Bringing Element Care PACE (Program of All-Inclusive Care for the Elderly) to Assisted Living Facilities Creates a Powerful Market Share Advantage. Judith Roark Mackey, Business Development Manager, Element Care

Throughout the COVID-19 pandemic, assisted living communities have provided extraordinary care and services for residents, including:  around-the-clock care; monitoring for symptoms; implementing infection control and cleaning protocols; screening of employees; ensuring social distancing; adjusting activities; hiring, and training, They also have heroically managed “move ins” for residents, sometimes in emergency situations.

Health Dimensions Group (HDG) recently published its Top Trends in Aging Services: Preparing for Historic Changes list for 2020, and it reports: “Like never before, senior living and care organizations are facing a time of great uncertainty. The speed and diversity of change seems unparalleled.”

Of interest on the list is the apparent convergence of two trends: occupancy and growth challenges, with the growing need for assisted living for middle income seniors. A quick look at the local landscape shows how investors and developers have focused almost entirely on the upper end of income levels. For lower income seniors, state and local programs, such as Medicaid, provide some housing and some care-related services, but the assisted living industry has not focused on the senior living needs of the middle income market.


A proven care model like Element Care’s PACE enhances the quality of life of residents, expands existing support, and makes assisted living

more affordable for middle income individuals.  A partnership with Element Care is a true differentiator in the marketplace and an additional tool to augment the facility’s accessibility and occupancy goals.  Element Care PACE enhances a participant’s quality of life and addresses the family and caregivers’ need for hands-on comprehensive medical care, insurance, and supportive services. We have partnered with several select assisted living partners in Middlesex and Essex Counties.  Our partners are now able to cast a wider net to attract individuals with more limited resources.

If you would like to learn more about Element Care’s Partnerships with Assisted Living Facilities, please contact Judy Mackey, Business Development Manager, email:

Can quitting smoking after age 60 actually offer health benefits?

As providers, we hear far too often “I have been smoking for 40 years. Quitting now won’t do me any good.”  This is, in fact, false. Quitting tobacco at ANY age, is linked to many health benefits. Currently, tobacco use is a worldwide epidemic and continues to be the leading global cause of preventable death. It kills nearly 6 million people a year. This statistic remains true for older adults yet, 40 million Americans still use tobacco products. Unfortunately, older adults who use tobacco have double the mortality rate compared to older adults who do not.

The health risk for smoking is extremely significant. Smoking is linked to a higher risk of cognitive impairment and dementia in older adults and has also been connected with increased risk of macular degeneration, cataracts, hearing changes, and decreased abilities in smell and taste. We know that smoking is linked to loss of functioning, mobility and independence in older adults. The risk for cardiovascular disease is greater in this age bracket. For older woman, smoking is associated with age‐related diseases such as osteoporosis and breast cancer.

The good news is that quitting tobacco delivers almost immediate health benefits. Twenty minutes after quitting, your heart rate drops to a normal level and after 12 hours, carbon monoxide level in your blood drops to normal. In as little as two days after quitting, you may notice a heightened sense of smell and more vivid tastes as these nerves heal. Your risk of having a heart attack begins to drop and your lung function begins to improve within 2-3 weeks. You may notice that coughing and shortness of breath decrease in as little as one month of quitting.

The longer a person avoids any tobacco product, the healthier a person will get. Improved health and decreased mortality occurs when people quit smoking even after age 60. Benefits of smoking cessation in older adults include reduced progression of respiratory disease and improvement in lung function. Older adults will see decreased cognitive impairment and prevention of dementia. Actually, there is a reduced risk of all major causes of death once you quit! An obvious benefit and one of the most important is improved safety, quality and length of life.

Element Care strives to help educate our participants around the harm of tobacco use and the benefits of quitting. We want our participants to enjoy time with their grandchildren, be able to go for walks with their spouses or play cards with their friends for years to come. This is why we have created a company wide smoking cessation program that involves every member of our Interdisciplinary Team.

To be honest, quitting isn’t always an easy thing to do especially after years of smoking. Cigarettes become your stress reliever, your pick me up on a bad day, a reward to yourself for an accomplishment or a friend to turn to. But know it can be successfully done and the benefits will outweigh any of the struggles you had to get there. The reason why people quit can be very different, but identifying your personal reason to quit is the first powerful step.

Here are a few more tips and tools to support your smoke free journey:

  • Commit to quit, Make a list of reasons why you would like to quit.
  • Pick a quit date. I plan to quit on (month/day/year): _______________________.
  • Identify the people in your life who can help support you.
  • Identify your triggers that may cause you to want to smoke. These can be people, places, events or situations.
  • Speak with your doctor about nicotine replacement therapy such as the nicotine patch, gum or lozenges.
  • Throw away all of your tobacco products, ashtrays and lighters.
  • Attend Element Care’s support group, Fresh Start.
  • Consider meeting with a counselor to work on smoking cessation and relapse prevention.
  • Reward yourself after reaching important milestones in your tobacco free life.
  • Learn how to manage your urges by utilizing coping skills. Here are a few suggestions:
  • Practice breathing techniques
  • Go for a walk
  • Read a book
  • Call a friend
  • Pray
  • Play a game with your grandchildren
  • Drink 6–8 glasses of water every day. It’s a surprisingly good craving-buster
  • Garden
  • Do a crossword puzzle
  • Suck on a breath mint. Mints relieve cravings for the taste of cigarettes
  • Drink some decaf stress relief herbal tea. This helps aide in stress reduction, caused from nicotine withdrawal.

And finally, try, try and try again! People may experience relapses. Maybe more than 10. Don’t get discouraged and don’t give up. Remember, you deserve this!

Katelin Hartigan
Psychotherapist at Element Care

Nurse Practitioner Role in Healthcare

What is a Nurse Practitioner?

When coming in and expecting to be seen with your Primary Care Physician sometimes you are instead seen by a Nurse Practitioner (NP). Some questions may arise. What does he/she do? How much education has he/she had? Is he/she capable of taking good care of me or my family member?

Nurse Practitioners need to be Registered Nurses as well, they need to have their Master’s degree in Nursing, and pass a professional certification in order to care for you or your family member. Many specialize specifically in caring for the elderly as I do. We can care for you or your family member by seeing you in the office with a compassionate attitude while assessing and diagnosing you or your loved one with many acute or chronic illnesses. NPs can also write prescriptions.  We have a collaborating physician we work directly with to ask any questions needed along the way.  Though NPs are not physicians we do undergo demanding training, licensures and credentialing. Nurse Practitioners are trained to also focus on the well-being of the whole person. They can also help with the primary care shortage and high healthcare costs.

At PACE we work side by side with your Primary Care physician to offer you well rounded care. My hope is that this has opened your eyes to the world of Nurse Practitioners. We will be honored to care for you or your loved one.

Christina M. Bertoli
Nurse Practitioner at Element Care

Choosing a Healthy Diet

It’s that time of year again… a time for New Year’s resolutions. As a physician, I am frequently asked for weight loss advice by patients of all ages. Achieving and maintaining a healthy weight is a key part of staying healthy and aging well. A good diet can improve more than just your waistline–it can lead to improved blood sugars, blood pressure, a lower risk for stroke and dementia, as well as a better mood.
Most people get understandably confused about how to improve their diets; there is a lot of conflicting advice in the news. Are eggs good or bad now? What’s gluten? The great news is that I can give you some simple tips to improve your diet which may help you not only look better, but feel better as well. The easiest way to control your diet is through portion control. By eating the right amount of healthy protein, fiber, and fat, you can feel full on fewer calories and lose weight. An easy way to make this change is to follow the MyPlate method — half of your plate should be split evenly between lean protein and whole grains and the other half should be split about ⅔ dark green vegetables and ⅓ fruit. You should try to add water with each meal and about 2-3 servings of dairy per day. Try to choose foods that are low in saturated fats, low in sodium, and low in added sugars. Keep the changes simple and always pick foods that you like to eat in each category.
At Element Care, we provide several resources to help our participants make healthy choices. We offer cooking classes and have an outdoor garden at our Lowell location in which participants not only grow their own vegetables, they also take them home to eat. Nutritionists are an integral part of our interdisciplinary team and promote food education. Additionally, our physical and occupational therapy department offers a Wellness program to assist participants with safe exercise. A healthy life starts with a healthy diet and our team at Element Care is dedicated to helping all of our participants achieve their health goals.

Dr. Jennifer Russo

Physician at Element Care

Flu and the Elderly

Flu is a disease of the respiratory system, including the nose, throat and lungs. Flu is short for “influenza.” Every year in the U.S. seasonal flu causes thousands of hospital admissions and deaths.

People 65 years of age and older are at greater risk for complications from the flu.

Why is that?

Our immune system weakens with age.

It is estimated that 70-90% of seasonal flu-related deaths have occurred in people 65 years and older.

Flu Symptoms

The most common symptoms of flu are body aches, fever, chills, runny nose and feeling tired. These symptoms can last a few days or as long as a week.

  • Flu is caused by a virus and it can be very serious.
  • Flu is spread easily from person to person by tiny droplets when people cough, sneeze or talk

 Know the Difference: Cold vs. Flu

How to Protect Yourself

Getting an annual flu vaccine is the best protection against the flu.  Vaccination is especially important for people over 65 because of the high risk of serious complications from flu.

Everyday precautions:

In addition to the flu vaccine, older adults and caregivers can take everyday steps to stop the spread of germs by practicing healthy habits like frequent hand washing and keeping environmental surfaces clean and disinfected.

  • Wash your hands with hand-sanitizer or soap and water
  • Cover your cough – – cough into the crook of your arm (not hands!)
  • Avoid touching your eyes, nose or mouth
  • Stay away from people who are sick
  • Stay home if you are sick

If you are diagnosed with the flu

  • Stay home
  • Avoid close contact with others
  • Get plenty of rest
  • Drink fluids

Talk to your healthcare provider about the use of antiviral medication.

Emergency Warning Signs

Anyone 65 years and older should seek emergency care with any if any of the following occur:

  • Difficulty breathing
  • Pain or pressure in the abdomen
  • Confusion
  • Severe vomiting
  • Flu symptoms that improve but then return with fever and worse cough

In an effort to keep all Element Care participants healthy each year we offer influenza vaccine to our staff and to all participants. We continue to offer flu vaccine throughout flu season as new staff join our organization and new participants enroll. The Centers for Disease Control (CDC) and Element Care recommends annual flu vaccination every year. Annual flu vaccination is the best way to prevent influenza and potentially serious complications. Immune defenses weaken with age, therefore flu vaccination is especially important for people 65 years and older. Older adults are at high risk of developing serious complications (like pneumonia) and being hospitalized from the flu.

Lisa Aptt
Infection Control Manager at Element Care

Coordinated Care: Why it’s necessary for Elders

I am a 46 year-old medical provider and describe the health care landscape as if we are in a dream sequence where we are running for safety across a tricky and difficult obstacle course only to realize that we are still at the beginning. If I feel this way then one can only imagine how our frail elders are navigating and dealing with the many complex changes. Sad to say many don’t and often their health fails on many fronts because coordination of care is time consuming and difficult. Many of these people feel forgotten or even beaten down by life.

But what if there existed a program that was a one stop shop that provided an interdisciplinary team who worked to not only do this but provide a social experience that many people could appreciate and thrive in?

Element Care practices the PACE (Program of all-inclusive Care of the Elderly) model across 51 cities and town in 8 different sites. It works to take in patients who we call our participants to identify their needs and set up a care plan that is specific to them. I have witnessed the ebb and flow of daily life at all of our Adult Day Health sites. What I can take away from all of this is that the PACE model offers many things to potential participants including medical, behavioral health, social services, activities, home services, transportation and physical therapy to name a few. In my opinion, the most vital is helping improve quality of life through reintroduction of hope. Many theorists have studied how the stressors of both physical and mental nature attack the essence of life creating a culture of negativity which is the quickest path to adverse long-term outcomes. The reintroduction of hope and positivity does more for this than any medication or treatment can.

PACE at Element Care has worked to perfect this and gives older adults the social, mental and physical interaction that has shown to be an integral part of longevity and health.

Written by:

Kenneth Comeiro
Nurse Practitioner at Element Care

Importance of Medication Compliance

Medication compliance is as important to an individual’s health plan as routine screenings and annual physicals. When the need for medication is identified by a health care provider to address illnesses and symptoms, medication compliance is key to the expected outcomes and quality of life. There are many approaches that can be utilized when assisting an individual with a medication regimen. It’s important to institute a system that identifies and meets the individual’s needs. There are simple adjustments, such as a 7 day medication planner, a container labeled with the days of the week and multiple times that can simplify and improve med compliance. Memory impaired individuals may need a more detailed plan that includes an alert to remind the individual to take their medication. This could be as simple as a phone call from a loved one to remind and initiate medication compliance, or as complex as the introduction of a visiting nurse to the home to administer the medications.

Element Care has been faced with multiple challenges when it comes to medication compliance. We pride ourselves on personalized care plans to meet the individual’s needs to allow all our participants to remain in the community with a better quality of life. Some of the approaches utilized by Element Care have included a specialized daily packaging system from the pharmacy called Meds on Time (MOT). This system places all daily meds in specific dated and timed bubble packs that are color coded for simplicity. We also utilize medication planners for those individuals that are overwhelmed with a month’s supply of medications. We have placed medication reminders in the home utilizing Element care staff, telephonic machines such as MD2 machines as well as piloted an avatar based program (link to Kendra’s blog here). When medications are complex and a more skilled need is warranted for compliance, an Element Care nurse or contracted agency nurse will provide a home visit and administer medications to the participant. As you can see there are a variety of ways to assist and ensure an individual is taking their medication as directed. The goal is to identify the best process to allow compliance for a better quality of life.

Linda Gauvain
Director of Nursing at Element Care

Patient Engagement

Patient engagement is a way to drive better health outcomes by empowering the patient and their loved ones to be active in their own care.

But why is patient engagement so important?

Studies have shown that patients and or their families who are involved in the decision making process and those who are engaged as decision-makers in their care tend to be healthier and have better outcomes then those who are not involved.

How does it work?

Patients and their providers work together to consider the patient’s condition, treatment options, benefits and risks of treatment, and patients’ preferences, and then arrive at and execute a treatment plan. Through increased communication and more information regarding the patients’ health, patients are more confident regarding their conditions, diagnosis and are overall satisfied with their care.

At Element Care we encourage consistent input and communication about PACE from our participants. Here are a few of our methods that we use to engage participants in their care:

The Participant Advisory Committee (PAC) and participant council meetings are held to serve as advisory resources and provide participants with the opportunity to share feedback regarding the design and delivery of health care services. The PAC meeting is scheduled to meet three times a year and it consists of two participants from each PACE site along with members from Element Care’s senior management team, board members, and department heads. The PAC member acts as a liaison between leadership and their home site in order to share collective feedback with regard to PACE program services. The Participant Council meetings are held monthly at each site in order to provide a forum for discussion between Element Care participants, PAC members and staff.

We also provide monthly Customer Service meetings with a representative at each site. The representative ensures participant satisfaction. Our feedback mechanisms through our grievance process are designed to enable our participants to express any concerns or dissatisfactions they may have and address them in a timely manner. In addition, we are happy to hear any positive feedback about our PACE program and our dedicated team members.

Carla Recinos Guzman
Customer Service Representative at Element Care

Tips for Healthy Living at Any Age

Staying healthy as you age can be a challenge. Programs like PACE at Element Care can help by giving older adults the knowledge and tools to prevent falls, manage chronic conditions, and improve their lives.

Keys to Aging Well

While maintaining your physical health is vital to healthy aging, it’s also important to value the experience and maturity you gain with advancing years. Practicing healthy habits throughout your life is ideal, but it’s never too late to reap the benefits of taking good care of yourself.

Here are some healthy aging tips for every stage of life:

  • Stay fit with regular exercise –Attending regular exercises classes either at your local senior center or taking advantage of the social activities and wellness gym at the Element Care Adult Day Health Centers.
  • Engage socially– Socializing with friends, family and within your community is important to keeping you healthy. Meet your neighbors, go on field trips offered by many community organizations, especially your local senior center or make new friends at Element Care’s Adult Day Health Center. See our Locations.
  • Get healthy with a well-balanced diet –Ditch the junk food in favor of a fiber-rich, low-fat and low-cholesterol diet. Be mindful of the time and quantity of your meals. Additionally, Element Care participants can also enjoy a hot meal and other healthy snacks every day at our PACE Centers. For more information on healthy diet tips visit
  • Keep up with your appointments – Regular check-ups with your doctor, dentist, and optometrist are even more important as you age. Element Care provides comprehensive services including specialty care and transportation to keep you healthy and help you age well at home.
  • Be mindful of your medications – Taking all your medications can be challenging if you see multiple specialists and are taking several medications every day. In addition, some medications can have a negative impact when taken together and put you at risk for dizziness and falls. If you need help managing your medications, consider programs like PACE at Element Care that provide coordinated and managed care. We have a dedicated pharmacist and offer free medication delivery straight to your home.
  • Stay smoke free and limit alcohol consumption – Alcohol can lead to balance disorders which can put you at risk for falls. Even a small amount of alcohol can affect your balance and reflexes. Studies from the National Institute on Aging show that the rate of hip fractures in older adults increases with alcohol use. In addition, smoking is particularly dangerous for older adults who are already at heightened risk for various health conditions such as cardiovascular disease, respiratory conditions, and cancer.  On average, smokers loose at least one decade of life expectancy compared to those who have never smoked.

It is never too late to quit smoking or limit your alcohol consumption. If you need help, programs like PACE at Element Care provide resources and supportive services to help you stay on the path to healthier living.

Finally, taking care of your physical self is vital, but it’s important that you tend to your emotional health as well and live with gratitude.

When asked what the secret was to her long and happy life, a Centenarian PACE participant stated:

“I never wanted what I did not have. I was grateful for all that I did have”.

A touching reminder that we should reap the rewards of our long life, and enjoy each and every day. Now is the time to savor good health and happiness.

Judith Roark Mackey
Strategic Partnerships & Business Development Manager

The Health Benefits of Socialization

Socialization can provide a number of benefits to your physical and mental health. People who socialize with others tend to live longer than those who are more isolated. Social engagement is associated with a stronger immune system, especially in older adults. It also benefits overall health and enables individuals to fight off colds, the flu or even some types of cancer.  Interacting with others will boost feelings of well-being and decrease feelings of depression. It is vital to create social connections with others in our day program to reap the benefits of social interaction.

The activity department at Element Care makes it a priority to introduce new participants to every individual in our program. This will give the individual an opportunity to engage in conversation with a variety of people. More recently there has been mounting evidence that socialization is good for your overall brain health. People who connect with others generally perform better in cognitive activities. Element Care offers a variety of classes and social programs which create conversation and debate among PACE participants to help with their overall mental health.

Kevin McGee
Activities Specialist at Element Care