hartprogram

UBMD Primary Care Partnership

Tue, 23 Sep 2025 18:28:56 GMT

HART is thrilled to join UBMD Primary Care in partnership to provide care to families in Western New York!

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Conversations with CASE

Tue, 23 Sep 2025 17:54:19 GMT

Conversations with CASE: Episode 1: HART

An Interview with Patricia E. Berggren, Chairperson, HART, Board of Directors

Respite Care

Tue, 20 May 2025 14:22:37 GMT

RESPITE CARE by Karmell Macoretta, MSN, ANP-BC May 20, 2025

Respite care provides short-term relief for primary caregivers, giving them time to rest, recharge and stay healthy over the course of their loved one’s illness. The care may last anywhere from a few hours to several weeks at a time.

Respite care can take place at home, in a health care facility, or at an adult day care center. It can be provided by family, friends, volunteers, non-profit groups or government agencies. Respite care can happen while the primary caregiver is still present, in the form of help with specific daily needs, or when the primary caregiver steps away for a few hours, days or even weeks.

Respite care is needed to provide time off from caregiving responsibilities because caregiving is HARD. Consistent breaks from caregiving is necessary to help caregivers stay physically and emotionally healthy themselves. Even a few short hours a week can provide significant improvement in caregiver well-being.

Respite care provided by a friend, relative, or volunteer may have no associated costs. Professional services may charge by the hour or by the number of days or weeks that services are provided. For a person receiving hospice care, Medicare will cover most of the cost for up to five consecutive days of respite care in a hospital or skilled nursing facility. Medicaid also may provide payment assistance.

Most private health insurance plans do not cover the costs of respite care. Some long-term care insurance plans may have coverage for this service. You must pay all costs for respite care that are not covered by insurance or government programs.

Accepting help can be difficult for caregivers, who feel obligated to do things on their own. They may not want to burden others or ask for help, or they may be worried about the cost of respite care. For those without coverage or financial means for respite care, understand that volunteers are out there. Many people want to help, and it makes them feel good to contribute.

Download the Worksheet: Coordinating Caregiving Responsibilities , to see a list of caregiving activities that you could divide up with others.

To explore local respite care options, talk with your Hart Program team for more information.

For additional information on other programs in your area, including state-sponsored programs, adult day care centers and services for veterans, visit the ARCH National Respite Locator Service(link is external) .

References:

National Alliance for Care at Home

U.S. Centers for Disease Control and Prevention

National Institute on Aging

American Academy of Family Physicians

Depression in Older Adults

Tue, 05 Sep 2023 15:08:35 GMT

Depression in Older Adults

Depression is a common but serious type of mood disorder. It can negatively affect the way you feel, act, and think. While depression is a common problem among older adults, it is not a normal part of aging. There are many types of depression, some more serious or lasting longer than others. Risk factors for depression in older adults include experiencing depression as a younger person, medical conditions like cancer, stroke or heart attack, stress, genes, social isolation, lack of physical activity and alcoholism or other addictions. Some medications or medical conditions can mimic symptoms of depression.

Symptoms of Depression in Older Adults

Depression can look different in people of differing ages and cultures. For many, the main symptom is sadness lasting two weeks or more. Often in older adults, the main symptom is lack of interest in activities.

The following is a list of the most common symptoms:

Persistent sad, anxious, or "empty" mood, flat mood
Feelings of hopelessness, guilt, shame, worthlessness, or helplessness
Irritability, restlessness, or having trouble sitting still
Loss of interest in once pleasurable activities, including sex
Decreased energy
Moving or talking more slowly
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, waking up too early in the morning, or oversleeping
Eating more or less than usual, and/or unplanned weight gain or loss
Thoughts of death or suicide, or suicide attempts

An individual with several of these signs and symptoms lasting for more than two weeks or more should report them to their doctor. These could be signs of depression or another health condition. Serious depression that is left untreated may lead to death by suicide. Primary care providers are recommended to screen patients for depression at their annual office visit with a questionnaire, but reporting symptoms shouldn’t wait.

Treatment for Depression

Treatment may be a single intervention or a combination of two or more therapies. Most insurance companies, including Medicare, will cover treatment for depression. It’s important to be patient when finding a therapy that works, as certain treatment interventions may work better for some than others.

Psychotherapy, counseling, or “talk therapy” that can help a person identify and change troubling emotions, thoughts, and behavior. This is provided by a psychologist, psychiatrist, licensed clinical social worker (LCSW), or other licensed mental health care professional such as a psychiatric nurse practitioner, and can be done individually or in a group.
Medications for depression that may balance chemicals that affect mood, such as serotonin. There are many different types of commonly used antidepressant medications. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants commonly prescribed to older adults. A psychiatrist, mental health nurse practitioner, or primary care physician can prescribe and help monitor medications and potential side effects.
Electroconvulsive Therapy (ECT), during which electrodes are placed on a person’s head to enable a safe, mild electric current to pass through the brain. This type of therapy is usually considered only if a person’s illness has not improved with other treatments.
Repetitive transcranial magnetic stimulation (rTMS), which uses magnets to activate the brain. rTMS does not require anesthesia and targets only specific regions of the brain to help reduce side effects such as fatigue, nausea, or memory loss that could happen with ECT.

Combining treatments, particularly psychotherapy and medications, has been shown to be effective for older adults. However, not all medications or therapies will be right for everyone. Treatment choices and results differ for each person, and sometimes multiple treatments must be tried in order to find one that works. It is important to be patient while trying these therapies, and to keep trying until the right therapy and/or combination of therapies works. Most insurance companies, including Medicare, will cover these therapies.

Complementary health approaches, like yoga, that improve well-being can be helpful. However, these approaches, on their own, can’t successfully treat depression. While they can be used in combination with other prescribed therapies, they should not replace medical treatment.

Preventing Depression

Although most cases of depression cannot be prevented, a healthy lifestyle can have long-term benefits for mental health.

The following is a list of things that can improve mental health:

Being physically active and eating a healthy, balanced diet.
Getting 7-9 hours of sleep each night.
Staying connected with friends and family.
Participating in enjoyable activities
Letting friends, family, and your physician know when you’re experiencing symptoms of depression.

Supporting Someone with Depression

Depression is a serious medical condition that requires treatment from a doctor or other mental health provider. While family and friends can help by offering support in finding treatment, they cannot treat a person’s depression.

A friend or family member of a person with depression might be supportive by:

Encouraging the person to seek medical treatment and stick with the prescribed treatment plan
Helping set up medical appointments or accompanying the person to the office or a support group.
Participating in activities the person likes to do.
Inviting the person to go for a walk or a bike ride. Physical activity can be great for boosting mood.
Not being afraid to ask if the person is depressed or thinking about suicide. The conversation may help them to consider getting treatment.

Resources for Individuals and Families

American Psychological Association
800-374-2721
202-336-6123 (TDD/TTY)
www.apa.org

National Institute for Mental Health Resource Center Phone: 1-866-615-6464
Live Online Chat: Talk to a representative
Email: nimhinfo@nih.gov
Hours: 8:30 a.m. – 5 p.m. ET, M-F

988 Suicide & Crisis Lifeline
988 or 800-273-8255 (24 hours a day)
711 then 988 or 800-799-4889 (TTY)
https://988lifeline.org

National Coalition on Mental Health and Aging (NCMHA)
309-531-2816
admin@ncmha.org
www.ncmha.org/

References:

National Institute on Mental Health

https://www.nimh.nih.gov/

National Institute on Aging

https://www.nia.nih.gov/

U.S. Centers for Disease Control (CDC)

https://www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html

American Psychological Association

https://www.apa.org/

John’s Hopkins Medicine

https://www.hopkinsmedicine.org/health/conditions-and-diseases/depression-what-you-need-to-know-as-you-age

Dietary Supplements in Older Adults

Thu, 13 Jul 2023 14:16:03 GMT

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Dietary supplements can be beneficial for some older adults, but they also carry risks that might be harmful. When deciding if dietary supplements are right for you, it’s important to understand these benefits and risks, as well as some general nutrition principles.

Your body processes nutrients best when they are introduced directly from food to your gastrointestinal tract. As such, our eating habits influence the amount of nutrients we consume and feed our bodies.

Many older adults eat less than the recommended type and amount of food each day. This can lead to lower nutrient levels, and possible health consequences. A balanced diet of the type and amount of recommended food sources can eliminate the need for dietary supplements.

Adults over 50 may need more vitamins and minerals than young adults do. Some of these include:

· Vitamin D – Helps your body absorb calcium, keeping bones strong and protecting against osteoporosis and fractures. Also plays a major role in immune health, fighting off viruses and bacteria, as well as nervous system health.

· Calcium – Along with Vitamin D, this mineral helps keep bones strong, protecting against fractures and osteoporosis. It is also needed for healthy nerves and blood vessels, and many vascular and hormone functions.

· Vitamin B12 - Helps keep your vascular and nervous system healthy and helps make DNA (the genetic material in all of your cells). Also prevents megaloblastic anemia, a condition that makes you weak and tired.

· Vitamin B6 – Helps support over 100 enzyme reactions involved in metabolism and is needed to help form red blood cells.

· Folate – Helps make DNA and other genetic material. Folic acid is the form found in supplements.

Do I Need A Dietary Supplement?

The first step is to determine if your levels are low, and to make sure your liver and kidneys are healthy enough to process any supplements. This can be done by asking your doctor or health care provider about blood testing.

If a supplement is recommended, your health care provider or pharmacist can help you determine how much you should take.

Forms and Safety

Dietary supplements come in various forms such as tablets, capsules, powders, liquids and extracts. They may contain vitamins, minerals, microbials (probiotics), amino acids or botanicals (herbals). In general, chewables, powders and liquids are better absorbed than hard-pressed tablets, making them more available for your body to use them. Choose a form you are more likely to take consistently.

Some supplements can cause harm in high doses or interfere with other important medications or upcoming procedures. Periodic blood testing to follow your levels and sharing a list of supplements you are taking can prevent this.

It’s important to remember that dietary supplements are not tested for safety and efficacy by the U.S. Food and Drug Administration. Just because a supplement is being sold at your favorite store does not mean it contains what the label states, is safe, or even works.

Herbal Supplements

Herbal supplements are a form of dietary supplements that come from plants. Common herbals include echinacea, ginkgo biloba and black cohosh. While many herbals have shown benefits, they are still being studied for safety and usefulness. They must be taken with caution and reviewed to make sure they do not interfere with your medications or upcoming procedures, just like other dietary supplements. Just because they are natural, doesn’t mean they’re safe for you.

Best Practices for Dietary Supplements in Older Adults:

Eat a healthy, balanced diet! Refer to the U.S. Department of Agriculture’s, Dietary Guidelines for Americans, 2020-2025 , for guidance on your nutritional needs. Remember, your body prefers vitamins and minerals come from food sources, not supplements.

Talk with your doctor or health care provider about whether you need a supplement; ask about blood testing before and periodically during supplementation.

Don’t forget about dieticians! Nutrition is their specialty. They can work with your doctor or health care provider to make safe recommendations for you. An appointment with a dietician is time and money well-spent.

When choosing a supplement, use a reputable, well-known supplement company with a history of safe, effective products. Do not rely solely on customer reviews.

Add any supplements you are taking to your daily medication list.

Read reputable sources of supplement information that are based on sound, scientific results that have been proven by multiple groups over time (not just a single study).

Beware of marketing schemes and claims; if something sounds too good to be true, it usually is!

References:

U.S. Department of Health and Human Services, National Institute on Aging

U.S. Food and Drug Administration

U. S. Department of Health and Human Services, National Institute of Health

U. S. Department of Health and Human Services, National Center for Complimentary and Integrative Health

Can Diet Choices Help Prevent Dementia

Thu, 13 Jul 2023 14:10:38 GMT

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Dementia is a general term used to describe decline in memory and cognition (thinking skills). There are many types of dementia, but the most common type of dementia is caused by Alzheimer’s disease.

Alzheimer’s is a degenerative brain disease caused by complex brain changes that occur in response to cell damage. It leads to dementia that worsens over time, and eventually other symptoms including confusion, behavior changes and difficulty speaking, swallowing and walking.

The greatest known risk factor for development of Alzheimer’s disease is age. Researchers are trying to determine if diet may also play a role, and there are two diets in particular that have gained their attention. Both the Mediterranean diet and the MIND diet have been shown to possibly reduce the risk for dementia caused by Alzheimer’s or slow down the rate of brain degeneration.

The Mediterranean diet consists of:

· Fruits

· Vegetables

· Whole grains

· Legumes

· Fish and other seafood

· Unsaturated fats

· Reduced amounts saturated fats (red meats, eggs and processed sugars)

The Mediterranean diet has been extensively studied for decades, and consistently has been found to improve cardiovascular outcomes. Scientists think this diet helps support brain health indirectly by influencing cardiovascular health. Eating fish, which is a part of this diet, is thought to be a big factor however in improving cognition and slowing brain decline. This diet may also directly protect the brain by anti-inflammatory and anti-oxidant properties and other nutrients found in the recommended foods. It may also inhibit beta-amyloid deposits (found in brains of people with Alzheimer’s) or improve cellular health to help protect the brain.

The MIND diet consists of:

· Leafy, green vegetables, 6 servings/week

· Other vegetables, 1 serving/day

· Berries, 2 servings/week

· Whole grains, 3 servings/day

· Fish, 1 serving/week

· Poultry, 2 servings/week

· Beans, 3 servings/week

· Nuts, 5 servings/week

· Wine, 1 glass/day

· Olive oil

· Limited servings of red meat, sugary sweets, cheese, butter/margarine and fried foods

MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. This diet is thought to directly reduce risk of Alzheimer’s dementia by eating plant-based foods that have been linked to dementia prevention. It incorporates elements of both the Mediterranean diet and the DASH diet (Dietary Approaches to Stop Hypertension). The DASH diet has been extensively studied and proven to lower blood pressure, which is another risk factor for Alzheimer’s.

Most of the evidence for MIND and Mediterranean diets comes from observational studies vs. experimental studies. This is the type of research normally used to study diseases within populations, and focuses on people in their natural state. Experimental studies are those that have a treatment or intervention applied to a group in a controlled environment. Clinical trials of this type are currently being conducted to hopefully bring more evidence to the table. Researchers are also looking at the connection between the digestive system and the brain including how the gut microbiome may influence Alzheimer’s rates and progression.

Currently, no single food or dietary supplement has been scientifically proven to reduce the risk of Alzheimer’s dementia or protect against brain degeneration.

While we wait for more evidence, following a diet linked to better cardiovascular health and possibly better brain health isn’t a bad idea. A good way to ease in to one of these diets is to just make one or two of the suggested changes each week. Talk or meet with a dietician for other suggestions and help. Lastly, check with your doctor or other health care provider before making any major diet changes.

References:

U.S. Department of Health and Human Services, National Institutes of Health and Aging

American Heart Association

Alzheimer’s Association

Aging In Place

Thu, 01 Jun 2023 15:59:46 GMT

Aging In Place

Aging in place, also known as “aging at home,” is a concept that has become increasingly popular in recent years as the baby boomer generation reaches retirement age. It refers to the idea of allowing older adults to remain in their own homes and communities as they age, rather than moving to a nursing home or retirement community. This allows older adults to maintain their independence, dignity, and quality of life.

One of the main benefits of aging in place is the sense of independence and control it provides to older adults. Many older adults value their autonomy and want to maintain their own living space, social connections, and daily routines. By staying in their own homes, they are able to do just that, which can lead to a greater sense of purpose and satisfaction with life.

Additionally, aging in place can provide a sense of familiarity and comfort. Many older adults have lived in their homes for decades and have a strong emotional attachment to the space. Moving to a new environment can be stressful and disorientating, particularly for those with cognitive impairments such as dementia. Staying in a familiar environment can reduce stress and promote a sense of well-being.

Another advantage of aging in place is the potential for social support. Older adults who stay in their own homes are more likely to have a strong social support network. This can include family members, neighbors, and community organizations. Social isolation is a major risk factor for poor health outcomes in older adults, and staying in one’s own home can help to combat this risk. By remaining in their own homes, older adults can maintain their existing social connections and continue to participate in community activities.

Finally, aging in place can be more cost-effective than moving to a retirement community or nursing home. While there may be upfront costs associated with modifying the home for aging in place, such as installing a stair lift or grab bars, these costs are often lower than the ongoing expenses associated with living in a retirement community or nursing home. Additionally, aging in place can allow older adults to remain in their communities and maintain their existing relationships and activities.

While there are many benefits to aging in place, there are also challenges that must be considered. One of the main challenges is the need for assistance with activities of daily living (ADL’s), such as bathing, dressing and meal preparation. Many older adults require support from family members, friends, or professional caregivers to remain in their homes. This can be difficult for family members who may have competing demands on their time, or for older adults who may be resistant to receiving help.

Another challenge is the need for home modifications to accommodate physical limitations or cognitive impairments. For example, older adults with mobility impairments may need ramps or stair lifts installed, while those with vision impairments may need brighter lighting or contrasting colors. These modifications can be costly and time-consuming and may require the assistance of a professional contractor.

Technology can play a significant role in supporting aging in place. Smart home technology, for instance, can allow older adults to control their homes with voice commands or a smartphone app, making it easier to turn off lights, adjust the temperature, and lock doors. Medical alert systems can also provide older adults with a sense of security and peace of mind, knowing that they can quickly call for help in case of emergency.

Many older adults are unable to drive or have limited access to transportation, which can make it challenging for them to maintain their independence. However, there are several transportation options available that can help seniors get around. Public transportation, ride-sharing services, and community shuttle buses are excellent options that can help older adults stay connected to their community.

Social isolation can be a significant issue for older adults living alone, which can negatively impact their mental and physical health. Encouraging seniors to participate in social activities, such as clubs, classes, and volunteer opportunities, can help reduce the risk of social isolation and promote overall well-being.

Home health care can provide seniors with the care they need while allowing them to remain in their own homes. Home health care services can include medication management, wound care, physical therapy, occupational therapy, and activities of daily living.

Many older adults living on a fixed income may struggle to pay for home modifications, home health care services, and other expenses related to aging in place. Fortunately, there are several financial assistance programs available that can help seniors afford these services. These programs include Medicare, and the Older Americans Act.

Having a support network can be invaluable for seniors living alone. Family members, friends, and neighbors can provide emotional support, help with household tasks, and assist with transportation. Additionally, local community centers and senior centers can provide older adults with access to a range of services and activities.

Falls are a significant risk for older adults, and preventing falls is critical to maintaining their independence. Home modifications, including removing throw rugs that easily cause you to trip, can help reduce the risk of falls. In addition, exercise programs that focus on improving balance and strength can also help reduce the risk of falls.

Finally, staying in one’s home can promote independence, comfort, social support, physical health, and cost-effectiveness for older adults. While there are challenges associated with aging in place, the benefits are significant and should be considered when making decisions about care options. By supporting older adults in their desire to stay in their homes, we can promote their overall well-being and quality of life.