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    Bob Mauterstock

    “My Healthcare Wishes” App can save your life!

    IMPORTANT UPDATE

    Effective in early September 2016, the ABA will no longer be selling or supporting the My Health Care Wishes Pro app. Due to reasons of financial sustainability, the app will be removed from both the iTunes and Google Play iStores as of September 3rd, 2016.

    The app will continue to be usable indefinitely on your phone, but it is important that you backup all your information. We highly recommend this if you have not previously done so. You must perform a Backup if you intend to upgrade to a new phone. The backing up process works only from iPhone to iPhone and from Android to Android phone.

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    You may have gone to the trouble of making sure all your family members have completed the important documents that they need if they suffer a critical illness or have a terrible accident. But what if they (or you) are traveling and don’t have the appropriate documents with them? These documents include a durable power of attorney, a health care proxy, a living will and a DNR ( Do Not Resuscitate) order.

    Now there is a solution. It is an Apple or Android app for the smartphone called “My Health Care Wishes.” It was created by the American Bar Association. Your family members don’t even need to have the app or a smartphone themselves as long as you have entered the information on your phone and they carry a wallet card indicating this. The information includes: contact information, summary of healthcare wishes, PDF copies of Advance Directives, Medical information, prescriptions, key medical contacts, healthcare proxy information and more.

    Let’s say your Mom lives in San Francisco and has a health care directive with end-of-life decisions. You’re her primary proxy and live in Washington DC. She’s on vacation in Boston and rushed to the ER at Mass General Hospital. A My Health Care Wishes wallet card is found stating her proxy has her advance care plan on his iPhone—that’s you! You’re coaching soccer but with one click you are able to email the documents needed to speak with staff to make key decisions. Crucial moments are saved and you’re there in a way never possible before in a medical crisis.

    Another example: Your Dad is 89 and your Mom is, 91. He takes her to the hospital and she’s admitted to the ICU but he’s told he can’t make medical decisions for her even if she is incapacitated. She’s his wife and he’s her proxy. What’s this about? He brought the wrong form with him! He brought the Power of Attorney document (POA) that only applies to financial and legal decisions. The Durable Health Care Power of Attorney (HCPOA) is what he needs but it’s at home and no one else is there. He has a cell phone, calls you, his daughter. You have what he needs securely stored on your Smartphone —the document showing your Dad as primary proxy. A click and the correct document is emailed, and your Dad loses little time tells doctors what his wife of 65 years wants.

    The medical community is very complex and filled with rules and disclaimers. If you don’t have access to the right legal documents your life or another family member’s life may be in danger. Get on your computer right now and order My Health Care Wishes from the Apple App Store or Google Play!

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    IMPORTANT UPDATE

    Effective in early September 2016, the ABA will no longer be selling or supporting the My Health Care Wishes Pro app. Due to reasons of financial sustainability, the app will be removed from both the iTunes and Google Play iStores as of September 3rd, 2016.

    The app will continue to be usable indefinitely on your phone, but it is important that you backup all your information. We highly recommend this if you have not previously done so. You must perform a Backup if you intend to upgrade to a new phone. The backing up process works only from iPhone to iPhone and from Android to Android phone.

     

    Consider a POLST Form for an ailing parent

    In 2011 I wrote a post that describes DNRs (Do Not Resuscitate Orders).

    A Do Not Resuscitate order is a binding legal document that states resuscitation should not be attempted if a person suffers cardiac or respiratory arrest. A DNR does not affect any treatment other than that which would require intubation or CPR. Patients who are DNR can continue to get chemotherapy, antibiotics, dialysis, or any other appropriate treatment.

    If you have an ailing family member who does not wish to be resuscitated, they should complete this document and have it signed by their physician. But please be careful to use the form approved in your state.

    This summer I attended an excellent seminar presented by Amy Florian, founder of Corgenius. Amy described another tool that can be used to supplement the DNR. It is called the POLST form.

    POLST stands for Physician Orders for Life Sustaining Treatment. It is is a form that gives seriously-ill patients more control over their end-of-life care, including medical treatment, extraordinary measures (such as a ventilator or feeding tube) and CPR.

    The POLST Paradigm is an approach to end-of-life planning emphasizing:

    • advance care planning conversations between patients, health care professionals and loved ones;
    • shared decision-making between a patient and his/her health care professional about the care the patient would like to receive at the end of his/her life; and
    • ensuring patient wishes are honored.

    As a result of these conversations, patient wishes may be documented in a POLST form, which translates the shared decisions into actionable medical orders. The POLST form assures patients that health care professionals will provide only the treatments that patients themselves wish to receive, and decreases the frequency of medical errors.

    The National POLST Paradigm originated in Oregon in 1991 as leading medical ethicists discovered that patient preferences for end-of-life care were not consistently honored. Recognizing that advance directives were inadequate for the patients with serious illness or frailty– who frequently require emergency medical care – a group of stakeholders developed a new tool for honoring patients’ wishes for end-of-life treatment.

    Although the POLST Paradigm began in Oregon, it quickly spread to other states, which tailored the paradigm to fit their unique legal, medical, and cultural contexts. Among the first states to develop POLST Programs were New York, Pennsylvania, Washington, West Virginia, and Wisconsin. These states – and others – have become leaders in improving the POLST Paradigm and demonstrating its importance to achieving patient-centered outcomes.

    You can go to the POLST site to determine if there is a POLST program approved in your state

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    Financial Advisors may reprint any articles from The Gift of Communication Blog in your own print or electronic newsletter. But please include the following paragraph:

    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.

    What will you do with all your stuff?

    One of the greatest concerns I have noted among older couples is, “What will happen to all our stuff when we are gone?” I can remember having a family meeting with a couple in their 70s and their four adult children and noticed that mom was getting very anxious. At first I thought her anxiety was due to the fact that she was preparing to discuss her end of life planning with her children.

    But when I asked her what her concern was, she responded, “I don’t know what I am going to do with all my stuff! I have several beautiful collections and I don’t want my children fighting over the objects right after my funeral or just putting them out in the yard for a giant garage sale!”

    She admitted to me that she hadn’t slept for several nights thinking about this terrible possibility. She confided in me that her husband still wasn’t talking to his sister after 20 years because she had raided the house when their parents died and taken everything of value before he had even arrived. “I don’t want that happening in my family!” she proclaimed.

    So what did we do? I asked her to describe her valuable collections to her children at the family meeting. She then created a list of all the items and asked each child to review them. If they wanted an item they were asked to put their name next to it. If more than one wanted something, they both listed their names next to it and mom would decide who got it.

    Mom collected the lists after the family meeting, reviewed them over the next few weeks and then reported to her children who would get what. No one disputed her decisions. After all, the collections were hers and she could give them to charity if she chose. The next time I talked to her I noticed her anxiety level was significantly less. She told me that for the first time in a long time she was sleeping very soundly.

    If you are a parent, don’t do your children a disservice. Don’t leave it up to them to decide what to do with your stuff after you are gone. The loveliest relationships are often spoiled by siblings fighting over the silver forks. Meet with your children and tell them what you intend to do. If you are an adult child, strongly suggest to your parents that they follow the procedure my client did. It will save much grief and anxiety for the whole family.

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    PERMISSION TO REPRINT:
    =======================
    Financial Advisors may reprint any articles from The Gift of Communication Blog in your own print or electronic newsletter. But please include the following paragraph:

    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.

    Share Your Wisdom With Your Children

    Did your parents share their wisdom with you? Did they make you aware of anything they learned from their own successes and failures? Was it helpful to you? Have you thought about sharing your wisdom with your own children?

    Susan Turnbull in her book, “The Wealth of Your Life” reminds us that “What you have learned is as valuable as what you have earned.” If you haven’t taken the time to share the important lessons you learned in life with your children, it’s important to do so now.

    Richard Lieder, a highly respected executive coach, wrote in his book, “Life Reimagined, Discovering Your New Life Possibilities”, “As we move through middle age, the uncertainty of the world moves us to focus on what matters; our own purpose and our connection to others”

    So where do you start? How do you pass on your legacy to the next generation? By writing them a “Legacy Letter”. It is a letter to your family that defines what has been important to you in your life and what you want to pass on.

    First decide whom you want to send the letter to; your children, your spouse, your brothers and sisters

    Second make some notes in the following areas:

    • Your values and the things you did in your life to act on your values
    • Something you learned from your grandparents/ parents/spouse/children
    • Something you learned from experience
    • A mistake that you made that you learned from.
    • Something you learned that you’re grateful for
    • Your hopes for the future

    Now take these notes and weave them into a letter that is addressed to the audience you want to letter to go to. Don’t forget to add stories from your personal life that expand the points you’re trying to make. And just like that you have created a Legacy Letter.

    Share it with your loved ones the next time you get together with them. And always remember, “The gift of communication is the greatest gift you can give your family.”

    Is A Hospice Program Right For Your Mom Or Dad?

    When the medical director of my mother’s assisted living residence called me I was curious to know what she wanted to talk to me about. After informing me how much everyone at the facility loved my mom she then made a statement that took me by surprise. “I think you mom would benefit greatly by going into a hospice program.”

    My thoughts immediately jumped to “Oh my God, she’s about to die. The end is very near.” The next day a hospice nurse visited me and explained to me what hospice was and whom it could benefit. She did state that in order to qualify for hospice an individual is expected to die in 6 months or less. But she added that some patients have been in hospice for a year or more. And in some cases they have improved so much they are taken off of the program.

    I learned that Medicare would pay for an upgrade to her wheelchair that would make her much more comfortable and provide for any other medical equipment she needed. A nurse would be assigned to her who would monitor her condition weekly, review her medications and report back to us if any changes in her condition occurred. In addition a home health aid would visit her three to four times a week to bathe her or provide any other personal care that would benefit her.

    She would be assigned a social worker that could assist her and our family with any emotional support that was needed. An experienced physician would participate in the development of her care plan and oversee her medical regimen. And all of these services would be fully covered by Medicare.

    Within two days the nurse had visited her, made specific recommendations to changes in her meds and brought in a new mattress and a more comfortable wheelchair for her. I was amazed at how quickly she went into action and how knowledgeable she was about the aging process.

    I had noticed for a few months that my mother had deteriorated significantly but I wasn’t sure how to deal with this and who to talk to. The hospice nurse made it clear to me she was available 24 hours a day, seven days a week if I had any questions or concerns. I immediately felt much more comfortable knowing that someone was watching her situation closely and would be available whenever we needed her.

    If you have a family member who is beginning to show signs of slipping away I would recommend strongly that you find out more about the hospice program and have a hospice nurse visit you to answer your questions. In most cases she will do an evaluation of your loved one at no cost. The website for the National Hospice and Palliative Care Organization will help you find a hospice organization in your area.

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    PERMISSION TO REPRINT:
    =======================
    Financial Advisors may reprint any articles from The Gift of Communication Blog in your own print or electronic newsletter. But please include the following paragraph:

    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.