What Are Advance Directives?

An advance directive is a legal document that spells out a person’s health care preferences for use in the event they become incapacitated or otherwise unable to make decisions for themselves. Drafting one provides invaluable guidance and peace of mind for family members and medical professionals.

Who Needs an Advance Directive?

It’s impossible to know if/when a car accident, stroke, heart attack or other serious illness may strike, rendering someone incapable of making their own medical decisions. Drafting an advance directive is highly recommended for older adults and individuals with chronic medical conditions. However, advance care planning isn’t reserved for seniors. Life is unpredictable, so these legal documents are important for people of all ages even if they do not have any existing medical conditions. (This includes family caregivers!)

Why Is Advance Care Planning Important?

Without the instructions that advance directives provide, family members are often conflicted over what kind of treatment their loved ones would have wanted in emergency and end-of-life situations. In the absence of any specific preferences, doctors are legally required to pursue all viable life-sustaining treatment options. These measures can be very extreme, and many frail and chronically ill individuals choose to opt out of specific interventions that may do more harm than good.

Advance directives can provide guidance in the following health care decisions:

The use of equipment such as ventilators and dialysis machines.

The use of cardiopulmonary resuscitation (CPR).

The use of artificial nutrition via tube feeding and/or artificial hydration via IV.

Treatments for pain, even if a person is unable to make other decisions (this may be called comfort care or palliative care).

The decision to donate organs or other body tissues.

Components of an Advance Directive

Advance directives go by different names in different states, but they are usually comprised of two main components: a living will and a durable power of attorney for health care. Add-ons like do-not-resuscitate (DNR) orders, physician orders for life-sustaining treatment (POLST) forms, and organ and tissue donation requests may also be part of a person’s advance directive.

Living Will

A living will states a person’s wishes that will guide their health care if they become mentally or physically unable to make decisions. The difference between this how to buy hospital bed rental medicare and a regular will is that a living will guides medical decisions before death while a standard “last will” guides estate decisions after death. A living will is used to declare which life-prolonging measures a person wants and does not want if they are dying or permanently unconscious.

Durable Power of Attorney for Health Care

A durable power of attorney (POA) for health care, or health care proxy, designates someone to act on the incapacitated person’s behalf to ensure they are cared for in accordance with the wishes explained in their living will.

Discussing Health Care Wishes

It’s crucial to discuss health care options, possible scenarios and personal preferences with a physician prior to executing an advance directive. Once the document has been drafted, its contents should be reviewed in detail with the person selected to act as power of attorney for health care.

Broaching such a heavy topic with a loved one can be difficult, but it’s crucial to find opportunities to talk about advance care planning. According to The Conversation Project (TCP), a public engagement initiative aimed at helping people talk about their wishes for care through the end of life, most are willing to discuss their preferences, but only a fraction actually follow through. A recent study published in Health Affairs found http://edition.cnn.com/search/?text=hospital bed that only about one-third of Americans have completed some type of advance directive.

Surprisingly, though, a 2018 TCP survey found that more than half (53 percent) of Americans say they would feel relieved if a loved one started “the Conversation.” If you plan to go this route, try using an example, such as a newspaper article about advance care directives or the experience of a friend or relative, to broach the topic. You can also try mentioning that you are considering drafting an advance care directive for yourself.

In instances where a loved one resists talking about this subject, ask their doctor for help. Medical professionals, especially those who deal with older or seriously ill patients, are usually well versed in these matters. You can write the doctor a note requesting that they address the topic during your loved one’s next appointment. Medicare Part B now covers advance care planning as part of a beneficiary’s yearly “wellness” visits, so there is no need to worry about additional charges.

Where to Get an Advance Directive

An attorney can assist with drafting a valid advance care directive but is not necessary. Local hospitals and seniors’ organizations, such as Area Agencies on Aging, should be able to direct you to the right forms. The American Bar Association has also compiled a helpful document with links to generic state-specific advance directive forms.

Ensure Advance Directives Are Valid and Up to Date

Desires for health care and end-of-life care cannot be followed if they haven’t been clearly communicated to key people. Keeping an open dialogue with all parties involved will ensure everyone is informed and on the same page.

As a caregiver, check that the following steps are taken to ensure your loved one’s documentation is both current and valid:

Make sure the documents have been signed in front of witnesses and/or a notary public. Requirements vary by state.

Provide all doctors caring for the patient with a copy of the advance directive. Keep a copy handy for yourself.

Make sure anyone named as an agent in a health care proxy has a copy of that document and knows the patient’s goals for medical care.

Explain the patient’s health care wishes to other family members as needed.

Realize that more than one discussion with doctors and family is warranted. Revisit the advance directive annually or whenever big changes occur in your loved one’s health to be sure the document still accurately reflects their needs and wishes.

When a person is admitted to a hospital or long-term care facility, request to review their advance directive with their physician and have a copy added to their medical chart.

Having these instructions expressed in writing removes the uncertainty of what medical care is desired and what is not. If we don’t spell out our wishes in a health care directive, these decisions are up to doctors who may not know us, or conflicts may arise among our loved ones over what our wishes might have been.

Caregivers in Phelps Health’s service area and other regions in Missouri can be better informed, prepared and able to care for their own needs due to a federal grant.

According to Phelps Health in a news release, a $3.75 million five-year grant funded by the U.S. Department of Health and Senior Services was awarded to the Saint Louis University Geriatric Education Center Geriatrics Workforce Enhancement Program.

A.T. Still University’s Area Health Education Center Program Office, based in Kirksville, works with seven regional health education centers across Missouri to support and grow the healthcare workforce in the state. Phelps Health hosts Mid-Missouri Area Health Education Center, which covers 23 counties in mid-Missouri.

A.T. Still University’s Area Health Education Center Program Office was a recipient and provided Mid-Missouri Area Health Education Center with over $8,600 for the caregiver project as part of the Geriatrics Workforce Enhancement Program grant, which is used to create caregiver resource packets to provide self-help resources.

According to Susan Bowles, health careers coordinator with Mid-Missouri Area Health Education Center, care management staff at Phelps Health will offer the packets and a Rapid Caregiver Well-Being Scale to caregivers and those interested in learning more about caregiving.

Caregiver Resource Packets

Susan Bowles, health careers coordinator with Mid-MO AHEC, shows the information available in caregiver resource packets.

According to Phelps Health, packets will be given to how to buy used hospital beds caregivers of patients who require long-term care when the patients are dismissed to homecare.

Bowles said that homecare is being used more, and many patients also have more complicated health issues.

She said, because of this, caregivers are reporting an increase in physical and mental health discomfort themselves.

“These packets will give hope and assistance to caregivers and help them address their own needs,” Bowles said.

Each packet includes:

• A magnet with caregiver tips and a phone number to Phelps Health if caregivers need assistance.

• A flyer about compassion fatigue — emotional and physical exhaustion leading to a reduced ability to empathize or feel compassion for others — and ways to help caregivers with compassion fatigue.

• A Missouri Senior Resource Guide.

• A Preparedness for Caregiving Scale survey has already been given to over 50 caregivers as part of this grant to help increase data about caregivers in Missouri.

• A form to record vital information and questions for the healthcare team in one place.

Older Adults and Aging in Place: The Role of Physiotherapy where can i get a hospital bed in healthy aging

The World Health Organization defines healthy aging as "the process of developing and maintaining the functional ability that enables well-being in older age." This is important for Winnipeggers because the 2016 census found that there are over 110,000 adults older than 65 years old living in Winnipeg. Aging in Place is often referred to as the ability of older adults to age healthily in their own community vs personal care homes. Why is it important to age in place? Because most seniors http://www.bbc.co.uk/search?q=hospital bed prefer it and it has been found to improve aspects of people’s lives such as housing and environmental satisfaction and community and social networking. These make up a person’s psychological well-being and are therefore important in their overall well-being and quality of life.

Seniors often present with various chronic illnesses that affect their mobility and function. A person’s mobility is important for their everyday life and well-being as its loss can affect access to several aspects of it. For example, an immobile person may suddenly lose their ability to shop for groceries (nutrition), attend medical appointments (health care), travel, pursue social activities, hobbies, or sports (societal participation and mental health). Poor mobility may also affect one’s ability to take care of themselves (dressing, grooming, bathing, toilet transfers, bed mobility) and their home (housekeeping, yard maintenance and laundry). It greatly impacts function and decreases a senior’s ability to age in place.

Physiotherapy is essential in keeping seniors in their homes for as long and as safe as possible by maintaining and or improving their independence. They are trained health care professionals with the knowledge, skills and ability required to perform a thorough assessment of the mobility and function of seniors. A Physiotherapy assessment may include an examination of your range of motion, muscle strength and balance. They may also assess your ability/limitations with performing specific functional activities. Information relating to your past medical/surgical history, medication history, and social history may also be collected as part of the assessment. It should be noted that there are a variety of other assessment tools which may also be used as clinically required and determined by your physiotherapist. After the assessment, they provide intervention which may include Education, Manual Therapy, Exercise Program and Equipment/ Environmental recommendations. The Physiotherapist can also provide you with knowledge about a wide variety of chronic illnesses, coping mechanisms as well as connection with other community resources as required.

The goal of Physiotherapy in seniors’ health is to keep Winnipeg Seniors safe and at home for as long as possible. They are primary health care professionals, which means you do not need a referral to access their services. You can always find great Physiotherapists near your home. They are the movement and function experts!