Simplifying medical care for older adults

How PACE is Streamlining Healthcare for Older Adults

The complexity of getting medical care as we age can turn into a full-time job of chasing appointments and providers. In addition to annual appointments, screenings and testing, specialists are playing a larger role in the medical care of the average senior. A study released in 2020.

Getting in to see all those different providers can be tricky, with transportation in particular posing a challenge when the office is located far away, the patient doesn’t drive, or the visit requires somebody go with them.

Between appointments, labs, and follow-ups, the time adds up. Then there’s the time it takes to sort through insurance coverage, obtain referrals, pursue appeals and sift through all those EOBs. Older adults and caregivers in this situation must be wondering: is there a better way? Actually, yes, through the Medicare and Medicaid-funded Program of All-Inclusive Care for the Elderly (PACE).

PACE programs bring all medical care (and more) under one roof. For participants, all their healthcare needs are provided for by a dedicated care team. Instead of driving all over town, many of those necessary visits will happen right at PACE centers like those operated by Element Care PACE across the North Shore and Merrimack Valley of Massachusetts.

From basic well and sick visits, dental, eye and hearing care to rehabilitation, every aspect of care for a participant is covered under the PACE program and facilitated by a unified care team. As a result, the work to patch together specialist and primary care visits, along with screenings, therapy appointments and sick visits, is streamlined significantly.

This consolidated care model offers a clear cost advantage over private insurance. *According to the Bureau of Labor Statistics, U.S. households whose heads were 65 or older spent $6,668 annually on health care, which amounts to 14% of total spending in those households for the year. Participants in PACE programs, like the one offered by Element Care, pay nothing when they qualify – for co-pays, glasses, therapy visits, procedures, or any other qualifying medical costs. Since independent living in the community is a hallmark of PACE programs, even home health visits from nurses, dietitians and physical therapy are included when necessary.

As we age, the average person begins taking more medications, which adds to the importance of receiving consistent care. According to the CDC, more than 83% of adults over 60 are taking at least one prescription medication and over 1/3 of seniors are taking five or more. These medications, and the conditions they’re meant to treat, need to be monitored – but a 2016 study reported only about 45% of older adults have good medication compliance habits. **In speaking with participants at one Element Care PACE center, they reported that the frequent interaction with their care team helped to improve their personal medication compliance habits significantly.

With PACE consolidating all care and associated costs under one roof, participating older adults and their caregivers reap the health and financial benefits of having a single, dedicated care team coordinating all visits and treatments needed.

To learn more about Element Care PACE or to find out if you or a loved one are eligible, visit or                 call (877) 803-5564  (TTY 711).

Upon enrollment participants must receive all health care, primary care and specialist physician services —other than emergency services —as authorized by PACE, or be fully and personally liable for costs of unauthorized services.










Three Things I Learned Visiting a PACE Center

As a healthcare writer, I’ve spent time in plenty of nursing homes, assisted care facilities, and independent living communities, but I’d never stepped foot in a PACE center until earlier this year. Here are three things I learned from visiting Element Care PACE in Beverly that shed light on why this senior care option is growing in popularity.

1. It’s a first-name basis kind of place.

From the driver who picks participants up to the receptionist who is familiar with their daily routine, PACE participants know the folks at their local PACE center. It shouldn’t come as a surprise – after all, many have been coming here for years – but it was nice to see the friendships between staff and participants.

Given how challenging it can be for seniors to begin a new arrangement for their day-to-day care, a familiar face checking their meds, serving their lunch, or greeting them in the morning can make a big difference.

2. There’s something for everyone.

As soon as you walk in, you get a sense of the lively atmosphere. On the day I visited, several different craft projects were underway. Friends were catching up as lunch was served, while cards on a nearby table waited for someone to get a game going. *According to Pew Research, 65% of adults over 65 consider more time for hobbies to be one of the best parts of aging, and participants at the Element Care PACE center in Beverly are taking full advantage.

Since PACE is committed to helping older adults live more fulfilling lives, each center is designed to bring people together. The activities and menus even place an emphasis on cultural traditions reflecting the heritage of the participants who come in, including those with Latinx and Khmer roots.

3. Participants value their time at their local PACE center.

Element Care PACE centers are still ramping back up to full schedules after two years of COVID safety protocols, but participants are eager to get in more often. Many of them came to the center five times a week before capacity limits were in effect.

When the Element Care PACE day programs at the local centers were closed for COVID lockdown, participants received medical care and support services at their homes and stayed connected to their PACE care team members via a GrandPad tablet.

*A 2021 report found 49% of adults over 65 felt COVID-19 posed a major threat to their health, so PACE’s virtual doctor visits and medication delivery service have been readily accepted among participants. With everything starting to open back up, however, it’s not surprising many are excited to get back to their daily routine of socializing over coffee and newspapers, and to see the return of activities like chair exercise.

As I wrapped up my visit, participants were departing for the day with a wave to the front desk or a doctor before boarding the Element Care van back to their homes. Knowing many would not be able to live independently without the medical and social support they receive from Element Care PACE makes each departure all the more meaningful.

To learn more about Element Care PACE or to find out if you or a loved one are eligible, visit or call (877) 803-5564  (TTY 711).

Upon enrollment participants must receive all health care, primary care and specialist physician services —other than emergency services —as authorized by PACE, or be fully and personally liable for costs of unauthorized services.

“Michelle Ellis, Independent Healthcare Writer”




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