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Coronavirus Features Special Coverage

The Shape of Things to Come

With the arrival of spring, stimulus checks, and vaccinations for growing numbers of residents, continued recovery from the steep economic decline of 2020 is in the forecast. But like the weather, economic rebounds are difficult to predict. With this recovery, there is still widespread speculation as to what shape it will take — U, V, W, K, even the Nike ‘swoosh.’ Myriad factors will ultimately determine that shape, from the ongoing threat of inflation to uncertainty about when and to what extent people will gather again, to questions about just how willing Americans are going to be when it comes to spending some of the money added to their bank accounts over the 12 months that ended in January.

$4 trillion!

That’s the amount Americans added to their bank accounts over the past 12 months or so, a savings rate perhaps never before seen in this country, which has hasn’t been known for that trait.

It came about because of all the things that people couldn’t spend money on, or didn’t see the need to spend on — everything from summer camp to vacation cruises; celebratory meals out at restaurants to new dress clothes; Red Sox tickets to visits to their favorite museum. Granted, there was some spending going on, especially when it came to things like pools, new flooring, and new deck furniture for the home — or a new home itself, be it a vacation home or a bigger primary residence.

“I am pretty optimistic that people are just to their wit’s end with being isolated; they really want to get out, do things, and buy things. They just want to live a normal life again.”

But, for the most part, Americans were saving in 2020.

And now that there is light at the end of the tunnel, and it seems like people will be able to spend some of the money they saved, the speculation involves just how willing they will be to go back in the water, if you will, and do some of the things they had to forgo for a year.

That’s just one of many factors that will ultimately decide the shape of the recovery we’re now in, and how quickly the nation will get back to something approaching normal.

As several of the stories in this issue reveal, the world, or at least this part of it, is returning to a sense of normal. Hotels are booking rooms again, airports are busy (or at least busier), Tanglewood and Jacob’s Pillow will have seasons in 2021 — albeit different kinds of seasons — and, overall, the state has entered into what Gov. Charlie Baker calls stage 4 of his recovery plan. This final stage will allow indoor and outdoor stadiums to run at 12% capacity, the state’s travel order to be downgraded to an advisory that recommends people entering Massachusetts quarantine for 10 days, public gatherings to be limited to 100 people indoors and 150 people outdoors, and exhibition and convention halls to operate if they can follow gathering limits.

It’s a big step forward, but much will depend on how willing people will be to gather in these places, and how confident they will be to travel. Meanwhile, there’s all that money that people saved and the latest round of stimulus checks now finding their way into people’s bank accounts. Will people spend them, and what will they spend them on?

And what if there is a spending frenzy and economists’ fears of inflation, potentially the runaway variety, become realized?

These are just some of the questions hanging over the job market and this overall recovery, which will, at the very least, be unlike anything else the country has experienced. Indeed, it has bounced back from recessions, tech bubbles, a 9/11 downturn, wars, and more. But it hasn’t seen anything quite like this — a pandemic-fueled economic crisis that wiped out millions of jobs, followed by, and accompanied by, federal stimulus on an unprecedented level.

Mark Melnik

Mark Melnik

“Just because we hear, ‘get back in the water, everybody,’ it doesn’t necessarily mean that folks will. I think there’s reason to be bullish about the Massachusetts economy in the second half of 2021 and the early part of 2022 because of the pent-up demand. But so many of these issues are going directly to the comfort level that people are going to have psychologically.”

“I’m a little less cautiously optimistic than some, but I am pretty optimistic that people are just to their wit’s end with being isolated; they really want to get out, do things, and buy things,” said Bob Nakosteen, professor of Economics at the Isenberg School of Management at UMass Amherst. “They just want to live a normal life again.”

Mark Melnik, director of Economic and Public Policy Research at the UMass Donahue Institute, concurred, but offered some caveats.

“There’s a psychological element to the economy,” he told BusinessWest. “Just because we hear, ‘get back in the water, everybody,’ it doesn’t necessarily mean that folks will. I think there’s reason to be bullish about the Massachusetts economy in the second half of 2021 and the early part of 2022 because of the pent-up demand. But so many of these issues are going directly to the comfort level that people are going to have psychologically.”

 

History Lessons

As they have many times over the past year, experts pointed to Worlds War II as the only recent point in history that can in any way compare with the ongoing pandemic, and noted that the comparisons hold when it comes to what happened when it was all over.

“During the war, people couldn’t buy a car, and there was a great deal of rationing,” said Nokosteen, adding that, as a result, people were saving. And while there was a lull right after the war ended, during which some feared the country would actually sink back into the Great Depression that officially ended with the war, people soon started spending — big time.

“Everyone wanted to spend money,” he told BusinessWest. “And they had some money — people started cashing in the war bonds they bought, and soldiers came home to the G.I. Bill. There were a lot of things that spurred the economy on, and it came back quickly after that initial slump.”

Experts are predicting something along those lines for 2021 and 2022, but there are a number of variables that could determine the ultimate shape of this recovery.

“In many ways, this recession has been the most unequal we’ve ever seen. And it has really exacerbated existing social inequalities, both in Massachusetts and nationally. People who were vulnerable to begin with are just made more vulnerable.”

“Looking at what’s taken place after the real substantial decrease in the first half of 2020, which was historic in terms of just how fast the economy contracted, and with the third round of stimulus hitting people’s bank accounts, we seem to have avoided some of the worst-case scenarios, which would have been a U-shaped recession, where we dragged along the bottom for a long time before we took off, or a very sharp, V-shaped recovery, which also would have been bad because of worries about inflation,” said Karl Petrik, a professor of Economics at Western New England University. “We managed to have missed both of those, and I’ve almost come to the opinion that we have a check-mark-like recovery.”

Elaborating, he said the country did see a recovery starting in the second half of 2020, and the second economic-stimulus package in January helped continue that momentum. The third stimulus package, coupled with pent-up demand and the ability to do things one couldn’t do in 2020 (spring break in Miami was one good example), should enable the economy to keep chugging, he went on, with the rosiest of forecasts calling for 6.5% growth, with the least rosy being around 4%.

“Both of which would be very good,” he told BusinessWest, adding that the expectation is that there will be a return to the ‘trend’ growth rate, which, after the Great Recession, was about 2.5%.

“One of the worries when you’re coming out of recession is that you know you’re going to go back to your trend growth rate — that’s why it’s the trend,” he explained. “You just don’t want to go back too soon because it just prolongs the pain in terms of the economy having the ability to recover; that’s what we saw after the Great Recession. We never saw the real takeoff, just a slow, steady, gradual growth rate up to 2019.”

Such fears probably fueled anxiety about going too small with recovery packages, Petrick noted, adding that he believes the $1.9 trillion bill that ultimately passed is certainly big enough.

Karl Petrick

Karl Petrick

“One of the worries when you’re coming out of recession is that you know you’re going to go back to your trend growth rate — that’s why it’s the trend. You just don’t want to go back too soon.”

But questions abound about how this recovery will play out and who will benefit most. With that, Melnik talked about the growing sentiment that the recovery has been, and will continue to be, K-shaped in nature, with lines going both up and down, depending on which income bracket you’re in.

“We’ve definitely seen a bifurcation in terms of educational attainment in industry, wages, and who’s been able to work and who’s been more likely to be unemployed, and long-term unemployed,” he explained. “Those people who tend to have limited educational attainment who were working in face-to-face industries, service-type sectors, including food service, restaurants, and hospitality, and other services like barber shops, dry cleaners, nail salons, and auto-repair places … those kinds of industries have been hurt dramatically, and they really haven’t recovered many of the lost jobs.

“In many ways, this recession has been the most unequal we’ve ever seen,” he went on. “And it has really exacerbated existing social inequalities, both in Massachusetts and nationally. People who were vulnerable to begin with are just made more vulnerable.”

Looking ahead and to what course the recovery will take, Nakosteen and others said so much depends on how comfortable people will be to go back to what life was like pre-pandemic, if you will.

“How are people going to feel going out in public when the public isn’t wearing masks?” he asked, adding quickly that he doesn’t know the answer. But whatever that answer is, it will go a long way toward determining how quickly and how profoundly the country, and this region, are able to rebound.

“It isn’t just vaccinations and dealing with these new variants,” he went on. “A lot of what will determine if there’s pent-up demand and how it’s released is truly behavioral. There’s no economic reason for there not to be a sharp rebound; I think it’s behavioral, it’s epidemiological, it’s medical.”

 

What’s in Store?

As for spending … area retailers are obviously looking for the lid to come off, although in some cases, the lid wasn’t on very hard to begin with.

Dave DiRico, owner of the golf shop in West Springfield that bears his name, said that, after a very quiet early spring last year, there was a surge in spending on golf equipment and apparel as many people picked up the game, or picked it up again, because it was one of the few things people could actually do.

It’s early in the new year, but that trend is continuing, he told BusinessWest, adding that the store has been packed with players loading up for the coming year.

“We’ve been really, really busy, even for this time of year,” he said. “A lot of people have money to spend, and … they’re spending it. We’re seeing a lot of people coming in telling us they’re spending their stimulus money, and that’s a good thing. That’s what it’s for, when you get right down to it — stimulating the economy.”

Peter Wirth, co-owner of Mercedes-Benz of Springfield, expressed similar sentiments, noting that, after sales ground to a halt right after the lockdown of last March, they picked back up as stimulus checks came in, carmakers started offering almost unprecedented incentives, and consumer confidence picked up.

Granted, lack of inventory, fueled by supply-chain issues, slowed the pace of progress somewhat, but many consumers simply ordered vehicles and waited — sometimes for months — for them to arrive at the dealership.

“The main things for us is consumer confidence,” he noted. “If the consumer has confidence in the economy as a whole and in their own situation, where they don’t feel like they’re going to lose their job next week, that’s when they’re going to spend money. And that affects us just like it impacts any other business. And I think more and more consumers feel we’re going to come out of the woods on this year, this summer, whenever it is.”

The picture is improving when it comes to inventory issues, said Wirth, who expects the numbers of new cars on the lot to continue rising through the year. Meanwhile, manufacturers are keeping their foot on the accelerator when it comes to incentives. Overall, he expects 2021 to be another solid year — one comparable to those just before the pandemic in terms of overall sales and service volume.

“We feel pretty about this year,” he said. “One news story can certainly change that, but the outlook for now is good, and that line about a rising tide lifting all boats is true, and we hope that this rising tide will help those businesses in hospitality and other sectors that have suffered so much.”

One sector certainly looking for a different kind of 2021 is the clothing industry, specifically businesses focused on dress clothes. Many workers simply didn’t have to buy any in 2020, as they working at home or still toiling in the office, often with more casual dress codes to match those of people working from their kitchen table.

“As a business owner, 2020 was my most challenging year, bar none; I was faced with more struggles and complications and challenges and problems to solve and situations to fix than I’ve ever faced before,” said William Brideau, owner of Jackson Connor, located in Thornes Market in Northampton, adding that the store has managed to keep going through persistence — and a PPP grant. But the challenges have continued into 2021.

Indeed, the first quarter of this year has in many ways been his most difficult, he said, due to a gap between infusions of stimulus, when it became more difficult to pay the bills. As more support comes in, he’s feeling optimistic about 2021, but he needs people to start investing in new threads — and not just shirts that can be seen during Zoom meetings.

William Brideau believes many people are ready to get dressed up

William Brideau believes many people are ready to get dressed up, which bodes well for his store, Jackson & Connor, which suffered through a rough 2020.

“A lot of people aren’t going for pants or more formal things below the waist,” he noted. “A lot of shirts, sweaters, and sport coats — and things have certainly veered more casual.”

But he has observed a pendulum swing of sorts, with more customers coming in recently looking for suits and ties.

“One of our really good customers came in recently and said, ‘I’ve had it — I’ve been in sweatpants for months, and I’m sick of it. I need a sportcoat, I need a shirt and tie, I need trousers. I want to look like I used to look; I miss that,’” said Brideau, adding that he believes many more people harbor similar sentiments.

 

Bottom Line

Over the past 12 months, people have come to miss a lot of the things they once enjoyed. The extent to which they’ve ‘had it’ with these matters — everything from the clothes on their back to the restaurants they haven’t been frequenting — will ultimately determine not just the composite shape of the recovery, but how, and for whom, things bounce back.

As Melnik noted, just because the ‘go back in the water’ advisories are out doesn’t mean people will heed them. And if they don’t, more of that $4 trillion will stay in bank accounts. And that might ultimately push back the date when we can really say the pandemic is behind us.

 

George O’Brien can be reached at [email protected]

Economic Outlook

The Big Picture

Bob Nakosteen has an old saying hanging in a frame in his office at the Isenberg School of Management at UMass Amherst — the one he hasn’t been in but once since last March.

It reads: “You Can See the Future by Looking at the Past.”

Nakosteen, a professor of Economics at Isenberg, said he’s lived by those words, especially at this time of year, when he’s asked to try to forecast what might come over the next 12 months.

Only this time, that saying doesn’t hold. Indeed, while people tend to throw that word ‘unprecedented’ into the mix early, often, and sometimes when it doesn’t actually apply, one could certainly use it with regard to COVID-19, the economy, and any efforts to look into the crystal ball and make some projections.

“In virtually every situation I’ve been in before, you can pick out an historical situation that came close and give some perspective on what might happen next,” he said. “Now, you can’t at all. Even 1919 and the last global pandemic was different; there was lingering demand from World War I, and a lot of global agriculture had been shut down. That really bolstered United States agriculture; we were still predominantly an agricultural country. There were some circumstances that we can’t duplicate now.”

So if people can’t look to the past to project what will happen in 2021, how can they handle that assignment?

“Not very easily,” said Nakosteen, who noted there are always question marks going into a new year. This year, they come by the bushel bag, and cover everything from vaccines — how effective they’ll be and when they’ll be widely available — to overall consumer confidence, always a huge issue in determining which way the arrow will point; from the election of a new president to what’s happening in other countries, especially with regard to the pandemic; from the employment scene (specifically, how many of those millions of lost jobs will actually come back) to whether, and to what degree, Congress keeps printing money and dispensing it to those in distress.

Bob Nakosteen

Bob Nakosteen

With these vaccines coming online, once people get them, and they have confidence that other people have done the same thing, then you’ll likely see a pretty robust recovery, starting slowly and then accelerating. But, then again, we’re in completely uncharted territory.”

Add it all up, and there is simply too much uncertainty to make any real projections, said Nakosteen, adding that, while the country may well avoid another recession, or the dreaded ‘double-dip recession,’ as it’s called, the eventual shape of the recovery — which has been the subject of endless conjecture, with possibilities ranging from a V to a U to something like a Nike swoosh — is still be to determined. Obviously.

“What we could have is a W-shaped recovery,” said Nakosteen, offering another possibility, noting that, in this scenario, the economy would move back down again, hopefully not as bad as it did when it cratered last March, but eventually climb back up.

“With these vaccines coming online, once people get them, and they have confidence that other people have done the same thing, then you’ll likely see a pretty robust recovery, starting slowly and then accelerating,” he told BusinessWest, adding that the bounce-back might also take the more dramatic Nike swoosh shape. “But, then again, we’re in completely uncharted territory.”

When asked about the factors that will dictate the eventual shape of the recovery, Nakosteen said there are almost too many to count. They include:

• How much more stimulus money will be injected into the economy. Like most, Nakosteen said the recent $900 billion package approved by Congress will help, but it won’t be enough. When asked if the federal government could keep on printing money, in essence, he said he didn’t see why it couldn’t. “One of the things that happens during an economic crisis is that the government will provide temporary support until the economy heals itself. This is not permanent; this is temporary, and it’s a bridge to the future. And right now, we need a bridge.”

• The election of a new president. “That generally seems to perk things up — there’s generally a first-administration bounce — but in these unprecedented times, who knows?”

• To what extent new habits might become permanent. These include everything from not dining out or traveling to doing most shopping online, to working remotely. “I would like to get back to going out more, but my guess is that my life has changed, and we’ll never really go back to the way it was before the pandemic.”

• How many of the jobs that have been lost are regained. Employment is always a key to any recovery, and there is conjecture that many jobs will be lost permanently due in part to those changes in behavior; and

• Whether this region can somehow benefit from these changes in behavior and attitude. Some have suggested that, now that people can successfully work remotely, they may choose to do so in a setting like Western Mass., which provides space and a lower cost of living than Boston or other major cities.

While making hard projections is difficult, Nakosteen said he could offer what he considers to be a best-case scenario:

“By early summer, enough of the country is vaccinated and enough of the state is vaccinated, and, almost as importantly, people have confidence in the vaccine and the percentage of the population that’s been vaccinated, and then you see people start to re-engage. The industries that have been hurt have all been face-to-face industries — accommodations, retail, other services, the arts, and recreation. These face-to-face services start to bounce back quickly because people have a great hunger to get back out. If things go well, you’re going to see them get back out in the summer, and that’s when you’ll start to see the beginning of a serious rebound.”

Again, that’s the best-case scenario.

The worst case? An insufficient percentage of the population receives the vaccine, supply-chain issues “gum things out,” news of new strains of the virus spreads fear, people lose confidence in a recovery, and things drag on into the fall and perhaps longer, he said, adding, again, that myriad factors will determine which scenario — possibly one in between those two — becomes reality.

Summing things up, Nakosteen noted that, in some respects, we know what’s coming next — the administering of vaccines to millions of people over the next several months. What we don’t know is how all that is going to play out.

As he said, normally you can look to the past to see the future. But not in this case.

 

Construction Special Coverage

Constructing a Picture

In its recently released 2021 Dodge Construction Outlook, Dodge Data & Analytics predicts that total U.S. construction starts will increase 4% in 2021, to $771 billion.

“The COVID-19 pandemic and recession has had a profound impact on the U.S. economy, leading to a deep dropoff in construction starts in the first half of 2020,” said Richard Branch, chief economist for Dodge Data & Analytics. “While the recovery is underway, the road to full recovery will be long and fraught with potential potholes. After losing an estimated 14% in 2020 to $738 billion, total construction starts will regain just 4% in 2021.”

Furthermore, he added, “uncertainty surrounding the next wave of COVID-19 infections in the fall and winter and delayed fiscal stimulus will lead to a slow and jagged recovery in 2021. Business and consumer confidence will improve over the year as further stimulus comes in early 2021 and a vaccine is approved and becomes more widely distributed, but construction markets have been deeply scarred and will take considerable time to fully recover.”

He noted that the dollar value of starts for residential buildings is expected to increase 5% in 2021, non-residential buildings will gain 3%, and non-building construction will improve 7%. “Only the residential sector, however, will exceed its 2019 level of starts thanks to historically low mortgage rates that boost single-family housing.”

The pattern of construction starts for more specific segments is as follows:

• The dollar value of single-family housing starts will be up 7% in 2021, and the number of units will grow 6% to 928,000. Historically low mortgage rates and a preference for less-dense living during the pandemic are clearly overpowering short-term labor-market and economic concerns.

• Multi-family construction, however, will pay the price for the single-family gain. The large overhang of high-end construction in large metro areas combined with declining rents will lead to a further pullback in 2021. Dollar value will drop 1%, while the number of units started falls 2% to 484,000.

• The dollar value of commercial-building starts will increase 5% in 2021. Warehouse construction will be the clear winner as e-commerce giants continue to build out their logistics infrastructure. Office starts will also increase due to rising demand for data centers (included in the office category), as well as renovations to existing space. Retail and hotel activity will languish.

• In 2021, institutional construction starts will increase by a tepid 1% as growing state and local budget deficits impact public-building construction. Education construction is expected to see further declines in 2021, while healthcare starts are predicted to rise as hospitals seek to improve in-patient bed counts.

• The dollar value of manufacturing plant construction will remain flat in 2021. Declining petrochemical construction and weak domestic and global activity will dampen starts, while a small handful of expected project groundbreakings will level out the year.

• Public-works construction starts will see little improvement as 2021 begins due to continued uncertainty surrounding additional federal aid for state and local areas. Additionally, the unfinished appropriations process for fiscal year 2021, which began Oct. 1, raises doubt about the sector’s ability to post a strong gain in 2021. Public-works construction starts will be flat over the year.

• Electric utilities and gas plants will gain 35% in 2021, led by expected groundbreakings for several large natural-gas export facilities and an increasing number of wind farms.

 

Business of Aging

Team Approach

By Mark Morris

the Bioness L200

This device, the Bioness L200, helps patients recovering from a brain injury to re-establish the use of their arms and hands.

In the U.S., 2.5 million adults and children sustain a traumatic brain injury (TBI) every year.

The Brain Injury Assoc. of America (BIAA) reports that more than 2 million of those injuries are treated in emergency departments, while approximately 50,000 result in death. Nearly 280,000 are admitted to hospitals, after which patients transition to inpatient rehabilitation, where the goal is to get back to their maximum level of function and independence.

But what’s involved in that rehabilitation process for brain injuries? It depends on the patient.

“Many people associate traumatic brain injuries with a younger population because they tend to engage in riskier behaviors. Older people who hit their heads from slips, trips, and falls are also susceptible to TBIs,” said Jennifer Blake, an occupational therapist with the inpatient program at Weldon Rehabilitation Hospital, adding, however, that anyone at any age can sustain a brain injury.

The Centers for Disease Control and Prevention (CDC) defines TBI as a “disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury.“

Traumatic brain injuries are evaluated on a spectrum, said Blake, noting that someone who experiences a concussion, also known as ‘mild traumatic brain injury,’ can usually return to normal with just limited therapy. On the other hand, people with moderate to severe brain injuries require medical care and more comprehensive inpatient rehabilitation. Often these patients need some level of supervision after discharge.

On occasion, someone may have a head injury and not immediately recognize it. For example, if a person is in a car accident and has a broken leg, that might get the primary treatment focus, Blake explained. Even after a CT scan, the brain injury may not initially show up. “It’s only after further investigation, when the person is having trouble concentrating or paying attention, that they discover the brain injury.”

“When they see their arm move and their hand open and close, it boosts their confidence and makes them feel more hopeful; you can see it in their faces.”

Because our brains are essential to all our physical and mental functions, therapists have found that taking a multi-disciplinary approach yields the best results in helping people recover from a brain injury. A team of physical therapists, occupational therapists, and speech pathologists, supported by 24/7 care by medical staff such as nurses, doctors, and pharmacists, make sure all the patient’s needs are addressed.

“We meet once a week to make sure we are all on the same page,” said Julie Bugeau, an occupational therapist for Encompass Health Rehabilitation Hospital of Western Massachusetts. “We have an open discussion to determine where the patient is in terms of therapy and function. We also ask questions outside of the therapy, such as, ‘how are they medically?’ ‘Are they eating well?’ We try to look at all the factors that can affect their rehab.”

What’s the Plan?

Blake said most admissions in the inpatient setting last only two weeks, so working as a team helps them determine the patient’s eventual discharge plan.

“By working together in an interdisciplinary team, we can figure out what’s working, what’s not, and make changes along the way.”

Blake said an individualized plan for rehabilitation is developed by therapists who work with patients in three key areas:

• The physical therapist studies a patient’s mobility: for example, how well they can get from one place to another, their balance, and how well their motor skills can function;

• The occupational therapist helps patients with self-care skills, such as eating, getting dressed, bathing, as well as tasks like cooking, cleaning, and managing medications; and

• The speech and language pathologist addresses higher levels of cognition, such as memory, attention, concentration, problem solving, and decision making. Sometimes the pathologist works with patients whose brain injury causes dysfunction in producing or understanding language.

Advancing technology offers therapists tools to aid in rehabilitation that were not available years ago. Bugeau discussed how devices such as the Bioness L300 and H200 help brain-injury patients regain the use of their legs and arms. The L300 attaches to the leg and, through electrical stimulation, can aid a person’s ability to walk.

“The idea is that, with repetition, those leg muscles will be able to move properly without the external stimulus,” she explained.

Meanwhile, the H200 helps re-establish the movement of arms and the grasping action of hands. Bugeau said using these devices results in positive responses from her patients.

help brain-injury patients

The Bioness L300 is used to help brain-injury patients regain their ability to walk through electrical stimulation.

“We’ll have patients who say, ‘my arm doesn’t work — I have a dead arm,’” she noted. “Then, when they see their arm move and their hand open and close, it boosts their confidence and makes them feel more hopeful; you can see it in their faces.”

By employing the different therapies, Bugeau went on, the hope is to maximize the patient’s abilities. But, she added, “while the therapy is important, rest is also an important part of the recovery.”

While many patients transition directly from inpatient to outpatient care, Bugeau said Encompass also offers a home-care component for those who are not yet ready to make the move.

“We will help patients settle into their home and continue training with them and their families to make sure they are safe and getting stronger,” she said. “It’s an option we recommend until the patient is ready to move into outpatient treatment.”

Blake added that the outpatient phase of care at Weldon involves working closely with families during outpatient therapy to help them manage that part of the process.

“Let’s say a patient is receiving all three therapies in an outpatient setting,” she explained. “We will try to schedule all of them on the same day to make it a little less overwhelming for the caretaker.”

Blake said it’s important for the injured person and their support group to understand that, when a person suffers a brain injury, it can be a difficult adjustment for everyone involved.

“You can’t see the residual impairments from a brain injury,” she said. “The person might experience a personality change, or a once-independent person may now need lots of assistance with daily life.”

That’s why Bugeau’s staff involves the patient’s family in training and education early in the process. She said the classes help the family understand how their loved one’s brain injury is progressing and how to properly handle behaviors that are out of the norm.

“We make sure to screen every patient with a brain injury for depression because it is a such a common symptom associated with brain injuries.”

Steady Improvement

While plenty of information and support are available for families, Bugeau said the trick is not to overdo it.

“We create a folder with specific, individualized information that is appropriate to the patient’s injury. We don’t want to overwhelm the family, but we want to make sure they have the information they need.”

Blake and Bugeau encourage families dealing with a brain-injured loved one to take advantage of the support groups available at their respective organizations. Weldon offers a faith-based group as well. Both therapists also cited the Brain Injury Assoc. of Massachusetts as a solid resource for families.

In all cases, the goal is helping patients with a brain injury get back to a maximum level of function and independence.

“It’s hard to say how much time each person needs,” Blake said. “And while things can change quickly or gradually, people do improve and get better.”

Business of Aging

And the Road to Recovery Program Needs More of Them

Ray Bishop, left, with cancer patient Norman Clarke, says volunteers helped him overcome illiteracy, and this inspired him to be part of the Road to Recovery program.

When asked how he came to participate in the American Cancer Society’s Road to Recovery program, which recruits volunteers to drive cancer patients to medical appointments, Ray Bishop was more than ready to answer that question.

He grabbed a book he had with him and quickly pointed to a passage within it while explaining that, 20 years ago, he couldn’t have read it — because he was essentially illiterate.

With help from literacy volunteers, he was able to put that embarrassing problem — one that he somehow managed to hide from others — behind him. Those volunteers gave him a precious gift, he said, but also something more, the firm desire to pay that kindness forward.

“If volunteers can help me, then I can volunteer to help others — that was my thinking,” said Bishop, as he talked with BusinessWest in the waiting room at the Sister Caritas Cancer Center at Mercy Medical Center. He was there with Norman Clarke, a West Springfield resident he has driven to that facility several times over the past year or so.

Now battling stage-4 cancer that has spread from his gallbladder to his liver, Clarke says he will go on fighting the disease, through aggressive chemotherapy treatments “that won’t stop until I tell them I can’t take it anymore.”

To fight this fight, he relies heavily on the Road to Recovery program and people like Bishop, many of whom have what amount to backstories when it come to their volunteerism and, specifically, this particular program. Indeed, many have loved ones who have battled the disease, and some have fought it themselves.

But others, like Becky Mason, simply have some flexibility in their schedules and found an intriguing and quite rewarding way to take full advantage of it.

“I was looking for a volunteer opportunity,” said Mason, who has been driving for just a few months now. “They had a table for the Road to Recovery program at a breast-cancer event I attended recently with a friend. I knew there was a large need because I’ve had a few friends who have had different types of cancer, and in talking to them, one of their biggest concerns, beyond getting well, was all their appointments and how they had to go here and there. And they can’t drive, obviously.

“I never really thought about it, because I never had to go through it myself,” she went on. “But it is definitely a stressor in their lives to make sure they have the rides to and from.”

Kelly Woods says there is a strong need for new drivers for the Road to Recovery program to meet demand for the service.

There are more than 75 volunteers (50 who would be considered active) working to help relieve this stress by donating time and energy to the Road to Recovery program for the American Cancer Society’s Northwest Region, headquartered in Holyoke, said Kelly Woods, senior manager for Mission Delivery at that office, adding that each one has a different story, a different motivation for getting involved.

“Sometimes they’re cancer survivors or they have someone in their life who’s a survivor and they want to give back, or there’s someone they lost and that they want to honor,” she said, adding that, through November, volunteers provided roughly 1,000 rides in the four western counties. “But there are also individuals who are just looking for something meaningful to do; each story is different.”

Behind all their stories, though, is an even bigger one, said Woods, who told BusinessWest there is now a critical need for more drivers to meet the number of requests for assistance pouring into the agency. Among all the statistics she has regarding this program — and there are many — perhaps the most eye-opening, and easily the most concerning, involves how many requests the agency is not able to honor.

“Last year, in Hampden County alone, there were a little more than 300 rides that we could not meet,” she said, adding that, over the past few years, the program has lost some drivers due to what she called “natural attrition,” a situation that has actually led to fewer requests for rides.

This has left the local chapter in what she termed a rebuilding mode, meaning it is actively recruiting new drivers, with the goal of being able to meet more requests, thus generating more referrals down the road, as they say.

For this issue, BusinessWest takes an in-depth look at the Road to Recovery program, the drivers who are its life blood, and the critical need for more volunteers to step forward.

Driving Force

Mason works as a project manager for a company called Test America, which tests water and soil. Her duties fall largely within the realm of customer service, she explained, adding that she’s often on the phone with clients discussing scheduling or test results.

While there’s always plenty to do, there is room for flexibility with her schedule, she went on, adding that she had this flexibility firmly in mind when she learned about the Road to Recovery program and started considering whether she could become a part of it.

The more she learned, the more intrigued she became. She learned, for instance, that drivers can essentially choose their assignments and how many they take on — at least a few times a month is requested. She was intrigued by the mission, impressed by the level of training that drivers must undertake (more on that later), and motivated by the obvious need for more volunteers.

Becky Mason has been driving just a few months, but she already finds her participation in the Road to Recovery program very rewarding.

And just a few months in, she can say it’s been an extremely rewarding experience.

“It gives me warm fuzzies when I do it,” she explained. “I like to help people, and I feel that when I do this I’m making a good impact on the world, I’m doing a good deed that is making a bright spot in someone’s life. I can’t change the world, but I can at least help one person with one small thing that they couldn’t get done.”

With that, she pretty much spoke for everyone who has been part of this program, said Woods, adding that Road to Recovery has been a big part of the landscape at the cancer society for decades now.

At the heart of the program lies a very basic need. Indeed, cancer care has improved exponentially over the past several decades, but it is a simple fact that, in most cases, people need to travel to receive treatments — often several times a week and even daily, as with radiation treatments.

And a good many of them, even those with family and a strong core of friends, need help getting ‘to and from,’ as Mason put it.

“These treatments can last several months, and then there’s follow-up appointments,” she explained. “Even for people with a good family network and friends, that gets tapped after a while. It may be that at the beginning they don’t need any help, but as time goes on, they do.

“And sometimes, we just serve as that ‘in-between,’” she went on. “Radiation treatment is six weeks — that’s 30 rides. They may be able to parcel 20 together, but they may need us for 10. And sometimes, we do all 30 because people don’t have a support network.”

To become a volunteer, one must obviously have a vehicle, a valid driver’s license, and a good driving record, said Woods. But they must also undergo a screening process and some training, the former involving a criminal background check and the latter including everything from using something called a service match portal computer to pick and schedule assignments to understanding the many rigid privacy laws now on the books.

“It’s great for the drivers, because there’s flexibility,” Woods said of the match portal. “They can log in as often as they want, and the system communicates with them and sends them e-mails if there are requested rides in their area.”

But there are some things that cannot really be taught, she told BusinessWest, noting that drivers essentially have to learn how to share time — and a front seat — with someone going through perhaps the most difficult time of their life.

Elaborating, she said they have to get a feel for what to talk about and when, knowing that cancer patients have both good and bad days.

Bishop, who drives two or three times a week, a schedule he’s maintained since he retired five years ago, said he learned this early on. He also learned that many patients do like to open up about their condition, their treatments, and life in general.
“They talk to me more about their stuff than I think they do with their own families,” he said. “I’m kind of like a second doctor sometimes; they’re not afraid to talk about it.”

Clarke said that individuals like Bishop are more than drivers; they’re companions and good listeners who help take some of the stress out of an already very stressful and difficult time.

“A lot of the people who drive me have been through cancer or have seen a family member affected by it, and that’s why they’re doing it,” he said. “I can’t thank them enough — they take a lot of stress off my wife; I do this to break it up so that she can have a life without running me back and forth all the time.”

The Ride Stuff

Moving forward, the biggest challenge is to recruit more drivers and thus reduce the number of requests that could not be met, said Woods, adding that, while there are many retirees within the current roster of drivers, one doesn’t have to wait until they’re done working to be a part of this program.

Indeed, she said a number of college students drive, as well as those who work second or third shift, like police officers and firefighters, and those like Mason — and Woods herself — who have some flexibility in their schedules.

The only real requirement is to be able to drive between 8 a.m. and 5 p.m., when most all appointments are scheduled, she said, adding that those interested in volunteering can call (800) 227-2345 or log onto cancer.org for more information.

If they do call that number and become part of this special volunteer force, they will find a way to give back that is rewarding on a number of levels, said all those we spoke with.

They’ll discover, as Mason did, that while they can’t change the world, they can help one person in a very meaningful way.

George O’Brien can be reached at [email protected]

Opinion

Opinion

By Christine Palmieri

September is National Recovery Month. ‘Recovery’ is a word that gets used a lot in the world of mental health and addiction services, sometimes so much so that I think we can easily lose sight of what it represents. In my role with the Mental Health Assoc. (MHA), I often have the opportunity to talk to newly hired staff about the idea of recovery. We discuss what it means and what it can look like in the context of working with people who have experienced trauma, homelessness, psychiatric diagnosis, and substance problems.

When I ask new staff the question, “what does it mean to recover?” I frequently hear things like “getting better” or “getting back to where you were” or “having a better quality of life.” Although I tell staff there are no wrong answers to this question, secretly I think there are. They’re common and easy, but insufficient.

As with many things, I think it’s easier to talk about what recovery is by defining what it isn’t. For me, recovery isn’t a cure. It isn’t a finish line or a place people get to. It isn’t a goal that can be neatly summarized in a treatment plan. I believe recovery is a process that is unique and intimately personal to the individual going through it. Ultimately, though, I think the answer to the question “what does it mean to recover?” should be “it isn’t for me to say.”

I believe recovery is a process that is unique and intimately personal to the individual going through it.

As providers of services, or as loved ones, community members, and policy makers, I don’t believe it’s up to us to define what recovery means or looks like for people going through it. Each person needs to examine and define what it means to them. For the rest of us, I think the more important question is “what makes recovery possible?” When the question is posed this way, we are able to engage this idea of recovery in a much different and more productive way. This question offers the opportunity to share the responsibility and partner with those we support.

The analogy of a seedling is often used when describing this process of recovery, and one I use when I talk to our new hires about their roles and responsibilities as providers of service. Seeds are remarkable little things. For me, they represent unlimited potential. A seed no bigger than a grain of rice contains within it everything it needs to grow into a giant sequoia. But no seed can grow without the right environmental conditions. No amount of force or assertion of control can make a seed grow. It needs the right soil, the right amount of water, and the right amount of light.

In the same way, within each person who has experienced trauma, homelessness, psychiatric diagnosis, or problems with substances, I believe there lies unlimited potential for growth, and each person needs the right environment for the process of recovery to take place. As providers, loved ones, community members, and policy makers, we very often control that environment. Metaphorically, we provide the soil, the water and the light.

Soil is the place where recovery begins. It offers a place for the seed to grow roots, to gather strength, security, and safety. Soil is what keeps trees rooted tightly to the ground through storms. It is our responsibility to offer environments where people in recovery feel safe and secure, to try out new ways of coping and new ways of managing the difficulties and challenges that life presents to all of us.

Water provides a seedling with essential nourishment. We need to find ways to support people in recovery to discover what truly nourishes them. The work of recovery is hard. It requires taking risks and feeling uncomfortable. We cannot do the work of recovery for anyone else, but we can and should work to help people in recovery find the supportive relationships, meaningful roles, and reasons to do that hard work.

Light provides the energy necessary for growth. In recovery, I believe light is offered through the hope and understanding that every person has within them the potential to live a full and active life in the community, whatever that means for them. As providers, loved ones, community members, and policy makers, it is our role to shine the light of hope for people who have experienced discrimination, loss of power and control, and in many cases a loss of their identity. We hold this hope and offer this light because we know, without question, that recovery, however it is defined, is not only possible, but is happening, right now, all around us.

Christine Palmieri is vice president of the Division of Recovery and Housing at MHA.