A durable power of attorney is your written authorization for someone to act for you in many financial and legal matters. This document will serve you best if it provides a broad range of authority, so be very careful in choosing your representative. And always consult an estate planning attorney on the proper creation and use of this powerful and trusted position.

	Request our free guide on what you need to ensure a complete and up-to-date estate plan.

You may authorize your power of attorney to:

• Pay for your support and care.
• Borrow money.
• Complete bank transactions.
• Manage property.
• Handle legal claims.
• Gain entry to safe-deposit boxes.
• Prepare and file tax returns.
• Deal with insurance and retirement benefits.
• Exercise stockholder rights.
• Contract for services.
• Make gifts to family and charitable organizations.
• Collect Social Security and other benefits.
• Exercise rights of the creator or beneficiary of a trust.

For more estate and gift planning information, contact Ellen Coble at 336-331-1312 or ellen.coble@hospicecarecenter.org.

For more information about Hospice & Palliative CareCenter, visit http://www.hospicecarecenter.org!

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Soure: Winston-Salem Journal

By Annette Fuller
Published: February 09, 2011

Doctors’ busy schedules are no excuse for them not taking the time to discuss end-of-life care options with their patients, said Dr. William Blackstock, program director of the Comprehensive Cancer Center at Wake Forest University Baptist Medical Center.

“Some of my colleagues do a fabulous job of discussing these issues with their patients,” Blackstock said. “But too many of my colleagues almost never have these discussions until the patient is seriously ill. At that point, they may be taking pain medication that can confuse them. We need to have these conversations sooner than that.”

And it’s not just an issue of doctors not having enough time, he said.

“There is a skill set to this,” Blackstock said. “We are not trained to do this. It’s not something that we emphasize during residencies or fellowships.”

That’s why Blackstock is glad that the American Society of Clinical Oncology recently published a 24-page booklet, available online, that advocates for more involved conversations between patient and doctor earlier in the process about the patient’s choices for care and treatments during his or her last few months of life, if treatments are not successful.

Cancer patients are “at different places” when doctors first bring up this topic, Blackstock said.

“Some want these discussions early; some want it later,” he said. Even if the patient puts off the topic, due to fear, “it is still the doctor’s responsibility to engage the patient in this discussion. It’s part of taking care of them, just as much as the medical treatment.”

READ THE ENTIRE ARTICLE

For more information about Hospice & Palliative CareCenter, contact Ann Gauthreaux, public relations director, at 336-768-3972, or see Hospice’s website at http://www.hospicecarecenter.org!

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The changes to Medicare for 2011 provide your loved one with several free prevention services. The idea is to catch major health problems early by lowering the cost for screenings.

The changes apply to everyone with Parts A and B. If your family member has a Medicare Advantage Plan, check with the plan itself about benefits for 2011.

Following is a sample of the services to be covered. Most are offered at no cost. Some require payment of 20% of the approved Medicare fee. Important: To get these savings, your family member must use a doctor who has signed on with Medicare.

• Yearly wellness exam. An annual visit to look at current health issues. This is also a time to discuss personal risk factors and steps for preventing disease. Patients new to Medicare are entitled to a more extensive “welcome” exam within their first year of signing up.
• Bone density screening. Bone mass evaluation every 24 months for persons at risk for brittle bones.
• Cancer screening. Four types of tests are covered for colon or rectal cancer. For women, there are yearly mammograms. Plus, there is coverage for Pap smears, pelvic exams, and a physical breast exam every 24 months. For men, PSA tests and physical exams for prostate cancer are provided yearly (with a 20% fee).
• Diabetes screening. Provided twice a year for at-risk individuals (with a 20% fee).
• Flu/pneumonia prevention. Flu shots are covered annually. Anti-pneumonia shots are also covered and typically last a lifetime.

Prescription costs may also go down for your family member in 2011. If he or she reaches the “donut hole” coverage gap, the cost of brand-name drugs will drop 50%.

For more information about Hospice & Palliative CareCenter, contact Ann Gauthreaux, public relations director, at 336-768-3972, or see Hospice’s website at http://www.hospicecarecenter.org!

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Caring for a seriously ill family member can lend a tinge of blue to the holidays. It may be sadness that cherished family rituals are no longer possible. Or worry that this year will be the last for your loved one. Here are some ways to handle these common stressors.

- It doesn’t have to be “all or nothing.” Even if some family customs are no longer realistic, embrace what’s still possible. And let go of the guilt-laden “shoulds.”

- Keep it simple. Perhaps you still gather at Mom and Dad’s, but order a precooked, take-out meal. Or have everyone contribute to the meal. Try to capture the essence in a way that no one person shoulders a big burden.

- Focus on the most meaningful activities. Your energy and your loved one’s energy are limited! Pick one ritual that truly gives you that holiday lift and consider any others an “extra gift” of the season.

Acknowledge the “anticipatory grief.” You’re not crazy if pulling out your holiday sweater brings on a bout of tears.

- A holiday can sharpen awareness of life’s impermanence. You may feel grief about the losses you have already experienced. And grief as you realize your loved one may not be with you next year. These feelings are normal. If possible, share them with someone who understands.

- Celebrate your loved one’s presence. Trying to “make this holiday the best” may distract you from spending quality time with your relative. Instead, take the opportunity to cherish what you have now, and revel together in shared memories of holidays past.

Maintain your normal self-care routines. In this season of extra stress, it’s especially important to get enough sleep, eat sensibly, and exercise regularly.

For more, visit http://www.hospicecarecenter.org!

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Source: JournalNow.com

Bea Ackenbom-Kelly and her husband, Sid Kelly, are both dying.

But in the past few months, their house off Country Club Road has brimmed with life with the frequent comings and goings of family and friends.

Friends from their church, St. Anne’s Episcopal, and from Ackenbom-Kelly’s book club have come over and brought food. Their children and grandchildren have visited. And people they haven’t talked to in years have called.

“It feels like little miracles everyday when you hear from somebody you haven’t heard from in 30 years,” Ackenbom-Kelly said yesterday.

She said she has had a chance to mend estranged relationships and deepen other ones.

Both she and her husband, Sid Kelly, a founder of Crossing 52, a group devoted to improving race relations, have been getting care from Hospice & Palliative CareCenter in Winston-Salem.

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Thanksgiving is a time we traditionally gather with family to celebrate our gratitude for life. As those who are dealing with a serious illness know, life is a gift. The fact that it does not last forever is part of what makes life precious. Join others who are choosing to spend a portion of this holiday gathering to engage with grace.

This is a national movement to gracefully promote family discussions about end-of-life preferences. Talking with family is key to ensuring that your own wishes are followed. In caring for a family member, knowing that person’s wishes ahead of time reduces the potential for guilt and conflict.

You can lead the way by reviewing with your family your own answers to these questions:

- Who would you like to have make decisions for you if you are unable to speak for yourself? Ideally, you have completed an advance directive. In this document, you name your medical power of attorney and give him or her some basic instructions. Use this time to let others know whom you have chosen and what you would like.

- Where would you like to spend your last days? At home or in a hospital? What would be the most comforting?

- Do you want aggressive medical treatment right up to the end? If so, make sure your family knows to advocate for you.

- Would you prefer minimal intervention? Depending on the circumstances, your priority in your last weeks may be to live as normally as possible, placing quality over quantity. Prepare your family to accept this as your choice.

During this season of thanks, you can thank your family for their support of you and encourage them to share their wishes as well.

For more, visit http://www.hospicecarecenter.org!

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Don’t be surprised if your aging parent reacts with some defensiveness if you raise the topic of driving skills. No one wants to have their independence snatched away! Make it obvious from the start that it’s a mutual goal to keep your loved one safely on the road. And that it’s not an all or nothing situation.

Here are several options for supporting your parent’s continued safe driving:

- Mature driver refresher classes. These classes are often sponsored by AARP or a local AAA club (American Automobile Association). Classes offer practical information on easy ways to accommodate the natural changes of aging[link back to natural changes of aging article]. They tend to be informal and include a lot of group discussion. Plus, persons over 55 may qualify for a discount on their car insurance! Online classes cost less than $20 and are offered by both AARP and AAA. Or, contact a professional driving specialist for a personalized, behind-the-wheel evaluation.

- Staying physically flexible. Being able to turn to look behind you is critical to safe driving. Encourage your loved one to practice simple flexibility exercises.

- Maintaining car fitness. Make sure the car is properly adjusted for your parent. Especially important is the ability to see clearly in all directions. The addition of wide-angle mirrors, for instance, can help reduce blind spots. Be sure the wipers are in good shape. Maintain the car for road safety, too. Tires should be properly inflated and have adequate tread. And don’t forget to have the brakes checked regularly.

- Improving driving habits. A few simple changes can greatly reduce the chance of problems. Suggest Mom reduce or avoid driving at night or in bad weather. Stick to routes and times with less traffic. Make fewer left turns. (Three right turns are much safer!) And practice extra caution in parking lots and when changing lanes.

For more, visit http://www.hospicecarecenter.org!

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Did your mom teach you to “do what the doctor says”? If she’s not following doctor’s orders for medications now, you’re probably feeling confused. And concerned.

It’s common for patients not to take pills as directed. Some reasons include:

- “It’s too costly.” One quarter of new prescriptions are never filled because of cost. Make sure the drug is on the insurance plan formulary. Or ask about generics. Find a discount pharmacy, or consider mail order.

- “I feel fine.” Many illnesses lack noticeable symptoms. High blood pressure and high cholesterol, for example. These prescriptions often go unfilled. Many people don’t finish their antibiotics for similar reasons: the symptoms went away. Ask the doctor or pharmacist to review with your loved one why a medication is necessary.

- “It made things worse.” Consult with the doctor or pharmacist. Reducing the dose or changing from morning to evening may fix the problem. Or taking a different medication may be advised.

- “It was too complicated.” Some drugs require multiple doses in a day. Others are restrictive (“30 minutes before eating”). Ask the doctor or pharmacist about alternatives.

- “I can’t get the bottle open” or “I can’t read the label.” Arthritic hands and poor eyesight can make it difficult to follow directions. Ask the pharmacist for large type on the label and a NON-child-proof container.

- “Why bother?” Hopelessness and depression are common reasons why people don’t take their medications. If you suspect depression, ask the doctor to do an evaluation.

- “It won’t do anything.” Perhaps your loved one has an entirely different interpretation of what is wrong. Consider using the motivational interviewing techniques described in our article, “Your changing role: Becoming a partner-in-care.” The discoveries you make in the conversation can help you increase the likelihood that he or she will follow the doctor’s orders.

- “I forgot.” Simple memory lapses are a fact of aging. Look for solutions to forgetfulness in next month’s newsletter.

For more, visit http://www.hospicecarecenter.org!

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Joann Davis, CEO of Hospice & Palliative CareCenter on Triad Today!

For more, visit http://www.hospicecarecenter.org!

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What is Palliative Care?

Palliative care is medical care focused on relief of pain, symptoms, and stress of serious illness – whatever the diagnosis. Palliative care is provided simultaneously with all other medical treatments.

How can the Palliative Care team help me and my family?

When you are on the front lines of an illness, you need answers, relief, expertise, and support. Our team of board-certified physicians, nurse practitioners, and licensed counselors makes sure that all your concerns are addressed.

For more, Visit us at: http://hospicecarecenter.org!

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