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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It seems that the older we get, the more pills we take. Remembering to take them, and to take them on time, can challenge even the sharpest mind.

If your loved one has occasional memory lapses, getting into a good routine for taking medications might be all that’s necessary to stick with the doctor’s recommendations. Some suggestions:

• Keep pills in sight. Good places might include the kitchen table or counter, or a bureau top. Keep them away from direct sunlight by a window or a steamy room, such as a bathroom.
• Link with other habits. Work with your loved one to associate pill-taking time with other routines, such as morning coffee or brushing teeth.
• Use a pill box. Pill boxes organize daily doses for a week. The simplest have seven compartments. Others have two or three compartments per day for am/pm doses.
• Add an alarm. Consider a pill box or a wristwatch with an alarm. Or program your loved one’s cell phone to ring a specific tone when it’s time to take a pill.

More active support may be necessary if your loved one has ongoing memory issues. Among the options available:

• Automated pill dispenser. These dispensers sound an alarm and open a dispensing drawer when it is time to take a pill. Some can notify you if a dose is skipped. Check the federal government’s database of available products.
• Telephone reminder. For a monthly fee, your loved one receives timed, daily phone calls and an automated message to take his or her medications. Some services will notify you if the phone is not answered.
• Email or text message. MyMedSchedule’s no-cost service provides email or text reminders. Or check online for smart phone medication apps.
• Personal medical alert. Many home-based medical alert systems include an optional medication reminder service.

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

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Is life with a terminal illness hopeless? Not at all. Seriously ill individuals thrive on hope, just like the rest of us. It gives us a sense of purpose.

According to hospice expert Cathleen Fanslow-Brunjes, hope in serious illness typically has four main stages:

- Hope for a cure. “I’m not going to let this stop me.”
-  Hope for treatment. “I think the radiation is really working!”
- Hope for prolongation of life. “I want to go to the family reunion.”
- Hope for a peaceful death. “I’m hoping for no pain in my final days.”

The four stages often align with disease progression. But it’s not uncommon for a person to move back and forth among them.

Knowing the four stages, you can better support your family member in sustaining his or her hope. Listen carefully for comments that indicate hope.

Many families are concerned about “realistic hope.” Find out what your loved one is hoping for and ask the doctor if it is feasible. If so, then all of you can work toward this shared goal.

If the hope is not realistic, it may signal the need for a change in care goals. But it does not mean your loved one must be without hope! Instead, it means you need to talk together with the doctor and come up with a more achievable project or purpose.

Dr. David Casarett, a hospice physician, wrote an insightful book about this topic called “Last Acts.” It specifically looks at the many ways his patients chose to find meaning in their last few months, weeks, and days.

Hope is always available. We just need help knowing how to look for it.

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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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!

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It’s a little known fact: men represent at least one third of family caregivers across the nation. In some respects, they are more likely than women to face challenges. But they are less likely to ask for or receive the kinds of support all caregivers need.

Researchers report a number of issues that complicate the lives of male caregivers:

* Household tasks. Most men face a learning curve when they take over household tasks (things such as doing the laundry or cooking three meals a day). They have to learn on the job.
* Personal care. When it comes to bathroom activities, the intimacy of personal care is especially challenging for sons. But even husbands can feel inadequate handling daily needs, such as fixing hair. When possible, men tend to hire others to do these tasks.
* Identity challenges. The mundane chores of caregiving can seem emasculating. And the inability to “fix” a loved one’s disease may feel disempowering. In addition, men in the workforce report feeling they must hide their caregiving role. A caregiving man is considered less serious about his career.
* Emotional demands. As a rule, men prefer to keep their world steady by avoiding talk about emotional issues. Meeting an ill loved one’s emotional needs can be taxing.
* Emotional losses. Men traditionally get their emotional support from someone close at hand. But that very person may now be the family member needing care. Men tend to feel less comfortable turning to alternative sources, such as support groups.

It is for these reasons that male caregivers are especially subject to isolation. If you know a male caregiver, consider reaching out. Offer to do a household task together. Working together may lead to more personal conversation. At the least, he, like any other caregiver, will appreciate not feeling so alone with the job.

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.

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1. Make sure you have an up-to-date will.
Your will is one of the most important documents you own. It provides clear direction for your family after you’re gone, when they’re making major decisions under stressful circumstances. When was the last time your will was updated? If it was years ago, you should arrange a meeting with your estate planning attorney to review your decisions. You might have overlooked a change that can affect your wishes, such as a move to another state, tax law changes, or the loss or addition of a family member.

2. Decide where the money goes.
Take some time to decide how you want to provide for the well-being of each of your family members. Don’t let your worries about fairness and equality discourage you. Simply start with the “big picture” items such as real estate, bank accounts, life insurance policies and retirement plan assets. This will help you prepare to meet with your estate planning attorney.

After you feel comfortable with your gifts for your family, you may begin to consider providing for Hospice & Palliative CareCenter and our mission to provide excellent health care in our communities. Within your estate, there are many assets, such as your IRA or life insurance, that can be used in whole or in part to help you make a big difference. Feel free to contact Ellen Coble at 336-331-1312 or ellen.coble@hospicecarecenter.org to learn about these options. Then, meet with your estate planning attorney to put your ideas into action.

3. Keep your loved ones informed.
Once you’re at peace with your decisions, gather your family and explain your choices. Help them understand your perspective to avoid any heartache later. Following are a few talking points to help you and your family feel more comfortable:

• Thank your family for recognizing what this meeting means to you.
• Emphasize your goals to be fair and your concerns for your loved ones’ futures.
• Detail the responsibilities, items and amounts you’ve chosen to give your family members and why.
• Express your desire to give to charity and your goals for your charitable gifts.

Request our FREE eBrochure on estate planning essentials.

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

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