A caregiver holding someone's hands

Why I Will Be in Line for A Flu Shot This Year

For many years, Ann Himmler of Monroe County, was required to get a flu shot every year because she was a Hospice volunteer. “I was 100 percent on board with the requirement,” said Ann, “because in addition to the patients I would be spending volunteer time with, my family had also been providing care to a senior parent with compromised health issues who lived in our home.”

Ann knew that older adults and people with certain medical conditions, including a weakened immune system, are among those who are at high risk of serious complications from the flu. “It was important that our entire family receive the flu shot as well, not only to protect ourselves from getting sick, but also reduce the risk of transmitting the flu to our relative who depended on us for their care,” said Ann.

How Dangerous A Virus Can Be

The COVID-19 pandemic has raised awareness of how dangerous a virus can be and how important it is to have an effective vaccine. “In 2019, the U.S. Centers for Disease Control and Prevention estimates between 39 million and 56 million people got sick with the flu and between 24,000 and 62,000 people died of flu complications,” said Dr. Stephen Cohen, Excellus BlueCross BlueShield senior vice president and corporate medical director.

For the very young, the very old, women who are pregnant, and individuals with compromised immune systems including many patients on chemotherapy, catching the flu can place them at high risk for serious complications, including death. “Fortunately, we have a flu vaccine in hand for this year’s strains that can provide a level of immunity or reduce the severity if you do get sick,” said Dr. Cohen.

Don’t Wait to Get a Flu Shot

The flu vaccine is now available at most major pharmacies, many physician practices, and other sites in our community. With rare exceptions, the CDC recommends it for everyone ages 6 months and older. Most health insurance plans cover the flu vaccine in full, and you usually don’t need an appointment to receive it at a pharmacy.

“The flu season will last until May, but it is important to get vaccinated sooner than later to help establish a level of immunity in our community,” said Dr. Cohen. “It takes about two weeks for the vaccine to provide protection.”

Older adults should consult with their health care provider to see if they recommend the high-dose flu vaccine that is approved for people ages 65 years and older. A study published in the New England Journal of Medicine indicated that the high-dose vaccine was 24-percent more effective in preventing flu in adults 65 years and older relative to a standard-dose vaccine.

Keeping Our Community Healthy

Because of COVID-19, it’s even more important to do everything that you can to keep yourself and your family healthy this flu season. “That’s why even though it’s not required for me now, I will be in line for a flu shot again this year,” Ann said.


To view or download an educational flu poster, visit ExcellusBCBS.com.

Small Steps to Prevent Big Falls: Protecting Older Adults from Injury

I had a reunion of sorts with some old friends from high school. Once we adjusted to seeing each other as “seasoned” adults, we caught up on the past 30 plus years since graduation.  We chatted about the highlights: families, careers, travel, and memories from high school.  As we settled in, our conversation turned toward our current stage of life: retirement, grandchildren and aging parents.

Since my parents passed away fairly young, I haven’t dealt with the caregiving challenges and issues that impact many older adults.  As I listened to the conversations, I was amazed that every person talked about a parent who had fallen and the tremendous impact it had on their family.

The Leading Cause of Injury Among Older Adults

I shouldn’t have been so surprised. In upstate New York, more than 1 in 4 adults over age 65 reporting falling at least once, according to research from Excellus BlueCross BlueShield.

View ‘Protect Yourself From Falls’ infographic

Even more eye opening was to hear that my friends’ parents had been hurt or had to enter a nursing home because of the fall. Unfortunately, this is quite common.  In fact, research shows that 60 percent of seniors in New York state who were hospitalized for a fall ended up in a nursing home.

Taking Steps to Avoid Falls

But falling doesn’t have to be an accepted part of the aging process. There are simple things you can do to help reduce the risk of a fall and promote independent and active lifestyles among older adults.

One friend actively involved in the care of her aging father shared her strategies to help him avoid a fall. She installed grab bars in his shower and removed throw rugs to help him avoid slipping and falling.  She routinely de-clutters his home to reduce his risk of tripping.  It helps that she’s a nurse, and assists her dad in managing his medications. There are certain medications, such as sedatives or some over the counter drugs, which can affect balance.

Since I’m not getting any younger, I’m taking note.  Thankfully, I’ve always been active.  In the past few years, I’ve become a big fan of yoga, which has helped me improve my flexibility and balance.  Exercise is a good investment because physical fitness can help prevent the incidence of falls and minimize potential injury.  I don’t want to be a statistic (not a bad one, anyway), so added to my long-term to do list is: continue to stay active and clean up the mess in my house.

To learn more about preventing falls, talk with your doctor or visit ExcellusBCBS.com. You might want to explore local falls prevention classes to help the older adult in your life stay healthy.  Here are two organizations that offer classes in upstate New York:

Lifespan (Rochester area)

Building Better Balance (Broome County)

Note: Classes may be on hold or held virtually due to the pandemic.

5 Ways to Reduce Caregiver Stress

When I was in high school, there were several years where my mom devoted herself to taking care of my grandparents. We lived in Syracuse, but my grandparents lived in Watertown, so my mom would regularly travel the hour or so north up I-81 to be with them. Back then, and for years after, she would often say how glad she was to be able to be there for her parents during that time. Despite the gratification caregiving brought her, I know it was hard for her to balance helping her parents while taking care of me and my sisters and working a full-time job.

Caregiving can be a rewarding experience, but it can also be very stressful. You may be experiencing caregiver stress if you’re feeling overwhelmed, alone, or are often worried. Whether you’re providing hands-on care or helping from afar, here are some tips from fellow caregivers to help reduce caregiver stress.

Take a break

Recognize that providing care for someone is an important job. Like all jobs, it’s important to seek a well-deserved break when you can. Don’t be shy about asking others for help. Jan Caster, a caregiver from Onondaga County, says that when someone offers to help, it’s important to “be specific about what the individual can do for you. Suggest choices like respite care, preparing meals or providing transportation.”

If you’re a long-distance caregiver, offer what you can to help the caregiver who is local. You can help research community resources or even give a small gift card to help give the other caregiver a break. That kind of help can be “a better gift than any ‘thing’,” says Jan.

There are also more formal respite services available to help give you a break and reduce caregiver stress. These services include:

  • In-home care: regular or periodic in-home care can provide someone to help with personal care, providing medical services and respite care.
  • Programs for All-Inclusive Care for the Elderly (PACE): these programs provide both medical and social services to individuals who live in the community.
  • Adult Day Care Centers: provide your loved one with some socialization while giving you an opportunity to work, run errands or take a break.
  • Nursing homes: many communities have nursing homes or other residential care facilities that can provide short-term overnight care if you need to go out of town.

Check with your local Office for the Aging and NY Connects to learn more about these and other respite services available in your community.

Communication is Key

Having open and honest conversations with your loved one can help to take the burden off of you, the caregiver. It’s helpful to understand the wishes of your loved one and make sure everyone is on the same page. Jim Redmond, a caregiver from Monroe County, says that when you’re a caregiver “you may need to have difficult conversations with your loved one…but you can still maintain a level of respect and help them preserve as much of their independence as possible. Part of having a difficult conversation is helping your loved one determine realistic goals based on their condition and the way it is changing.” Resources like AARP offer tips for having those difficult conversations.

It’s also important to establish open communication with other family members. “We have an on-going group text with my siblings and our spouses,” says Jim, “It helps everyone get the same information at the same time”. It’s one way to include everyone, even if they live out of town.”

Do Something You Enjoy

When you’re caring for someone else, you often prioritize your loved one’s health over your own. It’s important to remember to take care of your own health too to help you provide your loved one with the best care.

While it can be hard to do, Jan says it’s also helpful to “do something for yourself that you’ll look forward to.” You could watch a movie or take an exercise class. Jan enjoys a yoga class as one way to take time for her health. Finding time to rest or nap is important too, as many caregivers struggle with sleep. “Sleep is not overrated!” adds Jan.

Seek Support

Feeling isolated can be a challenge for caregivers. When you’re feeling alone, talking with others can help you to cope, whether it’s with a counselor or with a few good friends. My aunts were a main source of support for mom. They were helping to take care of my grandparents too. I remember the long phone calls my mom would have with them late into the night. Like with many of life’s challenges, it helps so much just to know you’re not alone.

Support groups are another great resource for caregivers. They can provide a safe space for venting frustration or sharing struggles. To find an in-person or online support group, contact your local Office for the Aging.

Keep Things in Perspective

It’s easy to become overwhelmed when caregiving, whether it’s with your loved one or with the situation in general. Jim says it helps to “maintain perspective” and remember that “everyone will have good days and bad days.” Many fellow caregivers say that when providing care for a loved one, it’s helpful to focus on what’s really important and not sweat the small stuff.

When all else fails, take deeps breaths and give yourself credit for doing one of the toughest jobs that there is. Jan adds, “Trust yourself when it comes to your loved one’s care – you know them better than anyone.”

Picture of a pill bottle

Your Questions About Medication Adherence Answered

The following article was written by Excellus BlueCross BlueShield SafetyNet Medical Directors Sudha Bakshi, MD, and Saba Abaci, MD

Often when patients are given a new prescription medication, they wonder why it’s being prescribed, how often they should take it, and what side effects to expect. Taking a medication as prescribed, also known as medication adherence, is especially important for prescription medications designed to treat mood disorders such as depression or anxiety. Questions about these medications are common, and it’s important for you, if you do have questions, to get the answers you need.


Start the Conversation

If you have questions about prescription medications for mood disorders, having a conversation with your health care provider is the right place to start. Your provider knows you and your medical history best and can determine if any symptoms you are experiencing are indicative of a mood disorder. Common symptoms of mood disorders include extreme sadness, loss of enjoyment, changes in sleep, changes in appetite, and difficulties with motivation and attention. Often, these symptoms are severe enough that they impact a person’s ability to function effectively in their daily lives. The goal of mood disorder treatment is to help improve those symptoms and, sometimes, that treatment involves prescription medications.

Being on a prescription medication, and for how long, depends on the condition you are experiencing. There are different medications for different diagnoses. Your provider will work with you to develop the course of treatment that is right for you. For example, the typical recommendation for depression is to take the prescription medication for nine months to a year. Some individuals may need to take medication longer.


Ask Questions and Speak Up About Side Effects

It is very important to take medications for a mood disorder exactly as prescribed. Before leaving your provider’s office, make sure you know how to take the medication safely, including the correct dosage (how much) and frequency (how often). It is also important to ask about potential side effects you may experience while taking the medication.

Side effects have been cited as a reason people stop taking their prescribed medications. Depending on the medication, side effects may include changes in sleep, appetite, mood, anxiety, energy, and sexual function. Talk with your provider about any changes in behavior or physical symptoms that are new and/or difficult to manage while taking a medication. It is also important to be aware of the Food and Drug Administration (FDA) warning of a new and sudden onset of negative or self-harming thoughts. These can be addressed by your provider and may require changes in the medication or dosage.


Keep the Conversation Going

After starting a medication for a mood disorder, you may not feel better right away. Mood disorders impact the neurochemical nature of the brain over time. Therefore, typically, you’ll need to take your medication for four to six weeks before your provider can assess your true response to it. However, for some, there can be a reduction in symptoms within the first two weeks. Taking your medication as prescribed can help you better manage your condition.

As your treatment continues, your provider will continually monitor and evaluate your progress. If you have additional questions or concerns related to prescription medications, talk with your health care provider.

For more help with taking medications, visit ExcellusBCBS.com and click on the “health and wellness” tab in the menu.

Alzheimers disease purple ribbon

Keeping Their Memories Alive: Alzheimer’s Disease and Dementia Education and Advocacy

Alzheimer’s disease and dementia are personal.

They impact not just those afflicted, but all the family members and friends around them. Shaquana P. Divers of Monroe County knows this first hand. Her great grandmother, Catherine Taylor, developed dementia during the latter part of her life.

Remembering A Family Tradition

“Our family tradition of making fresh dill pickles in the summer always reminds me of my great grandmother,” she said smiling. “My granny, who affectionately called me Shawnie, had a huge garden in East Northport, Long Island. She used to grow cucumbers in her garden and made the most delicious pickles from them.”

Picture of a grandmother and granddaughter

Shaquana and her Granny

But as time went on for her great grandmother, remembering even the things she had done for years like how to make her pickles, became impossible. Dementia is a general term for loss of memory and cognitive abilities that includes a range of medical conditions, including Alzheimer’s disease. Alzheimer’s disease is a neurological disorder in which the death of brain cells causes memory loss and cognitive decline, explains Nicholas Massa, MD, medical director at Excellus BlueCross BlueShield. “More than 400,000 New Yorkers aged 65 and older are living with Alzheimer’s or another dementia and more than one million family members and friends are providing care to their loved ones.” (Source: Alzheimer’s Association)

Alzheimer’s disease alone is the sixth leading cause of death among all Americans and the fifth leading cause of death among older adults. The medical and public health communities have deemed Alzheimer’s disease and dementia public health problems that need to be addressed, since the proportion of older adults in the United States is projected to increase dramatically in the coming decades.

A Call To Action

Joanna Dott of Onondaga County has also experienced the effects of these diseases. “About 5 years ago my grandmother, Julie (who I call Mom-mom), was diagnosed with early signs of Alzheimer’s/dementia,” she said. “She moved from her home in Philadelphia, P.A. to Syracuse to live with my mother. My Mom-mom has always been my hero growing up so it was wonderful having her so close to home – however, we quickly realized how different life would be.”

Picture of a senior woman in a wheel chair

Joanna’s Mom-Mom

Joanna’s family has watched the disease progress day-by-day and in a short amount of time. The stress on the caregivers is great, so she often steps-in to help her mother care for her grandmother.

Both Joanna and Shaquana knew they could not sit idle. Both have taken action to educate themselves, their community, and to raise awareness in hopes of finding a cure.

Get Involved

“While researching this disease and trying to educate myself on the various stages, I learned about the Alzheimer’s Association in Central New York. They have so many amazing resources available such as a 24/7 helpline, support groups for caregivers, care training, and planning for the future to name a few,” Joanna said.

In 2017, she decided to take part in the organization’s annual fundraising event, The Walk to End Alzheimer’s in CNY and created a team for her family and friends. “For the past three years, we have made walk day a huge celebration of my grandmother’s life – my family comes from out of town and after the walk we have a BBQ at my house and enjoy being together,” Joanna said. “Participating in the walk each year means so much to my family because, although there is no cure at this time, we have hopes that with our participation and fundraising efforts, we will see the first survivor of Alzheimer’s!”

A woman and her son dressed in purple at a community event

Joanna and her son at The Walk to End Alzheimers in CNY

The Alzheimer’s Association Walk to End Alzheimer’s is the world’s largest event to raise awareness and funds for Alzheimer’s care, support and research. The CNY Walk is scheduled to be held virtually on Sunday, September 27, 2020. This inspiring event calls on participants of all ages and abilities to join the fight against the disease.

Fundraising dollars and participation in the event help to change the level of Alzheimer’s awareness in the community.

The Longest Day

Shaquana connected with the Alzheimer’s Association in Rochester/Finger Lakes and learned about the Longest Day event. The Longest Day, which fell on June 20 this year, is the day with the most light — the summer solstice.

“I learned that lifestyle habits such as consistent physical activity, following a Mediterranean diet and getting ample sleep may ward off the disease,” she said. “But the condition is still a mystery, especially for African Americans and Latinos.  Our collective power is needed to raise awareness, contribute to funding for research and treatment, address social determinants of health, and support programs that uplift our elders and caregivers who are suffering.”

Learn More

The Alzheimer’s Association has offices throughout the nation. They provide a wealth of services that community members can benefit from, including:

  • 24/7 helpline
  • Care consultations for families affected by dementia
  • Support groups for caregivers
  • Social activities for individuals with dementia and their care partners
  • Educational programs for families, professional caregivers and community organizations.

All services are free and currently are provided virtually or by phone. Individuals with memory loss and family caregivers can call the helpline at 800-272-3900 to learn about the symptoms of dementia, find information about legal, financial, care and treatment options, get decision-making support, and receive around-the-clock crisis assistance.

Picture of a man lying in the grass listening to music

Mindfulness: Being Present is the Best Present to Give Yourself

With all of the uncertainty we have in the world at this time, it’s even more important to practice mindfulness. Mindfulness is truly a state of mind. It’s being present in the moment, focusing on what is going on right now. You can apply mindfulness to all aspects of your life. Being mindful allows you to experience life as it’s happening, without excessive worry over the past or future. Try these tips for practicing mindfulness.

Mindful Eating

  • Avoid distractions such as reading or watching TV while you eat.
  • Focus on your food. Before you dig in, spend a couple of minutes noticing your food.  How does it look, how does it smell, how does it make you feel?
  • Take a bite. How does it taste and feel in your mouth?
  • Savor your bites – sometimes the first couple are the most satisfying. Rate your hunger level from 1 to 10 before you move on.
  • Give yourself permission to enjoy food.

Mindful Exercise

  • Begin by doing something you enjoy or maybe with someone you like.
  • Notice your surroundings. If you’re outside, look for something new. Maybe it’s the flowers or the activity of squirrels.
  • Focus on how good it feels to simply move and be active.
  • Pay attention – to the sounds around you and the breeze on your skin. If you’re lifting weights, pay attention to your form and try to perform each rep perfectly. If you’re doing yoga, concentrate on your breathing and holding a pose.

Mindful Relationships

  • Pay attention to others, listening closely to their words. Try to understand another’s point of view and delay your own reaction and judgment.

Mindful Mind

  • Take a few deep breaths when you are feeling stressed. Think about what is stressing you. Will it matter in five years? Is there anything you can do about it? If not, let it go!
  • For support, try this link https://blog.calm.com/take-a-deep-breath.

Tips for Caregivers: 5 Ways to Help Your Loved One

Like in many families, my mom and my aunts spent several years caring for my grandparents. Each sister had a caregiver role. While one advised on medical decisions, another assisted with legal affairs. They did chores around the house, cooked meals, and helped my grandparents get to appointments. Most importantly, they all continued to bring laughter and joy to my grandparents, even in the most difficult of times.

In upstate New York, 20 percent of adults identify as informal, family caregivers. Another 14 percent of upstate New York adults are expecting to step into a caregiver role within the next two years. Caregiving can be a rewarding experience, but it can also be very stressful. Whether you’re providing hands-on care or helping from afar, here are some tips from fellow caregivers to help you provide care for your loved one.

Make a Plan and Put it to Paper

Phil Fielding of Monroe County learned a lot about caregiving from watching his own parents take care of his grandparents. “Have a plan way earlier than you think you need it,” suggests Phil, “Because you just never know when you may need it.” Phil added that making a plan early is “nothing to be scared of. But you need to make sure that your loved ones have a plan in place and wishes on file for what they want.”

Start planning by working with your loved one to complete necessary paperwork. Forms for a HIPAA authorization, or advance directives including a health care proxy, may need to be completed. For more information on advance care planning, visit CompassionandSupport.org. It may also be useful to consult with an elder law attorney to help protect your loved one’s finances should he or she need institutionalized care later.

Be an Advocate

It can be overwhelming when a loved one is diagnosed with a medical condition. If you’re suddenly in a caregiver role, Jan Caster, a caregiver from Onondaga County suggests learning about your loved one’s medical condition to “be your loved one’s best advocate.” Local chapters of health organizations like the Alzheimer’s Association, the American Cancer Society, and the American Heart Association can be good places to start when looking to learn more about a medical condition.

If you’re able to go with your loved one to the doctor, take notes during the appointment. This can help you and your loved one remember more about the appointment. Taking notes can also help trigger questions you may have. At home, using a calendar can help you keep track of your loved one’s health and activities. That makes it easier to share the information with the health care provider at the next appointment.

Choosing Wisely is another resource that can help with learning about whether certain tests, treatments or procedures are necessary for certain conditions.

Get Organized

Keeping track of documents can be challenging when medical bills, statements and educational materials start to pile up. Phil suggests “finding a system that works for you and using it to stay organized.” A filing cabinet or labeled folders can help you keep track of all the paperwork. Phil adds that you’ll also want to “find out the system of the person you are giving care for.” That way you can easily find the important documents that they were keeping track of.

Manage Medications

It’s important for your loved one to take any medications as directed by their doctor. One of my aunts, a pharmacist, took charge of helping my grandparents with their medications. She would explain why the medication was recommended, what the potential side effects were, and look for any potential drug interactions. For caregivers without a medical background, spending time looking up the medications and side effects can be helpful. The pharmacist or health care provider can also answer any medication questions.

Using a pill box can also help your loved one remember to take the right medications at the right time. You may even be able to save yourself a trip to the pharmacy by signing up for prescription home delivery. Some home delivery pharmacies will deliver a 90-day supply of a monthly medication right to the home, saving you time and/or money. Talk with the pharmacist to learn more.

Use Community Resources

Many caregivers stress the importance of having a strong network of community resources. But when you’re new to caregiving, it can be hard to even know where to start looking for help. Based on his experiences, Phil says that “Eldersource has been a huge help with linking to resources in the area. Senior centers in the region are also a great contact when caring for the elderly.” Contact your local Office for the Aging for assistance with things like transportation, long-term care insurance, or housing resources. To learn more about available services and supports for people with disabilities of all ages, utilize a hospital social worker or NY Connects to help you explore options.

5 Questions to Ask Your Doctor

It started with a slight pain in my heel about a week before my wedding. My heel hurt when I walked barefoot around my apartment, or when I’d slide my foot in or out of my shoes. I figured it would go away on its own. I waited.

The pain didn’t go away. It got worse. I was in pain whenever I walked.  Finally, I went to the doctor. I learned I had plantar fasciitis, a common cause of heel pain that involves inflammation in your foot.

I didn’t know much about the treatment of plantar fasciitis. So, when I went in for my appointment, I armed myself with “5 Questions to Ask Your Doctor.”

Start the Conversation With Your Doctor

These “5 questions” are part of a national initiative by the American Board of Internal Medicine (ABIM) Foundation. The questions help patients have more informed conversations with their health care providers to make sure they get the right care. Some medical tests, treatments, and procedures provide little benefit, and in some cases can even cause harm.

Here are the five questions to ask before having any test, treatment or procedure.

1.  Do I really need this test, treatment, or procedure?

There’s often more than one way to treat or test for a health condition. For the treatment of plantar fasciitis, I learned that options included over-the-counter pain relievers, steroids, or a cortisone shot. Others may recommend stretching, massage or extracorporeal pulse activation treatment. The best treatment for you will depend, among other things, on the seriousness of your condition and your preferences.

2. What are the risks?

It’s important to learn about the risks, side effects, and possibilities of additional testing or procedures. One doctor, for example, suggested I get a cortisone shot. But then I learned that getting a cortisone shot could reduce the pain, but it also had risks like the possible tearing of the tissue in my foot.

3. Are there simpler, safer options?

Sometimes lifestyle changes, like resting, eating healthier or exercising, may be good first steps to treatment. For me, adding a daily stretching routine helped reduce the pain that I was feeling.

4. What happens if I don’t do anything?

Ask if your condition is likely to get better or worse if you don’t have a treatment or test right away. I learned that I couldn’t expect to get better without taking some action. When I finally found sneakers with the proper arch support for my foot, I started to feel less pain right away.

5. How much does it cost?

Different treatment options usually come with different costs. Ask about the cost of all your options, what your insurance may cover and about opportunities for generic prescriptions or prescription home delivery.

Partners on the same team

I ended up talking to two different doctors to assess my options. After having the conversations with the doctors, I felt that I better understood my condition and was more empowered to make treatment decisions that worked for me.

I also felt like my doctor and I were partners on the same team because of our conversation. Don’t be afraid to start the conversation with your doctor. The doctor may “always know best”, but no one knows your body better than you. Take charge of your health and your healthcare.

Instead of the cortisone shots for my health issue, I went with the stretches and the proper sneakers. I’m happy to report that thanks to my doctor and my own advocacy, I’m now pain-free from plantar fasciitis!