herself a Buffalonian through and through. Her academic and work history would certainly reflect that fact, having received her bachelor’s degree from the University at Buffalo and her medical degree from the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo where she also completed her residency in psychiatry. Among many other roles that she has held, she is an associate professor of psychiatry at UB’s Jacobs School of Medicine and Biomedical Sciences where she has, and will continue to, mentor first- and second-year medical students. While her new position at Oishei Children’s Hospital will have her overseeing the medical affairs of the hospital and its pediatric and women’s

Benefits to Reducing Alcohol Consumption

Well, not even a glass of wine once in a while is good for your health, says local doctor By Deborah Jeanne Sergeant

o you recall hearing that a glass of wine a day supports heart health? As it turns out, “it’s not even clear red wine is beneficial,” said Mike Merrill, physician and internist and chief medical officer of Brook Health. “The core thinking now is alcohol is overall not beneficial. That’s the consensus.” Merrill serves as associate clinical professor of epidemiology at UB. He added that alcohol contributes excess calories to the diet, which can make it easy to gain weight. Consider the foods typically accompanying alcohol in social settings, such as cheese with wine or greasy “bar foods” with beer. These pairings can also ramp up calorie intake. Consuming alcohol regularly also saps the food budget. “You’ll have better nutrition if you switch to better food than alcohol,” Merrill said. “It’s expensive and you could spend your money better ways.”

He sees no improvement for longevity. Instead, drinking alcohol increases the risk of some cancers and some heart problems. “If you drink excessively, that leads to risk of liver disease like cirrhosis and cancer,” Merrill said. “It can lead to some severe psychiatric problems and personality change. You’re at risk of alcohol withdrawal, which can be life-threatening. If you have to go into the hospital for surgery, it will be pushed out as they have to treat the alcohol withdrawal.” Any health benefit arising from happy hour is likely because of socializing but not the alcohol itself. Grapes contain the beneficial resveratrol that wine contains. This compound is known as an antioxidant and may lower cholesterol, reduce risk of heart attack, stroke and lower blood sugar levels. But eliminate or at least minimize alcohol. “Even one drink a day increases breast cancer risk in women by 14%,”

ambulatory clinicals, she said she plans to bring her wealth of psychiatric knowledge and passion for the field to the table to help better serve the residents of this area. “What continues to draw me to the field of psychiatry, more than any other field, is you really get to know people in their entirety,” she said. “People will tell you their story in a way they’ve never told anybody else.” Marshall said that when you have that story, providers are better able to understand the ways their patients interpret and interact with the world in a way that can truly inform their care. She has no shortage of seeing this dynamic play out, either, as Marshall spent more than a decade with teenagers needing acute inpatient hospitalization. She noted that her time working with adolescents is an experience which she will bring with her in this new role in order to develop pediatric mental health care through the hospital, something which she said is needed now more than ever before. “Post-pandemic I think everybody knows that children’s mental health needs focusing on,” she said, adding that she has been glad to see commitment to that idea from officials at the state and county levels. “To have that commitment from the state and the county to this hospital to really improve access and develop improved mental health care for children in this area is so important and that’s a very important piece of it for me.” In her tenure in this new position, she said that one of her primary goals is to improve access to health care for the women and children both in the city of Buffalo and the communities beyond its borders. “There’re so many opportunities

to expand access and reach women in the city of Buffalo and in rural areas through telemedicine and other means and I think there’s just very exciting opportunities to really impact the health of women and children in Western New York,” she said. While those are some of her large and long-term goals, as she settles into her new role, Marshall said that her first focus is to keep learning the networks within the hospital and continue building relationships with those at Oishei Children’s Hospital and across Kaleida Health. While she has plenty of work ahead of her at Oishei Children’s Hospital, there are some things that will not be changing for Marshall, including that she plans to continue to mentor medical students both because she finds it to be a fulfilling endeavor, but also because it helps work toward a greater good. “Medical school is really tough. The first two years, in many ways, I think are the hardest and students do need encouragement,” she said. “It also gives me the opportunity to see who’s interested in OB-GYN and pediatrics and how we can encourage them to stay here in Western New York.” Staying in the area has certainly afforded Marshall the opportunity to achieve some impressive strides in her professional career, but along with her new, and arguably most impressive title to date, comes a deep sense of gratitude on her part for the opportunities it affords her to help improve access to services she feels are so deeply needed in her hometown. “It’s just so important and it’s not everyone in their career who gets the opportunity or finds the platform to speak to the issues that are dearest to their heart,” she said.

said Kerry Graff, physician and independent contractor in lifestyle medicine in Rochester. “It turns to formaldehyde. You see this even in wine tasters who spit it out. If you look at it overall, it’s not health promoting. If you want to include it, it’s a choice but not because it’s healthy. It’s a calculated risk; you don’t drink for good health. Wine itself is not healthy.” As the body ages, alcohol can increase the risk for falls. Within a year, older adults who fracture a hip have a 21% risk of death after a surgical repair and a 70% chance of death if it’s not surgically repaired, according to Acta Orthopaedica, an orthopedic trade journal published internationally. “Your balance gets worse as you age,” Graff said. “Your reaction time is slower. Your feet aren’t as good. Your nerves aren’t as good. Add alcohol to that and it’s much more prominent.” For those who choose to imbibe, the recommendation is no more than one drink per day for women and no more than two for men. “If you’re not already drinking alcohol, there is no benefit to start drinking for heart health,” said Melissa Verdi, registered dietitian nutritionist at Lifestyle Nutrition WNY,

PLLC in Niagara Falls. She added that drinking alcohol is linked to liver issues and heart problems, among other problems. Logan Walker, physician at UBMD Family Medicine, calls alcohol consumption a “modifiable risk” for health. “Our genes only account for 10% of the expression of cancer and any type of illness,” he said. “Lifestyle and environment account for 90% of the risk for expression.” Walker explained how alcohol affects the system. “Within 30 minutes of ingesting, there are negative microbiome changes that are pro-inflammatory,” he said. “Alcohol also causes damage to cells in the GI tract. It can increase the risk of autoimmune conditions and decrease nutrient absorption. It’s a toxin that increases the workload on the liver and burdens the kidneys.” These negative effects are cumulative after decades of drinking alcohol, especially when consumed in excess. Choosing to not imbibe may not reverse damage already done, but it prevents further damage. “It gives us the power in our hands that if we make changes, our genes aren’t our destiny,” Walker said.

December 2023 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 9

SmartBites By Anne Palumbo

Helpful Tips

The skinny on healthy eating

Why You Should Try Almond Flour

mericans purchase and consume more flour during December than any other month, according to the research elves at Fleischmann’s Yeast and Karo Syrup. No surprise there! Who doesn’t love to give as well as receive homebaked cookies, cakes, breads and pies during the holidays? I love to bake — and this year I’m shaking things up by baking with almond flour, a gluten-free flour with enough health benefits to give Santa pause. While I won’t use it for all recipes—the lightness of the real deal is hard to replicate—I’ll use it for many. Made from blanched almonds that are ground and sifted into a fine flour, almond flour has an astonishing array of valuable nutrients. One-fourth cup of almond flour (the amount typically found in one baked good) contains around 7 grams of protein, 3 grams of fiber, and 70 mg of calcium—all of which join hands to keep us strong, regular and full of energy. Almond flour teems with vitamin E, a powerhouse nutrient that acts as an antioxidant, neutralizing harmful free radicals that accelerate

aging and increase your risk of heart disease and cancer. Several studies, in fact, have linked higher levels of vitamin E intakes to lower rates of heart disease and Alzheimer’s. Consuming flour made of almonds also boosts levels of magnesium, an important nutrient that may help lower blood pressure and control blood sugar. Foods made with refined wheat flour—which are high in carbs but low in magnesium and fiber—may cause spikes in blood sugar followed by rapid drops. Some studies estimate that between 25-38% of people with Type 2 diabetes have a magnesium deficiency. Although almond flour is slightly higher in calories and fat than wheat flour, its fat is mostly monounsaturated fat—the beneficial fat that helps protect your heart by maintaining levels of “good” HDL cholesterol while reducing levels of “bad” LDL cholesterol. Another tempting reason to reach for this nutritious flour: Almond flour is both wheat- and gluten-free, making it a great alternative for those who can’t tolerate wheat or gluten.

For lighter, less-grainy baked goods, look for almond flour that says “super fine or finely sifted,” like Bob’s Red Mill Super Fine Almond Flour or Blue Diamond Finely Sifted Almond Flour. Many recipes recommend additional sifting for an even fluffier result. In most cases, almond flour can replace wheat flour in a l:1 ratio. Almond flour should be stored in a fridge, freezer or cool pantry to keep from going bad.

CHOCOLATE CHIP COOKIES WITH ALMOND FLOUR Adapted from simplyhomecooked.com | About 24-30 cookies ¾ cup butter, softened ¾ cup brown sugar 1½ teaspoons vanilla extract ¼ teaspoon almond extract (optional) 1 large egg and 1 large egg yolk

3 cups almond flour ½ teaspoon baking soda ½ teaspoon salt 1¼ cups semisweet chocolate chips ¾ cup chopped nuts: pecans, walnuts, or almonds

1. Preheat oven to 350F line two large baking sheets with parchment paper. 2. In a large mixing bowl, beat ¾ cup softened butter with ¾ cup brown sugar at medium speed for 3 minutes. 3. Add both extracts (if using almond, too), egg and egg yolk, and then mix on medium-high speed until well blended. 4. In a separate bowl, whisk together almond flour, baking soda, and salt. For a cookie with a finer texture, sift the dry ingredients right into the mixing bowl and mix at a slow speed until well blended.

Otherwise, slowly add the dry ingredients to the mixing bowl and blend well at a slow speed. 5. Fold in chips and nuts (if using). 6. Drop by large, rounded tablespoons onto prepared sheets and bake for 10 to 12 minutes or until golden brown. Cool on baking sheets for 2 minutes; remove to wire racks to cool completely. Note: For a more festive cookie, replace dark chocolate chips with white chips and chopped nuts with dried cranberries.

Major Study Confirms Salt’s Deadly Effect on Blood Pressure Cutting out just one teaspoon of salt every day lowers blood pressure almost as much as medication does, new research shows. Investigators said theirs is one of the largest studies ever to include people taking high blood pressure meds in a look at the effect of reducing dietary intake of sodium. “We found that 70-75% of all people, regardless of whether they are already on blood pressure medications or not, are likely to see a reduction in their blood pressure if they lower the sodium in their diet,” said study co-author Norrina Allen, a professor of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago. She said researchers previously didn’t know if people already on blood pressure meds could lower

their blood pressure even more by reducing their sodium intake. In the study, middle-aged to elderly participants reduced their salt intake by about 1 teaspoon a day. “The result was a decline in systolic blood pressure by about 6 millimeters of mercury (mm Hg), which is comparable to the effect produced by a commonly utilized first-line medication for high blood pressure,” said co-principal investigator Dr. Deepak Gupta, an associate professor of medicine at Vanderbilt University Medical Center, in Nashville, Tenn. Systolic blood pressure is the pressure in your arteries as your heart beats. It’s the first number in a blood pressure reading. High blood pressure is a leading cause of illness and death worldwide. The added pressure on arteries can

trigger heart failure, heart attacks and strokes. It affects the heart’s ability to pump blood effectively, Allen said. Compared to their usual diet, 72% of participants had lower systolic blood pressure when they followed the low-sodium regimen. Systolic pressure dropped 7 to 8 mm Hg when they ate the low-sodium diet compared to the high-sodium diet, and by 6 mm Hg compared with their usual eating habits, researchers said. “The effect of reduction in dietary sodium on blood pressure-lowering was consistent across nearly all individuals, including those with normal

Page 10 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2023

blood pressure, high blood pressure, treated blood pressure and untreated blood pressure,” Gupta said in a Northwestern news release. The findings were published Nov. 11 in the Journal of the American Medical Association and presented Saturday at an American Heart Association meeting in Philadelphia.

Holidays

Mental Health at the Holidays: ‘It’s OK to Not Be OK’ By Julie Halm

or many, the holidays are merry and bright. They are a time of celebration and community and all things joyful. But for a very significant number of people, this season can be one that brings on or exacerbates existing mental health struggles, according to Melinda DuBois, executive director of Mental Health Advocates, located on Broadway in Buffalo. According to DuBois, there are many reasons historically that the holidays have been a challenge for people and there are also some reasons which have surfaced locally and globally in the past several years. “The holidays can bring up trauma especially around childhood traumas and when your family is not intact or has been a source of struggle for you, the holidays can also be a struggle,” she said. DuBois also noted that for many,

any sense of loneliness or isolation may be heightened around this time of year as individuals are flooded with images and messages, both in media and real life, of others gathering together. While these factors have been consistent over a great number of years, DuBois said that this year, many Buffalonians may experiences some mental health struggles as we recall last year’s events. “For many, many people, it is going to be a struggle this year,” she said. “There’s the fact that last year during Christmas, we were experiencing the blizzard and watching people die in their cars and struggling with a loss of power and that can be a source of struggle for people this year.” DuBois also noted that after multiple holiday seasons of COVID isolation in recent years, some fami-

Post-Holiday Blues

After weeks of build-up, it’s easy to feel let down By Deborah Jeanne Sergeant

fter the busy holiday season, do you feel a little blue? A tad bummed? It’s a common phenomenon. “The holidays can cause situational depression,” said Louis Ciola, certified hypnotherapist and owner of Amherst Hypnosis in Snyder. “People expect that magically at this season all their expectations will come true. That’s the problem. The media plays into this. It fosters this expectation.” Instead of a Hallmark movie-perfect holiday, family members don’t get along, gifts disappoint and illnesses curb the festivities. It can also be a time where rumination over past holidays fosters all sorts of

feelings, such as regret, loneliness, and sadness. “After the holidays, returning to normal routines can feel mundane compared to the excitement and novelty of the festive period,” said. Lindsey Rickard, licensed mental health counselor and vice president of Training and Access Optimization with BestSelf Behavioral Health in Buffalo. “The contrast between the festive atmosphere and the return to work or school can lead to feelings of sadness.” There are also financial stressors for some. Rickard said that traveling expenses, gifts and entertainment often feed into overspending which “after the holidays can lead to stress

lies may be joining back together in the last holiday season or two without everyone present due to losses of family members or other loved ones. “For many people when they get together with their family, there’s somebody missing, so the holidays can also bring back how things have changed or people who are no longer in your life and that can be really sad,” she said. While these struggles exist for so many, there are an equally large number of ways that people can help to reduce stigma and assist those around them who may have a hard time this holiday season. The first, she said, is to acknowledge that mental health struggles are not only real, but common and not something to be ashamed of. DuBois, who is also the chairwoman of the Anti-Stigma Coalition, said that while she feels that the stigma around mental health has decreased over the past several years, unfortunately, mental health issues have also become more prevalent. “We are facing an unprecedented mental health crisis,” she said. “I think it’s everything, really. It’s COVID, which was pretty much a shock to everybody and really took away some of our stability and I think a lot of people are feeling that uncertainty; there’s also this political rhetoric which can be really aggressive and angry; there’s wars going on throughout the world; so all of these things contribute to this increase.” According to DuBois, statistics show that roughly one in four people have a mental health struggle and those numbers are on the rise. While some people might feel that they don’t know anyone experiencing these challenges, particularly at this time of year and thus don’t need to help create a feeling of safety for people who might be in that position, DuBois noted that is statistically nearly impossible. “While the statistics are one in four people have a mental health struggle,” said DuBois, “The way we talk about it is that about five in five people know somebody in their life who is struggling and if you think there are no people in your life who are struggling, you’re just not hearing them.”

and sadness.” Of course, lasting “blues” may indicate a more serious mental health issue such as depression. “While post-holiday blues might include feelings of sadness, fatigue and a sense of loss, depression involves more intense symptoms like deep sadness or hopelessness, significant changes in appetite or sleep, loss of interest in activities and in severe cases, thoughts of self-harm or suicide,” Rickard said. She added that depression has a significant effect on a person’s ability to do daily tasks, go to work and maintain relationships — far different from the temporary “down” feeling of post-holiday blues which don’t impact the ability to function. “It’s important to differentiate between the two because depression is a serious mental health condition that may require professional intervention, while post-holiday blues typically resolve on their own,” Rickard said. Talking about these symptoms with a primary care provider or mental health professional can help.

Melinda C. DuBois To end the stigma and help those who need it at this or any other time of year, the first step, according to DuBois, is to acknowledge that it’s OK not to be OK. “Having those feelings is completely fine,” she said, adding that those who are struggling should not aim to hide their feelings and should find a trusted person who they can reach out to. On the other end of things, it is important for people to create a safe space for those around them to openly express those feelings. “Sometimes it’s hard to put yourself into somebody else’s shoes and so if you’re able to just listen to the person who is struggling and hear what their issues are that’s really the best thing you can do…is to be right there with them and it’s not a matter of cheering them up or telling them they should be happy, that doesn’t help it never does but just to sit with that person,” she said. To have a broader impact, those looking to help can volunteer at organizations that create a sense of community and belonging as well as security for those who might be otherwise lacking those things this holiday season such as soup kitchens, Friends of Night People or any community organization distributing food or presents for the holiday season. Donating to organizations like Mental Health Advocates can also help those in need of support and to work towards bringing an end to stigma around mental health challenges at the holidays.

Anyone having thoughts of self-harm or harming others should call 911, 988 or seek emergency room care. Planning other things to look forward to can also help build happy anticipation. Perhaps it’s a time to see movies you’ve always wanted, start a new book series, engage in a new hobby or meet up with friends regularly. Wendy Weinstein, physician, adult unit chief of Psychiatry at BryLin Hospital in Buffalo, recommends planning special activities and social outings for other times of the year. “Why not get together with friends in the winter or get together with family during January?” she said. “Don’t just do it during the holidays. It’s Jan. 30 and I’ll take a trip to see my family or have dinner with my best friends. Or we’re going to have a holiday celebration during the middle of the winter.” She also views the post-holiday season as a good time to engage in self-care, such as eating right, exercising and getting plenty of rest.

December 2023 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 11

Holidays

Healthful Food Gifts

Have a foodie on your list? Treat ‘em right By Deborah Jeanne Sergeant

f you want to give a food gift this holiday season, skip the sugary baked goods and candy and give food gifts that are both decadent and healthful. Many people enjoy nut mixes or spiced nuts. They’re also good for your health. “Nuts and seeds have a lot of antioxidant potential and higher in the heart healthy fats,” said Mary Jo Parker, registered dietitian in private practice in Williamsville. “Nuts and seeds are good sources of fiber and protein. They’re great for stabilizing blood sugar. Nuts are helpful for weight loss. They’re great sources of vitamin E and many minerals.” She suggested including nuts in a trail mix or making cocoa dusted nuts or chocolate covered nuts.

Packaging nuts in glass jars adorned with ribbon bows adds a festive touch. Parker is also a fan of fruit, whether a fresh fruit basket or an assortment of dried fruits. “Dried fruits are a fabulous source of fiber,” she said. “Anything that’s a good source of fiber helps with gut health. If you have good motility in your GI tract, you’re decreasing the risk of diverticulosis and diverticulitis and other problems of the colon. It also bolsters your immunity. Fiber can also help to fill you up.” As for a fresh fruit basket, Parker advises going for a good variety of colors in the selection for optimal healthfulness. “Fruits are rich in polyphenols and have an anti-inflammatory

Give Healthful Memberships These gifts keep on giving all year By Deborah Jeanne Sergeant

ou can support the good health of the health buffs on your list with a subscription or membership. These kinds of gifts will definitely get used — unlike yet another tchotchke or sweater. “Most of the flavored olive oils are popular as gifts,” said Mary Jo Parker, registered dietitian in private practice in Williamsville. “Olive oil is probably by far has been studied more than any other. It’s the basis of the Mediterranean diet, which is considered the healthiest way to eat. They invite healthy cooking and can be added to salads.” Olive Oil Lovers (https://oliveoillovers.com) offers one example of monthly olive oil delivery subscription. As another healthful gift, Parker also likes balsamic vinegar, which may provide a tasty and healthful way to roast vegetables in the oven. It’s also flavorful for tossing a garden salad instead of using creamy dress-

ing. Cardenas (https://cardenastaproom.com) offers three-month olive oil and balsamic vinegar subscriptions. Consider giving membership with a meal kit service. These companies deliver the prepared, measured elements to make a meal, but the recipient does the mixing and cooking. In addition to saving time, meal prep packages also help people learn how to cook for themselves, which can aid in weight loss and improving produce intake. Most meal kit companies include options such as Mediterranean, keto, vegetarian, lowfat or other health-conscious meals to accommodate any preferred eating plan. “Fresh fruit is good in a subscription, like oranges from Florida,” said Rosanna Monteleone, functional nutritional therapy practitioner and owner of Nature to Nourish Wellness in Niagara Falls. Hale Groves (https://www.halegroves.com) is

property,” Parker said. “A standard fruit basket or edible arrangement is packed with fiber, vitamins and minerals and phytochemicals that are protective and would benefit every system of the body.” Lay a tea towel or other padding in the basket to cushion the fruit and arrange the fruit so it piles above the rim of the basket. Tuck in a few small items among the pieces of fruit, like English walnuts. Consider securing the fruit in place with cellophane if you need to transport the basket, and top with a large bow. Dark chocolate has long been touted for its antioxidant properties. Give dark chocolates that have at least 70% cacao. “It is loaded with antioxidants, polyphenols, and catechins (a powerful antioxidant),” Parker said. “They’re protective at the cellular level. In a similar vein is cocoa beans. If someone gave a cocoa mix or made one with cocoa that was dark, not alkalized or Dutch processed, they’ve been shown to possibly reduce cardiovascular risk, reduce blood pressure, and improve blood flow. It can reduce insulin resistance and lower LDL cholesterol levels and triglycerides. They’re good for circulation and can improve brain function.” She recommended dark chocolate drizzled popcorn, as it provides the above benefits of dark chocolate along with the popcorn’s fiber. For another DIY dark chocolate gift, create healthful dark chocolate bark by pouring a layer of melted chocolate over broken nuts arranged on waxed paper. Allow the chocolate to harden in the refrigerator before breaking into pieces and packaging. Create chocolate raspberries by washing raspberries to completely dry. Gently place a dark chocolate chip inside the berry with the flat side at the bottom and arrange on a glass tray.

Coffee and tea are also rich in antioxidants. Find a few “fancy” flavors to nestle in a basket with mugs, a tea towel and flavoring agents like honey. “Different types of teas have incredible antioxidant potential,” Parker said. “They’re loaded with flavonoids which decrease cardiovascular disease risk and some types of cancers. Some studies show that tea can help increase focus and attention because of the caffeine in it. Coffee can as well. Teas have been shown to improve fasting blood glucose levels, whether white, red, green or black. There’s a lot of variability with herbal tea.” Give local goods. Rosanna Monteleone, functional nutritional therapy practitioner and owner of Nature to Nourish Wellness in Niagara Falls, recommended New York-sourced products such as honey for its antimicrobial properties and maple syrup or maple sugar, as they contain antioxidants. “Maple syrup and sugar is something you can cook with, too,” Monteleone added. “It has trace minerals and calcium.” Many people have begun cooking more at home since the pandemic. “Organic spices would also be nice,” Monteleone said. “If you have your own rosemary, sage and thyme, that would be nice.” She also suggested DIY gifts such as soup mixes. Layer dried beans, dried pasta and spices and tying a recipe card to the jar with ribbon. https://masonjarrecipe.com/34-mason-jar-dry-soup-mixes-recipes offers numerous healthful mixes. Monteleone also said to try making jam with chia seeds, dehydrated apple rings or “anything like dill pickles or dill zucchini you put up. Make someone homemade pumpkin bread or banana bread. You can make it healthier.”

one example. Selecting a variety of produce items for regular delivery from a grocery service can especially help busy families or older adults who struggle to do weekly grocery shopping for perishable items. It also keeps fresh produce in the kitchen: a big plus for people who want to eat right. Fitness subscriptions can also help people who want to stay healthy. Richard Derwald, fitness trainer and consultant for the Erie County Senior Services, said that too many people spend far too much time “engaged for all hours on their phone, especially children. That’s the worst thing for them.” A big proponent of physical exercise for young and not-so-young, he believes that many people feel motivated through signing up for a class or formal instruction, which provide a sense of accountability and professional instruction. A gift certificate for active lessons, such as gymnastics, boxing, dancing or martial arts could help keep someone of any age moving more. Practices such as yoga and tai chi have been linked with stress reduction and tend to be gentle on the joints. Many fitness-minded people like trying new activities and a gift certificate for a class may be

just the motivation to branch out. “For the novice who’s motivated, look into a personal trainer or instructor with certification who can set them on the right path,” said physician Michael S. Freitas, who works in primary care sports medicine for UBMD Orthopaedics & Sports Medicine and directs the primary care sports medicine fellowship in the department of orthopedics at Jacobs School of Medicine and Biomedical Sciences, University at Buffalo. Freitas likes the anonymous aspect and convenience of virtual fitness memberships, such as Beach Body and Peloton, which help fitness-minded people connect from anywhere. “It’s not like a typical gym setting where you see other people you may think are noticing you — although they’re not,” he said. “Or you see other people lifting a lot more weight. You may feel intimidated. Joining an online club gives the physical and social aspect.” Good health also relies upon rest and relaxation, but most people take little time for self-care. Consider a gift card for a massage therapist. Their modalities can help induce a sense of deep relaxation.

Page 12 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2023

Holidays

Taking Care of the Caregivers at the Holidays By Julie Halm

ay in and day out, caregivers give the gifts of their time, their attention, their energy and their emotions to those who they look after and support. Whether it’s a major holiday or just another Tuesday, caregivers are constantly giving of themselves. So, when the holidays come around, what is an appropriate gift to give those who offer up so much of themselves? Rachael Young, clinical facilitator for the Wilson Support Center and Hospice Bereavement Center, said

that often, practical types of gifts are the best fit in these situations, as well as those that include offering up some time of one’s own. “I feel like a nice, thoughtful gift would be to offer some sort of practical assistance,” said Young. “Like somebody could create a coupon book of some sort, with hands-on practical gifts of sharing your time.” Coupons, she said, might include things like helping to decorate the caregiver’s home for the holidays, coming over to help prepare a meal, doing grocery shopping, other er-

Survival Guide for a StressFree Holiday Season By Kimberly Blaker

o you dread the hustle and bustle of another holiday season? Between shopping, wrapping, baking, holiday cards, parties, and many other obligations and tasks, surviving the season can be a feat, let alone finding the time to enjoy it with your family. This year, why not make a pact to eliminate stress by following these tips?

view the list, and calculate how much time and expense you've shaved off. If you haven't reached your predetermined reduction, go through your list again. Once you've decided which parties you'll attend and the commitments you'll make, plan how you'll say 'no' to all the others, so you're not caught off guard.

Early planning

Share in the preparation

First, close your eyes and think back to the last couple of years and how hectic and stressful they felt. What percentage of holiday activities and tasks would you need to eliminate to make the season truly enjoyable and relatively stress-free? During this process, don't think about what you can't remove. Just determine the percentage of reduction you need to make. Next, make a list of everything you need to do during the holiday season, to which parties you'll be invited, and how much money you'll spend. Now cross off the least important, least necessary, and least popular events and tasks. Then re-

Enlist your family to help prepare for the holidays, and divvy up the tasks. Don't expect perfection from yourself or your family. Remember, you probably don't notice or mind the imperfections in others' holiday gatherings. They're just as unlikely to see any in yours. Also, keep in mind the holiday season isn't the time to be head cook. Plan potluck gatherings. Then, either suggest what each person should bring or, to avoid duplicates, ask guests to let you know what they'll bring.

Holiday time-and-energy savers

rands or helping to clean their home. Young noted that those who act as caregivers for family members or other loved ones do so out of a place of love and compassion, but that taking on such a huge responsibility can also come with real restraints on their time to dedicate to other areas of their lives. “I feel like the caregivers, they are caring for their loved one because they’re honoring them and they love them and they don’t think of it as a burden,” she said. “That being said, there’s the flip side of, it’s just the practical amount of time that you have in a day to do those other things that you still have to do when you’re caring for someone.” This is where those who love a caregiver can step in and offer gifts that can lighten their load, especially during the holiday season which can be a particularly hectic time of year. “Maybe you can offer to baby-sit or take care of the people in the home so that they can go out and do their holiday shopping,” Young said. “Or offering to do some other kind of errand, offering to do their holiday shopping or even their holiday wrapping.” Simple companionship, she said, can also be a gift with a great impact. “Caregiving is such a beautiful thing that we can do for the people we love and when you’re in the midst of it, you’re doing it out of love,” she said. “But it is a lot and to step in and offer practical gifts or companionship or even the things they want to do themselves, you could offer to do it by their side.” While gifts of time and assistance can be of immense value to caregivers, those who want to have something to wrap and present have

Save time in gift-wrapping by setting up a station in a spare room or the basement. Or stock a large box or basket with wrapping paper, ribbon, bows, tags, tape, scissors, and pens, so everything is stored in one place. Have extras of everything on hand. Keep cleaning to a minimum during the holidays. Dismiss unused areas guests won't see or use, and clean only the obvious in rooms that will be seen. The barely-visible layer of dust on your baseboards is unlikely to be noticed with all the holiday decorations and festivities. Make everyday meals quick and easy throughout the season. Soups, sandwiches, fresh fruit and vegetables, cottage cheese, pre-cut veggies and dip, and other prepared or semi-prepared healthy foods will suffice for one month of the year. Do your holiday shopping early in the day on weekdays while your energy is high and crowds are small. Shop online or by catalog. If an item lacks details, search for a manufacturer's website to get the information you need. Give gift cards. Hard-to-shop-for recipients will appreciate something practical. Gift cards to restaurants, department stores, sporting good outlets, and specialty shops, or for a massage, pedicure, or round of golf make great gifts. Don't overdo the baking. Your guests will likely have had their fill

Rachael Young, clinical facilitator for the Wilson Support Center and Hospice Bereavement Center, some great options as well, according to Young. For example, she said, creating ready-made meal kits that don’t require a lot of work on the recipient’s end to prepare when they need them can lessen their load. Gift cards can also come in very handy, especially for things like food or grocery delivery. Another option is a self-care basket or bag with things like essential oils, to-go coffee mugs or a scalp massager can be sweet and useful gifts for caregivers. Whatever gift one might consider giving a caregiver this holiday season, Young said the important thing is that it is an act of love within a greater context of loving relationships. “I think the most important thing to know [about caregiving] is that it’s out of love and they take their role to heart,” she said. “To show them the reflection of that love buy offering thoughtful gifts is a way to show your love.”

of holiday treats long before your gathering arrives. As for the warm gesture of taking a plate of baked goodies to friends or neighbors, instead, show they're in your thoughts by visiting or calling them to wish them a happy holiday season.

Money saver Does your gift list grow each year? Decide with whom it's essential to exchange gifts. Then talk to extended family, friends, coworkers, and others about forgoing gift exchanges, putting a cap on the price, or doing a drawing instead. You'll likely learn many feel the same as you do.

Care for yourself Enjoy holiday treats in moderation. High fat and sugary foods and the lack of healthy meals can lead to tiredness and stress. Keep goodies stored in the freezer where they'll be less of a temptation. Have plenty of convenient, healthy snacks such as raw vegetables and nuts on hand. Prepare low-fat meals that won't bog you down. Pace yourself, and don't try to do everything in one day. Finally, give yourself a break. Get plenty of exercise such as a brisk walk in the fresh air, and set aside time for relaxation, like a long bubble bath.

December 2023 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 13

Q A &

with

Caribe

Bikers Against Child Abuse’s statewide public relations talks about the nonprofit mission and why all its members have funny nicknames

By Brenda Alesii

n organization active in 47 states and 18 countries, including eight in New York state, touts the following motto: “No child deserves to live in fear.” The organization, Bikers Against

Child Abuse, provides social and emotional support for abused children, including escorts through the criminal justice systems, interviews with the police and district attorney’s office — and, if necessary, support at

trials. BACA fills gaps provided by existing agencies, which refer many of their cases to the organization from child protective services and advocacy centers. Founded some 27 years ago in Utah by a licensed therapist, the chapters in New York state stretch from Long Island to Buffalo. The local chapter includes Allegany, Cattaraugus, Chautauqua, Erie and Wyoming counties. In Good Health recently spoke with BACA’s statewide public relations officer, who is called “Caribe.” For security reasons, members of BACA do not use their given names, but do use their road names, a traditional practice in the biker community. Q: Where do the members of BACA come from and how do the children you help connect with your organization? A: Our members, both men and women, come from all walks of life and range in age from their 20s to 70s. We are not compensated, but rather volunteer our time 12 months a year and handle our own expenses. To be in BACA, an individual must have a bike or have access to one. Our goal is to empower children to not feel afraid of the world in which they live. Kids range in age from 4 to 18. Criteria for the BACA child include a record of abuse and an expression of fear or pain. The perpetrator cannot live in the same house as the child. When a chapter officer receives a call from the BACA hotline, the matter is then taken to our executive board and we follow up with the family. We don’t purport to be therapists, but we do offer social support, designed to give these children empowerment. We also help empower children through the whole legal process if they take that path. We will escort the child to court, stay during the entire criminal proceeding and assure the victim that he or she is not alone. Even in the courtroom, we ask the child to look only at us and not make eye contact with the alleged perpetrator. We stay as long

as necessary, helping the victim find the internal physical and emotional strength they need. It’s not uncommon for a group of bikers to escort the child en masse to the D.A.’s office or to court. It’s important to note that BACA members never get involved with the alleged abuser. When a level one intervention takes place, a group of us will meet the child and his or her parent or guardian, give the child a biker vest, a signed and hugged teddy bear and take the youngster for a ride. We will then spend time with the child doing anything they like, be it playing cornhole or kickball. If there are threats against the child, or if he or she is afraid, we will have a presence around their home all day and night, doing whatever is necessary to be a calming presence for the child to enjoy a good night sleep.

becoming more prevalent in the United States, with about 2.5 million more people experiencing them in 2022 compared to 2021. Suicidal thoughts also increased among both adults and teens. “There are many different factors that contribute to the patterns and trends,” Miriam Delphin-Rittmon, HHS assistant secretary for mental

health and substance use and administrator of SAMHSA, said during a media briefing, CNN reported. “We do hear, in some instances, that people are continuing to experience some of the ripple effects of the pandemic. We know that there were challenges even before the pandemic and as a function of the pandemic. We see continued challenges.”

Q: You’re dealing with sensitive situations, to say the least. How are BACA members trained and vetted? A: We receive one solid year of training in how to deal with abused children and how to conduct ourselves in a courtroom. Each qualified person is fingerprinted and cleared through an FBI background check. And, after one year, the individual is eligible to become a full patched member. The process is a long slog. Q: How is BACA funded? A: We are a 501c3 organization. We accept donations from individuals and corporations, receive the occasional grant; our local chapter hosts a couple of fundraisers each year. Q: How can BACA be reached? A: Our monthly general information meetings are open to the public on the second Saturday of every month at 6:30 p.m. For more information on the meetings and membership requirements, call 716-222-2856; Hotline: 716-342-4107; website: www. BACAWorld.org.

Addiction: More Than 1 in 6 U.S. Adults, Teens Have Substance Use Disorder

ver one in six Americans, adults and teens alike, suffered a substance use disorder in 2022, new government data released in November shows. In the survey, alcohol and drug abuse involved roughly the same numbers of people: About 30 million had an alcohol use disorder, while 27 million had a drug use disorder — including about 6 million with an opioid use disorder. Some folks struggled with addictions to more than one substance: About 8 million people had both alcohol and drug use disorders. Mental illness often accompanied substance abuse, with the survey showing that nearly a quarter of adults had a mental health issue, including one in 12 who experienced both mental illness and substance use disorder.

The young were not spared: About one in five adolescents aged 12 to 17 — nearly 5 million youth – had experienced a major depressive episode in the past year. “The overdose epidemic is heartbreaking. But it's also preventable. We have and continue to make progress. To continue to make progress will require proper funding and commitment. We will not stop using every tool available to get Americans the help they need,” U.S. Health and Human Services Secretary Xavier Becerra said in an agency news release. The new data is based on responses to the National Survey on Drug Use and Health, a survey conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA). Substance use disorders are only

Page 14 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2023

MEET YOUR

PROVIDER

Community Services for Every1

Image of Richard Derwald during a 2020 interview with Erie County University Express.

At 88, ‘Mr. Fitness’ Still Going Strong

Wrestler, bodybuilder and now a fitness trainer — Richard Derwald is not about to stop By Deborah Jeanne Sergeant

hen Richard Derwald was a seventh grader, he lacked interested in fitness and wouldn’t have made it on any of his school sports teams because he was so physically unfit. After seeing a wrestling match at the old Buffalo War Memorial in 1949, he wished he could participate. “I visualized myself in there,” he said. “And at the age of 19, I was in that same ring. I quadrupled my strength and muscle size. It was a drive I had. Everything starts in the mind. You can’t change your life unless you first change your mind.” He helped himself picture his goals by putting pictures of the wrestlers on his bedroom wall and decided he would do what they do. In 1949, he ordered “Strength and Health Magazine” at a time when health magazines were not readily available on newsstands. “What I did gave me confidence,” Derwald said. “When you’re a kid and you can’t make a team, that’s not a confidence builder. The size of my biceps increased as did my confidence. I was much less afraid of everything.” By 1953, he won the Mr. Buffalo bodybuilding contest and became a professional wrestler. Derwald performed in more than 150 wrestling matches in The National Wrestling

Alliance and is a member of the Illio DiPaulo Wrestling Hall of Fame. Despite this accolade and being inducted into the Buffalo Weightlifting-Bodybuilding Hall of Fame in 2018 and receiving their Lifetime Achievement Award in 2019, he said he never became obsessed with bodybuilding. And unlike others, he never used steroids, which helps athletes cheat to gain muscle faster. The last bodybuilding competition was, one for those age 50-plus, and he was 62. “I saw all these guys who were razor sharp; I said to myself, ‘This isn’t the after 50!’” he said. “It was about what they were taking. It wasn’t exercise and diet. I can’t compete with that.” But he is 88 years old and still lifting weights and exercising regularly, with good health as his prize. Derwald has a home gym and pays special attention to working his legs. “As you get older, you have to have strong legs; it’s critical,” he said. He has led senior exercise classes for the past 26 years, sometimes two per day, because it keeps him active in retirement. He worked in IT (called “data process” for most of his career) and eventually worked as a consultant and operated Head to Toe, a day spa in Buffalo, where he offered massage therapy as a licensed

therapist. He also co-authored with Anthony Chiappone the book “For Men Only: The Secrets of a Successful Image” (Prometheus, 1995), available on Amazon. He has also been involved with music since 1957 as Richard “Dixie Dee” Derwald, playing upright bass, composing, singing and performing and recording. Derwald currently consults as a fitness trainer for Erie County Senior Services, where he worked in 1998 after retiring from IT. “I noticed that what all the seniors were doing at the senior centers was watching TV,” he said. Determined to change that unhealthful narrative, he approached county officials about starting an exercise program to provide an opportunity for more movement. “It exploded,” he said. “They gave me a lot of latitude. I built what came to be the longest-running senior fitness program in New York state, Club 99.” The club uses resistance bands to help adults aged 60-plus build and retain strength. Its goal is to help people live long and healthy lives, hence the “99.” It looks like Derwald is well on his way to achieving that milestone.

Community Services for Every1 partners with individuals of all abilities to reach their fullest potential, protecting their rights and promoting their independence and inclusion in our community. We are proud to be a leader in the industry and will continue providing high quality, Person-Centered Services to the Western New York Community. Our mission has always been to help those we support achieve their goals and become more independent. During the last three decades, we have continued to uphold this mission by enhancing our existing services and providing new programs to help people of all abilities. We continue to tailor our services to fit the needs of those we support and expand our reach to areas where we see a need. We provide support to over 2,200 people in 8 counties across WNY and employ over 950 staff members. The Agency’s administrative offices are strategically located throughout Erie County with offices in Buffalo, Lackawanna, Kenmore, and North Tonawanda. With over 40 different services to meet their personal, social, and vocational needs our goal is to empower the people we support, helping them lead the most independent lives while promoting inclusion in our community.

www.csevery1.com 180 Oak St. Buffalo, NY 14203

(716) 883-8888

December 2023 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 15

Nursing Homes on the Brink

Sector faces shortage of workers, increase wages and stagnant Medicaid reimbursement. ‘Across New York state in 2022, all nursing facilities collectively lost more than $756 million,’ says a nursing home operator By Deborah Jeanne Sergeant

ll areas of healthcare experienced significant challenges during the pandemic, but not as extreme as the seismic shift in long-term care facilities. Already struggling to care for a huge influx of aging baby boomers on decade-stagnant budgets, facilities faced an employment crisis, supply shortages, increased protocols and greater demand as seniors sick with COVID-19 needed someplace to go after discharge from the hospital. In more recent months, skyrocketing inflation and continuing employment and budgetary difficulties have pushed many nursing homes to the edge. “Across New York state in 2022, all nursing facilities collectively lost more than $756 million,” said Joe Murabito, president and managing member of Elemental Management Group, based in Oswego, which manages living facilities, residential care centers, and rehabilitation and nursing centers in in several Upstate locations. He is also part of the New York Providers Alliance, a group of 50 for-profit and nonprofit long-term care organizations from Buffalo to Lake Placid. This figure comes from the New

York Providers Alliance most recent report. Murabito said that the report clearly indicates that Downstate for-profit nursing homes made a $133 million profit as a group, but in every other category — nonprofits statewide and for-profits Upstate — “lost significant hundreds of millions of dollars,” Murabito said. He believes this stems from Medicaid bias and disproportionate funding allocation. “These numbers demonstrate while there’s a collective problem, a very big one, it’s not across the board,” Murabito said. “There have been influences over time that allow the for-profit nursing homes in Downstate to operate differently than all other in other areas.” One factor is wages; employers in New York City have been paying mandated higher minimum wages compared with Upstate, which places Upstate employers in a position of trying to catch up. Despite ubiquitous budget struggles at long-term care facilities, Upstate facilities are spending proportionately more on wages to raise them to a competitive level. Staffing shortages have caused lower occupancy rates. Upstate

facilities lag around 83% occupancy rates while Downstate, the rate has rebounded nearly to pre-pandemic levels. “The census recovery for Upstate is much slower for skilled nursing,” Murabito said. “That’s part of the answer.” The aging population both creates more demand for skilled nursing and thins the ranks of older workers. Murabito said that the projection of those 75-plus who will need assisted living or skilled care is 183% from 2016 to 2036, which he called “a significant increase in need and not the same labor projection to meet those needs. Whatever we’re feeling now for access, that will continue to get worse if we don’t find some way to incentivize people to work in the profession.” He thinks that increased funding for both paying for education and more instructors will help bring in more care providers. Greater access to education through technology may also help, especially for mid-career workers. Each day, the average Upstate facility loses $46 per person per day, according to the NYPA report. That averages $2.1 million per facility in

Page 16 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2023

2022. “The level of the crisis is higher than anyone knows,” Murabito said. “These losses are not sustainable. We’re approaching a ledge. There needs to be a targeted Medicaid rate increase of 12%. The need is not at Downstate proprietary facilities.” He added that in 30 years of working in the industry, he has not seen such dismal numbers. “If these numbers aren’t addressed in the right way, this is a survival issue for a lot of facilities,” Murabito added. “You can’t sustain losses like this for more than a year.” He said that hiring sufficient staff to meet minimum staffing requirements has been “a big challenge. We have significant agency use across the region.” One of the reasons that nursing homes across the state are in such financial distress is that they have gone 15 years without a Medicaid increase. The most recent approved increase was supposed to be a combination of 6.5% from New York and 1% from the federal government, spread across three years. So far, facilities have received only half the amount for one of those three years and that the proposed 7.5% increase was folded into a $168 million approved by New York two years ago to fund a mandated staffing ratio legislation passed two years ago. The situation is like a company offering a raise and then a holiday bonus, but later reneging on the bonus, claiming that it’s part of their raise. Christopher Koenig, MBA, licensed nursing home administrator and president and CEO of Niagara Lutheran Health System, said that said that receiving sufficient funding would help long-term care facilities pay better wages and attract more workers. “Every year, we get new regulations and new mandates for staffing and wage increases, but the state hasn’t followed through for funding increases and we don’t have the ability to fund wages,” Koenig said. Providing employees with quality-of-life perks such as childcare has helped attract workers. Niagara Lutheran is also looking at a means of providing transportation for workers, as a lack of public transportation presents a barrier to some. To help fund adequate levels of care, Koenig said that his organization has become more creative in combining administrative roles to help increase efficiency. In addition, “we’re working on retention ideas that aren’t just about wages, although we’re one of the top payers around,” he said. “We’re working at a deficit. The expenses continue to rise and that’s not something we can impart onto our residents.” Koenig fears for the entire longterm care industry. Offering other services such as rehabilitation, respite care and continuing care helps longterm care organizations scrape by. But the widespread budgetary shortfalls and employee shortages make it hard to staff these additional revenue streams. “If there’s nothing done to save the system, there’s a chance a lot of nursing homes will go out of business,” he said. “The reform has to come from a societal transition. People are living longer, but because of that, they have more health concerns that require higher level care. It will take decades to transform that.”

By Jim Miller

How Seniors Can Get Help Paying for Everyday Needs

Dear Savvy Senior,

What types of programs are available to help seniors struggling with their everyday bills, and how do I go about finding them? Since I lost my husband last year, my Social Security survivor benefit is barely enough to get by on.

Easier Pet Care for Older Adults

Searching Senior

Dear Searching, I’m very sorry for your loss, but you’ll be happy to know that there are dozens of different financial assistance programs and government benefits that may be able to help you with your everyday costs. To locate these types of programs, your best resource is Benefits CheckUp.org. This is a free, confidential online screening tool designed for older adults and people with disabilities. It will help you find federal, state and local benefits programs that can assist with paying for food, utilities, health care, medications, housing and many other needs. This site — created by the National Council on Aging in 2001 — contains nearly 2,000 programs across the country. To identify benefits, you’ll first need to type in your ZIP code and choose the types of benefits you’re interested in. Then you’ll need to answer a few questions regarding your personal and financial situation. Once completed, you’ll get a list of programs to choose from, followed by a personalized report that explains each program, and tells you where you can get help or how to apply. If you need some assistance or you don’t have internet access, you can always speak with a benefits support specialist by calling 800-7946559. You can also get help in-person at any of the 85 benefit enrollment centers located across 41 states. See NCOA.org/article/meet-our-benefits-enrollment-centers to search for a center in your area.

Types of Benefits Depending on your income level, location and circumstance, here are a few of the many different benefits you may be eligible for: • Nutrition assistance: Programs like the Supplemental Nutrition Assistance Program (SNAP) can help pay for food at the grocery store. The average SNAP benefit for 60-and-older households is around $105 per month. Some other nutrition programs that are available to seniors include the Senior Farmers Market Nutrition Program and the Commodity Supplemental Food Program.

• Utility assistance: There’s the Low-Income Home Energy Assistance Program (LIHEAP) that provides assistance in lowering home heating and cooling costs. And for broadband assistance, the Affordable Connectivity Program provides a $30 monthly subsidy that can be applied toward your home internet costs. • Health care and medicine: Medicare Savings Programs and Medicaid can help or completely pay for seniors’ out-of-pocket health care costs. And for assistance with medications, there’s a low-income subsidy program called ‘Extra Help’ that helps pay premiums, deductibles, and co-payments on Medicare (Part D) prescription drug coverage. You can also search for prescription drug help through patient assistance programs or your state pharmaceutical assistance program at Medicare.gov. • Supplemental Security Income (SSI): Administered by the Social Security Administration, SSI (see ssa. gov/ssi) provides monthly payments to very low-income seniors, age 65 and older, as well as to those who are blind and disabled. In 2023, SSI pays up to $914 per month for a single person and up to $1,371 for couples. In addition to these benefits, there are dozens of other programs BenefitsCheckUp can help you identify, like housing assistance, property tax reduction, home weatherization assistance, tax relief, veteran’s benefits, senior transportation, caregiving support, free legal assistance, disability services, job training and more. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

By Deborah Jeanne Sergeant

lthough pets bring many mental and physical health benefits, some older adults find caring for their cat or dog more challenging than it used to be. Fortunately, area resources can make it easier for them to enjoy their pets and keep up with their animals’ care. Quishara Williams, public relations assistant with Erie County Department of Senior Services, stressed the importance of “maintaining good hygiene, having the ability to keep pets healthy with vet checkups, vaccines and regular feeding and exercise,” all of which can become more challenging if physical ability diminishes with age. One way to mitigate these difficulties is to find help with pet care. Many companies offer non-medical domestic services for older adults and will complete basic pet care tasks. Typically, seeking pet care alone isn’t cost-effective. However, as an add-on service, it’s affordable. Many of these kinds of services will scoop cat litter, clean pet dishes and convey a pet to the vet or groomer. “There are a lot of services like pet walking to walk the dog or doggy daycare where you can drop the dog off for supervised playtime and activity where the older adult may not be able to get down,” said Tracy Fricano Chalmers, director of Public Health Planning and Emergency Preparedness for Niagara County Department of Health. “Older kids in the neighborhood may be able to walk the dog or change the litter or clean pet waste. There are also services that will pick up dog waste. You could always put less litter in the box with more boxes throughout the house.” That strategy would make the box easier to dump out. Buying the right products can also help, such as lightweight litter or small packages of litter if carrying 25-pound containers is too difficult. Clumping litter can reduce the frequency of lifting a full litterbox to dump it, as it’s easier to scoop

out soiled clumps and conserve the remaining clean litter. Many online companies like Chewy.com will regularly deliver products right to the doorstep, reducing the need to heft bags of food and litter. If tight finances make it difficult to keep a pet, those who receive Meals on Wheels ask about receiving pet food as well. Chalmers said that many food pantries also stock pet food. “There are a lot of services available in the community for people struggling to keep pets,” Chalmers said. “We don’t like to ever see finances get in the way of keeping a pet.” Most county health departments offer rabies clinics and some stores such as Country Max host periodic low-cost clinics for basic preventative care. Some vets and groomers offer house calls for people who struggle to transport their pet because they no longer drive or because of the pet’s size. In addition, the home set-up can make caring for pets easier. For example, a dog run can help with taking the animal outside to eliminate rather than walking it on a leash. Inside, reduce the risk of slips and trips by “making sure the food dishes are out of the way and that spilled water is mopped up,” Chalmers said. “Toys should be kept out of the way to avoid tripping. I tell people to avoid retractable leashes as they can get tangled around things.” Sometimes, the pet itself can contribute to falls. Chalmers recommends selecting medium-sized dogs, as often tiny dogs tend to get underfoot, and large ones can bowl over someone struggling with balance. Attaching a small bell to a cat’s collar and having the dog wear its collar with jingling tags can help owners know where their pet is. “If seniors have balance issues or if they’re more at risk of being knocked over, they should sit in a chair to interact with a pet, not bend over,” she added.

December 2023 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 17

The Social Ask Security Office From the Social Security District Office

Social Security Benefits Increase In 2024

Mindfulness Helpful for Depression and Anxiety

Mindfulness offers another tool to improve mental health By Deborah Jeanne Sergeant

ccording to the National Alliance on Mental Illness, 42.5 million adults in the US have anxiety and 21 million have depression, including more than six million aged 12 to 17 who have major to severe depression. In addition to other treatments and practices, mindfulness may offer one means of helping those afflicted with anxiety and depression. “When we feel anxious, it’s like the fear of the future,” said Gizelle Hinson, master’s prepared social worker. “Trauma is something from the past that contributes to depression. Mindfulness allows you to be in the present where you’re safe and not living in a space where the pain has happened to you and you can use breathwork to calm the body and make decision. If you’re still stuck on what happened before, it’s hard to learn and work. This is a tool to help improve self-regulation skills and emotions.” Hinson is a principal consultant and executive coach with The Mindful Institute in Buffalo. Mindfulness begins with paying attention to the body, beginning with breathing. Slowing breathing helps support the parasympathetic nervous system and calm the “fight or flight” response. People are better able to sensibly respond rather than react. “Mindfulness is a way about thinking about the way you think,” Hinson said. “It’s present moment awareness. It’s about not judging the things that come to your awareness. So often we judge things. We have the emotional attachment that comes with that and sometimes that doesn’t help what we’re trying to process. Mindfulness allows things to exist without judging so we can let go of the problem.” Slowing down is a key aspect of mindfulness and paying attention to sensory input: the feel of woolen mittens, the sound of snow squeaking under boots, the feel of snowflakes on the face and bite of cold in the air. It’s much easier to scurry through the weather on the way to the next

errand while ruminating over the embarrassing incident at work yesterday. Loralee Sessanna, Ph.D., registered nurse, board-certified advanced holistic nurse and clinical professor at UB, advised starting by paying attention to small practices, such as “mindfully brushing your teeth. Take time to smell the toothpaste, the feel of the brush and notice the taste. Notice how your mouth feels before and after. Pay attention to the present moment.” Sessanna said that deep, cleansing breaths in a private place helps when stressors pile up during the day, as this can help slow down the autonomic nervous system. “Part of this self-care entails advocating for yourself and making sure you have time to set aside for self-care and things for you,” she added. “To really acknowledge what you need for yourself and not be afraid to reach out if you need help.” It’s easy to let the mind drift to worrisome thoughts while trying to quiet it. When this happens, Tania T. Von Visger, advanced practice registered nurse in critical care, Ph.D. and assistant professor at UB advises allowing the feelings to happen and acknowledging them but to avoid judging them. “It gives you calm to reflect,” Visger said. “That can help with anxiety when you have something like a panic attack. You can slow things down. Research has shown that mindfulness can be equal in its effective with depression treatment like medication.” Many people find engaging in hobbies and physical activities they enjoy helps them stay in the moment in a mindful way. Exercise in particular promotes mindfulness as it typically includes deep breathing and shifting the focus away from troubling thoughts. “When you breathe deeply, it can help you get into rest and relaxation,” Visger said. “When you do that more, it balances your emotions and how you feel and it gives you calm to reflect.”

ore than 71 million Americans will see a 3.2% increase in their Social Security benefits and Supplemental Security Income (SSI) payments in 2024. On average, Social Security retirement benefits will increase by more than $50 per month starting in January. Federal benefit rates increase when the cost-of-living rises, as measured by the Department of Labor’s Consumer Price Index (CPI-W). The CPI-W rises when inflation increases, leading to a higher cost-of-living. This change means prices for goods and services, on average, are higher. The cost-of-living adjustment (COLA) helps to offset these costs. We will mail COLA notices throughout the month of December to retirement, survivors and disability beneficiaries, SSI recipients and representative payees. But if you want to know your new benefit amount sooner, you can securely obtain your Social Security COLA notice online using the Message Center in your personal My Social Security account at www.ssa.gov/myaccount. You can access this information in early December, prior to receiving the mailed notice. Benefit amounts will not be available before December. Since you will receive the COLA notice online or in the mail, you don’t need to contact us to get your new benefit amount. If you prefer to access your COLA notice online and not receive

Q&A Q.: Do members of Congress have to pay into Social Security? A.: Yes, they do. Members of Congress, the president and vice president, federal judges, and most political appointees, have paid taxes into the Social Security program since January 1984. They pay into the system just like everyone else, no matter how long they have been in office. Learn more about Social Security benefits at www.ssa.gov. Q.: I’m trying to figure out how much I need to save for my retirement. Does the government offer any help with financial education? A.: Yes. For starters, you may want to find out what you can expect from Social Security with a visit to Social Security’s Retirement Estimator at www.ssa.gov/estimator. The Financial Literacy and Education Commission has a website that can help you with the basics of financial education: www.mymoney.gov. Finally, you’ll want to check out

Page 18 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2023

the mailed notice, you can log in to your personal my Social Security account at www.ssa.gov/myaccount to opt out by changing your preferences in the Message Center. You can update your preferences to opt out of the mailed COLA notice, and any other notices that are available online. Did you know you can receive a text or email alert when there is a new message waiting for you? That way, you always know when we have something important for you — like your COLA notice. “Social Security and SSI benefits will increase in 2024, and this will help millions of people keep up with expenses,” said Kilolo Kijakazi, acting commissioner of Social Security. January 2024 marks when other changes will happen based on the increase in the national average wage index. For example, the maximum amount of earnings subject to Social Security payroll tax in 2024 will be higher. The retirement earnings test exempt amount will also change in 2024. Learn more at www.ssa. gov/news/press/factsheets/colafacts2024.pdf. Be among the first to know! Sign up for or log in to your personal my Social Security account today at www.ssa.gov/myaccount. Choose email or text under “Message Center Preferences” to receive courtesy notifications. You can find more information about the 2024 COLA at www.ssa. gov/cola.

the Consumer Financial Protection Bureau, which offers educational information on a number of financial matters, including mortgages, credit cards, retirement, and other big decisions. Visit the Consumer Financial Protection Bureau at www.consumerfinance.gov. Q.: I worked for the last 10 years and I now have my 40 credits. Does this mean that I get the maximum Social Security retirement benefit? A.: Probably not. The 40 credits are the minimum number you need to qualify for retirement benefits. However, we do not base your benefit amount on those credits; it's based on your earnings over a lifetime of work. To learn more about how you earn Social Security credits and how they work, read or listen to our publication How You Earn Credits, available at www.ssa.gov/pubs.

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December 2023 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 19

TOP: Cheryl Strauss (left) and Jocelyn Merlo own and operate HEAL BFLO in Buffalo.

Fitness: Try Bar League Yoga A unique league in Buffalo’s fitness scene offers new ways to stay in shape By Amanda Jowsey

healthy and positive sense of community plays a crucial role in the fitness world and in helping individuals meet their fitness goals. The support and encouragement of a shared workout offers several mind, body and spirit benefits. Plus, it’s just fun. But instead of joining a typical studio fitness class or the standard volleyball or bowling league (not that they aren’t great), kick your community exercise experience up a notch by signing up for one of Buffalo’s most unique fitness experiences: Bar League Yoga. “BLY is eight weeks of classes from 6:30 -7:30 p.m. on Wednesdays. During this time, we will flow together and take a class from a dif-

ferent [top tier] instructor from our community each week. Afterwards, we cheers at the bar, break bread and socialize-network with people just like you,” Strauss said. The co-founders of HEAL BFLO, Cheryl Strauss and Jocelyn Merlo, believe in the physical, mental and spiritual health benefits of trying new things and exposing yourself to new environments, including trying different styles of yoga (and all exercise). BLY is the perfect way to do this in a unique and creative way, Strauss said. Different professions and different lifestyles all require certain repetitive motions in our bodies (sitting at a chair, hunching over, driving, standing all day, etc....). Certain styles of yoga are specifically used to

BOTTOM: Bar league yoga sessions take place inside Forbes Theatre at 500 Pearl St. in downtown Buffalo. A new league will start Jan. 10. reverse the adverse effects this can have on our physical health. “Yoga is the opposite of what they do every day,” Strauss said. “It helps to undo all the damage we do to ourselves daily and over time.” Strauss and Merlo note how this eight-week session exposes different people to a variety of styles of yoga so that they can find the best fit for them. Strauss enjoys that “There’s a different teacher every week teaching a different style class.” There is a different lineup every season. They describe the league as “welcoming and inviting,” seeing friendships made and lasting connections formed. It is a safe and warm place to take time for your physical, mental and emotional health with others who wish to do the same. The league is for all skill levels, even those who have never done yoga before. “It is for everybody and every level,” Strauss said. The original idea came from Merlo, who was struggling to find the fun in the Bar League Volleyball that she and her husband signed up for.

Page 20 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2023

Strauss jumped on board to launch the idea. The starting number of 50 participants grew to 180 and they expect to have 200 this session. This is HEAL BFLO’s 20th season offering this experience. People seem to enjoy it so much that it sells out every year. Sessions are for participants 21 and up, but it is a very family-oriented community and participants are welcome to bring kids who may want to join in. “This experience also goes hand in hand with small businesses to elevate community awareness of food, drinks and space small buffalo business offers,” Merlo said. Merlo mentioned the additional benefit of a mid-week night out. “This is a fun and healthy way to take advantage of a mid-weeknight out without feeling any hangovers the next day,” she said. The upcoming session is scheduled from Jan. 10 to Feb. 28 and takes place inside Forbes Theatre at 500 Pearl St. in downtown Buffalo. To register, visit HEALBFLO. com. The fee is $95 a person and includes a jersey.