Power of Attorney

Advanced, palliative care plans important part of life


Published in Cleveland Jewish News by Becky Raspe

It’s best to be prepared in every situation, especially when it’s health-related.
According to Rabbi Akiva Feinstein, director of spiritual care at Montefiore in Beachwood, and Dr. Beth McLaughlin, chief medical officer at Hospice of the Western Reserve in Cleveland, creating a plan for advanced and palliative care makes decisions easier.

“Advanced care planning is important because any of us can have a major life change at any time,” McLaughlin stated. “It’s nice to have family and loved ones know what your wishes would be in that situation.”
Feinstein noted during one’s health journey, there are a lot of choices but the medical system is “not always good at pointing out the forks in the road.”

“Most times, patients are pushed towards more treatment and more surgery, and that approach is fine for some,” he said. “But, most people get to the point where they’ve endured a lot of difficult decisions. But with planning, as one learns about the disease and prognosis, it’s important to ask your healthcare provider about what you can do and your choices.

He added, “The plan isn’t always so much about what you’re going to do, but what you want and how people can help you get that along the way.” McLaughlin said advanced and palliative care planning has two components – completing legal documents, then communicating your wishes to family members.

“Both are important to do,” she explained. “Advanced care planning is anything you do ahead of time to plan for future health. There are resources online to help guide a conversation with family, like general things to talk about. And then, there are legal documents that are recognized in the state of Ohio like the living will, the health care power of attorney and the DNR form.” Since an individual can’t expect to make decisions about their health in real time during a crisis, preparation is important. Feinstein said plans begin with appointing a healthcare proxy.

“They can listen to your wishes and make those decisions for you when you can’t anymore,” he said. “The subsequent stuff is working with your doctor on what he or she thinks about what could happen and what their goals are with the treatment.” Feinstein said the last part of the process is discussing hospice.

“Many people don’t understand what hospice is,” he noted. “They think it’s either much worse than it is or they can’t perceive it as relevant at all. In America, understanding you do have an option and choices helps you make better medical decisions along the way.” McLaughlin said there is merit in involving the family in the planning process. “If something happens, the person who is making these decisions and plans isn’t going to usually be able to explain what their wishes are at that time,” she explained. “So, it’s important for the family to know what their wishes are. When that happens, the medical team will turn to the family for decisions.”
Feinstein added if the family can’t be involved, it’s critical to confide in someone.

“Culturally, I find that some families make decisions as collective groups,” he said. “But some people value autonomy. The main thing is finding a person you can go through the process with. Sometimes, it’s having that sounding board when you get information from doctors and make those decisions together.”

Though it’s best to make plans, Feinstein said many families don’t plan for crises. “They usually end up in the midst of a serious illness and suddenly wake up one day and realize they can’t do it,” he noted. “The typical family always find out they need to plan when it’s too late. It’s not about making people plan when it’s difficult. It’s about thinking about their values when it matters most.” But McLaughlin said even starting a plan can reduce a bit of the stress that comes along with medical crises.

Anytime someone is dying, it is very stressful and sad,” she explained. “There are often lots of medical decisions that have to be made. That is very overwhelming. It’s helpful to have these plans in place. It takes one bit of confusion and stress out of the equation.”

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Conversations Before The Crisis

Conversations Before The Crisis: National Healthcare Decisions Day April 16, 2016

The Most Important Conversation We’re Not Having

Mother and daughter portrait

How we want to receive care in the event of a medical crisis represents the most important and costly conversation that we are not having. Some families are so reluctant to discuss medical and end-of-life issues that loved ones die without having the opportunity to express their last wishes. And, physicians often are equally hesitant to discuss these issues. Houston Hospice is promoting National Healthcare Decisions Day (April 16, 2016) to inspire, educate and empower the public about the importance of advance care planning

Advance care planning involves making future healthcare decisions that include much more than deciding what care you would or would not want; it starts with expressing preferences, clarifying values, identifying health care preferences and selecting an agent to express healthcare decisions if you are unable to speak for yourself.

National Healthcare Decisions Day is a collaborative effort of national, state and community organizations committed to ensuring that all adults with decision-making capacity in the United States have the information and resources to communicate and document their future healthcare decisions.

Houston Hospice is offering free resources and consultations to help transform this seemingly difficult conversation into one of deep engagement, insight and empowerment.

Points To Consider:

 

Conversations Before the Crisis Dinner

Sharing your wishes can bring you closer to the people you love. Participate in National Healthcare Decision Day by filling your table with comfort food, family and friends and talking about your treatment preferences. Houston Hospice will give you the tools to host your “Conversations Before The Crisis Dinner”. Pick up your Healthcare Conversation Kit with resources such as Advance Medical Directives and Medical Power of Attorney documents and speak to one of our experts at Houston Hospice, 1905 Holcombe Blvd., Houston, Texas. Or download resources from www.houstonhospice.org.

Multi-generation family in park conversations

—Karla Goolsby, Houston Hospice Communication Specialist

 

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Helping an Aging Family Member Plan for the Future

MomAndDaughter

Take Control While You Can

The importance of advance planning for aging adults (especially those suffering from chronic illnesses) cannot be overstated. Without the right legal and financial documentation, caregivers and their loved ones could be faced with a host of problems in an emergency. Doctors may refuse to discuss important medical information with a caregiver, a dying elder may not get the end-of-life care they desire, and control over an incapacitated loved one’s bank accounts and property could be given to a complete stranger.

6 Must-Have Legal Documents for Family Caregivers

You can help a loved one plan for their current and future medical and financial needs by working with them to prepare six essential legal documents, described in further detail below:

Important documents for managing medical care

Important documents for managing finances

An elder law attorney can assist with the preparation of these documents; as well as valuable guidance for taking into account your loved one’s Familyindividual situation and preferences when planning for the future.

Don’t Wait for Disaster to Strike

Getting the necessary documents in order before a medical or financial disaster strikes can make an extremely difficult situation just a bit easier to navigate. Knowing that you’re carrying out your loved one’s wishes, even though they may not be able to voice them, can ease the crushing feelings of guilt and doubt than caregivers often experience in these situations.

*An additional note about POA: There can be confusion with regards to the difference between “durable” and “nondurable” powers of attorney. A durable POA is one that endures a person’s incapacitation, meaning that, until a person either passes away, or is able to regain control of their own affair, the POA remains in effect. This is as opposed to a nondurable POA, which becomes null upon a pre-defined contingency—such as a particular date, or in the event of a person’s incapacitation. For additional information on POA, see: Things You Can and Can’t Do With POA.

Provided courtesy of AgingCare.com, the go-to destination for family caregivers. AgingCare.com provides resources and guidance through financial and legal concerns, such as guardianship of elderly parents. This article is one of a series of articles included in the eBook, Family Caring for Family. Download your free copy at www.AgingCare.com/ebook.

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