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Care Planning for Elders: What You Should Know

Care Planning for Elders: What You Should Know

Caring for your growing elders can be stressful yet rewarding. You help maintain their health and bring a smile to their face. However, as they grow older, it is important that you consider more drastic situations in your care plan. An advanced care plan must be created for the benefit of your elders, yourself, and your family. An advanced care plan includes a living will, power of attorney, health care proxy, and a do not resuscitate order (DNR). This care plan is made to determine treatment directives and should be updated as health care related events occur.

Communication

It is crucial that there is communication when you construct an advanced care plan. You must consider your elder’s values. What are your loved one’s personal values and beliefs? Do they value religious practices or want family members to be present during their passing? These are personal beliefs that should be addressed and considered when creating a care plan.

Also consider your loved one’s preferences. Do they wish medication to be withheld? Do they wish to have CPR performed in an event of a medical emergency? Although this may be a difficult conversation to have, it is important that it is discussed. This will prevent a future conflict with your family.

Remember that you also have resources. There are professionals such as lawyers, social workers, clergy members, counselors, and more that are available to assist you. Constructing an advanced care plan is difficult to do. Do not feel that you are alone in the process.

What to Include in an Advanced Care Plan

Living Wills. Livings wills are also called medical directives. They are written instructions that determine what medical decisions will be made in case of an event. They are written by your the individual in this situation. 47 states and the District of Columbia have laws that authorize and legalize living wills. However, each state has different requirement and regulations, so it is crucial you research you state.

Power of Attorney. A power of attorney is the same as durable power of attorney. These documents determine the person that your elder will appoint to make medical decisions on their behalf. If your elder is unable to make a health care decision, the power of attorney will determine the next step. They will be able to make decisions even if your elder does not have a terminal illness.

Health Care Proxy. These individuals are also substitute decision makers for your elders. These individuals are similar to a power of attorney. However, some states regulate the decisions the proxy can make. All 50 states and the District of Columbia recognize this individual as an adequate decision maker.

Do Not Resuscitate (DNR) Order. This is a physician’s written order on behalf of your elder. It is attached to your elder’s medical record. DNRs will indicate whether your health care provider should attempt to perform life-saving measures such as CPR in events of heart attacks and cardiac or respiratory arrest. If your elder is able to make this decision, the physician will approve and carry out this order.

This is not an easy conversation to have. However, it is a conversation that must happen in order to maintain your elders wishes. Furthermore, it prevents future conflict between your elder, yourself, and your family and friends.

Genivity is here to help. We place emphasis on helping advisors with goal-based financial planning that incorporates health wealth factors to provide personalized reporting. Genivity can assist you in determining how your family members health impacts their future care planning. To determine how their health impacts their care plan, advise your family members to ask for an assessment with Genivity’s HALO to their financial advisors.

Health Information your Family Should Know in an Emergency

Health Information your Family Should Know in an Emergency

Certain things are better kept private. Your health information should not  be one of them, at least not for those close to you. Even if you find it embarrassing or uncomfortable to talk about, you will be glad you spoke up if you are ever in an emergency. Access to your health information can sometimes be the difference between life and death. Here is what your family needs to know in case of emergency. Allergies. Allergic reactions run the gamut from minor rashes to difficulty breathing. In one case, you could suffer an annoyance, in the other a fatal event. Having an allergy list at the ready can decrease the risk that you are exposed to treatments that could lead to complications. Medical conditions. Different medical conditions require targeted treatment approaches. A summary of your health issues can guide the emergency team in their approach to your care. For example, a history of diabetes would let them know to watch your blood sugar more frequently. Medications, including supplements. A list of medications provides more information to your providers than you realize. Drug interactions are all too common, and yes, too few people report taking vitamin supplements to their doctors. Just because a supplement is “natural” does not mean that it is safe or does not cause drug interactions. Knowing what medications you take may also change which ones an emergency team decides to use for your condition. Certain medications can have side effects that could affect your care plan. For example, it would be important for a surgeon to know that you are on blood thinners for atrial fibrillation since this would increase your bleeding risk during a procedure. List of doctors and healthcare providers. The more health information that can be accessed during an emergency the better. Who knows more details about your health than your own doctor? A list of your healthcare providers allows an emergency team to call out for more health information as they need it. End of life wishes. In the event that you suffer a serious complication and it is unclear if you will recover, your family ought to know your end of life wishes. This can be relayed through a living will or a healthcare proxy. You can assign a durable power of attorney for health care purposes by meeting with a lawyer or by completing forms on your own. These are often available through state agencies or other private organizations. Emergency response teams have two things in mind when they meet you. One, they want to keep you alive. Two, they want to minimize complications. By sharing health information with family and loved ones, you give emergency responders what they need to do their job and that is good news for everyone.
How to Choose an Emergency Contact Person

How to Choose an Emergency Contact Person

bigstock-dialing-emergency-call-using-81489782-1-6   How many times have you been asked to provide information for an emergency contact? It’s a common question on so many of the forms and applications that we fill out on a regular basis —from job applications to sports activity waivers. So who makes the best type of contact and what should they know?

Who to choose as your emergency contact

Someone who knows you well.

It could be a family member, friend or neighbor. Some people automatically put down their parents’ contact information because these are the people who know them best or, simply, because they always have. But if your parents are your default contacts, you may want to revisit that every so often. In some cases, adult children have removed their parents as their emergency contacts because they worry that their parents may not react well to receiving emergency news over the phone from a stranger, or are physically, mentally or emotionally unable to coordinate care for another person. This person should also have access to your other family members or close friends who you may want to know if you are in a health crisis. Does your emergency contact feel comfortable reaching out to your circle of loved ones? Do they have phone numbers for quick access? Will they know who you’d like to be reached?

Someone who is available.

Is your closest family member retired and travels often? Or are they out of town frequently for work? Has your trusted emergency contact moved out of state since you last updated your records? Be sure that your emergency contact is someone who is often available, and preferably, local. Being available also means that your emergency contact is likely to answer their phone immediately or check messages on a regular basis. Consider where they are in their life and if they have the time, bandwidth and attention to give to another’s person’s urgent needs.

Someone who you can share health details with confidentially.

If you are embarrassed to broach a health subject with someone, they may not be the best emergency contact candidate. You should feel comfortable sharing your disease history, medications, any addiction issues and the like with the person you choose. If it helps, write out essential health notes that you can use to explain, or you can hand off to your contact to read privately.

What you tell your emergency contact

“Your best contact is someone who knows your medical history and how to contact family and friends in the case of an emergency,” says Terri Palazzo MS, RN, Senior Director of Emergency Services and Nursing Quality at Mercy Medical Center, in Baltimore, Maryland. It’s best if your contact has an up-to-date list of:
  • Medications
  • Allergies
  • Brief medical history of any chronic medical conditions
  • Past surgical history and
  • Family contact information
“Many patients who present to the ED have a single page with an overview of history and accurate medication list that they bring with them or keep in their wallet,” Palazzo says. “This is very helpful and a good practice.” This also helps take some of the responsibility off the contact person, who would only need to verify that the information is up-to-date.

How to store the information

With more people than ever carrying around smart phones and other electronic devices, some people recommend that you use these devices to list your emergency contact information. For example, a tip that frequently circulates on the Internet is to use ICE in your contacts to identify your emergency contact info – ICE stands for In Case of Emergency. Palazzo doesn’t necessarily recommend this: “Phones are locked out many times,” she explains. “ICE can work if your phone does not have a passcode. The single sheet in your wallet is another way to do it. Sometimes low-tech is a better solution.”

Special considerations, such as travel

When traveling with a friend, spouse or family member, you may want to list two emergency contacts: the person you are with and someone at home. he person you are traveling with should then be able to provide some basic information about contacting family/friends and your basic medications and history. “If you become ill and need medical attention while traveling—sometimes you need someone who can answer health related questions and contact others at home,” Palazzo explains. The contact person at home would be for an emergency if the person you are traveling with isn’t available. No one plans to have a medical crisis or be in an accident, but life has a way of throwing curveballs when you least expect it. By planning ahead, you and your contact person can help make things a bit easier for those who may need to take care of you in an emergency.
How to Get an Advance Directive: A 10-Step Guide

How to Get an Advance Directive: A 10-Step Guide

What is an advance directive and how do you get one?

It’s the topic we don’t want to think about or even discuss, but is critical that we put to paper: What we want to happen in a medical emergency if we can’t express our own wishes. An advance directive is a legal document that outlines your wishes for end-of-life medical treatment and care to inform health care professionals and loved ones.  Here’s how to finally get started putting together your own advance directive or assisting a loved one, in simple, straight-forward steps. Step 1: Admit you need one Everyone over 18 years of age should have an advance directive, says Tracy Christner, a certified advance care planning facilitator and instructor. “Having a plan that makes your health care wishes known is the best way to ensure you get the treatment you want,” says Christner. “It also helps your loved ones make tough choices without having to worry whether they are doing the right thing for you.” Step 2: Learn the components It’s easy to get caught up in the legalese, but an advance directive is nearly self explanatory. It directs your loved ones and healthcare providers about what to do in advance of an end-of-life situation.  There are two types of advance directives and it is important to have both.
  • A living will expresses end-of-life medical preferences
  • A healthcare power of attorney designates a spokesperson (“health proxy”) who will be responsible for making health-related decisions on your behalf
Step 3: Seek out the paperwork This is state-dependent. Contact your local hospital, eldercare agency, or state website. Or, download free forms on the AARP’s website. Don’t get lost in the sea of options—pick one, make sure it meets your state’s legal requirements, and get started. “If you spend a significant amount of time in more than one state and they don’t have reciprocity in honoring each others’ directives, you should complete one for each state,” says Dr. John Saroyan, medical director for BAYADA Hospice. Step 4: Determine your wishes Five things to consider for your living will: CPR, breathing tubes, feeding tubes, dialysis and organ donation. Don’t get discouraged. If you aren’t sure how you feel about any specific aspect, focus on the big picture. “Most healthcare providers would agree we want people to feel as well as they can for as long as possible,” says Sabrina Mikan, PhD, RN, ACNS-BC, Director of Supportive Care Programs for Texas Oncology. “Improving a person’s quality of life and well being in any time of illness should be the goal of care.” For your healthcare proxy, designate a primary person and an alternate. And make sure these people understand your wishes and are comfortable carrying them out. “Choosing someone local is best since decisions may need to be made quickly,” says Christner. Step 5: Discuss your wishes Talk to family, friends and healthcare providers. “Be sure to include anyone who may play a part in your care,” says Christner. “Families can be torn apart caring for someone they love if they do not know their wishes ahead of time. While it is never easy to start this conversation, it is a lot easier than the consequences of avoiding it.” Step 6: Get the signatures Depending on your state, you may need an attorney’s signature. Most states require signatures in the presence of witnesses, or a notary, in order for the directive to be legally valid. Step 7: Keep the original copy Put it in an obvious, unsecured place. The most common mistake people make is completing an advance directive and then hiding it away, says Christner. “Advance Directives need to be accessible in order to be used.” Step 8: Distribute to key people Give copies of your advance directive to your primary and alternate healthcare proxies, and your primary care provider. Step 9: Make its presence known Note that you have an advance directive on an insurance card or medication list and keep these in your wallet. You can also flag its location in the letter of instruction included in your will. Step 10: Reevaluate periodically Healthcare desires change, so keep your advance directive updated. One way to stay on top of this is to upload your document to a website like US Living Will, which prompts users annually to update their information. Watch UPMC’s webinar on advance directives here.