Source: SeriousIllness.org

National Healthcare Decisions Day is April 16, a day when all Americans are encouraged to complete or review their advance directive.

The advance health care directive allows you to name someone to act as your “agent” if you become unable to speak for yourself.

That person becomes your “medical power of attorney.”

Your family member should have an advance directive. So should you!

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After a lifetime of maintaining your will, you may be wondering what exactly happens to it after you pass away. Well, after your lifetime, your will goes through what is known as probate, the legal procedure by which the courts oversee that your assets are properly distributed.

In general, if you leave a will, the will is submitted to a court for legal review. If you die without a will (called intestate), a court becomes responsible for ensuring that your estate is distributed according to your state’s intestate succession laws. A number of steps occur in the probate process, including:

• Your will and any codicils (separately written amendments to your will) are submitted to the probate court.
• An executor is appointed to act on behalf of your estate.
• People and businesses that have claims against your estate or owe money to your estate are notified.
• Your estate’s assets are inventoried.

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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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From: SeriousIllness.org

Happiness is universally desired. But do you know how to increase your happiness? In his book, Stumbling on Happiness, Harvard professor Daniel Gilbert explains that it’s not about big goals or events. The better house, the extra-long vacation, don’t really make us much happier.

Instead, happiness is closer at hand. It evolves from our day-to-day experience. Little achievements, a shift in attitude, a pleasant activity, all add up to more cheer. The sum total of little victories results in a better overall feeling about life.

The Caregiving Happiness Project is currently exploring how family caregivers can create happiness despite ongoing stress.

You can participate in this study! The project supplies a monthly theme and an online support community. Themes include simple ideas such as “space,” “quiet,” and “learn.” For example, here’s how two participants interpreted November’s theme of “let go”:

• One woman challenged her belief that “uncomfortable behavior in dementia is never accepted.” When company visited, she reminded herself to “let go.” She relaxed about her mother’s behavior. And she found that “it was okay; her challenges were accepted.”
• Another participant decided to “let go” of old family photos. As she took the albums apart, she found pleasure in sending packets of pictures to other relatives to enjoy.

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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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There’s a lot to do after bringing someone home from the hospital. The obvious goal is continued recovery. But roughly 20% of older adults are rehospitalized within 30 days because of problems that develop at home.

Research shows there are three things you can do to prevent a backslide. It’s important to get going on them even before your loved one is discharged.

- Understand the new medication schedule. Meet with the discharge planner to review medications. Bring a list of what your loved one was taking before hospitalization. If any of these drugs are not on the current list, ask if they should be restarted. Review each new medication. When should it be taken? How long should it be taken? Any side effects? Have new prescriptions phoned in to the pharmacy before you leave the hospital.

- See the doctor for follow-up within a week. Find out what doctor(s) your loved one should see. Request that the hospital forward records to all of them. Before you leave the hospital, call the doctor’s office to set up an appointment for the next week. You may need to be firm with the receptionist and explain that your loved one has just been hospitalized.

- Know the signs and symptoms of problems. Before leaving the hospital, consult with the discharge planner about what to expect. Ask them to group symptoms as “green light,” normal recovery. “Yellow light,” early signs of a possible problem. And “red light,” a significant problem. Find out what to do and who to call in case of yellow or red light symptoms.

Focusing on these three tasks can significantly speed recovery and reduce your family member’s chance of rehospitalization. If you are confused about any of these tasks, insist on having your questions answered before you leave the hospital.

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

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Dying at home, surrounded by family
Source: CNN.com
By Madison Park, CNN

Elizabeth Edwards died Tuesday, after doctors had told her further cancer treatment would be “unproductive.” She was at home, surrounded by people who loved her.

Next to picking a life partner or becoming a parent, there isn’t a more personal decision than how to die for those who get the opportunity to choose.

When the limits of modern medicine are reached, it’s a heavy consideration for terminally ill patients. For some, making the conscious decision to end treatment is tantamount to giving up or giving in. They worry about disappointing the people who care about them.

But one end-of-life expert sees it differently, noting that a growing number of patients are choosing hospice, so they can be made comfortable in familiar surroundings with family and friends close by.

“People in hospice don’t want to die. They want to live, and they want to live well,” said Dr. David Casarett, associate professor of medicine at the University of Pennsylvania. “They want to use whatever time they have to live the best way they can. I don’t think it’s giving up. It’s making a careful choice.”

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Death and dying are not topics we talk about easily in our culture. As a general rule, in fact, we avoid them, almost as if to talk about them would bring on a premature demise. As a result, many families are unaware of their loved one’s wishes at the end of life and are faced with making difficult decisions. This can lead to family discord and can make a trying situation even harder than it already is.

Norene’s father, Richard, showed caring and foresight in planning ahead. He thought about what “quality of life” meant to him. Reflecting on what made life worth living helped him to make decisions about life support issues. (It also helped Richard and his family maximize the things that gave him pleasure!) After clarifying his own values, Richard was able to write an advance directive, a document that stated his wishes concerning health care decisions in case he was unable to speak for himself. He talked with his family about his wishes and asked his eldest son to be his health care representative if a situation came up that was not covered in the advance directive. By planning ahead, Richard was able to lay the groundwork for things to unfold the way he would have wanted them to.

In addition to health care planning, Richard took steps to plan his finances. When he began to have difficulty getting to the bank, he gave his daughter Norene “durable power of attorney.” He was able to continue making financial decisions on his own, but this simple document legally allowed Norene to step in and handle his affairs during those times when he was too ill to do so himself. Richard prepared documents stating his wishes for how his belongings were to be distributed. He was also mindful of the fact that medical expenses could eat up the resources he did have and leave very little for his wife to live on afterward. With some planning, Richard was able to protect his assets and safeguard his wife’s security.

Not all patients are able to make these kinds of decisions ahead of time. Many need help from family members who can assure the patient that it’s okay to talk about these things and, in fact, would be helpful for the family if they were discussed. Ideally, all of us adults would have documents stating our desires for the distribution of our belongings and the handling of our medical care at the end of life. After all, any one of us could get in an accident tomorrow! These decisions especially need to be made when a serious illness has been diagnosed, and the sooner the better while the patient still has the ability to think and communicate clearly. To help you, we have tips to start the conversation about planning. Although it can be awkward at first, families who do have these discussions fare a lot better emotionally at the end, not having to guess and knowing they are doing what their loved one wanted them to do.

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

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Hospice & Palliative CareCenter is committed to improving excellence in the delivery of palliative, hospice, and end-of-life care.

Continuing Medical Education Offerings
Hospice & Palliative CareCenter’s medical staff services department offers several opportunities for medical professionals to gain a deeper understanding of end-of-life care.

Through a series of conferences, case studies, and other forums, our team of experienced physicians and nurse practitioners, will offer the following opportunities:

CME General Medicine Conference Series in Palliative Medicine
Hospice and palliative care focused training – various topics offered by our staff and guest speakers. The conference series is open to medical staff and other healthcare professionals interested in expanding their knowledge of Hospice and Palliative medicine.

Conferences are offered the 2nd & 4th Friday’s of each month and run from September thru June. Appropriate continuing education credits are awarded to healthcare professionals who attend.

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

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Some people maintain strong driving skills as they age. But over time, most of us lose physical abilities that are key to safe driving. Indeed, only teens have more accidents per mile than do adults over age 65.

Advanced years alone are not a reason to stop driving, however. Health, fitness, and thinking power, not age, determine a person’s ability.

Following are signs of possible problems:

- Trouble with vision or hearing. Watch for problems seeing lane lines or pedestrians, overlooking stop signs, or judging the speed of oncoming traffic. Other signs include discomfort with glare or driving at night.

- Inability to twist or turn easily. Arthritis and stiff muscles can make it painful to turn and look when needed. This can lead to trouble when backing up, changing lanes, or merging with traffic.

- Medication use. Many medicines can slow thinking and response time. Drugs for depression and anxiety can do this, as can sleeping pills and medicines for heart conditions, colds, and allergies.

- Dementia. At “early” stages, many individuals can still drive safely. Talk to your loved one’s doctor about a driving skills evaluation.

- Two or more recent tickets. Consider tickets a yellow, warning light. Common infractions include poor parking, running a stop sign, or going the wrong way.

- Two or more recent accidents. Parking lot and sideswipe accidents indicate driver error. Poor depth perception also causes seniors to have a very high rate of left turn accidents.

Take regular ride-along outings. Notice your loved one’s skill level and confidence level. Ask for input from friends and neighbors.

It is important to approach this subject with sensitivity. In the meantime, you may want to explore self-assessments your loved one can take privately, at home. These two were created by the American Automobile Association’s Foundation for Traffic Safety.

AAA Roadwise Review (30-minute multimedia screening tool measuring specific mental and physical capabilities)

AAA Drivers 55 Plus: Self-Rating Form (15 multiple choice, text-based questions)

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

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Ann Gauthreaux and Jane Smart from Hospice & Palliative CareCenter appear on Triad Today to discuss Palliative Care and the addition to the Kate B. Reynolds Hospice Home.

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

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