Thursday, January 26, 2012

Advance Directives Allow Choices and Support Medicare Savings

All the hoopla about “death panels” during the 2010 battle for healthcare reform spooked too many older adults into thinking they would be deprived of curative healthcare because they were older and the care too costly.

That talk has died down for the most part; however, the idea continues to haunt many when they think about end-of-life choices and hope their wishes will be honored and not limited to palliative care alone.

The results of a recent University of Michigan study, published in the Journal of the American Medical Association, show promise that advance directives and other end-of-life care choices have not had an impact on the quality of care provided. Nor have older Americans been denied curative care if they desired it, according to the study.

In regions of the country where curative care is the norm, the cost of medical care has surprisingly declined (and Medicare savings have increased) because of growth in the number of patients choosing palliative care instead of more costly aggressive care. The Michigan study showed that patients in those regions with advance directives received quality comfort care according to their final wishes. Many died at home instead of in hospitals, as was their wish.

The study’s results may encourage people to strongly consider their quality of life concerns and make their end-of life choices known to their families and their healthcare team. Even many study participants who chose treatment-limiting instructions also allowed for limited trials of intubation (inserting breathing or feeding tubes) and mechanical ventilation if needed. But their instructions also made it easier for their proxy (appointed person who has the legal power to make healthcare decisions if you cannot) to stop the treatments if they weren’t effective.

End-of-life care decisions require careful consideration; they can be as specific as you want or need them to be. Although impossible to address every scenario, it’s imperative to discuss the scope of your wishes with your family; your spokesperson and your healthcare team so that your intentions can be met. For instance, do you want everything possible done or do you want quality of life and freedom from pain and suffering (palliative care) if there is no hope of a cure?

If you would like to help people make important decisions in their healthcare, consider any of the online healthcare degrees.

Thursday, January 5, 2012

What is Palliative Care?

Palliative Care is about managing symptoms for those with chronic or fatal illnesses. It's something we're going to hear more about in the next few years.

Quality of life and managing pain and other symptoms instead of just prolonging life will help us all be comfortable in our last days.

Palliative Care also helps those with chronic symptoms of pain, nausea, shortness of breath, etc., from diseases such as Rheumatoid Arthritis, MS, and COPD, to live more comfortable lives with a better quality of life. Here's a great article to help you understand more about Palliative Care.

Friday, December 23, 2011

Thursday, December 1, 2011

Relax, Prioritize and Enjoy Your Holiday Season

I hope everyone had a great Thanksgiving and got to spend some quality time with loved ones. As we move into the major holiday season, stress and panic are two words that come to mind quickly. This is especially true of those involved in caregiving situations and those in the sandwich generation between being son or daughter and mom or dad as well as just being you and all that that entails.

Take time every single day to stop and close your eyes and take a few deep breaths -- in through your nose and out through your mouth. This doesn't take long and can be done several times a day. Deep breathing helps to improve your circulation. It will relax you and help clear your mind. When you feel the stress building or panic sneaking up to overcome you. STOP!! Close your eyes and breath deeply. It will help to stall the stress or panic and allow you to gain control over the situation again.

If you already have a great relaxation routine be sure to practice it regularly. And if you don't, these deep breathing moments can help you to begin to find a way to stop the dreaded stress and panic that can steal time and precious memories.

Make lists and prioritize tasks. As you cross them off your list, re-prioritize as the importance of some items may have changed. See which items you can delegate to someone else or work together to accomplish. Look at you list with an eye to how important in the long scheme of things this matter will be five years from now...that just might change how urgent it can seem right now. And then again it may add importance to the matter, but remember to prioritize things.

Another important tip to remember is to figure out which things you pushed to the bottom of the list because you really dread doing them. Sometimes if you get some of these things done first, the rest of your To-Do list seems much easier and less stressful. The more we procrastinate doing something we dread, the more it weighs us down knowing we have to get to it eventually. We don't really have a chance to enjoy the things in between because we have this nagging task lurking out there somewhere. Just do it and move on. It will take a huge load off your shoulders when you do. Or see if someone is willing to share the burden and work with you to get it done.

Caregiving can be a very thankless job. So be sure to build in some little rewards for yourself on a regular basis. Look for silver linings, but also make sure you get a little time to enjoy something you like to do too. Take time to read, watch TV, or rent a movie. Hire some respite care if needed and get out for a meal.

As the holidays approach, it's a time for reflection. Encourage family members who may be gathering to bring a list of questions fro your elder(s) to discuss. These may be directly related to your family, or just things in general. The population in their 80's plus has seen a lot in their lifetime. They didn't grow up with television, they listened to the radio. They saw air travel develop. They lived through the Great Depression. How did it compare to our economic situation now? They lived through several wars and may have been in the armed services. There's no better source of history than first hand information. Take the opportunity to fill in a few gaps. Record your conversations. And perhaps if you have several elders present you'll get a collection of history to pass on.

Most of all take time to enjoy the holiday season!!

photo from

Thursday, October 13, 2011

Only Four Kinds of People in the World...

I was reminded of this quote when reading my ezine from The Intentional Caregiver today...

"There are only four kinds of people in the world - those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers". ` Rosalyn Carter.

Thursday, October 6, 2011

Medicare Open Enrollment 2011

Open Enrollment for Medicare in 2011 is coming up very soon. The dates this year are from October 15-December 7, 2011. This is an earlier time frame than in the past so please take note. You don't have until Dec. 31 to decide as was the case in past years.

If you need to enroll or change Medicare plans, it must be done during this time open enrollment frame. All changes take effect January 1, 2012 and cannot be changed again until Open Enrollment in 2012.

For unbiased information about Medicare and all of the options to be considered such as Gap coverage, Part D Prescription Drug coverage and whether or not to enroll in an HMO plan is available from the source There are differences in the various plans and comparisons are available from this site. Specific Open Enrollment instructions are available: Click Here

Choose carefully the plan that meets your needs now. Understand that your needs can change over time and what was best in the past may not be best for your future health care.