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Meeting a Need

 

MiraVista Behavioral Health Center recently announced the expansion of its facilities with the opening of new adult inpatient treatment beds. These adult beds are in addition to the 16-bed adolescent unit which was recently renovated and now reopened.

The addition of these specialized beds reflects MiraVista’s ongoing commitment to meeting the growing demand for high-quality mental-healthcare services. With mental-health challenges on the rise globally, the Holyoke facility recognizes the importance of providing comprehensive and compassionate care to individuals with mental illness.

“We believe that everyone deserves access to effective treatment in a supportive environment, and these new beds will enable us to provide specialized care to more individuals in need.”

“Our decision to expand our inpatient treatment capacity underscores our dedication to serving our community and the Commonwealth and addressing the increasing need for mental-health services,” said Shelley Zimmerman, MiraVista’s hospital administrator. “We believe that everyone deserves access to effective treatment in a supportive environment, and these new beds will enable us to provide specialized care to more individuals in need.”

The new adult inpatient beds will offer a range of therapeutic interventions tailored to meet the unique needs of each patient. MiraVista’s multi-disciplinary team of experts, including psychiatrists, psychologists, social workers, and nurses, will work collaboratively to develop personalized treatment plans focused on promoting healing and recovery.

In addition to individualized therapy sessions, patients will have access to group therapy, medication management, recreational activities, educational workshops, and peer support, all designed to foster personal growth and empowerment. MiraVista’s holistic approach to treatment emphasizes wellness and resilience, empowering patients to achieve lasting positive change in their lives.

Direct admission without first being seen in an emergency department is a new process MiraVista introduced with the reopening of its adolescent unit.

 

Hope and Support

MiraVista also recognized May as Mental Health Awareness Month with a flag raising on May 9 and by illuminating its façade green.

“Green is used for the month to symbolize hope and support for individuals living with a mental illness,” said Kimberley Lee, chief of Creative Strategy and Development. “Our clinicians work across populations to help patients successfully manage their mental-health challenges and lead fulfilling lives in community.”

In conjunction with the Substance Abuse and Mental Health Services Administration’s (SAMHSA) observance of the month, Lee explained, MiraVista will highlight on its social media the diverse mental-health needs of various populations and encourage people to wear green.

“These 31 days are about advancing better understanding of mental health as a component of overall health and the importance of seeking evidence-based treatment for it when needed,” she said. “Whether someone is navigating personal challenges or extending empathy to others, this month holds significance for us all in showing support for mental healthcare.”

Lee said MiraVista will follow SAMHSA’s suggested weekly themes in highlighting the mental-health needs of older adults, children and teens, marginalized racial and ethnic groups, and those who identify as LGBTQIA+ and, as a result of bullying and discrimination, are at high risk for mental-health conditions.

“We are amplifying our efforts during May to destigmatize mental health, enhance understanding, and cultivate a supportive environment,” Lee said. “Promoting mental health and treatment for it benefits everyone — from the individual managing it to the family and friends who love them, to the community in which they live and contribute.”

Healthcare News Special Coverage

Breaking Down Barriers

Gándara’s Family Resource Centers

Gándara’s Family Resource Centers each provide a number of services for families in one location.

 

There’s no doubt, Lois Nesci said, that the COVID years triggered or exacerbated a lot of mental-health issues, which makes the multifaceted of Gándara Center more important than ever.

At the same time, the pandemic’s impact on mental health also got more people talking than ever before — and that’s good for everyone.

“The need has increased, absolutely,” said Nesci, Gándara’s CEO. “But at the same time, as we continue to break the stigma around mental health, people become more and more willing to discuss some of their struggles or ask for help. We as a society have been educating people: what are the signs people exhibit if they’re not doing well, if they’re depressed, anxious, or struggling with substance abuse?”

To help those who fall into those categories, as well as many others, Gándara’s services fall into five buckets:

• Behavioral health, which encompasses a broad array of clinical and substance-use services for adults, families, children, and adolescents, including individual and group psychotherapy, diagnostic assessments, and treatment;

• Youth, young-adult, and family services, including children’s behavioral health, foster care, and youth and young-adult residential ​homes;

• Substance use and recovery, with services include recovery coaching, peer recovery centers, and long-term residential treatment for men, women, and young adults with substance-use disorder and co-occurring mental-health disorders;

• Community and prevention, including health-education programs and initiatives that provide resources and information addressing numerous public-health areas while representing the multicultural needs of the region; and

• Intellectual and developmental disability services, which promote the health and well-being of adults with intellectual and developmental disabilities and those with behavioral health and/or substance-use disorders.

Gándara’s mental-health services — its most robust collection of offerings — focus on a few key areas: outpatient behavioral-health clinics, children’s behavioral health, substance-use and recovery services, and adult community clinical services.

“As we continue to break the stigma around mental health, people become more and more willing to discuss some of their struggles or ask for help.”

“Gándara has always had a mission to help people at the grassroots level,” Nesci said. “We’re in communities where people live. We’re accessible and very visible. We provide the linguistic ability to meet people where they’re at, and the staff reflects the population we serve.”

As a multi-service organization with a geographic footprint statewide, Gándara targets many of its programs at specific populations, such as recovery programs for Hispanic individuals and a residential group home for LGBTQ+ youth, Nesci noted. “Gándara has always responded to individual needs in the community.”

 

Five Decades of Growth

According to its website, Gándara Center was founded in Springfield in 1977 to advocate and provide for equal, culturally competent behavioral-health services for the Hispanic community.

The 1970s saw a large wave of Hispanic migration to the Greater Springfield area, and the portion of newcomers who had mental-health and substance-use issues had limited access to services that could help them.

Lois Nesci

Lois Nesci says mental-health needs have increased, but so have the conversations around them.

Fortunately, in 1977 — and later, as a part of President Carter’s Mental Health Systems Act of 1980 — funding was made available to communities across the U.S. to address the mental-health needs of individuals suffering from serious mental illness, including the elderly as well as racial and ethnic minority communities.

The city of Springfield submitted a citywide application that included needs in both the Hispanic and African-American communities. This funding strengthened the city’s mental-health services and aided the Gándara Center, whch was named after Dr. José Gándara Cartagena, a prominent physician and public servant from Puerto Rico who dedicated his life to providing services for those who could not afford medical care. He also advocated for urban renewal, especially the construction of much-needed new public housing.

Gándara Center was first housed in a storefront on Main Street in Springfield and then on the Mercy Hospital campus on Carew Street. In 1982, when the center opened an outpatient clinic on Main Street, it was the only agency in the area specifically providing culturally sensitive care to the Hispanic community.

In the early years, Gándara’s first executive director, Dr. Philip Guzman, laid the foundation for what the agency would later become. In 1982, Dr. Henry East-Trou joined the team as a supervisor for the agency’s psychiatric day treatment program. At the time, Gándara had just one Springfield location and approximately 50 staff to house all of residential, outpatient, and substance-use programs. Over the years, the agency secured numerous contacts and grants, expanded services, created additional programs, and increased staff size.

In 1989, when East-Trou began shepherding Gándara Center through an unprecedented era of growth as executive director, the agency employed 100 people and served approximately 2,000 individuals.

“We’re in communities where people live. We’re accessible and very visible. We provide the linguistic ability to meet people where they’re at, and the staff reflects the population we serve.”

After 30 years of service, East-Trou retired in May 2019. Throughout his tenure, he further expanded the agency and its services, which by that time offered behavioral-health, substance-use, prevention, and educational services to more than 40 communities throughout the Commonwealth, employed more than 900 staff, and served nearly 13,000 adults, children, and families from all backgrounds.

Gándara’s foster care program

Gándara’s foster care program has been placing youth in temporary, safe, therapeutic home environments for more than 30 years.

In 2020, Nesci joined the agency and assumed the role of CEO, bringing experience working with individuals from all races and ethnic backgrounds. In her time at the agency, she has led several relocation projects, program expansions, and agency-wide accreditation from the Council on Accreditation.

Today, around 1,100 Gándara employees serve more than 17,000 clients at more than 100 locations.

“We have a full complement of behavioral-health services delivered in community-based clinic settings, as well as our home behavioral-health services for youth and families,” Nesci said. “We’ve expanded and grown our in-home services to include hospital diversion for youth. In addition to that, we also provide services for people who are struggling with substance abuse. We have six recovery centers statewide, and then we are also providing recovery coaching to individuals in the community who are in recovery.

“I’ve been here almost four and a half years,” she added, “and during that time, I’ve seen our services grow in a lot of areas, particularly in the area of substance-abuse services, our youth services, and our behavioral-health services to children and adults.”

The organization’s footprint has also grown, expanding into the Berkshires, Fitchburg, Falmouth, and Worcester, to name a few more recent locations.

 

Starting the Conversation

May is Mental Health Awareness Month, but Nesci wants critical conversations to happen year-round.

“There was a time when mental health was something that was never discussed,” she said. “People didn’t understand it; therefore, they feared it. Subsequently, they made judgments about it.”

Participants in Gándara’s PhotoVoice educational campaign

The Problem Gambling Prevention: Youth and Caregivers Photovoice 2.0 program provides youth with leadership skills and knowledge to become change agents in their community, committed to raising awareness and prevention of underage gambling.

Though stigma still exists, she added, plenty of progress has been made to break down those barriers, and Gándara’s focus on cultural competency is part of that.

“When we started talking about mental health being just as important as physical health, it began to change the rhetoric around providing safe spaces for individuals to be able to get services.

“It’s very important to have a space that’s judgment-free,” Nesci continued. “When an agency like us meets people where they are in the community, as recovery coaches or with behavioral-health therapy in their homes, speaking the language of individuals, understanding cultural backgrounds, people feel welcome. They don’t feel judged. They feel like someone understands them.”

And that builds trust and relationships, which she calls the greatest catalyst for people to make needed improvements in their lives — which has, after all, been Gándara Center’s mission for almost 50 years.

Healthcare News

Breathing a Little Easier

About 3.4 million children and 13.6 million adults in the U.S. have been diagnosed with what’s known as immunoglobulin E-mediated (or IgE-mediated) food allergy, causing reactions ranging from mild to moderate (including hives and swelling) to severe and life-threatening, such as anaphylaxis.

More than 40% of children and more than half of adults with food allergies have experienced a severe reaction at least once, and it is estimated that food-related anaphylaxis results in 30,000 medical events treated in emergency rooms in the U.S. each year.

That’s why so many are encouraged by the U.S. Food and Drug Administration’s (FDA) approval of Xolair (omalizumab) injection for immunoglobulin E-mediated food allergy in certain adults and children 1 year or older for the reduction of allergic reactions that may occur with accidental exposure to one or more foods.

Xolair was originally approved in 2003 for the treatment of moderate to severe persistent allergic asthma in certain patients.

“This newly approved use for Xolair will provide a treatment option to reduce the risk of harmful allergic reactions among certain patients with IgE-mediated food allergies,” said Dr. Kelly Stone, associate director of the Division of Pulmonology, Allergy, and Critical Care in the FDA’s Center for Drug Evaluation and Research. “While it will not eliminate food allergies or allow patients to consume food allergens freely, its repeated use will help reduce the health impact if accidental exposure occurs.”

According to the Centers for Disease Control and Prevention, almost 6% of people in the U.S. in 2021 had a food allergy, and exposure to the particular food (or foods) to which they are allergic can lead to potentially life-threatening allergic reactions, such as anaphylaxis.

There is currently no cure for food allergy. Current treatment requires strict avoidance of the food(s) the patient is allergic to and prompt administration of epinephrine to treat anaphylaxis should accidental exposures occur.

Palforzia (peanut allergen powder) is an oral immunotherapy product approved in patients ages 4 to 17 for the mitigation of allergic reactions, including anaphylaxis, that may occur with accidental exposure to peanuts, but its benefits are restricted to peanut allergy. Xolair is the first FDA-approved medication to reduce allergic reactions to more than one type of food after accidental exposure.

“Over the past 35 years, I have seen how debilitating food allergies can be for patients and their loved ones, as they are consumed by the fear of accidental exposure,” said Dr. Robert Wood, director of the Eudowood Division of Allergy, Immunology and Rheumatology at Johns Hopkins Children’s Center and principal investigator of the OUtMATCH study that led to FDA approval.

“While allergic reactions to exposures are common and often severe, there have been limited treatment advancements for food allergy,” he added. “The results of the OUtMATCH study showed that anti-IgE therapy could significantly reduce the occurrence of allergic reactions across multiple foods in the event of an accidental exposure.”

OUtMATCH stands for Omalizumab as Monotherapy and as Adjunct Therapy to Multi-allergen OIT in Food Allergic Children and Adults.

“Living with food allergies has a profound impact on patients and their families, causing significant stress and requiring constant vigilance,” said Dr. R. Sharon Chinthrajah, associate professor of Medicine at Stanford School of Medicine, Sean N. Parker Center for Allergy and Asthma Research, and OUtMATCH co-lead study investigator.

“The OUtMATCH study demonstrated that anti-IgE therapy increased most patients’ threshold for an allergic reaction,” she added. “This presents an important new treatment option for patients and families in its potential to reduce the risk of allergic reactions from accidental exposures they may face in day-to-day life.”

 

Caution Warranted

As noted, Xolair isn’t a cure, and patients who take it must continue to avoid foods they are allergic to. Xolair is intended for repeated use to reduce the risk of allergic reactions and is not approved for the immediate emergency treatment of allergic reactions, including anaphylaxis. There are 160 different foods that cause IgE-mediated food allergy.

Still, detailed results from the OUtMATCH study showed treatment with Xolair increased, for a majority of trial participants, the amount of peanuts, tree nuts, egg, milk, and wheat they consumed without an allergic reaction, dramatically lessening the results of accidental ingestion or cross-contamination.

Xolair is a drug (in the class of drugs called monoclonal antibodies) that binds to IgE, the antibody type that triggers allergic reactions, and blocks IgE from binding to its receptors.

Xolair’s safety and efficacy in reducing allergic reactions in subjects with food allergies was established in one multi-center, double-blind, placebo-controlled study of 168 pediatric and adult subjects who were allergic to peanut and at least two other foods, including milk, egg, wheat, cashew, hazelnut, or walnut. Researchers randomly gave subjects either Xolair or placebo treatment for 16 to 20 weeks.

The primary measure of Xolair’s efficacy was the percentage of subjects who were able to eat a single dose (600 milligrams or greater) of peanut protein (equivalent to 2.5 peanuts) without moderate to severe allergic symptoms, such as moderate to severe skin, respiratory, or gastrointestinal symptoms, at the end of the treatment course.

Of those who received Xolair, 68% (75 of 110 subjects) were able to eat the single dose of peanut protein without moderate to severe allergic symptoms, compared to 6% (3 of 55 subjects) who received placebo. Of note, however, 17% of subjects receiving Xolair had no significant change in the amount of peanut protein tolerated (they could not tolerate 100 mg or more of peanut protein). As a result, continuation of strict allergen avoidance is still necessary, despite treatment with Xolair.

The key secondary measures of efficacy were the percentage of subjects who were able to consume a single dose (1,000 milligrams or greater) of cashew, milk, or egg protein without moderate to severe allergic symptoms at the end of the treatment course. For cashew, 42% who received Xolair achieved this endpoint, compared to 3% who received placebo.

For milk, 66% who received Xolair achieved this endpoint, compared to 11% who received placebo. For egg, 67% who received Xolair achieved this endpoint, compared to none of the 19 who received placebo. As a result, Xolair treatment is approved for certain patients with one or more IgE-mediated food allergies.

 

Optimistic Outlook

In the U.S., Genentech and Novartis Pharmaceuticals Corp. have worked together to develop and co-promote Xolair.

“Xolair offers patients and families an important new treatment option that can help redefine the way food allergies are managed and reduce the often-serious allergic reactions that can result from exposure to food allergens,” said Dr. Levi Garraway, Genentech’s chief medical officer and head of Global Product Development. “We look forward to bringing this treatment to the food-allergy community who have long awaited an advancement.”

Other allergy experts are equally hopeful.

“As more and more people are affected by food allergies, the need for a new approach to help prevent serious and often life-threatening allergic reactions and emergencies is critical,” said Sung Poblete, CEO of Food Allergy Research and Education. “As someone with food allergies, I know firsthand the significant impact they can have on people and their loved ones, and I share in the community’s excitement for this approval.”

Kenneth Mendez, president and CEO of the Asthma and Allergy Foundation of America, added that “the stress of living with food allergies can weigh heavily on people and their families, particularly when navigating events like children’s birthday parties, school lunches, and holiday dinners with friends and family. Given the growing prevalence of food allergies, this news offers hope to the many children and adults who may benefit from a new way to help manage their food allergies.”

Healthcare News Special Coverage

A Blooming Challenge

By David Robertson, MD, MPH, MBA

Spring is a season of rebirth and rejuvenation, with flowers blooming and the world around us turning from brown to green. However, for many area residents, this beautiful transformation comes with a less-welcome companion, with Springfield consistently ranking as one of the worst cities in the country for allergies and asthma.

This year, the warm winter that just came to an end is set to extend the allergy season, bringing about an early and possibly more intense onset of symptoms for allergy sufferers.

 

The Warm Winter Effect

Typically, cold winters help delay the start of the allergy season by keeping plants dormant and the ground frozen longer. A warmer winter can lead to an earlier thawing and activation of outdoor molds in the soil. This early activity, combined with spring rains, means that outdoor mold spores are already circulating, ready to trigger allergy symptoms. With tree pollen following closely behind, residents may find themselves in the midst of a particularly challenging allergy season.

 

Understanding Allergies and Asthma

Allergies occur when the immune system overreacts to substances in the environment, known as allergens, which are harmless to most people. These can include tree, grass, and weed pollens; molds; animal danders; and dust mites. When these allergens are inhaled or come into contact with the skin, they can cause symptoms such as sneezing, itching, runny nose, and watery eyes.

“Managing allergies and asthma requires a multifaceted approach. The three basic strategies for dealing with environmental allergens are avoidance, medications, and allergy immunotherapy.”

For some, allergies can also exacerbate asthma, a condition characterized by inflammation and narrowing of the airways in the lungs, leading to wheezing, shortness of breath, and coughing. Asthma can be triggered by allergens as well as changes in the weather, making the spring season particularly challenging for individuals with both allergies and asthma.

 

Strategies for Relief

Managing allergies and asthma requires a multifaceted approach. The three basic strategies for dealing with environmental allergens are avoidance, medications, and allergy immunotherapy.

The first line of defense is to minimize exposure to allergens. This can include staying indoors on days when pollen counts are high, using air purifiers at home, and changing clothes and rinsing off after time spent outside. Some people also find wearing masks or even protective eyewear helpful, particularly with activities that may increase allergen exposure, like cutting the grass and gardening.

Many over-the-counter (OTC) and prescription medications can help manage symptoms of allergies and asthma. Antihistamines, decongestants, nasal sprays, and eye drops are widely used to alleviate allergy symptoms, while asthma sufferers often use prescription inhalers to control their symptoms. However, choosing the right medication can be daunting due to the vast array of options available.

For those with severe allergies, allergy immunotherapy, which includes allergy shots and sublingual tablets, may be an option. This long-term treatment gradually desensitizes the body to specific allergens, potentially providing lasting relief.

 

Navigating Treatment Options

While many effective treatments are available over the counter, selecting the right product can be challenging without professional guidance.

In studies, nasal steroid sprays like Flonase or Nasacort are the most effective family of medicines for helping with congestion, sneezing, and post-nasal drip, but many people do not like using them. They may not be right for everyone, particularly people prone to nosebleeds or with glaucoma or cataracts.

Oral antihistamines, like Allegra, Claritin, or Zyrtec, can help with sneezing and itching, and these new antihistamines are not supposed to cause drowsiness, though everyone’s body is different. Antihistamine eye drops can help with itchy, watery, or swollen eyes, but can also cause or worsen dry eyes.

Oral decongestants can provide temporary relief of sinus pressure, but can also cause increased blood pressure and insomnia, so we generally recommend minimizing these medications. Nasal decongestant sprays like Afrin can provide temporary relief of congestion, but should not be used for more than two or three days in a row because they can cause increased congestion.

All of these medicines are available in less expensive generic forms, which most people find equally effective.

Given the number of treatment options and potential side effects for some people, it may beneficial to consult with a healthcare provider or an allergist to develop a personalized treatment plan. If you already have a treatment strategy that works for you and your family, now may be a good time to get a few boxes of your preferred medicine — in the last few years, there have been occasional shortages at the peak of allergy season. But leave enough for your neighbors!

 

The Road Ahead

As Springfield and the surrounding region brace for a longer allergy season, staying informed and proactive in dealing with allergens will be crucial for those looking to enjoy the spring while keeping their symptoms in check.

By understanding the triggers, using effective management strategies, and seeking professional guidance when necessary, allergy sufferers should be able to navigate the challenges of spring allergies and asthma with increased confidence.

 

Dr. David Robertson is an allergist and clinical immunologist and owner of Western Massachusetts Allergy, LLC in Springfield.

Healthcare News

Easing the Load

 

Currently, there are more than 11 million family members and friends across the country providing care to more than 6 million Americans living with Alzheimer’s disease.

Caring for those living with Alzheimer’s or other dementia poses special challenges for family caregivers. As dementia symptoms worsen, caregivers can experience increased emotional stress, depression, anxiety, and new or worsened health problems. Caregivers often experience depleted finances due to disruptions in employment and paying for healthcare or other services.
“Caring for a person with Alzheimer’s takes longer, lasts longer, is more personal and intrusive than most other diseases, and takes a heavy toll on the health of the caregivers themselves,” said Monica Moreno, senior director of Care and Support for the Alzheimer’s Assoc. “During the course of the disease, caregiving tasks escalate and become more intensive. Alzheimer’s and dementia caregivers are often managing multiple conditions, including memory loss, co-morbidities, loss of mobility, reduced communication skills, and behavioral and personality changes.”

Alzheimer’s Caregiving by the Numbers

• More than 11 million people in the U.S. are providing unpaid care to a person living with Alzheimer’s or dementia.
• Eighty-three percent of the help provided to older adults in the U.S. comes from family members, friends, or other unpaid caregivers.
• Nearly half of all caregivers (48%) who provide help to older adults do so for someone with Alzheimer’s or another dementia.
• Among primary caregivers of people with dementia, more than half take care of their parents.
• Approximately two-thirds of caregivers are women, and one-third of dementia caregivers are daughters.
• Approximately one-quarter of dementia caregivers are ‘sandwich generation’ caregivers, meaning they care not only for an aging parent, but also for children under age 18.
• In 2022, the lifetime cost of care for a person living with dementia was $377,621.
• Seventy percent of the lifetime cost of care is borne by family caregivers in the forms of unpaid caregiving and out-of-pocket expenses.
• Forty-one percent of caregivers have a household income of $50,000 or less.
Source: Alzheimer’s Assoc.

Across the country, 59% of dementia caregivers report high to very high emotional stress due to caregiving, and 38% report high to very high physical stress due to caregiving. Seventy-four percent of dementia caregivers report they are “somewhat concerned” to “very concerned” about maintaining their own health since becoming a caregiver.

To help caregivers balance competing priorities while maintaining their overall health and well-being, the Alzheimer’s Assoc. offers these tips:

• Find time for yourself. It’s normal to need a break from caregiving duties. No one can do it all by themselves. Consider taking advantage of respite care or help from family and friends to spend time doing something you enjoy.

• Become an educated caregiver. Understand the disease, its progression, and accompanying behavioral and physical changes. Know resources in your community that can help.

• Build a support network. Organize friends and family who want to help provide care and support. Access local caregiver support groups or online communities such as ALZConnected to connect with other caregivers. If stress becomes overwhelming, seek professional help.

• Take care of yourself. Try to eat well, exercise, and get plenty of rest. Making sure that you are healthy can help you be a better caregiver.

• Accept changes. Eventually, your loved one will need more intensive kinds of care. Research care options now so you are ready for the changes as they occur.

• Know you’re doing your best. It’s normal to lose patience or feel like your care may fall short sometimes. You’re doing the best you can. For support and encouragement, consider joining an online or in-person support group.

“As difficult as it may be, caregivers need to make their health and well-being an equal priority,” Moreno said. “Maintaining your health can help you be a better caregiver. No caregiver should face this disease alone. The Alzheimer’s Association is here to help.”

The Alzheimer’s Assoc. provides local support and programs to families facing this devastating disease, including a 24/7 helpline staffed by master’s-level clinicians and specialists who are available 365 days a year and can help families navigate a variety of disease-related issues. Call (800) 272-3900.

Healthcare News Special Coverage

Peace of Mind

Allison Baker

Allison Baker says the Atrium at Cardinal Drive aims to both give residents a high quality of life and take stress away from their loved ones.

It’s a moment so many families dread — until they come out on the other side.

“There’s a lot of anxiety. There’s a lot of guilt,” said Allison Baker, director of Community Relations at the Atrium at Cardinal Drive in Agawam, about the decision to move a loved one — usually a parent or spouse — into the assisted-living facility, which specializes in memory care.

“Families can feel like they might be giving up on their loved one by moving them to a setting like ours. And I think our challenge is to show that you’re not placing your loved one in a place just to live out the rest of their life. The point of our community is to give them the best quality of life.”

Cathy Ballini, executive director of Mason Wright Senior Living in Springfield, agreed.

“I always tell families, ‘nobody shops for this until they have to shop for this.’ And there’s a lot of guilt involved when you take parents out of their home. But you have to look at the bigger picture of what’s best for them.”

What often precedes that discussion, especially with individuals with Alzheimer’s disease or another dementia, is large quantities of “caregiver burnout,” Ballini added.

“When one or two people are caring for someone, there comes a time when something is sacrificed or suffers because you’re not providing this level of care. There’s only so much one person can do to keep someone entertained. There’s only so much the television can do.

Cathy Ballini

Cathy Ballini

“That time they have left should be quality time. You’re taking the business end of the relationship and putting that on us so that you can truly enjoy your time with your with your parent, with your brother, with your spouse.”

“Coming here, they’re building friendships and trust with us so their relationship with the parent becomes what it should be,” she went on. “That time they have left should be quality time. You’re taking the business end of the relationship and putting that on us so that you can truly enjoy your time with your with your parent, with your brother, with your spouse.”

But what makes it quality time, and how does memory care differ from traditional assisted living?

Since it opened 26 years ago, the Atrium has featured two buildings with 22 apartments each, both dedicated to a memory-care model.

“We don’t divide residents based on their care level or their cognitive functioning,” Baker said. “With residents with memory loss or cognitive impairment, huge crowds can be overwhelming or overstimulating, so limiting the number of people is better for a resident. That’s why we have two neighborhoods. They have the same amenities — they both have a courtyard, they both have dining rooms, they both have the atrium area, they both have living rooms and sitting-room areas; they’re identical to one another.”

The Atrium aims to provide a level of care often associated with skilled-nursing facilities — such as two-person transfer assistance, feeding assistance, medication administration, and total care with all aspects of daily living — but in a home-like, assisted-living environment, she added. “It’s a little bit different model than most other communities, but the hope is that our residents can remain here in their home through end of life and not have to move to another setting.”

Mason Wright, like many assisted-living residences, has a neighborhood, called Reflections, dedicated to memory care on its third floor. There, “the caregivers build consistency and trust with the same people,” Ballini said. “The caregivers who are helping them out of bed in the morning are doing activities throughout the day and are serving meals to them. The routine is very important.”

That daily routine includes an extensive roster of activities that actively engage the mind. Residents in Reflections are able to join the rest of the Mason Wright community for events like entertainers, baking sessions, and other activities that anyone can enjoy, but also engage in activities exclusive to their neighborhood that are aimed at preserving cognition.

Laura Lovoie

Laura Lavoie

“Some people contact me when they’re almost at the end of their rope and they just need somebody to say, ‘it’s OK. You’ve done a great job, but there needs to be more support around them 24/7, and you need to sleep.’”

At the Atrium, Baker said, “we’re often able to pique new interest with our residents or encourage them to try something that they haven’t done, like our art therapy program, for example. Residents who have never had an interest in art or painting may be willing to try, and we have seen them partake in that and do an amazing job.”

The Atrium infuses music into many activities, she added, from bringing in professional musicians to utilizing the baby grand pianos in both neighborhoods to playing instrumental music during mealtimes.

“In memory care, music is something that resonates with pretty much the entire population, all of our residents. Not necessarily the same song or same genre, but music is something they can relate to, regardless of what stage someone’s at with dementia, Alzheimer’s, or any cognitive impairment.”

 

Helping the Helpers

Laura Lavoie straddles both the world of family caregiving and residential senior-care facilities through her consulting business, Our Dementia Life, which offers assistance to families dealing with the challenges of memory care and workshops and training to assisted-living facilities and other settings.

With the latter, “it’s really focused on relationships between the staff member and the person living with dementia so that they can give them better care,” she explained, adding that facilities are mandated to offer just two hours per year of dementia training, which isn’t nearly enough. “So many people, not only in memory care but in assisted living and independent living, have dementia, and nobody’s taught how to actually work with these people in order to support them and let them be as autonomous as possible and let them feel as empowered as possible, while still asking for help.”

Meanwhile, Lavoie said, “I also deal with families, especially people who have their loved one in their home, who are really struggling with how they can understand what’s happening, what’s going on inside their brain, and how they can communicate better so that they can care for them better.”

Sometimes those conversations lead to a realization that the family simply can’t do it alone. “Some people contact me when they’re almost at the end of their rope and they just need somebody to say, ‘it’s OK. You’ve done a great job, but there needs to be more support around them 24/7, and you need to sleep.’”

Lavoie said she got into this work almost three decades ago. “My grandfather had dementia. He had a brain tumor, and then he developed dementia because of it and lived with us for a couple of years. And I watched my mom care for him 24/7 with zero training, and she did a beautiful job, but I remember the struggles that she had.”

With people living longer and the over-65 population growing, the need for her services is only growing.

“The mindset at many facilities needs to change and grow with it, and we need people to be well-trained to work with these people in order for them to have a really good quality of life,” she told BusinessWest. “Just because you get a dementia diagnosis does not mean you stop living. Some people have dementia for many years, and why do they have to be bad years?”

She emphasized that the crux of her beliefs lies in looking at the person living with dementia and discovering — and cultivating — what they still have, rather than focusing on what has been lost. “There is a mass culture change that has to happen as the Baby Boomers begin to explode into the various realms of dementias, and I hope to be a part of that even more than I am now.”

Baker also wants to cultivate what residents enjoy, which is why residents at the Atrium are encouraged not to spend the majority of their time in their apartments, but rather in the common areas, taking part in activities that range from trivia and conversations about history to physical activities like cornhole or bowling, as well as outings to local restaurants, parks, and community events.

“We’re trying to keep our residents as engaged as possible throughout the day,” she explained, “with the understanding that we know not every single resident enjoys every single activity that we offer, but the idea is to offer such a variety that there’s something that our residents will enjoy.”

 

Being the Problem Solver

Meanwhile, what families enjoy is spending time with their loved ones without the burden of constant caregiving, Baker said.

“I often talk with families and say, ‘our goal is to relieve you of all that caregiver stress.’ We want them to be able to come and visit their loved one and just be their daughter, son, niece, nephew, husband, wife, and not be worried about whether they got their medications on time, did they take a shower, did they get whatever level of personal care that they may need? We want our families to visit their loved ones and let us worry about all of those other pieces.

“Sometimes you can visibly see the stress relieved from somebody,” she went on. “They just look so much more relaxed once their loved one acclimates.”

Ballini said the need for quality memory care is only growing, and most facilities have waiting lists — and, as a result, many people end up in nursing homes before they need to because there’s not enough spots at facilities like Mason Wright that can meet their care needs in a home-like setting. “In this age of medicine, people are living longer, and there aren’t enough beds for people.”

For the families that can access the right care, however, the rewards can be great, especially if they’re burned out on caregiving at home.

“To see someone come in, not knowing what to do with all the stress, walking through, and they’re not sure it’s right for their loved one, but then seeing their loved one a month or two later, it’s so gratifying,” Ballini told BusinessWest. “It’s nice to be the problem solver. You’re taking care of the family as much as the actual resident.”

Lavoie finds her work satisfying as well, both working with families and helping to train facility staff on how to interact with people with dementia, showing them techniques and communication skills that enhance quality of life for everyone involved.

“It’s the best thing in the world. I get these ‘a-ha’ moments all the time, where even really good care workers in facilities that are really dedicated realize they can make this person feel like they can paint again, and they come to you crying, saying, ‘you should have seen her face.’ Or families say, ‘I can’t believe this this is all it took.’ It’s just the most gratifying thing ever, and I’m thrilled to be doing it, and I just want to give more people the opportunity to learn more.”

Health Care Healthcare News

Off on the Right Foot

 

Did you include better health in your New Year’s resolutions?

Health experts at Baystate Health suggest setting realistic goals and prioritizing what is most important to you, taking small steps, and remembering not to beat yourself up if you encounter a setback in your health goals for 2024. Here are three goals to consider as you continue on your journey:

 

Improve Your Blood Sugars

From Dr. Cecilia Lozier, chief of the Division of Endocrinology and Diabetes, Baystate Health:

There are three important approaches to improve your blood-sugar numbers as we start the new year. First, moderate your carbohydrate intake. No dramatic approach is needed. If before you would take two scoops of potatoes, now consistently take one and fill the empty space with non-starchy vegetables.

Dr. Cecilia Lozier

Dr. Cecilia Lozier

“Moderate your carbohydrate intake. No dramatic approach is needed. If before you would take two scoops of potatoes, now consistently take one and fill the empty space with non-starchy vegetables.”

Second, increase your physical activity. Using your muscles will push sugar into your cells and out of your bloodstream. The more you move and are physically active, the better your numbers will look. Third, modest weight loss. Losing between 5% and 10% of your body weight will have a dramatic impact on how you metabolize sugar. Speak with your healthcare provider to personalize this approach for you.

 

Address Sleep Problems

From Dr. Karin Johnson, medical director, Baystate Health Regional Sleep Program and Baystate Medical Center Sleep Laboratory, Baystate Health:

Stress levels are higher today in the world we live in. While stress can make sleeping well more challenging, it is important to prioritize sleep, which is necessary for health and well-being. Most adults function best with seven to eight hours of sleep, and teenagers need around nine hours.

Good-quality sleep is important for preventing infections and keeping your immune system working well. Studies have shown that sleep-deprived people don’t mount the same immune response after vaccinations as good sleepers, so it is important to make sure you get a good night’s sleep prior to getting a flu or COVID vaccine, for example.

Keeping a regular sleep schedule will allow your body’s internal clock to help you get the best night’s sleep. If you are having difficulty sleeping or show signs of poor-quality sleep with loud snoring, difficulty staying asleep, urinating frequently at night, or daytime sleepiness or tiredness, you may benefit from a sleep-medicine evaluation.

 

Control Your Weight

From Eliana Terry, registered dietitian, Baystate Noble Hospital:

Is your New Year’s resolution to eat healthier, exercise more, or achieve another health-related goal? The new year brings with it the opportunity to start on a path toward wellness or, if you’ve already done so, to maintain healthy habits. However, it can be difficult to make these goals stick with all the challenges the year throws our way. What is the best way to be successful in achieving your health resolutions? Consider the following.

• Be specific with your goals. Instead of ‘I will eat healthier,’ consider something like ‘I will replace four sodas per week with water.’ Setting a more specific goal can help you actually check whether you have completed the goal each day and, thus, be successful long-term.

• Make sure your goals are measurable. If your goal is weight loss, for example, set a measurable amount with a time frame to reach your goal by. For example, ‘I want to lose 10 pounds by April 2024’ and ‘exercise for 30 minutes, three times per week’ are more measurable goals than ‘lose weight this year.’

• Make your goals realistic for you. For example, if you travel daily for work, ‘no longer eat on the go’ as a resolution may be unrealistic for your lifestyle. You may find yourself giving up by February if you have purchased any meals out. This hinders any progress you could have made in a longer period. Instead, try a more realistic and flexible goal such as ‘pack a healthy lunch to keep in a cooler four times per week.’

Set yourself up for success this year with specific, measurable, realistic resolutions. Otherwise, you may find yourself quickly frustrated by your inability to stick to and achieve your goals.

Healthcare News Special Coverage

One Workout at a Time

By Emily Thurlow

Steve Conca

Steve Conca, owner of Conca Sport and Fitness

Between platefuls of coma-inducing turkey, complete with all the fixings, and palatable pies and pastries, it’s safe to say that many people are happy to see the hearty overindulgences of the 2023 holiday season firmly in the rear-view mirror.

For many, the start of the new year provides an opportunity to start out on the right foot, by developing better habits and establishing goals. Through myriad resolutions, one theme that tends to stand out year after year is health.

Notably, an October 2023 survey from Forbes Health/OnePoll revealed that 48% of U.S. adults say improving fitness is a top priority for them in 2024. Google Trends also released data showing that some of the top health-related searches in January include meal preparation, healthy meal ideas, and gym memberships.

And while some say they resolve to lose weight or improve their health in January, it often takes another month before they will deliver, said Danny Deane, who owns two local F45 Training franchises with his wife, Jessye.

“February is the number-one month in the fitness industry, with September being second,” he said. “In January, everybody starts to think about it, and then, by the time February rolls around, they’re really making good on their promise.”

Whether it’s during the winter doldrums or as the leaves begin to turn in the fall, local fitness studios and gyms continue to see positive gains in this post-pandemic climate — in both their business and their clients.

“I think people are realizing that putting an investment into themselves pays big dividends.”

“I think people are realizing that putting an investment into themselves pays big dividends,” said Steve Conca, owner of Conca Sport and Fitness in West Springfield.

During the pandemic, gyms and fitness centers were severely challenged by shutdowns and limitations on the amount of people in a space at any given time. For some, the impact was minimal. For others, it’s been rather extreme.

F45 Training

One key to success at gyms like F45 Training is accountability with a workout partner.

In fact, 25% of fitness studios and gyms have closed permanently since the onset of COVID-19, according the National Health & Fitness Alliance, an industry group.

However, Jon Davis, owner and performance director of Powerhouse Training in East Longmeadow, said business is “as good as it ever has been.”

Powerhouse Training, which Davis founded in 2010, offers sports-specific lessons for baseball and softball athletes as well as general performance training in speed, agility, strength, and mobility. The majority of his clientele includes athletes between age 8 and pro-rank levels.

Because Powerhouse Training provides more of a specialized kind of exercise regimen, Davis said he didn’t see the decline in attendance that many commercial gyms did. He said he’s also found that parents are valuing their children’s access to being physically active.

“I think a lot of parents realize the importance of having their kids get outside and socialize and stay active, for not only their physical health, but also their mental health,” he told BusinessWest. “Since we provide more of a specialized training, the kids really can’t train on their own, and they need assistance as well as special equipment, and they need a lot more space. So I think we were a necessity for them, which has certainly helped out.”

The group training, which involves youth athletes coming in two to three times a week, costs between $145 and $195 per month. Prices range between $50 and $90 for baseball lessons and $50 and $75 for fitness training.

 

Investing in Health

For the most part, Conca’s entire membership stuck with his gym. He expressed gratitude for the tight-knit community, or “family,” that is Conca Sport and Fitness, which first opened in 2009.

For months, all the personal training and small-group training was done outside. Unlike more recent weather patterns, the forecast remained relatively sunny, with little precipitation. And once the clouds of the pandemic restrictions cleared, he actually saw a slight resurgence.

“People are always going to want the newest, latest, and greatest thing — and, certainly, some of those innovations are really helpful — but honestly, I think learning good form and focusing on staying balanced, working mobility, and strength training will never get old.”

“I think it’s opened people’s eyes to realize, ‘I really wasn’t taking great care of myself,’ so it’s led them to want to invest in themselves,” he said. “Here, we call investing in yourself a health savings account. The more you can put in now, the more you can reap the benefits.”

In addition to personal training and group training, Conca Sport and Fitness also offers health nutrition and wellness coaching. Memberships range between $209 to $349 a month, with individual sessions ranging between $20 to $37.

“When people come here, they aren’t just going to bang out a few workouts, high-five, fist-bump, and ‘see ya later,’” he said. “It’s a whole process that includes teaching people how to take better care of themselves as they age.”

As for the Deanes, the couple, who opened their first gym, F45 Training Hampshire Meadows in Hadley in 2018, decided to open a second location in West Springfield in 2020.

“A lot of doors closed throughout the last couple years in the fitness world, but we are lucky enough to be on the other side of it and are actually above pre-COVID numbers at Hampshire Meadows,” Danny said. “We made it through.”

The 45 in F45 stands for 45 minutes of functional fitness, with sessions led by two personal trainers in a motivating team environment, said Jessye Deane, who is also executive director of the Franklin County Chamber of Commerce and Regional Tourism Council.

F45 Training does not employ heavy equipment or machinery

F45 Training does not employ heavy equipment or machinery, but it does include the use of kettlebells, free weights, and body-weight-based movements.

“The goal is really functional fitness. It’s scalable and adaptable, so it fits every fitness level,” she said. “A lot of times, what we hear is that folks go to the gym and want to get healthier, want to be able to move better, and want to be able to feel better, but they don’t quite know how to work the machines or they don’t know what they’re doing, and they get hurt, or they get frustrated. And this is kind of the answer to that. All you have to do is walk through the door, and we will take it from there.”

Every day, the gym features a different workout. F45 Training does not incorporate heavy equipment or machinery, but it does include the use of kettlebells, free weights, and body-weight-based movements.

The workouts for the Australian-based franchise combine elements of high-intensity interval training, circuit training, and functional training. The West Springfield location also currently offers a free seven-day trial, and the Hadley location is offering a seven days for $7 offer.

Trends come and go, but according to the area gym owners BusinessWest spoke with, having a healthier lifestyle comes down to the basics.

“People are always going to want the newest, latest, and greatest thing — and, certainly, some of those innovations are really helpful — but honestly, I think learning good form and focusing on staying balanced, working mobility, and strength training will never get old,” Davis said. “I think those tend to produce the best results.”

Conca agreed, noting that, as people age, he explained, they lose strength, muscle mass and function.

“Father time just begins chipping away,” Conca said. “That’s why maintaining muscle mass and strength levels — the fundamentals — is super important. I’d argue that it’s more important than so-called cardio, because you can get a good cardiovascular response with some very good strength training.”

According to the National Institutes of Health, muscle mass decreases approximately 3% to 8% per decade after age 30. After age 60, the rate of decline is even higher.

While F45 workouts have the adaptability to pull in emerging trends, Jessye Deane emphasized that trends are not the mainstay of the gym.

“We want you to feel great now, and we want you to feel great in 20 years — that’s our motivator,” she said. “The focus of our programming is to make sure that we’re providing people the safest, most effective functional fitness workout they can have.”

One way F45 workouts tap into recent trends is through supersets, she added. A superset includes performing a set of two different exercises back to back with little to no rest in between. One example of this would be doing a set of 10 push-ups, followed immediately by pull-ups.

 

Sticking with It

Finding motivation to stick with any new habit can be difficult, of course. It can potentially be even harder when the only opportunity to dedicate time to fitness is before the sun rises or well after it sinks below the horizon. That time crunch, combined with inclement winter weather, can make someone want to shed their new goal before they even begin.

One way Conca and the Deanes have seen clients stick with their fitness routines is by not doing it alone.

“Accountability is key. Having a group of people that you’re excited to see every day helps,” Jessye Deane said, adding that her husband is her workout partner. “Danny is my accountability partner. He wakes me up every morning whether I want to or not.”

At Powerhouse, Davis coaches each athlete differently based on their personality. Some kids may require more positive affirmation to help build their confidence, while others require him to be blunt and upfront and tell them directly what they’re doing incorrectly.

“It’s getting to know these athletes — getting to know what they like, what they don’t like, what motivates them, and then trying to find out what makes them tick and make sure that, when it’s time to push, we know what button to push,” he explained.

Throughout his tenure, Davis has produced more than 100 All-Western Mass. high-school all-stars, 13 All-Americans at the high-school and collegiate levels, and three Western Mass. Players of the Year in football, baseball, and girls lacrosse. He’s also helped produce 10 Major League Baseball draft picks out of the high-school ranks, including Isan Díaz and Seamus Curran.

At Conca’s gym, motivational phrases festoon the walls, including quotes from famous folks ranging from Wayne Gretzky to Amelia Earhart. The gym also features a so-called ‘strong wall’ that includes one-word motivational phrases that clients create to help drive their personal success. At the time of this interview, Conca was still tinkering with the specifics of the acronym LIFT, with the goal of lifting others up.

For those looking to dip their toe into the fitness and exercise pool, Jessye Deane said anytime is a good time to start.

“There is nothing more important than your health,” she told BusinessWest. “Whether you’re working out at an F45 or you’re doing yoga or you’re visiting any of the wonderful studios in the Valley, we really want people just to feel better and be healthier.”

 

Healthcare News

Gone to the Dogs

Melinda Harris has always wanted to work with animals.

“That was never a question in my mind,” she said. “My grandfather had dogs and birds and everything else. My mom always joked that I got it from him because he was the animal lover. I had dogs and cats growing up, and as soon as I was in high school and I had the option of taking physics or doing an internship at a veterinary hospital, well, guess which one I picked?”

She’s had a winding path in animal care since then, all of which led her to the culmination of a dream: opening Power Paws Canine Rehabilitation in Granby last spring.

“I was booked up for a month solid before I even opened the doors,” she told BusinessWest. “And I have never not been booked less than two or three weeks out since then. So it’s been really busy.”

Harris’s canine patients have ranged in age from 6 months to 18 years, and they’re brought in for a variety of reasons.

“It’s definitely a mix. There are different kinds of knee surgeries out there, and I’ll see dogs that have had any one of them. I have dogs that come in that are trying to avoid knee surgery, so we’re trying to build up and strengthen that leg so they don’t need to go forward with surgery. I’ve had hip surgeries, and I’ve had geriatric dogs that come in for conditioning and to keep their strength up. I’ve had neurologic cases like strokes.

“And I’ve had a few agility dogs and working dogs that want to keep their strength up so that they can compete at a high level,” she continued. “I have a couple of FEMA dogs, search and rescue, that come in, and they’re very strong. So they go in the underwater treadmill and run for 20 minutes, and it helps keep them strong.”

“I was booked up for a month solid before I even opened the doors. And I have never not been booked less than two or three weeks out since then. So it’s been really busy.”

Harris offers a series of treatment packages targeted to each patient’s needs, starting with an in-depth consultation and plan, which may include a combination of exercise equipment, an underwater treadmill, and laser therapy.

“Almost every dog, unless they’re coming in for general conditioning, will get a laser treatment on whatever is bothering them,” she said. “And then we’ll do different exercises depending on what the condition requires; they’re beneficial for so many different things. And I would say 90% of the clients will also use the underwater treadmill; that has been fantastic for a lot of dogs.”

The device, which offers different levels of resistance through both the moving tread and the water, isn’t exactly the fun part of the session.

“People ask me, ‘do you have a hard time getting them to go in there? Do they fight you?’ I mean, some of them get a little upset when they first go in. They might try to climb out or splash, but I haven’t had a dog yet that I haven’t been able to train to accept the treadmill.”

Part of Harris’s training and expertise, obviously, has to do with how she handles the dogs.

“Generally speaking, my rule of thumb is, I don’t force a dog to do anything,” she explained. “So if a dog doesn’t want to do something, we’ll find a different way to do it, or we’ll skip that altogether. So maybe the first or second visit, we don’t go in the treadmill. Or maybe we throw some cookies in, let them go in and sniff it out, and when they seem more comfortable with me, then we’ll go in the treadmill and see what the dog is willing to do.

Melinda Harris

Melinda Harris stands beside the water treadmill at Power Paws.

“But I don’t muzzle dogs, and I don’t force them to do things, because we have to have a working relationship for weeks and months, and if they’re afraid of me, it’s not going to work,” she went on. “So everything is very treat-based, play-based — and the dogs are absolutely looking forward to running in the door when they get here.”

 

Animal Attraction

It helps that Harris has loved animals all her life. After high school, she took a year off, working at a pet store and as a groomer — “I’ve always been working with animals, even if it’s not in the veterinary setting” — and then went back to school, earning a certification in veterinary science in 2003.

“I was a veterinary nurse for about six years, working at Southwick Animal Hospital,” she recalled. “The owner/doctor there had another doctor coming in and doing orthopedic surgeries, and she said, ‘why don’t you check out this class on rehab and see if you like it?’ So I said, ‘sure.’”

As it turned out, Harris loved the class and decided to seek certification in that specialty, so she enrolled a program at the University of Tennessee, which, beyond the classwork, involved a 200-hour internship, six case studies, practical work, and more, and in 2009, she became a certified canine rehabilitation practitioner.

Three years later, she took a job with Riverbend Animal Hospital in Hadley, working for Dr. David Thomson, one of the region’s foremost animal surgeons. Her initial role there was in wellness and as a technician, but a few months in, she began doing rehab work.

“He really let me do what I needed to do for rehab; I set all the programs up, I did all the post-op care, all that kind of stuff, and started making connections with local veterinarians, and they would start referring some of their patients over to me as well, outside of Dr. Thomson,” she said. “And after doing that for about six years or so, I thought, this is a really good business model.”

“Everything is very treat-based, play-based — and the dogs are absolutely looking forward to running in the door when they get here.”

She also knew there weren’t many full-service canine rehabilitation practices in the region, so she could fill a need by opening her own. But at first, she struggled to find the right location, one that offered her the space and amenities she needed at an affordable price.

“And right about this time last year, I was driving by, and this place was for lease. I thought, it’s a really good standalone building that could be perfect for rehab. So I called up the number on the sign, I got right in, and I fell in love with it instantly. I knew this was absolutely the space that I want to do rehab in.”

After a few months building it out with new walls and flooring, paint, and other renovations, Harris opened Power Paws on April 3, and she hasn’t regretted the move once. “It’s been a crazy year. After nine months, it’s just as successful as I thought it was going to be.”

The job is one of constant learning and evolution, too.

For example, “laser therapy used to be much different when I first went to school for it. It was much lower power, there wasn’t a lot of science behind it, and a lot of research since then has gone into what wavelengths and joules and energy are most effective for different things. And now I can just put in a condition, the size of the dog, the color of the dog, and it gives me exactly what I need, which is really helpful. So that’s definitely come a long way.”

In addition, she explained, shockwave treatments have long been helpful for tendon and ligament injuries, but the dogs had to be fully anesthetized because it was painful and very loud, so it wasn’t cost-effective for a lot of people. But now, mobile units are available that don’t require anesthesia. “Someday, I’ll get that here — I don’t have it quite yet — but that’s been a big change for sure.”

Beyond technology, Harris also attends continuing-education classes in rehab each year, while drawing on ideas from other sources as well.

“I’m always learning new exercises that I can do with dogs because there are so many smart people in the world that have put together videos and blogs, and every day, I’m just constantly learning — how can I make this dog better? What’s a different exercise I can do that would make a bigger difference for this dog? It’s a really great community out there where everybody shares information and collaborates, which is really nice.”

 

Pet Project

Not surprisingly, the most gratifying part of Harris’s job is seeing how happy the dogs are when they come in — and seeing them gradually grow stronger and healthier.

“I really love seeing them yanking their owners across the parking lot to come in because they want to come in and play, and I love seeing them get better, having them go from withdrawn and not engaging much with their owners, because they’re in pain, to figuring out what’s painful, treating that, and turning them into a dog the owners forgot they had. That’s really, really rewarding.”

The dog owners are often surprised at the effectiveness of properly targeted rehab, she added.

“Usually they’re pretty blown away after a few treatments. They’re like, ‘they’re so much better, and they’re doing this thing that they never did in a long time,’ or ‘they’re playing with toys again; they’re playing with the other dog.’ It’s great to hear the stories of how much happier their dog is.”

Harris still works one day a week at Riverbend, and appreciates how supportive Thomson has been in her reaching her goal of owning a business.

“He’s retiring soon, so it was a good time for me to transition out and do my own thing here,” she said. “I’m very grateful and very lucky to be here.”

Healthcare News Special Coverage

Bridging the Gap

By Emily Thurlow

With classic Christmas carols softly emanating from a TV across the room and an Irish wolfhound named Veren panting rhythmically a short distance behind her, Barbara Chiampa pedaled a stationary bicycle on a recent afternoon at Mont Marie Rehabilitation & Healthcare Center’s therapy gym.

With guidance from Reliant Rehabilitation physical therapy assistant Tara McCauley, Chiampa was working on improving her balance and walking. After noting improvement in her gait and movement with a handheld assist, Chiampa paused for a few kisses from Veren, a 2-year-old therapy dog.

The staff at the Holyoke facility benefits from the canine too, said his handler, registered occupational therapist Sylvia Korza of Reliant Rehabilitation. “He comes to work with me, and he loves everybody. He’s great for therapy — even the staff. He helps lift everyone’s mood.”

The gym, which was expanded in 2016, features several pieces of equipment dedicated to improving mobility, including parallel bars and practice stairs. Beyond the machines, the therapy gym offers opportunities for McCauley and Korza to customize regimens that are tailored to the specific needs of patients recovering from medical procedures, injuries, or illnesses.

The therapy offered at the center’s gym is one of multiple subacute rehabilitation care services offered at the 84-bed Mont Marie facility, which was built in 1962 and formerly owned and operated by the Congregation of the Sisters of St. Joseph. In 2014, Mont Marie was purchased by Tryko Partners, which is headquartered in New Jersey, and is managed by its healthcare subsidiary, Marquis Health Consulting Services. Mont Marie is one of 10 of Marquis’ facilities in Massachusetts.

In recent years, the licensed nursing facility’s short-term rehabilitation care services have continued to grow, adding new programs and certifications, to meet the growing needs of the community.

A need for subacute or short-term rehabilitative care can emerge after a hospital stay for hip surgery or a stroke, or if an individual needs some physical strengthening or medication management, said Natasha Pieciak, administrator at Mont Marie.

“Baby Boomers are getting older, so as the population ages, there’s more of a demand for supportive services. We’re not a hospital — we’re kind of like a step down; we’re supportive services to bridge that gap between home-care services and the hospital.”

Initially, the 26-bed first floor was dedicated to this service, but it has since expanded to the 29-bed second floor as well. At times, admissions have jumped as high as 50 per month.

“There are a lot of factors that influence this growth,” said Pieciak, who has served as administrator of the center since September 2022. “Baby Boomers are getting older, so as the population ages, there’s more of a demand for supportive services. We’re not a hospital — we’re kind of like a step down; we’re supportive services to bridge that gap between home-care services and the hospital.

“With the aging population, I think these services become more needed out in the community, so we’re here to support people in that way, so they can be successful at home. People want to be at home, so we’re really here to try to support them to get them ready to do that.”

Barbara Chiampa

Barbara Chiampa pedals an exercise bicycle at Mont Marie Rehabilitation & Healthcare Center in Holyoke.

Through Mont Marie’s partnerships with Baystate Medical Center in Springfield and Holyoke Medical Center, as well as referrals from Mercy Medical Center in Springfield and Cooley Dickinson Hospital in Northampton, Pieciak said Mont Marie has been made aware of the growing demand for these rehabilitative services.

“We work closely with our partners within the hospital systems; we collaborate,” she said. “With Baystate, for example, we have weekly calls with their accountable-care organization management team, who will follow a patient from hospital to home, and we communicate with them, and they tell us what they’re seeing, what their needs are. We’re just really building that relationship and working with them to help identify and meet the needs that we’re seeing out in the community.”

“The goal of these specialty programs is to educate and train the residents how to manage and live with their conditions.”

In working with Baystate, Pieciak said Mont Marie has become one of two skilled-nursing facilities that have qualified for a waiver for the three-day requirement under the Medicare Shared Savings Program. The waiver eliminates the requirement to have a three-day inpatient hospital stay prior to a Medicare-covered, post-hospital, extended-care service.

What this means, Pieciak explained, is that, if a patient is in a hospital emergency department but don’t have a three-day stay, instead of going back home and potentially falling or fracturing a hip, they could go to Mont Marie as long as they meet a skilled need.

“This is huge because there’s a gap there,” she said. “Residents would go home and could potentially have worse outcomes. What we’re doing is bridging that gap from hospital to home.”

In addition to physical and occupational therapies, Mont Marie’s subacute rehab offers speech therapy up to seven days a week.

 

Life Goals

Within its major focus on subacute rehabilitation care, Mont Marie offers three specialty programs: cardiopulmonary, chronic kidney disease management, and heart failure.

“The goal of these specialty programs is to educate and train the residents how to manage and live with their conditions,” Pieciak said.

Natasha Pieciak

Natasha Pieciak says Mont Marie works closely with its partners within hospital systems.

The cardiopulmonary rehabilitation program is physician-led under the direction of a pulmonologist and focuses on helping patients achieve the most active life possible despite any physical limitations and/or cardiopulmonary diagnoses. The program, which is geared toward individuals with diagnoses of chronic obstructive pulmonary disease (COPD), post-lung transplants, emphysema, and acute respiratory failure, offers access to lab and radiology services, tracheostomy care and management, nebulizer therapies, bladder scanning, and several oxygen therapies, including liquid nitrogen.

The renal program is focused on reducing symptoms of chronic kidney disease, increasing a patient’s quality of life, and promoting independence. Mont Marie offers onsite dialysis provided by American Renal Associates, consultative visits by staff nephrologists, diabetic management and education, a monthly support group, and health coaching.

In October, Mont Marie received its skilled-nursing facility heart-failure certification from the American Heart Assoc. (AHA). In order to be considered eligible for this certification, facilities must be located in the U.S. or a U.S. territory and implement a heart-failure program that uses a standardized method of delivering clinical care based on current evidence-based guidelines.

“This was a huge accomplishment,” Pieciak said. “There are very few facilities that are credentialed. The American Heart Association has armed us with innovative methods and additional tools so that we can be trailblazers and give our heart-failure patients the best care.”

The vetting provides an evidence-based framework for evaluating skilled-nursing facilities against the AHA’s science-based requirements for heart failure patients, including care coordination, clinical management, quality improvement, program management, and patient and caregiver education and support.

According to the AHA, nearly one in four heart failure patients are readmitted within 30 days of discharge, and approximately half are readmitted within six months. It has also been suggested that about 25% of readmissions may be preventable.

“We’re trying to get ahead of hospital readmissions,” said Raymonda Sample, the lead for the heart-failure program and unit manager.

With the certification, Mont Marie has been provided with access to centers on treating heart failure and its co-morbidities.

Sample noted that one of the biggest benefits to the staff’s education on the heart-failure program is being able to educate patients on how they can live more independently with fewer flareups of their disease.

To that end, Mont Marie uses what’s called a ‘zone tool.’ The traffic-light color-coded guide indicates an all-clear, or green, when a patient has no shortness of breath; chest pain; swelling of the feet, ankles, legs, or stomach; or weight gain of more than two pounds. It’s time to call a doctor if a patient is in the so-called warning (yellow) zone, when they’re experiencing dizziness; dry, hacking cough; more shortness of breath; uneasy feelings; no energy; difficulty breathing when lying down; swelling of the feet, ankles, legs, or stomach; or weight gain of three or more pounds in one day or five pounds in one week.

A medical alert, or red zone, is when the previous symptoms have been exacerbated and a patient is having a hard time breathing or is experiencing unrelieved shortness of breath while sitting still, chest pain, or confusion.

In addition to this tool, Sample has created an entire guide board for staff that she also uses to educate family members of patients. The tool helps provide a better continuity of care, she explained.

“With this education, we are able to identify how the patient is feeling for the day,” she said. “If say, the patient is in the middle of therapy and they’re feeling short of breath, or telling the therapist maybe they haven’t eaten much in the last couple of days, or not sleeping well — there’s a sort of board out there where you can see the different signs and symptoms of heart failure.”

 

Safe at Home

Even though a patient has a plan in place to be discharged from the facility following treatment at Mont Marie, care doesn’t end at the door.

“When we discharge patients, we do follow-up calls with the patient just to find out how the transition back home goes, the home care services … we make sure they’re seen by their primary-care physician within 10 days, and if they don’t have a scale, we make sure we send them home with one,” Sample said. “This is so both our patients and the staff recognize the signs and symptoms of heart failure, so we can try to avoid rehospitalization.”

Health Care Healthcare News

An Unsustainable Path

 

The Massachusetts Health Policy Commission (HPC) recently voted to issue the 2023 Health Care Cost Trends Report and comprehensive policy recommendations.

Notably, the HPC reports that the average expense of employer-based private health insurance in 2021 climbed to $22,163, outpacing growth in wages and salaries. Including co-payments, deductibles, and out-of-pocket spending, healthcare costs for Massachusetts families neared $25,000 annually. The HPC found that 72% of small-business health-insurance plans featured deductibles exceeding $2,800 for families (or $1,400 for individuals) in 2021, with annual family premiums simultaneously surging from $16,000 to $23,000 since 2012.

The report highlights the unequal burden of these trends, finding persistent disparities across income and racial/ethnic groups, with nearly one in five lower-income residents having high out-of-pocket spending, for example, and significantly higher infant-mortality rates and rates of premature deaths from treatable causes among Black and Hispanic residents compared to other residents. To address these complex and interrelated challenges, the HPC calls for urgent action to update the state’s policy framework to more effectively contain cost growth, alleviate the financial burden of healthcare costs on Massachusetts families, and promote equity in access to care and outcomes for all residents.

“Policymakers do not have to choose between high-quality care and affordability. We have tremendous opportunities for transformative action to support patients and employers.”

“The 2023 Health Care Cost Trends report makes clear how we must do more in Massachusetts to provide more affordable and equitable access,” said Deb Devaux, HPC board chair. “Policymakers do not have to choose between high-quality care and affordability. We have tremendous opportunities for transformative action to support patients and employers.”

Among the report’s findings were that, on average from 2019 to 2021, total healthcare spending increased 3.2% per year, higher than the 3.1% healthcare cost growth benchmark. Commercial spending grew by 5.8% per year, far outpacing the national average in a reversal of prior years of relatively slower growth.

Commercial expenditures for prescription drugs and hospital outpatient care grew the fastest; the average price per prescription for branded drugs exceeded $1,000 in 2021, up from $684 in 2017, while the average commercial price for hospital outpatient services grew by 8.4% from 2019 to 2021.

The average price for many common hospital stays also increased, with most growing by 10% or more over the same period. The HPC estimates that, by eliminating excessive spending due to unreasonably high prices, overuse of high-cost sites of care, and overprovision of care, the Commonwealth could see systemwide savings of nearly $3.5 billion annually.

 

Policy Recommendations

With the report, the HPC announced nine policy recommendations.

“The residents of the Commonwealth deserve a policy framework equal to the novel challenges facing our healthcare system today,” said David Seltz, HPC executive director. “The recommendations in this report provide a roadmap for policymakers to equip the state with the tools it needs to constrain healthcare cost growth equitably and sustainably in a manner that meaningfully addresses existing disparities in access and outcomes.”

The HPC recommends the following reforms to reduce healthcare cost growth, promote affordability, and advance equity, with an emphasis on modernizing the state’s nation-leading benchmark framework.

• Modernize the Commonwealth’s benchmark framework to prioritize healthcare affordability and equity for all. As recommended in past years, the Commonwealth should strengthen the accountability mechanisms of the benchmark, such as by updating the metrics and referral standards used in the performance improvement plan (PIP) process and enhancing transparency and PIP enforcement tools. The state should also modernize its healthcare policy framework to promote affordability and equity, including through the establishment of affordability and equity benchmarks.

David Setz

David Setz

“The residents of the Commonwealth deserve a policy framework equal to the novel challenges facing our healthcare system today.”

• Constrain excessive provider prices. As found in previous cost-trends reports, prices continue to be the primary driver of healthcare spending growth in Massachusetts. To address the substantial impact of high and variable provider prices, the HPC recommends the Legislature enact limitations on excessively high commercial provider prices, require site-neutral payments for routine ambulatory services, and adopt a default, out-of-network payment rate for ‘surprise billing’ situations.

• Enhance oversight of pharmaceutical spending. The HPC continues to recommend that policymakers take steps to address the rapid increase in retail drug spending in Massachusetts with policy action to enhance oversight and transparency. Specific policy actions include adding pharmaceutical manufacturers and pharmacy benefit managers (PBMs) under the HPC’s oversight, enabling the Center for Health Information and Analysis to collect comprehensive drug-pricing data, requiring licensure of PBMs, expanding the HPC’s drug-pricing review authority, and establishing caps on monthly out-of-pocket costs for high-value prescription drugs.

• Make health plans accountable for affordability. The Division of Insurance (DOI) should closely monitor premium growth factors and utilize affordability targets for evaluating health-plan rate filings. Policymakers should promote enrollment through the Massachusetts Connector and the expansion of alternative payment methods (APMs). Lower-income employees should be supported by reducing premium contributions through tax credits or wage-adjusted contributions.

• Advance health equity for all. To address enduring health inequities in Massachusetts, the state must invest in affordable housing, improved food and transportation systems, and solutions to mitigate the impact of climate change. Payer-provider contracts should promote health equity via performance-data stratification and link payments to meeting equity targets. Payers should commit to the adoption of the data standards recommended by the Health Equity Data Standards Technical Advisory Group, and efforts should be made to ensure that the healthcare workforce reflects the diversity of the state’s population.

• Reduce administrative complexity. The Legislature should require standardization in payer claims administration and processing, build upon the momentum from recent federal initiatives to require automation of prior authorization processes, and mandate the adoption of a standardized measure set to reduce reporting burdens and ensure consistency.

• Strengthen tools to monitor the provider market and align the supply and distribution of services with community need. The HPC recommends enhanced regulatory measures including focused, data-driven assessments of service supply and distribution based on identified needs and updates to the state’s existing regulatory tools, such as the Essential Services Closures process, the Determination of Need (DoN) program, and the HPC’s material change notice oversight authority.

• Support and invest in the Commonwealth’s healthcare workforce. The state and healthcare organizations should build on recent state investments to stabilize and strengthen the healthcare workforce. The Commonwealth should offer initial financial assistance to ease the costs of education and training, minimize entry barriers, explore policy adjustments for improved wages in underserved areas, and adopt the Nurse Licensure Compact to simplify hiring from other states. Healthcare delivery organizations should invest in their workforces, improve working conditions, provide opportunities for advancement, improve compensation for non-clinical staff (e.g., community health workers, community navigators, and peer recovery coaches), and take collaborative steps to enhance workforce diversity.

• Strengthen primary and behavioral healthcare. Payers and providers should increase investment in primary care and behavioral health while adhering to cost growth benchmarks. Addressing the need for behavioral-health services involves measures such as enhancing access to appropriate care, expanding inpatient beds, investing in community-based alternatives, aligning the behavioral-health workforce to current needs, employing telehealth, and improving access to treatment for opioid-use disorder, particularly in places where existing inequities present barriers.

 

Key Findings

Prices continue to be the primary driver of healthcare spending growth in Massachusetts. In the report, the HPC identifies price, rather than utilization, as the primary driver of the increase in spending. Commercial prices grew substantially from 2018 to 2021, with an 8.8% increase for office-based services, a 12.1% rise for hospital outpatient services, and a 10.2% uptick for inpatient care. Total payment per hospital discharge for commercially insured patients grew by 23% between 2017 and 2021, primarily driven by a 34% price increase for non-labor-and-delivery discharges.

HPC’s analyses of excess spending found that private insurers paid providers more than twice what Medicare would have paid for nearly 40% of all lab tests and imaging procedures in 2021. Taken together, commercial spending on lab tests, imaging procedures, inpatient hospital stays, clinician-administered drugs, endoscopies, prescription drugs, and certain specialty services accounted for 45% of commercial spending. Among this spending, 27% was in excess of double what Medicare would have paid (or 120% of international drug prices), equivalent to approximately $3,000 annually for a family with private insurance.

Other findings include:

• Unnecessary utilization of care, such as procedures that could be performed in more cost-effective ambulatory surgery centers, care that provides no clinical benefit to patients, and low-risk births in academic medical centers that are reimbursed at higher rates than those in community hospitals, contribute to excessive spending.

• Administrative spending of both hospitals and insurers has increased substantially, with hospital administrative costs nearly doubling from 2011 to 2021 and insurers experiencing growth in administrative spending for both small- and large-group coverage.

• Escalating price trends are evident from 2018 to 2021, with commercial prices increasing for various services, including office services, hospital outpatient care, and inpatient services. Payments for inpatient hospital care grew by 23%, driven primarily by non-labor-and-delivery discharges.

• Variation in provider organization performance continues, with medical spending differing widely between major provider groups and the rate of avoidable visits and imaging utilization varying significantly.

• Massachusetts maintains the highest hospital-utilization rate for Medicare beneficiaries among all states, as well as higher statewide rates of inpatient stays, outpatient visits, and emergency-department visits. The Commonwealth also ranks among the highest in the nation in preventable hospitalizations and readmission rates.

• Between 2017 and 2021, primary-care spending grew more slowly than other medical spending, leading to a decrease in primary care’s share of total commercial spending. Meanwhile, significant disparities in access to primary care between low- and high-income communities persist.

• Behavioral-health trends show a substantial increase in psychotherapy visits and mental-health prescriptions among young adults, alongside a rise in the proportion of patients admitted to acute-care hospitals for mental-health conditions. While opioid-related hospitalizations declined overall, Black non-Hispanic residents experienced persistent increases until 2020.

Healthcare News Special Coverage

Building Blocks for the Future

Dr. Lynnette Watkins

Dr. Lynnette Watkins called 2023 a rebuilding year and a time for “getting back to basics.”

 

As she talked about the relative fiscal health of hospitals, and especially Cooley Dickinson Hospital (CDH) in Northampton, which she serves as president and CEO, and the outlook for the coming year, Dr. Lynnette Watkins looked back on 2023 and described it with phrases often reserved for struggling sports teams — yes, like the one in Foxboro.

“It’s been a very challenging year,” she told BusinessWest. “It was definitely a rebuilding year, with a lot of focus on getting back to basics, and getting to what I would call a new normal.”

While we’re used to hearing those terms in sports, they work in healthcare, and especially when it comes to hospitals, said Watkins and others we spoke with.

Indeed, hospitals are rebuilding from several years of turmoil, falling revenues, rising costs, and struggles with recruiting and retaining a workforce. Many of these issues predate the pandemic, to one extent or another, but COVID certainly exacerbated the problems.

Dr. Mark Keroack, president and CEO of the Baystate Health system, which includes four hospitals — Baystate Medical Center in Springfield, Baystate Noble Hospital in Westfield, Baystate Franklin Medical Center in Greenfield, and Baystate Wing Hospital in Palmer — put things in perspective with some eye-opening numbers.

“It’s been a very challenging year. It was definitely a rebuilding year, with a lot of focus on getting back to basics, and getting to what I would call a new normal.”

He said the Baystate system, which also includes the health insurer Health New England, a range of physician practices, and a home-health agency (a $3 billion organization), essentially lost $61 million in the fiscal year that ended on Sept. 30 — $44 million from health delivery and $17 million from the health plan, which “had a bad year.”

And that’s a significant improvement over the previous fiscal year, when it lost $177 million.

And when it comes to workforce, the Baystate system has roughly 1,400 openings across several different departments, he said, noting that, again, this is an improvement from the peak of more than 2,000 in 2022.

Spiros Hatiras

Spiros Hatiras says HMC has taken aggressive steps on the workforce front, such as large sign-on bonuses and staffing ratios for nurses.

“It’s still more than double what it used to be before the pandemic,” said Keroack, who will be retiring next summer, adding that the system has nonetheless seen progress when it comes vacancy rates, turnover rates, and overall retention through strategies including flex scheduling, workforce-safety initiatives, upward movement on salaries and benefits, wellness programs, career counseling, and more — progress he expects will continue on these and other fronts in 2024.

Dr. Robert Roose, president of Mercy Medical Center in Springfield, agreed there was some improvement in 2023 on several of the fronts on which hospitals are battling, from overall volumes in the ER and with hospital stays (sometimes for the wrong reasons) to decreased use of travel nurses and their sky-high costs.

But there are still formidable challenges in the form of higher costs for everything from labor to equipment to medication; inadequate reimbursements for care (a problem hospitals have been dealing with for decades now); and, most recently, backlogs on the patient floors and the ER resulting from a shortage of nursing-home beds.

Overall, there are still many “mismatches,” as he called them, when it comes to demand in various settings and with specific needs, such as behavioral health.

“Hospitals are at a crossroads,” Roose said, noting that the pressures currently facing them will not likely abate in the years to come. “We have to think about how we focus on three main areas — health equity, system redesign and how we can do things differently, and workforce development.”

When it comes to getting back to basics, that phrase applies to everything to improving access, through initiatives such as an expansion of the ER at CDH (more on that later), to different strategies for recruiting and retaining employees — everything from greater flexibility with hours to a concert to celebrate nurses.

In that latter realm, there is certainly room for innovation and even what amounts to risk taking, said Spiros Hatiras, president and CEO of Holyoke Medical Center and Valley Health Systems, who said he and his team have certainly done so with some aggressive initiatives with bonuses for nurses, staffing ratios, and taking on nursing students right out of college.

“Hospitals are at a crossroads. We have to think about how we focus on three main areas — health equity, system redesign and how we can do things differently, and workforce development.”

Elaborating, he said HMC took some of the federal and state money funneled to hospitals in the wake of the pandemic and “invested” in programs to bolster the workforce through initiatives such as rising pay scales and benefits, ratios, and especially bonuses for nurses, both recent graduates and those with years of experience — initiatives that have generated strong results and eliminated the need for travel nurses, as we’ll see later.

For this issue, BusinessWest talked with these hospital administrators about the various forms of progress made in 2023 — and there were several — as well as the stern challenges that remain and the expectations for the year ahead.

 

Working in Concert

They called it Nurses Rock.

That was the name attached to a concert last spring featuring the local cover band Trailer Trash, staged in the former Colony Club space in Tower Square and orchestrated by Holyoke Medical Center. And that name speaks volumes about what this different kind of event was all about.

Indeed, this was a celebration of nurses, said Hatiras, noting that nurses from across the region, not just HMC, were invited. And more than 400 turned out.

Nurses Rock II is well into the planning stage, he went on, adding that the band Aquanett has been secured, and the event has been scheduled to coincide with National Nurses Week in early May.

Dr. Mark Keroack says 2023 was another difficult year

Dr. Mark Keroack says 2023 was another difficult year for hospitals, on several fronts, but it was a vast improvement over 2022.

Nurses Rock is just one example of rebuilding, going back to basics, being innovative, and, yes, thinking outside the box when it comes to the many challenges that are still confronting hospitals, which are, in many ways, still digging out from the fiscal turmoil created by, or exacerbated by, the pandemic.

With that, Keroack returned to those numbers he referenced earlier, such as the posted losses of $61 million system-wide in FY 2023, and put them into historical perspective.

“To really understand this, you need to turn the clock back to before the pandemic,” he said. “Before the pandemic, we would routinely generate margins of 2% to 3%, and we were generally stable; we were rated A+ by Standard & Poor’s, which put us roughly in the top quartile of health systems in New England.

“In 2020 and 2021, we were propped up by some generous federal subsidies from the CARES Act,” he went on, adding that these amounted to roughly $180 million. “They papered over some serious financial problems and enabled us to post 1% to 2% margins those two years.”

But that relief went away in 2022, and the system was still left with a huge bill for contract labor and overtime pay, he continued, adding that, when it comes to that $177 million loss in FY 2022, more than 70% of that came from higher labor costs.

In 2023, Baystate was able to make about $170 million worth of margin improvement, Keroack said, adding that much of this resulted from one-time grants from FEMA and ARPA monies, as well as some revenue-enhancement initiatives, efforts to improve supply-chain expenses, and a reduction of roughly 60 positions from the executive leadership ranks.

“We’re running an extraordinarily lean organization right now,” he told BusinessWest. For example, I used to have six direct reports, and now I have 12.”

What’s more, the system “turned the tide,” as he put it, when it comes to the use of contract labor, while also embarking on a number of joint ventures, such as the new behavioral-health hospital that opened recently in Holyoke, that help avoid capital expenditures, and exiting some small lines of business such as in-vitro fertilization and urgent care, areas where Baystate either couldn’t recruit talent or determined that these areas were not the core mission and were better left to others to handle.

Overall, volumes returned in 2023 across the board, Keroack said, meaning in the ER, surgeries, and discharges. But hospital stays or ‘days’ were considerably over budget because length of stay has increased, often because it’s more difficult to discharge a patient to a nursing home or home care.

“Hospitals are at a crossroads. We have to think about how we focus on three main areas — health equity, system redesign and how we can do things differently, and workforce development.”

“It’s causing a traffic jam,” he explained. “And it results in dozens and dozens of patients being stuck, waiting for a discharge to happen; that jams up the in-patient unit, causes backup in the emergency room, long waits, etc. It’s been stressful, but we’re beginning to get some progress on that.”

Watkins agreed, noting that more progress is needed in 2024 and beyond because there are many consequences as hospital stays lengthen, everything from greater potential for hospital-acquired infections and patient falls to further financial hardship for hospitals because insurers will not reimburse for those longer stays.

Much of the problem results from workforce issues, she went on, noting that “workforce drives access — access to our acute-care facilities, access to our ambulatory clinics, access to our VNA and hospice — and it really drives the value and quality of service that we offer.”

 

Work in Progress

Overall, there has been even more progress on the workforce front, although considerable challenges remain, said all those we spoke with.

Due to a heightened focus on various strategies regarding recruitment and retention, hospitals have greatly reduced their dependence on travel, or contract, nurses, who are paid at rates at least double what staff nurses receive, Watkins said.

At HMC, use of travel nurses has been eliminated altogether, said Hatiras, with a discernable dose of pride in his voice, noting that this was achieved through some rather aggressive risk-taking.

And, overall, the hospital has made itself a good place to work, he said, making it easier to recruit not only nurses but also doctors and other providers as well.

“The main theme in 2023 for us was to really leverage many, many years of work to create a great culture here,” he said. “That work, that culture, enabled us to attract physicians here where otherwise, we would have no shot. And it has essentially enabled us to solve our staffing problem. We have solved it for now — knock on wood.”

The most significant progress has come with attracting and retaining nurses and thus eliminating dependence on travel nurses, he went on, adding this has been accomplished through creation of that culture, but also through large bonuses and staffing ratios, initiatives launched in the early stages of the pandemic that are paying real dividends now.

“We gave the nurses something that no one else wanted to give them — something they really wanted, and something we fought for years not to give them: ratios,” he said. “None of my colleagues like my answer, but it has worked for us.”

Elaborating, Hatiras said that, pre-pandemic, his hospital, and all hospitals, fought hard against ratios demanded by nurses unions, primarily because there was no flexibility built into the equation, and penalties were imposed upon those who did not comply. HMC has injected some flexibility, keeping a 5-to-1 ratio whenever possible.

Meanwhile, rather than spend pandemic-related state and federal assistance on the “middleman,” meaning agency nurses for which the hospital paid $200 per hour, the hospital opted to put it toward retention bonuses and other initiatives for nurses and other providers of care.

“We basically said, ‘you’re here, and you work for us; we don’t want you to leave — so we’re going to pay you $20,000 over the next four years as a bonus, just to stay,’” he said, adding that very few nurses who accepted those terms have left.

Meanwhile, more recently, the hospital decided to make some additional investments, this time in recent college graduates, at a time when fewer hospitals were taking on such inexperienced individuals because of the high cost of training them. HMC offered them the chance to join the staff in May, after graduating, but not take on a full patient load until October.

On top of that, it offered something most “couldn’t say no to” — a $50,000 sign-on bonus for a commitment to stay five years.

“We said, ‘listen, we’ll cut you a check so long as you sign a note that says you’ll come and work for us,’” he said, adding that these bonuses were larger than most being offered and upfront in nature.

And they have worked, with many recent graduates signing on. And while many of his colleagues have questioned his math, Hatiras has told them, as he told BusinessWest, that, in the long run, it’s more cost-effective to incentivize nurses to stay in this aggressive fashion than it is to replace them when they leave. And that same guiding philosophy prompted him to put in place a similar program for experienced nurses, one that offers them $40,000 bonuses if they stay three years.

 

Reality Check

While there has been progress on workforce issues and other fronts, there are still a large number of pain points for hospitals, said Roose, adding that these will certainly continue in 2024.

“The pressures on hospitals have been increasing; they’ve been changing, and the needs of our community have been changing over the past several years, but the pressures have not relented,” he said, noting that the pandemic exacerbated the workforce crisis and compounded a financial crisis for hospitals across the country.

“Those various elements lead to pressures on everything from access to care for patients through traditional models that we’ve had for the past several decades, to having enough colleagues to provide care to meet the demands in different kinds of settings, to how to continue to invest in resources to innovate and grow to where healthcare is going.”

Moving forward, he said the healthcare system must continue to evolve to meet the changing needs of the public and continue to provide access to care, especially amid an ongoing shift toward more care being provided in outpatient settings.

“Hospitals and healthcare systems are evolving, but perhaps not quick enough to best meet those needs,” he went on. “We need to provide access points of care that are the most convenient, that are readily available, at the right level of care when needed, and with a high level of excellence.”

Watkins agreed, but noted that, while 2023 was certainly a time of ongoing challenge and duress for hospitals, it was also a period for rebuilding and, at CDH, celebrating such things as the 10th anniversary of the hospital’s partnership with Mass General Brigham, an expansion and renovation of the hospital’s labor and delivery suites, and the advancement of plans for expanding the ER, a project that will greatly enhance the delivery of care in that unit.

Ground will be broken on the new facility shortly, she said, adding that work to enlarge and redesign the ER brings into focus many of the pressing issues in healthcare today — everything from access to care to workplace conditions to retention of talent.

All are addressed in a design that adds 7,000 square feet of space but also improves safety through an overall configuration that enhances lines of sight while also improving staff satisfaction.

“They want to be in an environment that is pleasing to them, that they can move around in, because we spend a lot of the day at work,” Watkins said. “All of these things come back to workforce, which is going to be the key driver as we move into 2024.”

 

Bottom Line

As he talked briefly about his pending retirement and tenure at Baystate, Keroack joked that it has “never been dull.”

That’s an understatement and a rather polite way of summing up the past few years in particular.

It’s been a time of extreme challenge, but also intriguing and sometimes even exhilarating work to confront those challenges and find solutions.

As for what is to come and the outlook for 2024, hospitals will continue to rebuild and stress the basics. And, like any struggling sports team, they’ll look forward to the new year with optimism.

That’s the best you can do when you’re at a crossroads.

Healthcare News

A Survivor’s Story

By James Basler

 

There have been 1 million drug-overdose deaths in this country since 1999. On March 21, 2018, my brother was one of them.

I am very lucky, at age 46, to not be one of them, as I, too, have overdosed, but survived. My paper route, as I tell people about my life’s journey, has not been an easy one, with jail time for aggressive behavior while under the influence, time wasted in denial about my substance use and mental health, and letting judgment of others keep me from seeking treatment.

However, I did seek treatment, finding success with daily medication to maintain recovery, along with the behavioral-health counseling that goes with it, in my mind, like peanut butter and jelly. I now share my story with others, as many of us have lost family members and friends to drug overdose.

I tell anyone with addiction that if I can maintain recovery — despite a long history of misuse, startovers, and decisions that did not focus on what I needed to do — you can do it, too. You can find the right combination of support to start and sustain recovery.

My substance use dates to weekend drinking as a young adult, and my addiction and recovery are, you might say, a timeline for the public-health emergency that substance use and mental health have become during the last two decades.

My journey has included alcohol, the once widely prescribed pain med Oxycontin that flamed the country’s overdose crisis, heroin, Section 35 court-order treatment, stays in residential recovery programs, and hospital admissions on a voluntary basis for psychiatric treatment.

I got married; fathered three children, whom I see regularly; and learned and accepted that my addiction, the most severe form of substance use, may have started as a form of self-medication in response to mental-health issues and exposure to trauma.

“I tell anyone with addiction that if I can maintain recovery — despite a long history of misuse, startovers, and decisions that did not focus on what I needed to do — you can do it, too. You can find the right combination of support to start and sustain recovery.”

I have been clean for the last five years except for one relapse three years into my sobriety. Anyone in recovery will tell you relapse is part of recovery. Your brain misses the pleasurable feelings drug dependency produces, especially when life’s realities sideline how such dependency can ruin your life altogether.

I live in sober housing and work daily to maintain recovery, as no one ever said recovery is easy, despite its rewards. You need to stay connected to your treatment and supports, and not go it alone.

I take methadone at the MiraVista Behavioral Health Center in Holyoke, and I also do one-one-counseling for my mental health, as well as group sessions. Substance use can contribute to poor mental health, and poor mental health can contribute to substance use. Finding the right medications and getting the right providers in place for both can take time, but are what enable individuals like myself with a substance-use and mental-health diagnosis to lead fulfilling lives in our community and have healthy relationships.

I was oblivious, growing up in Middlesex County during the 1990s, to the dangers and consequences of substance use. I now understand addiction for what it is: a medical condition that needs individualized treatment, and that there is no shame in getting treatment to manage it.

I have survived to 46 thanks to a little luck, as illicit drugs laced with fentanyl, a laboratory-made opioid that is cheap and 100 times more potent than heroin, have become mainly responsible for the majority of overdose deaths at record numbers in this country; much ongoing support from family and friends; and access as well as commitment to medication-assisted recovery like that at MiraVista.

I hope that my story offers hope for recovery to anyone with substance-use and mental-health disorders. Medications can get you into recovery, and the work you do in counseling motivates and helps sustain it.

 

James Basler was born in Melrose and raised in Burlington. He is a resident of Holyoke, the father of three, and a patient of MiraVista Behavioral Health Center’s Opioid Treatment program. He is in his fifth year of successful, sustained recovery. For more information on MiraVista’s treatment and recovery programs, call (413) 701-2600, option 3, or visit www.miravistabhc.care.

Healthcare News Special Coverage

Stemming the Tide

Christine Palmieri

Christine Palmieri says economic tides, particularly around housing availability, have exacerbated the opioid epidemic.

When BusinessWest visited the Mental Health Assoc. (MHA) in Springfield last fall, Christine Palmieri reported what she called a “troubling” trend locally: more deaths by overdose, over the previous year or two, than she’d seen in her entire career.

She wishes she had different news to report now.

“Anecdotally, it hasn’t improved. We’ve lost a number of individuals over the course of this year to opioid overdose,” Palmieri, vice president of Recovery and Housing at MHA, said this month.

Earlier this year, the state reported a similar lack of positive news. Specifically, opioid-related overdose deaths in Massachusetts increased by 2.5% in 2022 compared to 2021, with 2,357 such confirmed and estimated deaths in 2022.

Breaking it down further, the data showed that non-Hispanic Black men saw their opioid-related overdose death rate increase 41%, from 56.4 to 79.6 per 100,000, while the rate for non-Hispanic Black women increased by 47%, from 17.4 to 25.5 per 100,000.

Some of the broader trends may track back to the isolation and loss of connection people were feeling during the pandemic, Palmieri said, but economic tides are more significant factors right now, from access to work to higher costs of food, transportation, and especially housing — key social determinants of health that hinder recovery.

“It’s a difficult environment to try to get better in now,” she told BusinessWest, noting that the state Department of Public Health (DPH) has begun investing significantly in housing programs for people experiencing substance abuse. Using funds from the state’s Opioid Recovery and Remediation Fund, DPH expects to increase low-threshold housing units — housing provided in conjunction with supportive recovery services — statewide from 394 to 761 this year.

“MHA and a lot of our colleagues have been benefactors of that funding, which helps get people off the street into a warm and safe place and on the path to recovery,” Palmieri said. “It’s hard to do the work of recovery if you don’t have a safe place to lay your head. Getting people off the streets into safe housing is critical. It’s the first step on the path to recovery.”

“It hasn’t improved. We’ve lost a number of individuals over the course of this year to opioid overdose.”

Among MHA’s transitional and permanent housing programs are three residences in its GRIT program, for individuals with co-occurring substance-abuse and mental-health diagnoses, which require no time limit on a stay as long as a resident is benefiting and engaging in the program.

“Housing is the biggest barrier for us in the mental-health world,” she added. “The thing that keeps people in programs longer than anything else is the lack of affordable housing. We don’t discharge people into homelessness; we help them land somewhere — sober houses, transitional houses, re-housing programs.

“That’s why funding from the state is so crucial. It allows us to subsidize housing costs for people with very low incomes who experience substance-use issues,” Palmieri added, noting that MHA also has relationships, often spanning decades, with local landlords. “When a unit becomes available, they’ll call us because they know the rent will get paid and that we’ll be there to support them with whatever they experience.”

Dr. Katie Krauskopf

Dr. Katie Krauskopf says everyone should have access to naloxone, the only intervention that can reverse an overdose.

Dr. Katie Krauskopf, medical director of Substance Use Disorder Services at MiraVista Behavioral Health Center in Holyoke, said her organization has expanded outpatient substance-abuse treatment services — both programs and operating hours — as well as broadening an effort to treat patients with co-occurring mental-health and substance-abuse issues through its inpatient psychiatric services.

“The work definitely continues,” she told BusinessWest. “We’re still seeing overdoses at high rates — and any overdose is too many. We’re also seeing an adulterated drug supply.”

And it’s not just fentanyl, she noted; the new additive on the street is a tranquilizer called xylazine, which is being detected in an increasing number of drug-overdose deaths.

“To address the opioid crisis, we need to prioritize overdose death prevention while simultaneously investing in comprehensive supports for those dealing with substance-use disorder, to ensure they have every opportunity for recovery,”  Secretary of Health and Human Services Kate Walsh said when the DPH report was released. “We have to lean into the disparities we see in impacts on Black residents and target our interventions accordingly. Challenges like housing, hunger, and accessing education, behavioral-health treatment, and transportation need to be addressed in concert with substance-use treatment in order to turn the tide of this epidemic.”

 

Instant Intervention

To save lives while an overdose is in progress, the state, its municipalities, and organizations like MiraVista and Tapestry Health have worked in concert to make naloxone, also known as Narcan, more widely accessible, in order to reverse the deadly effects of an overdose as it’s happening.

For instance, the city of Greenfield recently announced that four naloxone boxes have been installed at Energy Park, Hillside Park, and the two Greenfield City Hall public restrooms, and the boxes will be refilled weekly by Tapestry.

This effort, spearheaded by the Opioid Task Force of Franklin County and the North Quabbin, Tapestry, the North Quabbin Community Coalition, and Boston Medical Center, is part of the National Institutes of Health’s HEALing Communities Study, which began in 2019 with 16 Massachusetts communities that qualified based on opioid overdose fatality rates.

The new naloxone boxes are part of the $800,000 the local task force received to finance opioid-related fatality-reduction strategies in Greenfield, Athol, Montague, and Orange. In addition, the task force and Tapestry continue to host virtual overdose-prevention and Narcan trainings.

“The city welcomes the opportunity to be a partner with Tapestry and the Opioid Task Force in this effective, life-saving, harm-reduction effort by allowing naloxone boxes to be available in our City Hall and public parks,” Greenfield Mayor Roxann Wedegartner said.

According to the DPH, Massachusetts has already exceeded, and plans to expand upon, federal naloxone ‘saturation’ goals, providing communities with enough naloxone to prevent overdose deaths that may occur from a lack of medication access. Since 2020, DPH has distributed close to 300,000 naloxone kits to harm-reduction programs, opioid treatment providers, community health centers, hospital emergency departments, and county houses of correction, with distribution increasing about 40% each year.

In 2022, the DPH launched the Community Naloxone Purchasing Program with the aim of increasing distribution of free naloxone through organizations to the community. Meanwhile, this past spring, in response to the rise in opioid-related overdose deaths, DPH issued an advisory urging healthcare providers to increase availability of naloxone kits and train staff to administer naloxone to anyone who may need it, and retail pharmacies to continue to dispense it without a prescription as part of a statewide standing order.

“Narcan is the only intervention we have to reverse an overdose. And if you have a medication that does that, everyone should have access to it. It does save lives,” Krauskopf said.

Roxann Wedegartner

“The city welcomes the opportunity to be a partner with Tapestry and the Opioid Task Force in this effective, life-saving, harm-reduction effort by allowing naloxone boxes to be available in our City Hall and public parks.”

Meanwhile, since August 2022, DPH has increased its distribution of rapid fentanyl test strip kits at no cost to providers and community organizations. Single-use fentanyl test strips help reduce the chances of overdose by allowing people who use drugs to test their supply prior to consumption to determine if it is tainted with fentanyl.

Other recent innovations in battling substance abuse range from medical — such as Sublocade, a long-acting injectable that has helped many patients keep off opioids — to regulatory, such as a move during the pandemic to allow patients to take home medications they could not previously, Krauskopf added.

Palmieri noted that the Western Mass. region — and the organizations within it that deal with addiction — do a good job of providing a wide spectrum of residential and outpatient services, from acute detox centers to medication-assisted treatment to recovery coaching.

“It’s vitally important that the community has options to meet everyone’s needs,” she added. “No one size fits all, and there are many different pathways to recovery.”

 

A Slowing Trend?

There is also, perhaps, some good news from the DPH’s recent study, which reported that, according to preliminary data, there were 522 confirmed and estimated opioid-related overdose deaths in the first three months of 2023, a 7.7% decrease (and an estimated 44 fewer deaths) from the same time period in 2022.

“Too many Massachusetts families, particularly families of color, have been impacted by this crisis,” Gov. Healey said at the time, “and in order to effectively respond, we need to address the gaps in the system by advancing long-term solutions that include housing, jobs, mental healthcare, and more resources for our cities and towns.”

And addiction doesn’t discriminate by the size of those cities and towns. According to the DPH report, the most rural communities in Massachusetts had the highest opioid-related overdose death rate in 2022 at 36.1 deaths per 100,000 residents.

However, Springfield was among the cities and towns that experienced notable increases in opioid-related overdose deaths in 2022 compared with 2021; others high on that list included Lawrence, Leominster, Lynn, Waltham, Weymouth, and Worcester.

“We know overdose deaths are preventable,” DPH Commissioner Dr. Robert Goldstein said. “The pandemic has had a devastating impact on mental health and substance use, especially among marginalized communities. We are working to reverse these troubling trends by continuing to build on our data-driven and equity-based approaches toward responsive support and treatment.”

Healthcare News

Critical Catch

Dr. A. Daniyal Siddiqui

Dr. A. Daniyal Siddiqui says screening is the most important factor in preventing deaths from colorectal cancer.

According to the American Cancer Society, the incidence of young-onset colorectal cancer is rising globally, with about 10% of patients with a new colon-cancer diagnosis, and 25% of patients with a new rectal-cancer diagnosis, being diagnosed under age 50.

Experts are still debating what that means, but there’s broad agreement that people need to start thinking about colonoscopies earlier than ever.

“One should not get to where cancer is diagnosed by symptoms. At that point, it’s a much more advanced stage; you want to get it when the cancer is not causing any symptoms,” said Dr. A. Daniyal Siddiqui, medical director of the Mass General Cancer Center at Cooley Dickinson Hospital and associate professor of Medicine at UMass Chan Medical School.

The statistics bear him out. While treatment of cancer has improved markedly over the decades, so has awareness of the importance of catching it at the earliest stages. In 1975, Siddiqui said, the five-year survival rate for colorectal cancer, across all stages, was 40% to 45%; today, it’s close to 70%.

And the increased incidence in younger people has caused the oncology community to further rethink screening recommendations, pushing them even younger.

The good news, Siddiqui noted, is that colorectal cancer (around 70% of which is colon cancer, 30% rectal) has been declining since the 1980s and declining even faster — between 1% and 1.8% a year — since 2009.

But at the same time, there has been an increase in incidence for younger people. In 1995, 11% of all colorectal cancer diagnoses were in patients 54 or younger; in 2019, it was 20%. For that reason, doctors now recommend starting screening at age 45, instead of the long-recognized guideline of age 50.

Siddiqui says wider adherence to screening recommendations has been impactful over the decades. “If cancers are picked up in the earliest stages, they’re more curable. So the death rate has been going down regardless of age because of better screenings. But the important thing is that incidence is increasing 1% to 1.5% per year in people under age 50. That’s why we should start screening at age 45.”

“One should not get to where cancer is diagnosed by symptoms. At that point, it’s a much more advanced stage; you want to get it when the cancer is not causing any symptoms.”

Why is a colonoscopy so critical? The answer begins with how the disease develops.

Colorectal cancer involves malignant cells that grow in the colon or the rectum, explained Dr. Aparna Parikh, medical director for the Center for Young Adult Colorectal Cancer at the Mass General Cancer Center. Often, colorectal cancers start as polyps, which are non-cancerous, but can turn into cancer over time.

According to the American Cancer Society, when a polyp — a non-cancerous growth in the lining of the colon or rectum — progresses to cancer, it usually grows into the wall of the colon or rectum, where it may invade blood or lymph vessels.

The extent to which cancer has spread at the time of diagnosis is described as its stage. The stages are described as localized (grown into the wall of the colon or rectum but not into nearby tissues), regional (spread through the wall of the colon or rectum and invading nearby tissues or lymph nodes), and distant (spread to other parts of the body, such as the liver or lung).

“Early on, when a polyp is benign, before it becomes cancer, at that point you’re talking a 100% cure,” Siddiqui said. “When you’re in stage 1, localized to the colon or rectum, you’re talking a 90% cure. The rate changes to 70% when the cancer has moved to local lymph nodes.”

And by later stages, the outlook is even worse. In fact, while it’s the fourth-most-common cancer after breast, prostate, and lung cancers, he noted, colorectal cancer is the second-leading cause of cancer-related deaths in the U.S. So it can be critical to undergo regular colonoscopies after 45 — typically once every 10 years.

“There are other screening options, including stool-based tests, but it is important to talk to your primary-care doctor about the advantages and disadvantages of different types of screenings,” Parikh said.

That said, “it’s important to note that these other screening methods are only for patients without symptoms. If you are having any symptoms, it’s important to get a colonoscopy.”

 

Determining the Risk

Siddiqui stressed that the new age recommendations apply only to average-risk individuals. The higher-risk group includes those with a personal history of colorectal cancer or polyp removal, family history of the disease, a history of seed radiation to the abdomen, or personal or family history of endocrine syndromes or inflammatory bowel diseases like colitis or Crohn’s.

Dr. Aparna Parikh

Dr. Aparna Parikh

“To help reduce your risk of getting colorectal cancer, eat healthy foods, including plenty of vegetables, fruits, and whole grains. Exercise regularly, limit or avoid alcohol, and maintain a healthy weight. Finally, quit smoking, or better yet, don’t even start.”

“For those individuals, there’s no black-and-white answer,” he said, explaining that recommendations of when to start screening and how often to go back are determined on a case-by-case basis: what kind of polyp was found, which hereditary factors are present, and so on.

But in general, for the average person, the guidelines start at age 45 and continue until 75, at which time it becomes a more individualized decision between a doctor and patient based on a number of lifestyle factors.

“Screening is the most important thing,” Siddiqui emphasized. “We know now, from prostate cancer and colon cancer and lung cancer, that screening works. That’s the main driving force behind death rates going down.”

The second key factor is improvement in the treatments available after colorectal cancer (CRC) is detected. Options include colorectal surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, and access to clinical trials, Parikh noted, adding that “colorectal cancer is largely preventable and, in most cases, curable, especially if it’s detected early.”

As far as prevention strategies are concerned, some risk factors are more easily altered than others. The American Cancer Society reports that 55% of all CRCs are attributable to lifestyle factors, such as an unhealthy diet, insufficient physical activity, high alcohol consumption, and smoking.

“People have been more aware of risk factors of various cancers, and if they’re proactive in terms of reducing them through lifestyle changes, that’s the important thing,” Siddiqui said. “Age is an important risk factor, and so is family history. You can’t change those, but you can change your diet. If you’re obese, you can modify that. If you’re a smoker, you can quit smoking.”

Physical activity is an important factor as well, he added. “We know that from multiple studies with thousands of patients. I’m not saying you should start running a marathon, but simply a 25- to 30-minute walk, three to five times a week, significantly reduces the risk of colon cancer, or any kind of cancer.”

However, the strongest risk factor is a family history of the disease; people with a first-degree relative (parent, sibling, or child) who has been diagnosed with CRC have two to four times the risk of developing the disease compared to people without this family history, with a higher risk when diagnosis is before age 50 and when multiple relatives are affected, the American Cancer Society reports.

Meanwhile, up to 30% of people diagnosed with colorectal cancer have a family history of the disease, which is why these individuals should begin screening early, the organization notes. Young people with a family history should have a conversation with their healthcare provider about when to start screening.

“Everyone should know their family history, and not just colon cancer, but any cancer, especially at a young age,” Siddiqui said. “And that should be brought to a doctor’s attention because that may change the screening guidelines about when to start and how frequently.”

 

Changes for the Better

Dr. Xavier Lor, medical director of the Colorectal Cancer Prevention Program at Yale Cancer Center and Smilow Cancer Hospital, said recently that certain lifestyle habits associated with colorectal cancer (CRC) aren’t by themselves causing the worrisome trend of higher incidence in younger people.

“Some factors have been identified, and these increase risk, especially at older ages. Obesity, sedentary lifestyle, the western diet, and high sugar intake would only explain a fraction of these cases,” he noted.

“Genetic syndromes are also more commonly the cause for younger CRC patients than older ones, but these remain quite stable over the years and can’t explain a sudden raise in cases as we have seen in the last two decades,” he added. “It will likely boil down to environmental and dietary factors that we have not quite identified yet to explain many of these cases.”

Even absent the cancer risk, there’s nothing wrong with some healthy habits, however.

“To help reduce your risk of getting colorectal cancer, eat healthy foods, including plenty of vegetables, fruits, and whole grains,” Parikh said. “Exercise regularly, limit or avoid alcohol, and maintain a healthy weight. Finally, quit smoking, or better yet, don’t even start.”

When a CRC does develop, the symptoms can vary, she noted.

“Different people may have different symptoms of colorectal cancer, and some people may not have any signs or symptoms at all,” she said, adding that symptoms may include abdominal discomfort or cramping; bleeding from the rectum or finding blood in one’s stool; changes in how the stool looks or frequency of bowel movement; diarrhea, constipation, or increased gas; or unexplained weight loss.

“It is important to remember that these symptoms can be attributed to things that are not related to colorectal cancer,” she added, so it’s important to consult a primary-care doctor with any concerns.

But, as Siddiqui noted up top, the key is catching problems before symptoms arise at all.

“Colonoscopies can detect cancer before you have symptoms or have advanced disease. Early detection is critical,” Parikh said. “But it’s important to advocate for your own health and well-being if you have any concerning symptoms.”

Healthcare News Special Coverage

A Holistic Approach

The infusion spaces at the cancer center were designed to be calming and comfortable.

The infusion spaces at the cancer center were designed to be calming and comfortable.

ribbon-cutting ceremony

Helen Blake, whose daughter the center was named after, speaks at the ribbon-cutting ceremony alongside Deborah Bitsoli, president of Trinity Health Of New England Medical Group, and Dr. Robert Roose.

Sometimes, opportunity is born from a flood of difficulty. Or, simply, a flood.

That was the starting point, anyway, of what has become a $6 million construction and renovation project to renovate and add 5,500 square feet to the Karen Davis Krzynowek Cancer Center at Johnson Memorial Hospital in Enfield, Conn.

“About 16 months ago, as a result of a flood that had occurred in the old cancer center, we took it upon ourselves to set out a vision for what we could do to enhance and expand oncology services for the patients in Enfield and the surrounding towns,” said Dr. Robert Roose, administrative officer for two Trinity Health of New England hospitals: Johnson and Mercy Medical Center in Springfield.

“From there, it became an opportunity for us to create a state-of-the-art facility with infusion bays with natural light, and to bring medical-office infusion, medical oncology, and radiation oncology under one roof in a newly expanded and beautiful space to better meet the needs of the patients receiving cancer care in and around this community.”

Indeed, the project brings all of Johnson’s outpatient cancer services together under one roof, allowing patients to receive multiple facets of their treatment in one location. In addition to improving accessibility for physician appointments, the project also includes new medical oncology infusion bays that feature privacy screening, personal televisions, and space to accommodate a supporting family member or friend.

“Having all those services there, and especially having our partners in radiation next door in that same building, ensures that patients don’t have to go to multiple locations to get different aspects of their care,” said Tory Murtha, director of Ambulatory Oncology.

“I think that is key for this population,” she went on. “They’re already not feeling well, they’re already stressed, and they have a lot of other things going on in their lives. If you’re telling them, ‘well, first you have to go here and here and here and here,’ I think that’s really hard. So if they can just come and see their physician, see their nurse, get their infusion, have some blood drawn, have holistic support staff with the financial navigators and the nurses and the social-work team, that helps them feel like, ‘oh, they’re looking at me from every angle, every aspect of my holistic well-being.’”

This enhanced, multi-disciplinary care will extend even to surgical services, Murtha noted.

“We’re going to be able to bring breast surgeons over to our space within this cancer center to see patients for those diseases, and have the medical oncologist there with them. That makes a huge difference when you’re a new patient and you’re able to have both physicians there from both modalities of care. And the surgical center is going to be next door. That’s huge.”

Tory Murtha

Tory Murtha

“Having all those services there, and especially having our partners in radiation next door in that same building, ensures that patients don’t have to go to multiple locations to get different aspects of their care.”

Indeed, the new Karen Davis Krzynowek Cancer Center is part of a broader, $40 million expansion and renovation project designed to create a comprehensive hub for outpatient services on the hospital’s Enfield campus. Once complete, the S. Prestley and Helen Blake Ambulatory Care Center will include an upgraded surgery center with four state-of-the-art operating rooms, recovery areas, and additional medical office space.

“You’ll notice some of the design elements between the two centers are going to match,” Roose said, “so that there’s some harmony in the appearance, very much elevating the physical space to match the care that’s provided, so that it is top-notch and really delivers on the promises we have made to meet the needs in the community.”

 

Under One Roof

Small changes make a difference in cancer care, medical oncologist Dr. Karishma Mehra said, noting, for example, that patients require a physical examination before they can be cleared to receive chemotherapy.

“It’s important to make receiving care as easy as possible for cancer patients. Now, with physician offices just steps away from the infusion area, patients can begin their treatment more quickly. They also have peace of mind knowing their physician is nearby.”

Other changes in the reopened center are aesthetic, aiming to boost calmness, stress reduction, and peace of mind, Murtha said.

“Having natural light coming in, even if it’s on a cloudy day, is important,” she explained, noting that multiple studies have bolstered the connection between sunlight and a positive mindset. She added that the color scheme and artwork on the walls are intended to be calming, as are amenities like heated seats and blankets in the infusion spaces. And designing large-enough rooms to sit with a family member was also important.

Helen Blake cuts the ribbon for the reopening of the Karen Davis Krzynowek Cancer Center

Helen Blake cuts the ribbon for the reopening of the Karen Davis Krzynowek Cancer Center, which is named in honor of Blake’s late daughter, who passed away after a six-year battle with cancer.

“Before, we really didn’t have that, and many times, especially going through COVID, there was not an opportunity for patients to have a family member with them,” she said. “Even if situations arise where we have to be judicious with how many people we allow in, there’s still enough space to allow caregivers and family members to be with them in their space.”

In addition, Murtha said, “it was important to ensure that, in the nursing station for the infusion area, there’s line of sight to every patient. It’s a big space, but you can still see everything, and that’s from a safety perspective, because we give a lot of medications that can have lots of reactions. So ensuring that the nurses have a line of sight to everybody was really important.”

Also, “one thing I love about the Trinity standards is making sure that everything you need is in the exam room,” she added. “So I can do your vital signs, I can take your weight, I can take your height, all in the exam room. You don’t have go to three different rooms to do different things.”

Murtha added that the employees at the cancer center, many of whom have worked there for 15 or 20 years, were gratified to return. “The people who work there, they stay because it is a family, and they do feel very dedicated to this location and to each other and to their patients.”

Enfield has been an important location for Trinity Health Of New England, Roose noted, sitting between its hospitals in Springfield (Mercy) and Hartford, Conn. (St. Francis Hospital and Medical Center).

“We recognize the needs of this community,” he told BusinessWest, “and we have prided ourself on providing great care in this community and very excited about some of the strategic expansions of services that are happening there, which include the renovation and the expansion of the Karen Davis Krzynowek Cancer Center.”

The idea, he added, was “ensuring that each individual has an environment that is comfortable, state-of-the-art, and beautiful, so that we can fully meet the biological, medical, psychological, spiritual, and social needs of each individual patient in this new space. Our mission is to be a transforming, healing presence in the community.”

Murtha added that Enfield is the health system’s fastest-growing market in the region.

“This is not a generalist model, like some smaller cancer centers. We have doctors that are dedicated to specific diseases to ensure that patients get that same level of high-level service that they would get at a large, academic cancer center.”

“Unfortunately, as people get older, we are seeing more and more cancers, and we’re also seeing a lot more cancers earlier on,” she said, partly due to more ambitious early screening recommendations.

“Even with our GI and our lung-cancer patients, we are seeing some of those a lot earlier now than we have historically. So I think it’s really important that ensure that we provide some specialized care. This is not a generalist model, like some smaller cancer centers. We have doctors that are dedicated to specific diseases to ensure that patients get that same level of high-level service that they would get at a large, academic cancer center. That’s another thing that we’ve really worked on to ensure that our patients get everything that they need in this location.”

 

Bottom Line

At the end of the day, Murtha said, while the building might be impressive, it’s really about the people.

“We want to make sure we’re holistically managing every patient that walks through the door, and their family members, because there’s a lot of burden on the caregivers, too. So we really do take a holistic approach when we meet each of them and ensure that we’re supporting them at every step of the way.”

Roose agreed, noting that “we are confident that these improvements will ease the cancer journey for many individuals in the greater Enfield community.”

Healthcare News

‘It’s the Right Thing to Do’

State Sen. John Velis and Ramona Rivera-Reno

State Sen. John Velis and Ramona Rivera-Reno say being a Recovery Ready Workplace is good for employees — and the bottom line.

 

State Sen. John Velis knows something about addiction and recovery, having experienced both in his life. And as chair of the state Legislature’s Joint Committee on Mental Health, Substance Use, and Recovery who also serves on a national mental-health task force, he’s keenly aware of the intertwined challenges of recovery and employment.

That’s why he firmly believes the Recovery Ready Workplace initiative offers businesses a roadmap to not only help employees with the biggest challenges of their lives, but to help their business succeed at the same time.

“If you don’t have a healthy workforce, if you don’t have a workforce that is there, in the here and now, to do their job, you’re going to see that in your productivity — more specifically, loss of productivity,” he said.

So helping employees struggling with mental-health issues, addiction, and other challenges is certainly a bottom-line issue, he went on. But, more importantly, it’s a human issue. “It’s important to do it for many reasons, but most importantly, it’s the right thing to do.”

Velis shared these thoughts at a recent employer-appreciation breakfast presented by MassHire Holyoke’s Pillars of the Community Workforce (PCW) initiative, during which several local businesses were honored for their pledge to become a Recovery Ready Workplace — a national program he believes is more crucial than ever.

“What I know with absolute certainty is that the pain that’s being felt out there right now, the number of people dying, the number of people struggling with their mental health, is unprecedented,” he said, adding that this issue “absolutely transcends age, socioeconomic status, race, ethnicity, everything. There is pain out there.”

A Recovery Ready Workplace supports its community by recognizing recovery from substance-use disorder as a strength, according to MassHire. Companies that take the pledge actively work to maintain and support the employment of people in recovery and their loved ones, and creates a healthy and safe environment where employers and employees can work together to eliminate barriers for those impacted by addiction, reduce stigma and judgment of people in recovery, and start to shift attitudes and perceptions around these issues.

“What’s our mission? To create a culture of support for employers and employees that have been impacted by substance use and addiction,” said Ramona Rivera-Reno, executive director of MassHire Holyoke’s Re-entry & Recovery program. “And when I say create a culture, I’m talking about breaking down the stigma that goes with substance-use disorder.”

“What I know with absolute certainty is that the pain that’s being felt out there right now, the number of people dying, the number of people struggling with their mental health, is unprecedented.”

Reducing or eliminating that stigma is a critical step, she emphasized.

“We’re all in recovery from something, whether it’s recovering from surgery, recovering from the pandemic, recovering economically. There’s a lot of pressure on all of us. And we need to have the coping skills and the communication skills to overcome that as a community together. And that’s what the Recovery Ready Workplace is all about — educating employers, helping them educate their staff, adding it as a wellness benefit to their benefits. The more people you educate, the more communication you get out there, the more we’ll break down that barrier.”

MassHire Holyoke recently recognized

MassHire Holyoke recently recognized about a dozen local businesses for taking the Recovery Ready Workplace pledge.

MassHire notes that being a Recovery Ready Workplace does not mean accepting or enabling intoxication, substance use, or any unsafe conditions in the workplace. What it does mean is that the business:

• Acknowledges that addiction is an issue for many people by openly addressing the topic of drug and alcohol misuse, communicating about these issues in a non-judgmental and honest way to reduce stigma, and encouraging employees to discuss substance-use concerns and recovery successes in a non-punitive setting;

• Educates employees and customers about the disease of addiction and treatment resources and options;

• Offers policies and accommodations that support employees while rethinking hiring standards around gaps in employment, addiction-related justice history, and other considerations;

• Prioritizes safety by preventing employee exposure to unsafe conditions that could cause injury or illness that contribute to the development or recurrence of substance-use disorders, ensuring the workplace is an emotionally and socially safe and healthy environment for staff, and improving access to recovery supports; and

• Improves access to recovery supports by lowering barriers to seeking and receiving care for addiction, and maintaining recovery.

 

Making a Difference

Holyoke Mayor Joshua Garcia said the city itself is taking a pledge to be a Recovery Ready Workplace. He recognized why some companies would be hesitant to sign on, but agreed with Velis that it’s the right thing to do.

“Obviously, as a company, you have to make sure you have your systems in place to help navigate potential liability and harm to your company because that’s the bottom line,” Garcia noted. “But these are the folks that are helping you build that. So, whatever little bit you can do to help build people up, you’re going to see a return from those individuals that really appreciate the level of interest you’ve taken on them, and the risk you’ve taken on them.”

Rivera-Reno said companies and organizations that take the pledge agree to acknowledge and openly address the employees’ experience with drug and alcohol misuse in the process of recovery.

“A lot of people suffer from different things, whether it’s substance-use disorder, alcoholism, mental-health issues, and they don’t ask for help because the stigma attached to it. It’s a sign of weakness for a lot of people.”

“You’re free to educate your employees about the disease of addiction and treatment options in recovery support, and offer support. And there’s so many ways you can offer support.”

It can be as simple as offering a dollop of schedule flexibility. She cited one client who used to go to lunchtime recovery meetings, but could no longer do that at a new job. “So we had someone talk to the employer, and the employer decided, ‘well, you can come in early, and you can have a longer lunch and just stay later.’

“That makes a big difference to someone,” she went on. “Something simple like a flex schedule made all the difference. And that person’s still working today, and he wouldn’t have had the courage, I think, to do this if we didn’t have a recovery coach talking with him along the way, and if the employer wasn’t aware of our services and aware of what a recovery-friendly place is.”

Rivera-Reno called stigma a more deadly killer than cigarettes, heroin, or whatever substance because it keeps people in the shadows and keeps them from asking for help. Companies that pledge to help break that stigma, she said, are changing lives.

“A lot of people suffer from different things, whether it’s substance-use disorder, alcoholism, mental-health issues, and they don’t ask for help because the stigma attached to it. It’s a sign of weakness for a lot of people. It’s a sign of, like, maybe you’re not ready to work here. So by getting us into the different employers’ offices, talking about recovery as a community, we really make a difference in their lives.”

Garcia emphasized that, with the cost of turnover and difficulty retaining talent these days, it makes business sense for employers to support their employees who are struggling with some of these issues, rather than letting them fall through the cracks.

“Sometimes it’s not even the individual that’s suffering from personal addiction; it’s a son or a daughter or a significant other that impacts them and their performance in the workplace,” the mayor said. “So we’re taking a much more proactive approach when dealing with our employees to help them navigate these problems so that we keep our employees and don’t lose them.”

Indeed, MassHire emphasizes the bottom-line benefits of cultivating a Recovery Ready Workplace, including increased retention and fewer absences, a healthier and safer work environment, greater productivity and loyalty among staff, lower healthcare costs, and an enhanced reputation as a supportive, yet accountable organization.

And with 22 million Americans identifying themselves as people in recovery, it’s not something businesses can afford to ignore.

“You already have countless employees who are struggling with something, whether it be a substance-use disorder or something else,” Velis told those attending the breakfast. “You have that without knowing it.”

 

Breaking the Cycle

Velis ended his address on a personal note, and an encouragement to practice self-care. He said he was late to the event because he was bringing his son to daycare.

“Probably two or three years ago, I would have said to my better half, ‘I gotta go. I gotta be at work. I’m speaking at this event.’ And I don’t do that now because being a dad is the most important thing in my life, but also because I firmly believe when I go to bed at night that self-care is the most important thing every human being does — whether it’s going for a run, doing yoga, meditating, going to a 12-step meeting, or hanging out with my son.”

And that’s what Recovery Ready Workplaces do, proponents say, noting that recovery isn’t just stopping substance use, but taking a journey of growth, improvement, and perseverance. And that’s exactly the kind of employee companies taking the pledge value.

“If you were to look out at your employees and say, ‘raise your hand if you’ve ever struggled with a mental-health issue or a substance-use issue,’ you wouldn’t do that, but trust me when I tell you, many people in that room are struggling with it right now,” Velis said. “And when you welcome that, when you talk about it, when you let it be known that it’s OK, you’re doing a really beautiful thing.”

That’s because the stigma still exists, he added. “The three hardest words for any human being to say are also the most courageous words: ‘I need help.’ Behavioral health today is about meeting people where they are.”

Healthcare News

Mental Health Shouldn’t Take a Break

 

 

Dr. Negar Beheshti

Dr. Negar Beheshti

How do students stay emotionally healthy during a long stretch of school vacation?

Dr. Negar Beheshti, a board-certified adult, child, and adolescent psychiatrist and chief medical officer for Holyoke-based MiraVista Behavioral Health Center and its sister hospital, TaraVista Behavioral Health Center in Devens, recommends a balance of structured fun and learning. She recommends as well that primary-care givers, be they parents or other guardians, do their due diligence to keep everyone safe and engaged in behavior that supports mental health.

With that in mind, BusinessWest asked Beheshti to talk about ways to make school breaks beneficial for students of all ages.

 

BusinessWest: What expectations around behavior are good to set during this time away from school?

Beheshti: This is a conversation geared to the child’s age. For example, children in elementary school may be doing a lot of summer-camp activities, and this is an opportunity to talk about appropriate behavior with other peers at the camp.

Should there be other informal activities for this age group more regulated by parents and guardians, it is good for primary caregivers to get to know them, advise their children to stay away from people they don’t know, and know that all activities are in a safe space, contained and chaperoned by an adult.

When you get to the tweens, they may not want the regular, structured routine of summer camp. However, it is still good to do some type of structured program, as it gives middle-schoolers the opportunity to continue social development and promotes new learning opportunities. Some school districts offer enriched learning programming at least part of the day that holds the potential to explore something new in a fun way.

The state Executive Office of Education has a web resource page (www.mass.gov/info-details/summer-learning) on summer programs for youth that are a mix of academic and the recreational.

 

BusinessWest: What about older teens? How can parents and guardians balance their desire for freedom with safety and wellness?

Beheshti: Young people old enough to hang out with their friends without an adult chaperone should have some type of device that allows their primary caregiver to reach them. There are all types of devices today, from smartphones to smartwatches, by which you can regulate whom your child can contact and track their whereabouts.

Again, you want to do your due diligence as a primary caregiver, get to know any parents or other guardians involved, know your young person is in a safe place, and, if they are going out, where they are headed and when they will return.

Parents and guardians should prepare as well for some age-appropriate talks on the expectations and pressures of friendships and relationships and that discourage experimentation with substance use. Drug-overdose deaths of teens have spiked in recent years; underage drinking remains a serious health problem in this country, and studies on the impact of the legalization of adult cannabis show an increase in use among teens.

High school brings a little more autonomy for teenagers and the need for more candid discussions on dating and substance use, including that the minimum legal age for buying, transporting, or drinking alcoholic beverages is 21.

“Parents and guardians should prepare as well for some age-appropriate talks on the expectations and pressures of friendships and relationships and that discourage experimentation with substance use.”

There is value for a teen who is old enough to look for a job. It gives the ability to have more autonomy and more cash to spend and save, and is a good use of their free time.

Parents and guardians should continue their due diligence in knowing who their child is hanging out with in high school, where they are going, and when they will return.

College students can be bit of a conundrum because they are adults. Maybe it is time to say they are coming back home as adults, and you will hold them to that standard in terms of their personal habits around the house.

They are old enough to get a job. This, again, allows them more bandwidth in what they might want to purchase for themselves, help with cost-of-living expenses when they are home, and helps structure their time.

Having structure is key in helping young folks during the summer not get distracted and into risky situations, as is knowing their friends. Have their friends (new and old) over the house and meet them during the summer. There is no harm in meeting your children’s friends of any age.

 

BusinessWest: How can parents and guardians best initiate a talk around accountability and acceptability during vacation?

Beheshti: The best approach is often from an angle of curiosity. This makes it conversational rather than who, what, when, and where. For example, adults often share about each other’s friends just out of an interest, and this tact will likely have more traction with teenagers and young adults versus grilling them.

There is also value in saying to your young person, “I remember my summers when I was a teen, and how my parents (your grandparents) were, and I understand today their concerns for me back then.” The more transparent and sharing (within reason) parents and guardians are, the better chance for more open discussion.

 

BusinessWest: How important is adhering to routines like bedtime during summer?

Beheshti: There can be some leeway. For example, if you have a 9- or 10-year-old, the average bedtime should be between 8 and 9 p.m. If you want to push it to 10 p.m. during the summer and have them sleep a bit later, you need — about two weeks before the start of school — to get that back closer to their school-year sleep pattern so they don’t wake up super tired and have a hard time adjusting the first week of school.

You also want to make sure they are eating healthy, balanced meals during the day with plenty of exercise.

 

BusinessWest: Is it important to spend more family time together during vacation?

Beheshti: There is value in trying to schedule at least one week, maybe two if you have the luxury, for some vacation — even if it is a staycation — with your kids, even when they are high-schoolers. They may roll their eyes, asking why the family is doing something, but being together as a family is something you may not get to do a lot during the school year.

 

BusinessWest: What mental-health issues come up during summer for school kids?

Beheshti: Historically speaking, and the pandemic years aside, the inpatient child and adolescent psychiatric bed census drops during the summer for several reasons. There is less demand on young people during the summer. This means, if they have been managing a diagnosis of depression or anxiety, for example, their symptoms tend to be less severe with less pressure.

However, one cohort of children that particularly benefits from structure and routine are those with developmental delays, including those with related neurobehavioral disorders such as autism spectrum disorder. We see the same amount of prevalence of children with a neurodevelopmental disorder needing hospitalization during summer because their preferred school routines have gone away.

 

BusinessWest: Why symptoms might indicate to a primary caregiver that a child is struggling emotionally?

Beheshti: If you see a noticeable change from what’s typical in their daily activities, meaning their sleeping, eating, or day-to-day mood, pay attention especially if it continues for more than two weeks. This is true even in someone who does not have a previous mental-health diagnosis. Consider making a call to your child’s pediatrician or primary-care provider, especially if they are not established with a psychiatrist.

Parents and guardians — again, coming from an angle of curiosity — could gently ask a child about a noticed change. If they are eating less, for example, you might ask if there is something wrong with their stomach, or is there something else going on in their life? A conversational approach, starting young, can make communication easier as a child ages.

 

BusinessWest: What support is important during the summer for a young person who may be questioning their sexual orientation or gender identity?

Beheshti: You hope that young people who are going through these transitions have had support during the school year. However, some kids may not get this, and there is the potential as well for peer abuse or bullying. A peer counselor would be a good source of support, along with finding a therapist who is experienced in delivering culturally competent care to individuals who identify as LGBTQIA+.

The Massachusetts Department of Mental Health has a web resource page, Young Adult Resource Guide LGBTQIA+ Resources, at www.mass.gov/info-details/dmh-young-adult-resource-guide-lgbtq-resources.

 

For more information on MiraVista’s inpatient behavioral-health treatment for adolescents, as well as adults, call (413) 701-2600 or visit www.miravistabhc.care

Healthcare News Special Coverage

Specialized Approach

 

The new hospital

The new hospital, seen here in the late stages of construction, will open in August.

 

As Dr. Barry Sarvet surveys Valley Springs Behavioral Health Hospital a couple months before its opening, he’s excited about what he sees.

“We are extremely excited to be providing a brand new, state-of-the-art psychiatric hospital facility for our communities in the Pioneer Valley,” said Sarvet, chair of the Department of Psychiatry at Baystate Health. “Hospital care for behavioral-health patients requires a specialized environment of care to ensure safety, comfort, and privacy for patients and a setting for a full range of therapeutic services to support their recovery.”

The Holyoke-based hospital does just that, he noted. “Our new facility is spacious and will have an abundance of natural light. It includes ample spaces for psychotherapy, rooms for art and occupational therapy, a gymnasium for physical activity and recreation, and access to outdoor spaces for fresh air. Psychiatric patients deserve to be treated in an environment of care that supports their dignity, and we’re so pleased to be able to offer this.”

But he’s just as excited, if not moreso, about what the hospital, a joint venture between Baystate Health and Lifepoint Behavioral Health, means for access to behavioral healthcare in the region, which still faces a shortage of inpatient psychiatric services and increasing mental-health needs.

“We care deeply about people who need psychiatric services and are committed to the success of this new project,” he said, adding that the partnership with Lifepoint is smart considering that organization’s expertise in the development of new specialty hospitals and its commitment to quality care. “In developing this new hospital with our Lifepoint partners, we are continuing and enhancing our commitment to fulfilling the mental-health needs of people in our region.”

Dr. Barry Sarvet

Dr. Barry Sarvet

“Hospital care for behavioral-health patients requires a specialized environment of care to ensure safety, comfort, and privacy for patients and a setting for a full range of therapeutic services to support their recovery.”

Baystate actually announced a partnership on this project with Kindred Healthcare LLC during the summer of 2000, before Kindred was purchased by Lifepoint Health about a year and a half ago. Lifepoint boasts more than 100 specialty hospitals across the U.S. focused on four divisions: skilled nursing, rehabilitation, acute care, and behavioral health, said Roy Sasenaraine, CEO of Valley Springs.

“There’s a significant need in Western Mass. for this specialized hospital. The behavioral-health needs in the population are so great, and the differentiation between this service line and every other service line is so different, you need something like this; just like having a specialty hospital for children, you need a special team to come together to care for behavioral-health patients.”

The new facility, set to open in mid-August, will increase capacity for inpatient behavioral healthcare for adults, children, and adolescents in the area by 50%. Built with the unique needs of behavioral-health patients in mind, the $72 million hospital is designed so patients receive their care and treatment in an environment that supports their recovery, Sasenaraine said.

The 150-bed hospital at 45 Lower Westfield Road in Holyoke, including 30 beds dedicated to longer-term care through the Massachusetts Department of Mental Health, has been planned with patient safety in mind, he added.

“A benefit of new construction is that patient safety and privacy has been factored into every aspect of the building, from patient rooms to the gymnasium. We have fine-tuned every detail and thought of everything in terms of safety: toilets, window blinds, even door jambs. The new building allows us to make use of modern technology to elevate patient safety in a way retrofitting an existing unit could not.”

 

Access Points

A new service offered by Valley Springs Behavioral Health Hospital will be on-site evaluations following a provider referral, allowing some patients to be admitted without an Emergency Department visit at a different hospital.

Currently, around one-third of the behavioral-health patients evaluated in Baystate Health’s four emergency departments are transferred to facilities outside of Western Mass. due to a shortage of psychiatric beds in the region. With the opening of Valley Springs, more patients will have the opportunity to receive treatment close to home, Sasenaraine explained. The hospital’s location is intended to provide accessibility, being close to Routes 90 and 91, while also providing a facility focused solely on specialized care for mental health.

Roy Sasenaraine

Roy Sasenaraine

“The new building allows us to make use of modern technology to elevate patient safety in a way retrofitting an existing unit could not.”

He explained that patients will be admitted in three ways: people in crisis can be taken directly to the hospital by ambulance, other care providers will refer patients in need of behavioral-health treatment, and people can also walk in off the street.

“They might say, ‘I think I need help. I’m suicidal.’ That’s what my intake-assessment team is here for, to assess them for clinical issues, suicidal ideations, whatever it may be.”

Sasenaraine also noted that the new facility will provide employment opportunities with the opportunity to positively impact the lives of patients and families in the community. Employees currently working in Baystate facilities whose services will be transferred to Valley Springs Behavioral Health Hospital will have the opportunity to apply for positions there, in addition to opportunities for new employees to be a part of the joint venture.

“We’ll employ a lot of people, even some departments that didn’t exist before,” he said, such as a 24/7 intake department that will provide 18 full-time equivalent jobs. “For many people, this will be a once-in-a-lifetime opportunity to be a part of building a new organization from the ground up.”

Behavioral-health services from Baystate Wing Hospital and Baystate Noble Hospital, as well as pediatric behavioral-health services from Baystate Medical Center, will begin to transition to the Valley Springs site in August. Spaces in those facilities will then be converted to primary and specialty care or will be used to accommodate the increasing demand for inpatient medical services.

Baystate Health is working closely with the Department of Public Health (DPH) during this transition. The affected inpatient facilities are expected to be fully transitioned by the end of the year, with most completing the move in the fall, and partial hospitalization programs transitioning by January 2024.

As Baystate Health works with DPH to facilitate the transition, a series of formal notices will be made, public hearings will be held, and DPH will work with Baystate Health to assure patient-access needs are met. This process has already begun, about four months before the intended full transition for each affected unit, starting in late May for Baystate Wing, mid-June for Baystate Medical Center, and late June for Baystate Noble Hospital; it will continue in July for the partial-hospitalization program at Baystate Franklin Medical Center.

Valley Springs Behavioral Health Hospital will be affiliated with the psychiatric services operated directly by Baystate Health, including a 28-bed Adult Psychiatric Treatment Unit at Baystate Medical Center, which serves as a primary site of training for medical students and psychiatric residents within UMass Chan Medical School – Baystate educational programs. This unit has a unique role in the care of patients with co-occurring and complex medical issues, requiring the resources of a general hospital.

Baystate’s Department of Psychiatry will also continue to operate its array of ambulatory behavioral-health services, psychiatric consultation services, emergency psychiatric services, and programs supporting mental-health treatment in the primary-care setting.

In addition, Baystate Health will continue to operate its 22-bed Mental Health Unit at Baystate Franklin Medical Center, which provides inpatient behavioral healthcare for patients in Greenfield and the surrounding communities. According to Ronald Bryant, president of Baystate Regional Hospitals, the decision to keep this unit open was made based on geography and Baystate Franklin’s history of integration of behavioral-health services, such as the 24/7 presence of recovery coaches in the Emergency Department.

“Baystate Franklin has spent many years building strength in behavioral-health practices that really connects with a lot of the other types of care provided,” Bryant said. “We didn’t want to lose the continuity of that integration.”

 

Fulfilling a Mission

Before coming to Valley Springs, Sasenaraine served as vice president of Operations for the central region of Spire Orthopedic Partners, where he led new construction, patient-access initiatives, and acquisition and integration work for Spire’s nine locations in Connecticut.

Prior to that, he served as vice president of Operations for Hartford Healthcare System’s East Region behavioral-health network, where he oversaw 18 locations, including six school-based programs, two emergency departments, one inpatient psychiatric hospital, eight ambulatory locations, and one inpatient juvenile program. His leadership led to the implementation of a new care model for adolescent, pediatric, and adult patients in inpatient care, along with the implementation of a new electronic medical record across all sites of care.

“Roy’s breadth of operational experience and his deep understanding of the behavioral-health setting make him the right leader for this new, state-of-the art facility that we are excited to open in the coming months,” Dr. Andrew Artenstein, Baystate Health’s chief physician executive and chief academic officer, said when the appointment was announced in the spring.

For his part, Sasenaraine said he embraces the opportunity to oversee a new specialty hospital that will increase employment in the region and generate $1.6 million in taxes annually — but, most importantly, provide more access to behavioral healthcare at a time when it’s needed.

“I know that we have an exciting road ahead of us,” he said. “I look forward to serving patients in Western Massachusetts with safe, high-quality behavioral-healthcare services.”

Healthcare News

Introducing the Area’s 2023 Nursing Graduates

Hundreds of nursing students recently graduated from the area’s colleges. American International College, the American Women’s College at Bay Path University, Elms College, Holyoke Community College, Springfield Technical Community College, and UMass Amherst have announced the names of their 2023 nursing graduates. BusinessWest congratulates all of the graduates on their success.

AMERICAN INTERNATIONAL COLLEGE

Bachelor of Science in Nursing
Banyatie BahTraore
Kendal Bates
Rileigh Berneche
Abigail Carney
Erin Chase
Valery Cortes
Catherine Desrochers
Shannon Dion
Sean Dziuba
Brianna Fontaine
Briahna-Mary Hersom
Sophia Hess
Sara Howard
Yvonne James
Meghan Kalbaugh
Liza Lapko
Mildred Lefebvre
Ariana Martel

 

Phuong Mazza
Debi McEnaney
Morgan Miller
Jade Mitchell
Laura Moya Mejia
Maria Navarro
Sarah Newsome
Madison Paul
Alyx Pollard
Courtney Provencher
Julitza Rivera
Shannon Santos
Michael Shvetsov
Danielle Sica
Jennifer Tousignant
Genesis Vasquez
Luigi Zebrowski

Master of Science in Nursing
Amanda Allegra
Janessa Andrews
Cherise Antoine
Nicole Bagge
Kerilyn Barrios
Katherine Bean
Danielle Brouillette
Tamia Cheeks
Amanda Chen
Annmarie Goulas
Ashley Graveline
Bertram Henry
Christina Latorra
Joel Leconte
Emily Mendez
Christine Murphy
Judy Nham
Claribel Parra
Katherine Pawlowski
Muoi Petruff
Alycia Piedra
Kristen Robertson
Victoria Rondinelli

BAY PATH UNIVERSITY

Bachelor of Science in Nursing
Angela Abbatemarco
Bethanie Deleon
Thea Gallagher
Shenell Gayle
Winnie Lopez Sanchez
Jane Marozzi
Christina Mbabazi
Jaime Richter
Samantha Sardella
Karen Scott
Salifyanji Thomas

 

Doctor of Nursing Practice
Colleen Barker
Monique Brunelle
Sylvia Darko
Hyemi Kim
Jill Kordas
Elizabeth Nantaba
Jason Reyes
Jenna Tymkowiche

ELMS COLLEGE

Bachelor of Science in Nursing
Dianelise Acevedo
Courtney Adams
Rebecca Adjei-Nyame
Emma Agli
Priscilla Akuffo
Stephanie Alden
Gabriel Asare
Jonathan Bailey
Leah Barr
Marie Basil
Reyna Bautista
Yelena Bazukina
Chelsea Bergeron
Maggie Berrier
Jillian Russell Buendia
Anna Burgener
Nicholas Butera
Miranda Cadena
Sara Campbell
Alexandria Carmon
Madison Carra
Gabriela Chavez
Daisy Chege
Kristen Chianese
Emily Christie
Brian Cintron
Kelly Clare
Kathreen Collado
Danielle Collette
Dominic Colucci
Sarah Congden
Mikayla Costello
Rosemary Costello
Ashley Cronkhite
Cynthia Davis
Autumn DeBlois
Nicole DeFeo
Alyssa Dunham
Monica Esten

Adriana Ewig
Krystal Fitzgerald
Hayleigh Gagne
Emily Gay
Jennifer Girard
Ashley Girouard
Samantha Goncalves
Abigail Goodnow
Julia Grando
Tori Grano
Aleesha Grochoweski
Victoria Guay
Sara Guijarro-Sines
Lily Gyasi-Denteh
Maria Hernandez
Sydney Howard
David Ivanov
Taylor Johnson
Katie Jones
Miranda Kamukala
Alfiya Khuzhakhmetova
Caroline Kirk
Matthew Kisiel
Agata Kluk
Emily Krasinkiewicz
Connor LaFlamme
Rachel Lambert
Samantha Landry
Rheanna Lannon
Jayla Latham
Brittany LaVigne
Miranda Lebel
Michael Maggipinto Jr.
Taylor Malinowski
Flavia Marques
Jemma Marsh
Margaret Mathon

Kiana McDonald
Nicholas McElroy
Madison McGinnis
Kelsey Doray McMorrow
Mary Michaud
Lainey Mwangi
Sarah Nguyen
Ruth Njaaga
Caroline Njenga
Dekyong Nyandak
Solomon Tomeka
Parslow Oneka
Peter Otiende
Chynna Pacheco
Kayla Pasquel
Karlie Petlock
Meaghan Petty
Amber Piedra
Amy Pont
Danielle Poppel
Madison Quinn
Gabriela Rasuk
Michelle Redenz
Victoria Ricciardi
Deviyana Rivera
Kiara Rivera
Jocelyn Rodriguez
Mia Rotatori
Amanda Santerre
Shana Spratt
Daisia Stinson
Cassidy Sweeney
Alexander Szarkowski
Hanna Ton
Dawa Tsering
Josephine Yeboah
Yitian Zhang

 

Master of Science in Nursing
Jessica Abisla
Melinda Behrens
Lindsey Bowen
Tracina Brown
Kerrin Conceicao
Ann Covey
Erika Cisneros Cullen
Jessica Douglas
Michelle Ewing
Pamela Garrity
Rena Gilliam
Elaine Kalinowsky
Cassandra Keller
Kirsten Kennedy-Alvarado
Melissa Stewart Laws
Lia Long
Alexandra Marques
Caroline Mechan
Georgeann Natale
Pamela Neleber
Beth Osha
Courtney Peets

Deborah Pipan
Tara Schiller
Fawne St. Pierre
Ashley Stazzone
Nicholas Taylor
Brian Toia
Susan Williams

Certificate of Advanced Graduate Study in Nursing
Samantha Gilpatrick
Lori Gramolini
Carly Masse
Claudia Palframan

Graduate Certificate
Sandra Neubig
Fawne St. Pierre
Nicholas Taylor
Susan Williams

Doctor of Nursing Practice
Anne Albano
Louisa Asianmah
Jaime Caron
David Chastain-Stultz
Lacey Harding
Marina Hoag
Beata Kubacka
Yolanda Marrow
Laura Monette-Currie
Kathleen Pont
Lou Rios
Abigayle Sidur
Jennifer Stebbins
Melecio Tan Jr.
Jennifer Tarczali
Lynda Tenorio
Catherine Thresher
Ashley Williams

HOLYOKE COMMUNITY COLLEGE

Associate of Science in Nursing
Latisha Abraham
Ahmed Aljanabi
Matthew Aube
Paris Beaudette
Ash Berman
Jessica Boulanger
Kathryn Cardin
Enette Claxton-Toliver
Michelle Cosme Serrano
Jacquelyn Crosler
Chelsea Daniels
Leigh Montemagni
Rosemary Dennis
Makailah Desharnais
Elissa Dingman
Lillian Doherty
Amber Doucette

Monica Drew
Yana Dyurteyeva
Samuel Farinloye
Madeline Fenderson
Jose Flores
Noelle Fournier
Alison Hansen
Lindsay Hawley
Billie Jackson
Jessica Tynea Johnson
Kaye-Loni Johnson
Tanner Johnson
Victor Koskey
Jenafer Kularski
Valeriy Kuznetsov
Jennifer Lagoy
Laura Levin

Becky Lexial
Vadym Malenkyy
Shelley Mather
Sam Methe
Courtney Munns
Kerry Jo Nagle
Crystal Pares
Maurice Ramogi
Jennifer Rivera
Jamie Schmitt
Amarilys Sepulveda
Briana Silva
Ryan Skowron
Jocelyn Soto
Jackie Tran
Mildred Velez
Evans Wangari
Megan Williams

SPRINGFIELD TECHNICAL COMMUNITY COLLEGE

Associate of Science in Nursing
Julia Bihler
Natia Bledose
Lori Borrego
Chase Boudreau
Olga Caraballo
Sharon Velazquez
Rossana Chum
Hope Connaughton
Chloe Connery
Brittany Cortis
Sandi Croteau
Leah Daisy
Alesya Danyuk
Julie Demoracski
Rebecca Ellis
Mariah Flores
Di Fu
Janice Garcia
John Graham

Savannah Granger
Madelyne Grunden
Rachael Hawley Gutierrez
Jameson Kebba
Ashlyne Khayesi
Maria Lajara-Cris
Diana Lane
Jasmin Lantigua
Elizabeth Lombardi
Taylor Lukas
Dana Lund
Ashley Maldonado
Alyssa Mansfield
Paskel McDonald
Danasha McKenzie
SophiecLellan
Robin Molina
Kayla Monroe

Leah Muise
Kristin Nothe
Dorothy Atieno Omondi
Janet Perez-Rivera
Brenda Pomeroy
Jessica Provenzano
Matthew Przybyszewski
Adam Quinn
Zachary Rajpold
Kavya Rejikumar
Joleen Rettura
Tifanie Rivera
Alexander Rokosz
Christopher Singer
Pavel Slivka
Waniekie Stewart
Melissa Stokowski
Samantha Trace
Thea Yvon
Anna Zelasko

UMASS AMHERST

Bachelor of Science in Nursing
Rachel Aalto
Brendan Barrie
Patrick Bartosiewicz
Emma Becker
Makayla Belfiore
Laura Berry
Allison Brightman
Andrea Callahan
Allison Cebollero
Alana Connelly
Alexa Cruz
Alex Dai
Ria Deshpande
Tess Downes
Robin Dupre
Anna Duquette
Kevin Farwell
Katerina Filipova
Jillian Flynn
Marcus Friedel
Lauren Gusmini
Casey Heinrich
Jackson Hicks

Caroline Kennedy
Jennifer Kovarik
Andrew Lachtara
Joyce Li
Piper Lieto
Sarah Los
Jenelle Marius
Lauren McGrath
Alyssa Mello
Sophie Meltzer
Cailyn Merrill
Victor Mora
Tiffany Nguyen
Julie Obeng-Nyarkoh
Galen Oey-Langen
Luna Peary
Julie Pehlert
Jason Pham
Christina Phillips
Tessa Robertson
Jessica Rodrigues
Emily Schroeder
Grace Seaborn
Matthew Serdy
Brianna Shepherd
Aaron Sherck

Jessica Smith
Zuzanna Stepnowski
Olivia Teh
Holly Tremblay
Kylene True
Jefferson Wermuth
John Wilson
Samantha Yee
Joshua Zelikman

Accelerated BSN
Denise Anderson
Hannah Buckley
Devante Clarke
Danielle Culver
Karla Garcia
Todd Ruby

RN to BSN
Ronald Cruz
Robert Erardy
Michelle Gingras
Maryblessing Nnodim
Michele Ragston

Doctor of Nursing Practice
Olivia O’Brien Bass
Rebecca Brady
Mara Clawson
Christopher Diaz
Katherine Doherty
Alicia Ellis
Cori Fappiano
Alyssa Freeman
Stephanie Henry
Lorraine Howlett
Lucky Igbokwe
Sophia Khalifa
Kendra Lehman
Tara Moseni
Daniel Njuguna
Ronald Rollon
Emily Thomas
Mildrine Tulysse

Healthcare News

‘I Need to Be a Nurse’

Meghan Kalbaugh

Meghan Kalbaugh plans to progress toward her master’s degree while working full-time as a nurse.

 

Meghan Kalbaugh’s mother was a nurse who worked in emergency rooms and on patient floors at local medical centers, including Baystate, Mercy, and Holyoke. Her example was a quiet one.

“Surprisingly, we never really talked about it growing up,” said Kalbaugh, who graduated from American International College (AIC) this spring with a bachelor of science in nursing degree. “It was always just my mom; she was a nurse, and she would come home, and I didn’t really have it in my mind to be a nurse.”

But in high school, Kalbaugh participated in a healthcare-careers program, thinking she wanted to be a veterinarian. She eventually realized that wasn’t for her, but she stayed in the program because her parents convinced her to follow through and finish it.

“So, my last year, I became a CNA because the final year of the program is doing a CNA course that’s completely paid for because it was dual enrollment with Holyoke Community College,” she recalled. “Throughout the course, I fell in love with taking care of people and forming a really special bond with my patients. I came home one day, and out of the blue, I was like, ‘I need to be a nurse. I love this, and I want to further my education.’”

Kalbaugh’s original goal when she enrolled at AIC was pediatrics, and she still loves that work, but a labor and delivery rotation changed her mind, and that has become her preferred setting down the road. “But I’m actually starting my nurse residency at Baystate on July 24, and I’ll be in the heart and vascular unit, because labor and delivery wasn’t hiring new graduates. I figured going to a different unit will still provide me with valuable skills and experience. So I’m really excited; I’ll get some heart and vascular experience and then hopefully, within a year, move over to labor and delivery.”

The past four years weren’t easy for Kalbaugh and her classmates, she said, due to the disruptions caused by the pandemic.

“What draws me in is how rewarding it is, knowing I’m helping people and making an impact in their life and changing lives every day; I absolutely love that.”

“It was really, really hard doing it all online from home, especially not seeing the professors in person and not having lectures in person, and just being alone. The coursework was challenging, and that was a time when we all really needed each other, and we couldn’t be with each other. So it was hard, honestly, managing like the isolation from everyone. I’m a very social person, and I just wanted to be around my peers so we could help each other and talk about concepts and be able to like connect with our professors.”

That said, “I’m happy we got through it as a class and were able to come back in person. I was so relieved. I remember the day that they told us we could come back, and I was so excited. I thought, no more of this awful being alone.”

After all, Kalbaugh is, as she noted, a people person, and she values the connections she can make as a nurse.

“What draws me in is how rewarding it is, knowing I’m helping people and making an impact in their life and changing lives every day; I absolutely love that.”

That’s not the only draw for nurses these days. As hospitals and organizations struggle to fully staff and retain their nursing teams, career opportunities abound.

“Everyone is hiring, and they’re offering great incentives, sign-on bonuses, and there are lots of new positions opening,” Kalbaugh said. “There’s a lot of room for growth in healthcare, too, whether that’s climbing up to manager or supervisor or advancing your practice, like becoming a nurse practitioner. There’s a lot of room for growth.”

That’s why she’ll be back at AIC in the fall to start pursuing her master’s degree: to open up new avenues for career growth.

With a degree beyond the BSN, she noted, “you get to be an advanced-practice provider … and, obviously, there’s a better paycheck, and you have more autonomy. So I’m definitely going to keep going because I can see myself doing that, and I believe I have the capability.”

The three-year master’s program is fully online, except for clinical experiences, she explained, an ideal model for people who are actively working full-time or have children and families and other responsibilities.

“I like how it’s broken into one class at a time to make it more easily manageable for people who are working full-time like me,” she said. “So I’ll be working full-time at Baystate and doing this. My unit manager is pretty awesome; I told her I was going to keep going, and she seems like she’ll be very flexible with my schedule and hours, which is good.

“It’s a great way to keep people moving up and progressing as they learn because so much help is needed,” she added. “I mean, you need nurses working, but you can actually continue your education as well. That’s a cool model. And after my first year at Baystate, they’ll give me some tuition reimbursement as well, which is amazing.”

In short, Kalbaugh is a woman with a plan.

“I’m very excited, and also very nervous because it’s going to be a lot. But challenge hasn’t stopped me before, so I’m excited.”

 

—Joseph Bednar

Healthcare News

‘I Love the Profession’

Ashley Girouard

Ashley Girouard is gaining experience through Baystate’s SNAP program for new nurses.

 

To Ashley Girouard, seeing patients isn’t just treating them and sending them on their way. There’s a connection to be made in each encounter.

“I love making connections with my patients,” she said of her current work in an orthopedic unit at Baystate Medical Center. “A lot of these patients come in for routine hip and knee surgeries, and they’re healthy. And I love being able to talk to them. We’ll talk about sports, we’ll talk about their lives, their family, and I think it’s great. I love making those connections by talking to them.”

At Elms College, where she recently earned her bachelor of science in nursing degree and will soon add the title of registered nurse, Girouard followed in the footsteps of her mother, who made nursing her profession as well.

“I’ve always looked up to her. I see what she does day in and day out,” she said. “I know that I love caring for everybody around me, so I just decided to go into this profession … and I love it.”

Girouard currently works in the Student Nurse Associate Program (SNAP) at Baystate. SNAP nurses function in a supportive role to a registered nurse and work collaboratively with the healthcare team in the management of patient care. This position allows the student to gain experience in providing care to a diverse patient population and to develop strong communication and organizational skills.

Meanwhile, they perform direct patient care, obtain and record vital signs, collect laboratory specimens, document intake and output, communicate with patients and staff, promote patient safety, and function as a team member within the health system. Girouard appreciates the experience she’s getting through the program, not only in the specifics of orthopedics, but how to relate to patients. And she intends to keep learning, in a variety of settings.

“I want to get some med-surg experience, and I’ve always been interested in intensive care. And then I definitely want to go back to school,” she said, looking to move on to a master’s program. “My goal is to be a nurse practitioner.”

When asked why she strives for an ICU role, she said the “go, go, go” of the setting appeals to her. “These patients are very critical, and I’d like to be able to help them in any way possible, and just get them even a little better than they were in the morning.”

Taking classes and gaining learning experiences through the COVID-19 years was difficult, she admitted. “I’m a very hands-on visual learner, and having to learn from home in my room on a desk was not ideal at all.

“But we had amazing professors at Elms,” she added. “And they helped so much, all the time. They would have hourly extra time when you could go on Zoom with them, and if you needed help, they were always willing to help. I think the professors really made a difference. After all, they had to adjust to this big change as well.”

Even a period of mask wearing in class was a reminder that the pandemic wasn’t quite over, so being able to attend classes without masks this past year — and, more recently, work clinical rotations without them — have been pleasant reminders that life has returned to normal.

For health systems, of course, it’s still a very challenging time because of nurse shortages, as all the recent graduates we spoke with told us. And that means greater career opportunities for those entering the field, who are able to write their own tickets — with the right degrees of course.

“Even if there weren’t so many jobs out there, I still would be interested in nursing. I love the profession,” Girouard said. “But I think a lot of people want to go into nursing because they know they can go into deeper specialties like ICU or PICU, things like that.”

The work certainly requires certain traits, she said. “Definitely caring, for sure. And patience. If you don’t have patience, I don’t think this would be a good career choice for you; a lot of patients can be very difficult. And you need to be careful, too. A lot of errors can happen, and we learn in nursing school how important it is to prevent errors. It’s so easy to make a mistake.”

So, as Girouard ponders what might be next for her, both in the work setting and eyeing the next steps in her education, she’s walking into a world of opportunities as an RN with a healthy sense of caution and care, but not anxiety.

“I’m just so excited,” she said. “The last four years were so difficult, especially with COVID and working in the hospital during COVID. And now I get to go to work and not wear a mask. And I’m going to be a nurse, and actually take care of patients and be a difference maker.”

 

—Joseph Bednar

Healthcare News

‘I Always Wanted to Help People’

Jane Marozzi

Even after many fulfilling years in nursing, Jane Marozzi’s dream was to earn a BSN, so she did.

 

When Jane Marozzi says she’s been looking forward to earning a bachelor of science in nursing degree for a long time, she means it.

Because in her case, the BSN isn’t just the culmination of four years of college, but a highlight of a career that has spanned almost four decades.

Still, like other, more traditional graduates of area programs, her interest in a nursing career started early.

“I have a picture of me with a stethoscope at Christmas time when I was little,” Marozzi recalled. “I felt a natural draw to the field.”

So, after high school, she enrolled in a three-year diploma program at St. Francis Hospital School of Nursing in Hartford, Conn. and started her nursing career at its affiliate hospital, now operated by Trinity Health Of New England, in 1985.

Thirty-eight years later, she is celebrating earning her BSN at Bay Path University.

“I always wanted to help people,” she said of her long career, spent exclusively at St. Francis, first on the cardiac floor and then in maternity.

“Throughout that time, I got married and had children,” she said, but throughout her career, “I always wanted to get my BSN. After my parents had passed in 2018, I said, ‘I’m going to do it.’ Bay Path gave me such great flexibility, to be able to do it online five days a week. It was a lot, but it was doable.”

While nothing could replace a lifetime of caring for patients, “the nursing program taught me so much about wellness, diversity, nursing research, and community health, which was huge because I did not get that in my diploma program. I became a better writer. My leadership skills grew.”

Marozzi graduated in December 2022, and on Jan. 1, BSN in hand, she was offered the nurse manager position in the maternity unit at St. Francis.

With a few months in that role under her belt, and just a few months short of her 60th birthday, she’s glad she made the effort to earn that degree.

“I said to my husband, ‘why am I doing this? I’m 59.’ And he said, ‘you wanted this. Keep going.’ So there were professional reasons, but a lot of personal ones too.”

“I felt like the BSN nurse was looked at a little differently. It became my personal goal to strive for this, and as I got close to the end, I saw I had an opportunity to become a nurse manager,” she said. “I said to my husband, ‘why am I doing this? I’m 59.’ And he said, ‘you wanted this. Keep going.’ So there were professional reasons, but a lot of personal ones too.”

In both the cardiac unit early in her career and the maternity unit later on, she had opportunities to learn and grow into leadership roles; her last position before becoming nurse manager was senior clinical advisor, which was a mix of bedside and office duties.

As for that bedside role, she said it has changed a great deal over the years.

“The amount of computer charting, I think, has removed the nurse from the bedside. When I was first a bedside nurse, we gave backrubs — there was so much care we did. Now that kind of care is either missing or is in a nursing assistant role. There’s so much documentation now.”

She is intrigued by a ‘virtual nurse’ technology being introduced by Trinity Health at St. Francis later this summer, through which patients can be observed via a TV screen by a remote nurse, who can respond to needs right away and summon the right personnel into the room.

“I still jump out there if the staff needs me, to keep up on my bedside skills. I don’t want to forget what it’s like to be at the bedside.”

“I find that fascinating,” Marozzi said, but responding to patients’ needs has always been the heart of the nursing life for her. “I still jump out there if the staff needs me, to keep up on my bedside skills. I don’t want to forget what it’s like to be at the bedside.”

And her hospital, like so many others, needs nurses at the bedside.

“We’re getting graduate nurses, and we have a great training program here,” she added. “We try to bring them in early in their careers — student nurses, interns … we get them in, get them some skills, and maybe they will be interested in becoming a nurse.”

With nurse shortages a national concern, Marozzi is intrigued by the fact that hospitals are even bringing in LPNs for roles that previously required an RN.

“They don’t have the amount of nursing candidates that they need; it’s quite a different world right now. They’re looking for nurses,” she said. “Hospitals, we were told 10 years ago, didn’t take anyone unless they had the BSN. My whole capstone project was on how LPNs and team nursing are coming back. You need a team to get it done. And the LPNs have been just fabulous, giving medications, doing treatments, taking the pressure off registered nurses.”

Clearly, career possibilities abound in nursing — no matter one’s age.

“It’s definitely a great time to be a nurse,” Marozzi said. “There are so many opportunities for growth, and hospitals need so many nurses.”

 

—Joseph Bednar

Healthcare News Special Coverage

Easing the Strain

Teresa Kuta Reske

Teresa Kuta Reske, in the nursing simulation lab at Elms College, said many nurses were influenced in their career choice by care they or a loved one received.

Teresa Kuta Reske loves nursing.

She said that on more than one occasion when speaking with BusinessWest recently for this special HCN section celebrating nurses, and especially recent nursing graduates beginning to enter the workforce.

As interim dean of the Elms College School of Nursing and director of the college’s Doctor of Nursing Practice program, she also loves seeing that passion develop in students.

“We prepare nurses with the skills and knowledge it requires to be in the nursing workforce, but when partnered up in the hospital setting, with students having clinical experience and being mentored by these organizations, they’re learning about what nurses contribute to patient care, watching nurses in action, and seeing systems come together,” Reske said, adding that there’s only so much students can learn in a simulation lab; they learn to form their own professional identity when training inside the healthcare system.

She noted that many students gravitate to the profession because of positive experiences with nurses, either for themselves or a loved one. In other cases  they were influenced by a parent’s career in the field. But that passion also quickly gets tempered by the realities of an increasingly challenging job.

“When we build a strong nursing workforce, it begins with education. And educators are tasked with teaching the new demands of the healthcare system,” Reske said, with factors ranging from population-health concerns to a more interdisciplinary focus in patient care. “Learning to become a nurse means understanding the realities of the nursing workforce today.”

Those realities come at a time when staffing shortages have increased stress on nurses. At a time when the annual Gallup Honesty and Ethics poll, released in January, ranks nursing as the most trusted profession for the 21st year in a row, nurses are feeling strain.

In fact, the American Hospital Assoc. (AHA) reports that about 100,000 registered nurses left the workforce during the past two years due to stress, burnout, and retirements, and another 610,388 intend to leave by 2027, according to a recent study by the National Council of State Boards of Nursing (NCSBN).

“The pandemic has stressed nurses to leave the workforce and has expedited an intent to leave in the near future, which will become a greater crisis and threaten patient populations if solutions are not enacted immediately,” said Maryann Alexander, NCSBN’s chief officer of Nursing Regulation. “There is an urgent opportunity today for healthcare systems, policymakers, regulators, and academic leaders to coalesce and enact solutions that will spur positive systemic evolution to address these challenges and maximize patient protection in care into the future.”

Among other recommendations to strengthen the healthcare workforce, AHA has urged federal lawmakers to invest in nursing schools, nurse faculty salaries, and hospital training time; enact federal protections for healthcare workers against violence and intimidation; support apprenticeship programs for nursing assistants; increase funding for the National Health Service Corps and the National Nurse Corps; and support expedition of visas for foreign-trained nurses.

For its part, Baystate Health said the Gallup poll is worth celebrating.

“The honor comes as nurses throughout the country, including here at Baystate Health, continue to deal with the effects of a nationwide nursing shortage and the emotional impact that the COVID pandemic has had on nurses,” said Joanne Miller, chief Nursing executive for Baystate Health and chief Nursing officer at Baystate Medical Center. “I am proud to say that, since the beginning of the pandemic, every nurse at Baystate Health has fulfilled our promise of advancing care and enhancing lives.”

Today’s nearly 4.4 million registered nurses in the U.S. constitute the nation’s largest healthcare profession, and the field offers a wide range of opportunities to those considering a career, including practicing as clinicians, administrators, researchers, educators, and policymakers.

In 2022, Baystate Health welcomed more than 900 nursing students into clinical placements from nursing programs at American International College, Bay Path University, Elms College, Holyoke Community College, Greenfield Community College, Springfield Technical Community College, UMass Amherst, and Westfield State University.

Linda Thompson, left, and Holyoke Community College President Christina Royal

Westfield State University President Linda Thompson, left, and Holyoke Community College President Christina Royal shake hands after signing a dual-enrollment nursing program agreement.

Newly graduated registered nurses (with less than 12 months of clinical nursing experience) can apply to its 10-month paid nurse residency program. During that time, they work directly with a unit preceptor and nurse educator for clinical instruction combined with classroom-style seminars and skills/simulation sessions. The collaborative learning approach is designed to provide the knowledge base and skillset needed to successfully transition into the role of a professional nurse.

Reske said professional experiences like these demonstrate the need for collaborative practice. “They’re not alone but working with other teams, providing patient care where everyone is thinking about how to improve the patient’s health and experience, looking at that patient’s values and experiences.

“We’re preparing students to understand the complex realities of healthcare today,” she went on. “Nurses can really make a unique difference by looking at patients through the nursing lens with a more holistic view.”

 

Satisfaction Suffers

While all this is meaningful work, many nurses feel there’s a long way to go to reach ideal job satisfaction. According to the annual “State of Nursing in Massachusetts” survey conducted by the Massachusetts Nurses Assoc. (MNA), bedside nurses feel undermined in their ability to provide quality care by understaffing and assigning unsafe numbers of patients, which fuels the flight of nurses away from the profession and leads to hospitals relying on expensive travel nurses to fill the void. Among the survey data:

• 85% of nurses say hospital care quality has deteriorated over the past two years;

• 53% say hospitals that rely on travel nurses have worse care;

• 71% of nurses say their biggest obstacle to delivering quality care is understaffing and/or having too many patients at one time; and

• 88% of nurses support legislation limiting the number of patients assigned to a nurse at one time.
That last statistic rises to 98% when only new nurses are surveyed, demonstrating that nurses are entering the field with eyes wide open to to the impact of staffing challenges.

Rather than causing the staffing crisis, said Katie Murphy, a practicing ICU nurse and president of the MNA, “the COVID-19 pandemic has simply laid bare a system already broken by hospital executives. The industry claims it cannot find nurses, but the data shows there are more nurses than ever. There is not a shortage of nurses, but rather a shortage of nurses willing to work in these unsafe conditions.”

“Nurses throughout the country, including here at Baystate Health, continue to deal with the effects of a nationwide nursing shortage and the emotional impact that the COVID pandemic has had on nurses.”

This year’s survey featured an all-time high number of nurses saying hospital care quality has gotten worse over the past two years. The survey has tracked this number since 2014, when it was 38%. In 2023, 85% of nurses saw care quality decline, up two points from last year, 30 points from 2021, and 46 points from 2019. This troubling trend tracks with survey results showing increased numbers of nurses who do not have enough time to give their patients the care and attention they need and who are forced to care for too many patients at one time. In 2023, 72% of nurses saw both of those issues as “major challenges,” up 11 and 13 points from 2021.

Newer nurses are disproportionately feeling the impact. Sixty-three percent of nurses with five or fewer years of experience say understaffing is their biggest obstacle to providing quality care, compared to 56% of all nurses. Of those nurses planning to leave the field within two years, 67% of newer nurses say they will find work outside of healthcare, compared to 31% of all nurses.

Colleges are doing what they can to draw new nurses into the pipeline. For example, Holyoke Community College (HCC) and Westfield State University (WSU) recently announced a new pathway for individuals to earn both an associate degree and bachelor’s degree in nursing simultaneously or in a streamlined manner by combining the curricula of both programs. The concurrent program is the first in the Commonwealth.

“The concurrent ADN-to-BSN pathway is an innovative approach to nursing education,” WSU Executive Director of Nursing Jessica Holden said. “It enables students to earn their ADN while simultaneously completing coursework that counts toward their BSN. This integration of education allows for a more efficient and streamlined approach to nursing education that is advantageous to some students.”

The concurrent nursing program will help address the nursing shortage by increasing the number of students who can get into a bachelor of nursing program and allow them to earn their degree faster.

According to a Massachusetts Health Policy Commission report, “registered-nurse vacancy rates in acute-care hospitals doubled from 6.4% in 2019 to 13.6% in 2022, with especially high vacancy rates in community hospitals. Employment in nursing and residential care facilities has not recovered since 2020 and remained below 2018 levels.”

HCC Director of Nursing Teresa Beaudry explained that “we had to meet with the Massachusetts Board of Registration in Nursing, who had to approve it, and they’re equally as excited as we are to create another pathway for nurses to advance in their education and a different way for those students who might not be able to get into a bachelor’s of nursing program.”

 

A Question of Balance

In fact, moving up in the profession is a significant draw to many aspiring nurses. Most area colleges and universities with nursing programs have master’s and doctoral programs structured in such a way that nurses can work full-time while earning advanced degrees that will open up more doors and set them on track to be nursing managers, educators, administrators, or work in other roles.

“Usually, nurses return for an advanced degree,” Reske said. “They begin to look at, ‘what can I contribute in practice? What attracts me? Is it working in an ambulatory-care setting or rehabilitation, or as a nurse leader or a nurse educator? Maybe I want to be a nurse practitioner.’ The opportunities for nurses are amazing.”

And the education they’re getting — both in the classroom and in the field — must prepare them for the new complexities of medical care today, she added.

“Nurses definitely have to deal with more complex issues — speak the language of finance, speak the language of marketing, speak the language of population health. All those require additional learning beyond the classroom. You’re connecting practice to knowledge and knowledge to practice, and learning how to apply that.”

In short, it’s a challenging time to be a nurse, and also a time of great opportunity. Whether their love of nursing outweighs the stresses is a question for every professional in the field — and those questions are not going away any time soon.

Healthcare News

Don’t Ignore the Signs

Like with any disease, Cheryl Moran said, early detection of Alzheimer’s can make a big difference.

That’s why the Atrium at Cardinal Drive in Agawam and Orchard Valley at Wilbraham, both Benchmark mind and memory-care communities, have been hosting a series of memory screenings at area senior centers.

“Over the past 25-plus years, we’ve seen that people and families affected by dementia often delay planning, which makes for a much more challenging situation later,” said Moran, executive director of the Atrium. “By offering this to the community, we want to help ease the burden.”

Alzheimer’s disease and dementia affects nearly 350,000 people in Massachusetts, and the numbers continue to grow.

Cheryl Moran

Cheryl Moran

“Over the past 25-plus years, we’ve seen that people and families affected by dementia often delay planning, which makes for a much more challenging situation later.”

Memory screenings, Moran noted, are appropriate for anyone concerned about memory loss or experiencing symptoms of dementia or who believes they are at risk due to family history. Screenings like the ones being offered at area senior center provide a safe, simple, face-to-face way to check a person’s memory, language, intellectual functions, and other thinking skills using a series of questions and tasks.

Screenings have already taken place at Wilbraham Senior Center and West Springfield Senior Center in April, and the next two are slated for Wednesday, May 17 from 10 a.m. to noon at Agawam Senior Center, 954 Main St.; and Wednesday, May 31 from noon to 2 p.m. at Palmer Senior Center, 1029 Central St. Attendees can register for either event by calling (413) 821-0605 for Agawam or (413) 283-2670 for Palmer.

A screening can indicate whether someone should consult with a medical provider in order to identify what is causing memory loss. If dementia is the cause, early diagnosis can help both individuals and their family members learn about the disease, set realistic expectations, and plan for their future together.

“If they are able to obtain a diagnosis for the cause of their dementia, it can help to better understand what the individual is struggling with and what to expect as the dementia progresses over time,” said Julie Waniewski, executive director of Armbrook Village in Westfield, which has a memory-care neighborhood called Compass. “There are also clinical drug trials that they can partake in to aid in research and hopefully find a cure one day.”

 

What to Look For

According to the Alzheimer’s Assoc., memory loss that disrupts daily life may be a symptom of Alzheimer’s or other dementia. The organization lists 10 signs in particular to keep an eye on:

1. Forgetting recently learned information. Similar signs include forgetting important dates or events, asking the same questions over and over, and increasingly needing to rely on memory aids (such as reminder notes or electronic devices) or family members for things they used to handle on their own.

Julie Waniewski

Julie Waniewski

“If they are able to obtain a diagnosis for the cause of their dementia, it can help to better understand what the individual is struggling with and what to expect as the dementia progresses over time.”

2. Challenges in planning or solving problems. Some people living with dementia may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.

3. Difficulty completing familiar tasks. People with Alzheimer’s often find it hard to complete daily tasks. Sometimes they may have trouble driving to a familiar location, organizing a grocery list, or remembering the rules of a favorite game.

4. Confusion with time or place. People living with Alzheimer’s can lose track of dates, seasons, and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

5. Trouble understanding visual images and spatial relationships. For some people, having vision problems is a sign of Alzheimer’s. This may lead to difficulty with balance or trouble reading. They may also have problems judging distance and determining color or contrast, causing issues with driving.

6. New problems with words in speaking or writing. People living with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue, or they may repeat themselves. They may also struggle with vocabulary, have trouble naming a familiar object, or use the wrong name.

7. Misplacing things and losing the ability to retrace steps. A person living with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. He or she may accuse others of stealing, especially as the disease progresses.

8. Decreased or poor judgment. Individuals may experience changes in judgment or decision making. For example, they may use poor judgment when dealing with money or pay less attention to grooming or keeping themselves clean.

9. Withdrawal from work or social activities. A person living with Alzheimer’s disease may experience changes in the ability to hold or follow a conversation. As a result, he or she may withdraw from hobbies, social activities, or other engagements. They may have trouble keeping up with a favorite team or activity.

10. Changes in mood and personality. Individuals living with Alzheimer’s may experience mood and personality changes. They can become confused, suspicious, depressed, fearful, or anxious. They may be easily upset at home, with friends, or when out of their comfort zone.

“There are many warning signs of memory issues or early-stage dementia,” Waniewski said. “Sometimes a person is struggling to prepare meals, which leads to improper nutrition, or they are not taking their medications correctly, the house is unkept, appliances may not be working, or their personal hygiene is not what it used to be. They may also ask the same question repeatedly, which is a sign of short-term memory loss. They may lack interest in previously enjoyed activities or group gatherings, which is usually because they are afraid that others will start to notice that they are struggling cognitively.”

Other warning signs may include piles of unopened mail or shutoff notices, indicating that their executive functioning is declining and finances are becoming difficult to handle on their own, Waniewski added. “Also, their car may have new signs of damage, or they may have gotten lost driving, and the yard may be overgrown and not tended to.”

 

Next Steps

While not every symptom is a sign of dementia, the Alzheimer’s Assoc. stresses the importance of getting screened, as early detection matters.

“If you notice one or more signs in yourself or another person, it can be difficult to know what to do,” the organization notes. “It’s natural to feel uncertain or nervous about discussing these changes with others. Voicing worries about your own health might make them seem more ‘real.’ Or you may fear upsetting someone by sharing observations about changes in his or her abilities or behavior. However, these are significant health concerns that should be evaluated by a doctor, and it’s important to take action to figure out what’s going on.”

Early detection may also open doors to treatments that may provide some relief of symptoms and help maintain independence longer, as well as increase one’s chances of participating in clinical drug trials that help advance research. Waniewski noted that Armbrook Village and its parent company, Senior Living Residences, are affiliated with Boston University’s Alzheimer’s Disease Research Center, which offers clinical trials in which people can participate.

Healthcare News

Making Progress

 

In January, the U.S. Food and Drug Administration approved Leqembi (lecanemab-irmb) via the Accelerated Approval pathway for the treatment of Alzheimer’s disease. Leqembi is the second of a new category of medications approved for Alzheimer’s disease that target the fundamental pathophysiology of the disease. According to the FDA, these medications represent an important advancement in the ongoing fight to effectively treat Alzheimer’s disease.

“Alzheimer’s disease immeasurably incapacitates the lives of those who suffer from it and has devastating effects on their loved ones,” said Dr. Billy Dunn, director of the Office of Neuroscience in the FDA’s Center for Drug Evaluation and Research. “This treatment option is the latest therapy to target and affect the underlying disease process of Alzheimer’s, instead of only treating the symptoms of the disease.”

Alzheimer’s disease is an irreversible, progressive brain disorder affecting more than 6.5 million Americans that slowly destroys memory and thinking skills and, eventually, the ability to carry out simple tasks. While the specific causes of Alzheimer’s are not fully known, it is characterized by changes in the brain — including amyloid beta plaques and neurofibrillary, or tau, tangles — that result in loss of neurons and their connections. These changes affect a person’s ability to remember and think.

Leqembi was approved using the Accelerated Approval pathway, under which the FDA may approve drugs for serious conditions where there is an unmet medical need and a drug is shown to have an effect on a surrogate endpoint that is reasonably likely to predict a clinical benefit to patients.

Researchers evaluated Leqembi’s efficacy in a double-blind, placebo-controlled study of 856 patients with Alzheimer’s disease. Treatment was initiated in patients with mild cognitive impairment or mild dementia and confirmed presence of amyloid beta pathology. Patients receiving the treatment had significant dose- and time-dependent reduction of amyloid beta plaque, with patients receiving the approved dose of lecanemab every two weeks having a statistically significant reduction in brain amyloid plaque from baseline to week 79 compared to the placebo arm, which had no reduction of amyloid beta plaque.

These results support the accelerated approval of Leqembi, which is based on the observed reduction of amyloid beta plaque, a marker of Alzheimer’s disease. Amyloid beta plaque was quantified using positron emission tomography imaging to estimate the brain levels of amyloid beta plaque in a composite of brain regions expected to be widely affected by Alzheimer’s disease pathology compared to a brain region expected to be spared of such pathology.

According to McKnight’s Long-Term Care News, neurologists in the U.S. have a strong interest in prescribing the Leqembi, with the majority of 73 specialists surveyed saying they would prescribe the treatment if the government fully approves it.

The March 2023 survey, from Spherix Global Insights, found that a healthy proportion of neurologists had already begun prescribing Leqembi within a month of commercial availability, while most have chosen to wait for the FDA’s decision when it reviews the request by Eisai, the drug’s manufacturer, for traditional approval on July 6. If traditional FDA approval is granted, nearly all of the surveyed specialists said they planned to prescribe the treatment, mostly within the year following the greenlight, Spherix reported.

The prescribing information for Leqembi includes a warning for amyloid-related imaging abnormalities (ARIA), which are known to occur with antibodies of this class. ARIA usually does not have symptoms, although serious and life-threatening events rarely may occur. ARIA most commonly presents as temporary swelling in areas of the brain that usually resolves over time and may be accompanied by small spots of bleeding in or on the surface of the brain, though some people may have symptoms such as headache, confusion, dizziness, vision changes, nausea, and seizure.

Another warning for Leqembi is for a risk of infusion-related reactions, with symptoms such as flu-like symptoms, nausea, vomiting, and changes in blood pressure. The most common side effects of Leqembi were infusion-related reactions, headache, and ARIA.

According to Fierce Pharma, while there is another new drug on the market for Alzheimer’s — Aduhelm, which Eisai helped create with Biogen — that drug is commercially non-viable at the moment.

Specifically, the Centers for Medicare & Medicaid Services refused to cover payments of Aduhelm, which was also damaged by the controversial way the FDA approved the drug in 2021. The drug passed the regulatory hurdle despite serious safety and efficacy questions, including from the FDA’s own drug-review experts, who denied its approval at the drug’s advisory committee and were overruled by the FDA itself several months later.

Healthcare News Special Coverage

Living in Their World

Beth Cardillo calls them ‘fiblets.’

These are things that are said to someone with dementia that … well, do not represent the whole truth, or even a portion of it, at least to the person making that statement.

But to that person suffering from Alzheimer’s or one of the many other forms of dementia, it is the truth as they see it in their world. “It’s not a lie,” she said of these fiblets. “It’s an OK thing to tell people with memory issues.”

She offered up an example.

“Let’s say someone’s husband has been dead for 20 years; she might say, ‘I’m not going out shopping, I’m waiting for my husband to get home,’” noted Cardillo. “A fiblet would be … ‘oh, he just called; his tooth is hurting him and he’s going to see a dentist. Why don’t you and I go out for a ride and go to the grocery store?’”

“You’re going to tell someone that their husband died over and over again, every day?” she went on, asking that question rhetorically before answering it poignantly. “I mean, why would I want to do that? It’s cruel.”

Indeed, and fiblets are a good example of how those caring for and simply around individuals with dementia regularly should try to live in their world, rather than constantly try to pull them into the ‘real’ world. It’s also an example of the kind of work that Cardillo has made into a career, or at the least the latter stages of one.

Beth Cardillo

Beth Cardillo

Her latest move comes as a part-time social worker for a unique program called Baystate House Calls. As that name suggests, it’s a program operated by Baystate Health that involves healthcare professionals making house calls to older adults. It includes a physician, nurse practitioner, nurse, social worker, and community health worker, team members who will visit individuals in their home to assess their needs and provide recommendations.

The initiative concentrates on what administrators call the 4Ms — ‘mobility,’ ‘what matters,’ ‘medication,’ and ‘mind.’

It focuses not only on those in need of help and services, but caregivers as well, said Cardillo, adding that her work, and that of her colleagues, takes them to every corner of Springfield. And while she is helping seniors and caregivers with a wide variety of issues from substance abuse to falls to depression, much of her work involves those with memory issues.

And, increasingly, it involves what is known as habilitation therapy (HT), a holistic approach to dementia care that focuses on the abilities that the person still has, rather than what they have lost, and can reduce difficult symptoms.

“It focuses on everything positive — it focuses on people’s strengths, not their weaknesses,” she said of HT, adding that it brings caregivers and patients closer together as they work on daily tasks, makes those suffering from dementia feel respected and valued, reduces stress among caregivers, and creates positive emotional experiences that bring comfort and happiness.

“The reality therapy is for us to learn to live in their reality, not for them to live in our reality of our world. That’s probably the biggest lesson there is.”

Cardillo was recognized by BusinessWest and its sister publication, HCN, with a Healthcare Heroes Award in 2021 in the category of Community Health for her work during her years as executive director at Armbrook Village in Westfield to create ‘dementia-friendly’ communities and help others better understand — and communicate with — those suffering from memory loss.

For this HCN Monthly Feature and its focus on Memory Care, we talked with her at length about the importance of understanding what is reality that for those with dementia — and enabling them to thrive, as much as possible, in that reality.

 

Reality Check

Cardillo told BusinessWest that, years ago, she and others involved with providing memory-care services would offer to those with dementia what was called, by some at least, ‘reality therapy.’

“We would say, ‘no, no, no, you’re wrong — today’s Thursday, or today’s this, and tomorrow is that,’ she said, correcting wrong statements and answers to questions whenever the need arose. “But what we’ve learned is that it doesn’t matter. The reality therapy is for us to learn to live in their reality, not for them to live in our reality of our world. That’s probably the biggest lesson there is.”

Helping others live in the reality of those with dementia is a big part of the work Cardillo has been involved with over the years, especially at Armbrook, but also now as a social worker. She said that to make this leap — and it is a leap for most — it begins with education and an understanding of the disease and how it impacts people.

It robs them of short-term memory and the ability to do certain things — from driving to cooking to reading. But it doesn’t, or shouldn’t, take from them the things that are important to them, and have been important throughout their lives, be it what they did for a living, or travel, music, pets, or a love of the movies.

Cardillo recalled the case of a long-retired college professor who had (and still has) a passion for the New York Times and carries it with her daily.

“Some days, it’s upside-down,” said Cardillo. “But it doesn’t matter; that was her identity. Those are they types of things you don’t want to change; you don’t want to correct people.”

Overall, she said it’s important to treat those with dementia with respect and to not embarrass them with ‘reality’ questions or constant corrections concerning what day it is and what members of the family are no longer alive.

“It doesn’t matter if they say it’s Tuesday and it’s really Sunday. It just doesn’t matter. So, we don’t want to correct people. Does it matter if Mr. Smith thinks it’s a different day? Is that going to change the world? No. If he thinks it’s Christmas tomorrow, that’s OK. Why take that joy away?”

“Just because you have Alzheimer’s doesn’t mean you’re stupid,” she explained. “It doesn’t mean you can’t read people’s emotions. “I know people who will say to family members, ‘what’s my name? What’s my name?’ Why are you saying that to them? It embarrasses them. They know you have a connection. Is it because you think that if they know your name, they’re having a good day and that makes you feel good?

“Because it doesn’t matter if they know your name,” she went on. “It doesn’t matter if they say it’s Tuesday and it’s really Sunday. It just doesn’t matter. So, we don’t want to correct people. Does it matter if Mr. Smith thinks it’s a different day? Is that going to change the world? No. If he thinks it’s Christmas tomorrow, that’s OK. Why take that joy away?”

She recalled the case of a woman who told her that she was pregnant at 66. Instead of correcting her, Cardillo said she simply told her, ‘if that’s true, you’re going to make history.’

“You laugh about it with her, because she tells me these wacky stories,” she went on. “Her parents have been dead, but she’ll say, ‘oh, my mother wants you to come over for dinner.’ “I’ll say, ‘oh, how is your mother? I like your mother; tell her I said hello.’

“Her husband, on the other hand, keeps saying, ‘your mother is dead!’” she continued. “We need to stop that because it doesn’t matter. She doesn’t remember and she doesn’t care, and in in her head, her mother is alive. That’s fine. Who does it hurt?”

Overall, she said it’s important to try to communicate with a positive spin, rather than a negative one.

Indeed, instead of telling someone with dementia that they are not supposed to be going outside, when they suggest that they want to do so, one should instead stay positive and suggest that this person can sit outside when the weather is better.

As she talked about those suffering from dementia and how those caring for them should approach daily conversation and activities, Cardillo said it is important to keep them engaged and to focus “on what they can do, not what they can’t do.”

This brings her back to the concept of habilitation therapy, which, she believes, has benefits, and many of them, for those living with memory loss, their caregivers, family, and friends.

“It’s important to keep people meaningfully busy and not just silly busy,” she told BusinessWest, adding there is a big difference between the two.

Elaborating, she said that television is not a good option.

“We don’t want to put people in front of a TV all day, because it’s … not good,” she said. “It doesn’t make them happy campers. It doesn’t mean that TV is bad, just not as a babysitter all day.”

Instead, such individuals should be involved in activities that speak to who they are, who they were professionally, and what interests them.

“It’s really important to know what people did in their work,” she explained, “because they still retain some of those skills, and it’s still a part of who they are as an identity. For those who were teachers, give them papers to correct; you come up with things that they can do.

“I had someone whose father was a retired electrician,” she went on. “He had a manual of electrical … something; it was bigger than the New York City phonebook. He looked through those pages every day. I don’t know if he knew what was in it — I sure didn’t — but that gave him comfort.”

And some form of comfort is what those caring for people with dementia should be trying to provide each day, she said, adding that this can be done through HT, emphasizing the positive, and, yes, focusing on what those with dementia can do, not what they can’t.

 

 

Bottom Line

Summing up what she tells those caring for people with dementia, Cardillo said it is simply that reality is in the eyes — and mind — of the beholder.

And if we really want to help those with this disease, we have to at least try to live in their world, rather than make them live in ours. It’s not an easy assignment, especially when one is asked the same questions over and over, day after day, but it’s the key to those on both sides of the equation being able to thrive.

Healthcare News

All Hands on Deck

 

In the six months since the Biden-Harris administration hosted the second-ever White House Conference on Hunger, Nutrition, and Health, U.S. Rep. Jim McGovern has recognized the significance of the moment — only, he hopes it’s more than a moment.

“The first and only other conference was held more than 50 years ago — in 1969, the year we put somebody on the moon,” McGovern said at a recent virtual gathering with officials from food-justice organizations, farm advocates, public-health leaders, healthcare providers, and other legislators, to discuss the White House event, legislative action that has emerged in its wake, and what is being done in Massachusetts — and what more can be done — to end hunger.

Liz Wills-O’Gilvie

Liz Wills-O’Gilvie

“The only way that we’re going to eradicate hunger and improve health is by centering our work with a racial-equity lens.”

“Out of this conference came an ambitious but achievable roadmap to end hunger and reduce diet-related disease by the year 2030,” McGovern said, adding that the conference has the potential to impact even more change than the 1969 event, which is saying a lot, since innovations like WIC, the modern-day SNAP program, and better food labeling came out of that session.

“There were so many important things,” he went on. “But I think this conference, if we do the follow-through, has the potential to have even a greater impact on this country.”

The March 17 briefing, attended by about 300 people, was co-hosted and organized by the Food Bank of Western Massachusetts, Growing Places, Stone Soup Cafe, CISA, the Springfield Food Policy Council, the Massachusetts Food System Collaborative, Project Bread, and the Western Mass. state legislative delegation, including state Sen. Jo Comerford and state Rep. Mindy Domb.

Liz Wills-O’Gilvie, who chairs the Springfield Food Policy Council, saw the historic nature of the White House event, which she attended, from a unique perspective: her own personal history as “a little Black girl from Springfield who was dependent upon commodities food before food stamps as we know it now existed.

“Our family’s life improved when food stamps emerged out of the last conference,” she recalled, “so I was struck by the significance of the moment I got to be there in that room and hear both President Biden and Secretary [of Agriculture Tom] Vilsack make the comments that they did … that the only way that we’re going to eradicate hunger and improve health is by centering our work with a racial-equity lens.”

To that end, Wills-O’Gilvie called Massachusetts’ Healthy Incentives Program (HIP) — which reimburses EBT card users when they used SNAP benefits for healthy produce from local farm vendors — a tool for racial equity as well as a way to improve the health of families.”

She also called for making universal free school meals permanent in the Bay State, a priority shared by Domb, who also praised HIP, talked up the benefits of food-literacy education, and called for a conversation about hunger on college campuses.

“We need to make universal free school meals in Massachusetts permanent,” Domb said. “It’s terrific that we extended it this year. It’s wonderful that the Legislature in the supplemental budget has included additional money to make sure it continues through the end of this academic year.”

“There’s obviously much, much more that needs to be done in these areas. But we’re off to a good start. And there is finally momentum at a national level behind efforts to end hunger.”

U.S. Rep. Jim McGovern

U.S. Rep. Jim McGovern

But she said expansion of such benefits during COVID demonstrated how important they are to families, even beyond the pandemic. “So we need to make sure that that continues.”

 

One Bite at a Time

McGovern said President Biden has made it clear that the federal government wants to implement an aggressive national strategy to end hunger in the next decade.

“In the months following the conference, Congress has gotten to work on some of the priorities that were laid out in the strategy,” he noted. “We created a permanent summer EBT program to give families with kids $40 per child per month over the summer, when we know that hunger is often worse. It’s a small step in the right direction, but it’s an important step in the right direction. And especially during these times of high inflation and especially in the aftermath of the SNAP pandemic boost being cut, this is really, really crucial.”

He also said lawmakers responded to a recent EBT-skimming problem by requiring benefit replacement for those who had SNAP benefits stolen through no fault of their own, mandated that the Department of Defense screen military families for food insecurity, and passed the Food Donation Improvement Act to make it easier for retailers, manufacturers, farmers, and schools to donate food directly to hungry people.

“And we passed a massive omnibus spending bill that includes the highest level of non-defense spending in history. That translates into robust funding for WIC, farm-to-school grants, school meal equipment grants, among other things,” McGovern went on. “There’s obviously much, much more that needs to be done in these areas. But we’re off to a good start. And there is finally momentum at a national level behind efforts to end hunger. We have people in the administration saying that we want to end hunger.”

He also recently introduced legislation to permanently increase the reimbursement rates paid by the federal government to schools for every breakfast and lunch served.

“We talk a lot about the quality of food that we provide our kids in school, but we also talk about the importance of supporting our local farmers,” he explained. “With a little more money for breakfast and lunch, it gives school districts and people who oversee school meals some flexibility to do some things that, right now, they don’t do because it’s too complicated or it might cost a little bit more.”

Kirsten Levitt, executive chef and co-director of Stone Soup Café, a volunteer-driven, pay-what-you-want meal spot in Greenfield, also attended the White House conference and came away with the belief it will take all sectors of the nation to eradicate hunger, and Western Mass. has the ability to be a national model for its emphasis on farms, food, and nutrition. She added that children will be the best ambassadors for health and nutrition, especially if school meals are funded properly.

Erin McAleer, president of Project Bread, an anti-hunger nonprofit based in Boston, identified five pillars to a statewide strategy on hunger, nutrition, and health: increasing access and improving quality of child-nutrition programs, increasing access and affordability of food for all, integrating food access into healthcare, strengthening and integrating the local food system, and ensuring economic stability and promoting economic opportunities to address the root causes of hunger.

“I never imagined I would be sitting in a room with the president of the United States, and certainly never imagined I would be sitting in the room when he expressed that what I went through my childhood was unacceptable — that food insecurity is unacceptable,” McAleer said.

“When 21% of families in Massachusetts are food-insecure and 33% of the Black and Latino families in Massachusetts are food-insecure, that is a systemic issue. And that requires systemic solutions. Too often, we focus on individualized solutions when it comes to this issue.”

Erin McAleer

Erin McAleer

“What I really appreciated about the plan that was put together by the White House is the focus on systemic solutions,” she went on. “When 21% of families in Massachusetts are food-insecure and 33% of the Black and Latino families in Massachusetts are food-insecure, that is a systemic issue. And that requires systemic solutions. Too often, we focus on individualized solutions when it comes to this issue.”

McGovern agreed that fighting hunger and improving nutrition is a battle that can, and should, be waged on all levels — federal, state, and local.

“There are things that can be done at the local level — things like expanding access to culturally appropriate cooking classes, bringing gardens and hydroponics to every school, and more robust food-recovery partnerships. All of this is going to require close collaboration.”

 

Menu of Activity

On the state level, myriad bills have been filed recently relating to nutrition, hunger, and agriculture: “An Act Relative to Universal School Meals,” “An Act to Promote Food Literacy,” “An Act Protecting Our Soil and Farms from PFAS Contamination,” “An Act Strengthening Local Food Systems,” “An Act Promoting Equity in Agriculture,” “An Act Relative to an Agricultural Healthy Incentives Program,” “An Act Supporting the Commonwealth’s Food System,” “An Act Encouraging the Donation of Food to Persons in Need,” “An Act Establishing the Massachusetts Hunger-free Campus Initiative” … the list goes on.

Comerford said those who organized the March 17 briefing with McGovern wanted participants to be inspired by the White House’s 2030 hunger goals, tackle diet-related diseases like hypertension and obesity in the Commonwealth, and strengthen the region’s food system and farms in the process.

“We also want to help participants take away concrete and timely action steps around critical budget priorities and policy proposals that are going to move the Commonwealth boldly toward ending hunger in just a handful of years.”

 

 

Healthcare News

An Active Office

Standing desks are standard at many local companies.

Since COVID-19 swept across the globe, many industries have shifted to fully remote or hybrid working. During the pandemic, 70% of the workforce was working from home, and since then, 62% of companies have planned to incorporate remote work, be it fully remote or hybrid.

With more and more people working from the comfort of their own home, concerns have arisen that this model may be associated with more sedentary lifestyles and, in turn, increased risk of obesity. Most of our calories throughout the day are burned through non-exercise activity thermogenesis, which includes walking and other basic activities. When working from home, sometimes those activities can be even more limited.

Here are a few ideas from online fitness resource Total Shape to stay fit even while working from home.

Standing Desk ($150-$600)

Standing desks have gained popularity over the last few years and have been proven to provide many positive health benefits. Simply put, standing burns more calories than sitting, even if you simply stand still. Research has also shown that 66% of workers felt more productive, and 87% felt more energized, using standing desks. Standing activates the muscles in your legs and core while stimulating circulation, which can help you to burn extra calories (typically 60 to 90 per hour) and build your strength. Standing desks come in a range of styles and cater to many different budgets, meaning this is an accessible option for all.

Desk Treadmill ($200-$800)

Although it is a more expensive option, this is one of the most effective ways to stay fit while working at home. It essentially takes the standing desk a step further by adding the walking element. Studies have shown that walking between 1 and 2.5 mph can lead to an extra 170 to 240 calories burned per hour. Not only have people encountered the physical benefits of getting more exercise, but walking helps oxygenate the brain by stimulating blood circulation. In other words, we think better and more efficiently when we walk. With most people having busy schedules outside of work, it can be difficult to get the recommended amount of physical exercise, which makes this a great way to stay fit while working from home.

Under-desk Bike ($50-$200)

A very similar concept to the desk treadmill, an under-desk bike features a small set of pedals that can slide under your desk so that you can pedal while sitting. The small machines can be altered to have more resistance, which makes it harder or easier to pedal. This type of aerobic exercise is good for staying fit and can help strengthen your legs and joints. Studies estimate that pedaling while seated can burn up to 10 calories per minute, depending on the intensity, which means you could burn up to 600 calories per hour. However, the average gentle pedaling will most likely burn 100 to 300 calories per hour.

Resistance Bands ($15-$40)

Resistance bands are an affordable option to help train your body and get fitter, by helping you build muscle and burn calories (180 to 250 per hour) while seated at your desk. You can perform plenty of passive resistance-band workouts even when you’re doing something at your desk, and in between typing and during brainstorming sessions, your body can keep active alongside your mind. Exercises could include bicep curls, overhead tricep extensions, and shoulder raises. However, there are many variations and other exercises that can be done with resistance bands. A study published in 2022 showed that resistance-band training lowers body fat in people who are overweight better than other forms of training, including free weights and body-weight exercises.

Seven-minute Workout

Searching ‘seven-minute workout’ on an app store will reveal an app that will guide you through various workouts you can do in your own home, which take just seven minutes at a time. The best thing about the seven-minute workout app is that its programs are designed especially for people who are doing the workouts at home, and who have no special equipment. The brief nature of these workouts allows people with busy schedules to fit in exercise and can help break up your workday, which can increase productivity while burning 20 to 50 calories per session. While there are some in-app purchases available, you can use the app completely free, so there’s nothing stopping you from getting started.

Diet

Exercise and living an active lifestyle are obviously important in staying fit and healthy; however, diet is a key contributor to overall health and fitness. People with few distractions at home may find they are more aware of hunger than they would be at the workplace, which can lead to more snacking and possibly an unhealthier diet. By focusing on eating healthy foods and healthy snacks, people who work from home can ensure they are staying fit and keeping their bodies healthy. Studies show that both the overall composition of the human diet and specific dietary components have been shown to have an impact on brain function, which means diet isn’t only going to keep you fit, but it’s going to improve cognitive function, and thus the quality of work produced.

Why It’s Important

A spokesperson from Total Shape noted that “roughly two in three people in the U.S. are overweight, and with many aspects of life becoming more sedentary, it’s important that people try to find new ways to keep fit and healthy. Life has become busy and more expensive, meaning that it’s harder to find the time and money to attend gyms or activities that help us to remain fit. This guide provides a plethora of choices for people on various budgets and with specific preferences to ensure we are keeping ourselves healthy.”

Total Shape is a fitness resource site providing information about workouts, supplements, and fitness to help people reach your goals. Total Shape does not provide medical advice, diagnosis, or treatment.

Healthcare News

Set Up to Fail

 

 

“How to lose weight fast” has an average 284,000 monthly search volume in the U.S., demonstrating that Americans are desperate for a quick fix to help shed those unwanted pounds in time for summer.

How to lose weight is one of the most pressing health questions for many people. As many as 95% of dieters fail to reach their body target or quickly backslide and regain the weight they lost once their diet is finished. Because of this, a massive number of people are serial dieters who skip from one eating plan to the next, trying to find best way to lose weight and keep it off.

While there are thousands of diets to choose from, the overall rule is, if you want to lose weight, get toned, build muscle, or even just improve your energy levels, you’ll probably need to change what you eat.

“Provided that your diet of choice meets your caloric needs, it will have the desired effect,” an exercise and nutrition expert at online resource Fitness Volt said. “For example, consume fewer calories than you need, and you will burn fat and lose weight, but consume more than you need, and you will gain weight.

“However, most people fail to stick with their diet long enough for it to work sustainably. They’re strong out of the gate, but soon fall off the wagon and return to their previously sub-optimal eating plan,” the expert continued. “That’s why so many of us lose weight only to regain it shortly afterward, and it seems long-term, sustainable weight loss is rare nowadays.”

According to Fitness Volt, here are six reasons why most diets fail.

 

Foods Are Too Restrictive

Most diets ban certain food or food groups. For example, the paleo diet excludes all processed foods, while keto severely limits your carb intake. Other diets will cut out sugar or alcohol. The problem is, while cutting out certain foods can help contribute to your daily calorie deficit, this technique is also guaranteed to trigger cravings.

Essentially, any diet that bans a particular food or food group will invariably result in cravings, driving you to cheat on your diet. So allow yourself the smallest amount of this particular food or drink to allow your body to feel like it isn’t being deprived of something. In other words, everything in moderation.

 

Ingredients Cost Too Much

It is good to follow a diet of healthy, fresh ingredients, but with food being one of life’s unavoidable expenses, it will be harder for you to sustain this diet plan long-term if you aren’t always financially stable.

For example, some diets specify that you must eat expensive foods and that somehow these products are better for weight loss than those that are more reasonably priced. Organic vegetables and grass-fed beef from free-roaming cattle cost a lot more than the basics you get at Costco, but nutritionally are not all that different. They certainly won’t help you lose weight faster.

For a diet to be sustainable, you need to be comfortable with how much your food costs. For example, if your grocery bill doubles overnight, you’ve got a ready-made excuse for quitting your new eating plan.

 

It’s Too Complicated

To make diets unique, they are often unnecessarily complicated. This complexity can often cause people to make mistakes or just give up after a while.

Food-combing diets are a perfect example of this. Some may say things like “you can’t eat fat and carbs in the same meal,” which looks OK on paper, but makes meal prep far more complicated than it needs to be. Ultimately, for any diet to work, it needs to be simple enough to follow every day.

 

Perfection or Failure

Diets can often be very prescriptive and allow no variation. However, in everyday life, any diet can be difficult to stick to. Perhaps you have a friend’s birthday or an off day, and you decide to indulge in something sweet.

The reality is that your diet doesn’t have to be perfect; it just needs to pretty good most of the time, which is more than enough to reach weight-loss goals.

 

Ignoring the Long Term

Putting a timeframe on any diet sets you up for failure. Some of the most common ways diets are advertised are through their quick-fix timestamp, like “lose 30 pounds in 90 days” or “30-day get-ripped plan.”

Excess body fat accumulates over many years, and no one goes to bed lean and then wakes up fat. Likewise, achieving your body goal could take many months, or even years. To achieve a significant result in just a few weeks, any diet must be very restrictive, and, therefore, it may be unsustainable, as your body will soon put the weight back on that it dramatically lost. Before considering any diet, ask yourself, “can I follow it for the next six to 12 months?”

 

What’s the Science?

Some diets are based on very flawed science or may not be based on any science at all. One example of this is calorie-burning or negative-calorie foods, such as celery. No food burns more calories than it contains, and these claims are very misleading.

Effective diets work by manipulating your calorie balance. Consume fewer calories, and your body will make up the shortfall by using stored body fat for energy. No deficit means no fat burning. There are no shortcuts around this law of thermodynamics.

 

Bottom Line

As a rule, if a diet promises something that sounds too good to be true, it probably is, so don’t fall for it.

“Fortunately, healthy eating doesn’t have to be complicated or unpleasant, and weight management doesn’t have to take over your life,” Fitness Volt’s expert said. “You don’t even have to give up your favorite foods. However, you will need to quit looking for short-term fixes and adopt healthier, long-term habits.”

 

Fitness Volt is a comprehensive online resource dedicated to strength sports. Its mission is to empower readers with tried and tested knowledge and practices surrounding the latest fitness and nutritional information.

Healthcare News Special Coverage

Second Wind

By Mark Morris

Steve Conca

Steve Conca says he’s seen a post-pandemic uptick in people wanting to take charge of their health.

Editor’s Note:

These are exciting, challenging, and ever-changing times for healthcare and the businesses and individuals providing it. To better inform and educate its readers about the many issues, trends, and developments in the healthcare sector, BusinessWest will be introducing a new, monthly segment that will present content from its sister publication, Healthcare News (HCN) .

This new resource will be called “HCN Monthly Feature,” bringing news and information on the many health, wellness, and fitness issues and developments of today, from both regional and national sources. Each HCN Monthly Feature will have specific themes and points of emphasis — everything from health and fitness (this month) to behavioral health; from cancer care to a salute to the region’s nurses — and it will be made available online at both businesswest.com and healthcarenews.com, as well as via the daily e-newsletters BusinessWest Daily News and HCN News & Notes, making it readily available to subscribers and consumers in the Western Mass. region and beyond. 

For subscriptions, additional information, and to send us your news and story ideas, please visit BusinessWest  and HCN

Marina Lebo remembers what Healthtrax in East Longmeadow looked like during the pandemic — and is glad it looks a lot different now.

“The plastic barriers are down, and the equipment is all back where it was,” said Lebo, vice president of Operations at the club. “We have more cleaning supplies available, but that’s the only difference.”

Fortunately, that return to normal is manifesting in other ways as well — including an increase in activity.

That’s only natural; at the start of the pandemic in March 2020, fitness centers were forced to shut down. Three months later, they were allowed to reopen at 40% occupancy only after installing clear plastic barriers at the front desk, mandating masks for everyone, spacing out exercise machines, and providing lots more sanitizing wipes to clean the equipment after each use.

With Healthtrax membership back to about 70% of pre-pandemic levels, Lebo’s goal is to keep increasing everyone’s comfort level to encourage going to the club as a normal activity again.

Steve Conca, owner of Conca Sport and Fitness in West Springfield, described the last few years as a whirlwind. He’s grateful his business has survived — and even thrived — since the early days of the pandemic.

“We don’t have a huge membership base, probably around 150, and it’s a very tight-knit community where people support each other inside and outside the gym,” he said.

When everything shut down in the spring of 2020, Conca began meeting with clients outdoors and over Zoom. “Everyone stuck with us, which was great. We didn’t lose too many people once we got back into the swing of things.”

Outdoor gatherings and livestreams were options Ashley Brodeur also used to keep her business going during the height of the pandemic. The owner of Active Lifestyle Fitness in Agawam hosted a private group on Facebook Live to keep her members on a regular workout schedule. While she appreciated virtual classes as a short-term necessity, she said, nothing beats the in-person experience.

In fact, shortly after in-person sessions resumed, Brodeur noticed several members getting easily winded from doing the same workouts they were performing during the livestream sessions. “When I asked why, they admitted that they weren’t doing the entire workout at home.”

So everyone was glad to return, she went on. “There is an accountability in having to show up somewhere and having someone watch how you are exercising.”

 

Wake-up Call

Everyone who spoke with BusinessWest pointed out that the pandemic served as a wake-up call about the importance of good health. As their members return to fitness centers, all agree there’s a new emphasis on getting results.

Marina Lebo

Marina Lebo says the rise of flexible and hybrid work schedules has led to Healthtrax being busy at less traditional times.

“I think a lot of people’s minds shifted during the pandemic,” Brodeur said. “Instead of working out to quickly lose some weight, our typical member now seeks a higher quality of life and to avoid becoming an unhealthy person.”

Lebo noted that the most vulnerable people to getting COVID usually have issues with obesity or struggle with other health problems.

“There’s been a realization that, if you stay in shape, you will be better-prepared for all kinds of ailments, and you’ll be less likely to have symptoms over someone who isn’t as healthy.”

For the past year or so, Conca has seen a resurgence in his West Springfield facility due to people taking more initiative with their own health and wellness — especially older people or those who navigated the pandemic with heart disease, diabetes, weight issues, or other health factors, and now want to improve their outlook.

“They weren’t really paying attention to their fitness or health before,” he said. “These are folks who want to take a much closer look at their health.”

Most of Conca’s members are in their mid-40s through their 60s. “We have some folks in their 30s, but they’re not the majority,” he said. “It’s a nice mix of folks, and no one’s here for vanity reasons like getting ready for bikini season. They want to move better, feel better, take care of themselves. When they go on vacation, they want to be able to go on a hike without pain.”

The demand for more results-oriented workouts has meant growth in the personal training and small-group training programs at Healthtrax. Lebo said the small-group training appeals to people who like a dedicated workout at a scheduled time.

“If you’re a biker, golfer, tennis player, runner, obviously you can’t go as fast and hard and aggressive as you did in your 20s or 30s, but you can still go out and enjoy doing it, at maybe a little less intensity.”

“If you have a goal and you start to see results, you are more likely to stick with the training,” she said. “It’s far more effective than going to the gym for weeks, doing your own thing, and not seeing any noticeable results.”

To establish a starting point for fitness, Healthtrax uses a high-tech body-composition machine known as InBody 570. While the user stands on it barefoot and holds the handles, the machine provides a wealth of fitness information that helps a person understand what type of workout would benefit them most.

“For example, someone who is thin might learn they are not as fit as they thought, and the InBody might also reveal a heavy person has a good amount of muscle, so they can concentrate on exercises that burn fat,” Lebo said.

At Active Lifestyle Fitness, Brodeur offers what she calls a 6 Week Transformation Challenge, with an emphasis on strength, cardio health, and flexibility. She emphasized this is not a quick fix, but a results-oriented approach to a healthy and balanced body.

“We developed this program because people told me, ‘I need help. I don’t want to mess around with my health anymore’” she said. “It’s been successful because it centers around the basics of helping people properly move their body and build strength.”

Ashley Brodeur

Instead of just wanting to lose some weight, Ashley Brodeur says, today’s fitness crowd is looking to improve their quality of life.

An emphasis on long-term health comes with many rewards. Conca noted that, while everyone knows the definition of ‘lifespan,’ he talks with members about ‘healthspan’ — the number of years one spends without being hampered by chronic disease — and ‘playspan,’ the number of years one is able to continue to enjoy favorite activities.

“If you’re a biker, golfer, tennis player, runner, obviously you can’t go as fast and hard and aggressive as you did in your 20s or 30s, but you can still go out and enjoy doing it, at maybe a little less intensity.”

Understanding the value of that playspan, and of maintaining the ability to enjoy quality-of-life moments like getting on the floor to play with a grandchild and easily getting back up, puts a real-life emphasis on fitness goals, Conca said, which are more powerful than the numbers attached to weight-loss goals.

“When they come here, a lot of folks are not in a good place; they’re struggling, and there’s a lot of misinformation out there,” he explained, adding that many people have tried different approaches but lacked proper accountability along the way.

“We really personalize it. I’ve been really blessed to help people and have a team around me who feel the same way. It’s exciting because we’re really helping people.”

 

Opportunity Knocks

Lebo has seen a huge change involving when people choose to access her club. In the past, the hours before and after work were consistently busy, while the club was practically a ghost town in the early afternoon. That’s no longer the case.

“We are busy at all different times during the day,” she said. “With more people working from home or on floating work schedules, they might come in after 9 a.m. or after 2 p.m.”

All-day activity has been a positive development because, in addition to seeing activity all day, members no longer experience those congested times waiting to use the more popular exercise equipment.

“It’s also good for our training classes because we can schedule throughout the day instead of trying to jam everyone in after work,” Lebo said.

Whether it’s through personal training sessions, small groups, open gym time, or an introductory, six-week program called Mastering Your Best Self, Conca emphasizes that fitness should not be stressful. In fact, when done properly, it should reduce other stressors in life.

“Everyone’s dealing with something, whether it’s physical stress, financial stress, or family situations, taking care of someone. Everyone’s got a lot of stuff on their plate. So we try not to make fitness another burden for them,” he said.

“We want people to recognize, they have an opportunity to take better care of themselves, and it’s going to make all those things they are dealing with much more manageable. Fitness can be fun, let’s not make it a punishment.”