tag:blogger.com,1999:blog-28709032248036011042024-02-19T16:30:47.049-08:00Your Life Your WishesMeridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.comBlogger12125tag:blogger.com,1999:blog-2870903224803601104.post-34380849643309780532017-05-30T10:14:00.000-07:002017-05-30T10:14:30.465-07:00Talking to Loved Ones about End-of-Life Choices<div class="separator" style="clear: both; text-align: center;">
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By: Vipul Bhatia, M.D.</div>
Medical Director, Post-Acute Services<br />WellSpan Health<br /><br />Advance care planning often starts with a tough conversation. This talk can be difficult for just about anyone. None of us want to consider the likelihood of death, yet a health crisis can come at any time. Following certain steps can make the task of discussing your wishes less daunting. Having the conversation with your loved ones before a crisis can reduce the stress and anguish that could occur if your wishes are not known when a crisis happens. <br /><br />One tip is to get a head start when you are healthy; advance care planning is not just about old age. A medical crisis can occur at any time, which could leave you unable to make your own health care decisions. If you start this process early, your primary decision will be to identify the person who will make decisions for you if you are unable to make decisions for yourself. The next step is to make sure that person is aware of what you value by discussing your end-of-life wishes. <br /><br />Once you have identified the key family member or friend who will be your health care proxy, or the person who will hold your durable power of attorney for health care, a bit of preparation on your part can help make the conversation easier. For those of us who find it difficult to broach this topic with loved ones, preparation would include identifying what truly matters to you. You may want to explore why you are thinking about these topics in the first place. Is this due to a particular event in your life or that of someone close to you? Perhaps a car accident or a sudden diagnosis of cancer? What else motivated you to have these discussions and conversations now? <br /><br />If you can answer these questions, you may be better prepared to have this discussion with loved ones. You might also explore your basic principles and values and how they would still apply near the end of your life. It’s important to keep in mind that the first conversation on end-of-life issues may be the start of a learning process and could continue with more conversations throughout life.<br /><br />If you have this difficult conversation when you are healthy, it may make the process easier as you age. With advanced age, you may find yourself developing new medical conditions or that your functional ability has declined. As this happens, it is important to revisit your choices and decisions. This self-reflection will help to identify anything that has changed since the last time you talked to your loved one. If that is the case, you should approach your loved one again to explain what led you to change your decisions and choices. <br /><br />The conversations that can be held with family or closest friends ahead of death can allow you, at any age, to fulfill your five wishes:<br /><br />1. To be represented by the person you want to make health care decisions if you can’t.<br /><br />2. To be clear on whether extreme measures should be taken, what life support means and how pain should be managed.<br /><br />3. To know how comfortable you want to be when you near death.<br /><br />4. To know how you want people to treat you, including if you wish to die at home.<br /><br />5. To have the opportunity to share important stories with loved ones; this also includes after-death arrangements that can be clearly expressed before death occurs.<br /><br />As a physician, I can tell you it is often difficult for health care team members to talk with patients about these issues. However, if our patients give us permission to talk about end-of-life choices, it becomes easier for us–as your trusted health care partners–to guide you through the process. So, once you have done your preparation and have spoken to a loved one, please take the next step and talk with your health care team members. <br /><br />No one knows your preferences and values better than you do. Your health care team members can help guide you in that decision-making process with key information about your health, but they cannot make decisions for you. With that in mind, the more you share with your health care team about what you value and how you prefer to be treated during the end of your life, the better they will understand your advance care planning wishes. <br /><br />Everyone has a health horizon, so let’s plan for it. By taking these steps and starting conversations early, you will ensure that your care in the future will be exactly how you planned. More importantly, you will diminish the chances of moral and personal distress that your loved ones could face when making decisions for you. Talk to your loved ones now about your end-of-life wishes. You and your family will be glad you did.<br /><br />More resources are available at <a href="http://www.yourlifeyourwishes.com/">www.yourlifeyourwishes.com</a>.<br /><br /><i>Vipul Bhatia, M.D. is the medical director for Post-Acute Services at WellSpan Health, and director of WellSpan’s Horizon Planning initiative. </i>Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0tag:blogger.com,1999:blog-2870903224803601104.post-20844734233499901462017-04-12T13:27:00.000-07:002017-04-18T12:32:43.455-07:00POLST: The Actionable Solution to a Universal Question<div class="separator" style="clear: both; text-align: center;">
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By: Amy Frieman, M.D.<br />
Hospice and Palliative Medicine<br />
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Most of us won’t find it surprising that studies show the vast majority of Americans would prefer to die in their own home, with friends and family by their side, than at a care facility. <br />
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When juxtaposed with recent data from the Centers for Disease Control, however, these findings illuminate the sobering reality of the current state of end-of-life care: <strong>Although 70% of Americans say they would rather die at home, in actuality, 70% of Americans die in a hospital, nursing home, or assisted-living facility.</strong><br />
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Reconciling patients’ care wants/wishes and the reality of care received is part of the rationale behind Practitioner Orders for Life-Sustaining Treatment (POLST), a medical order form that empowers individuals to work closely with their medical team to detail their personal goals and medical preferences when facing a serious illness. <br />
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“It’s a way of honoring the wishes of both the patient who wants the most aggressive interventional treatment to prolong life, AND the patient who wants to spend their last days focused on comfort at home with loved ones,” says Amy Frieman, M.D., Medical Director, Palliative Care, Legacy Meridian Health; Clinical Assistant Professor, Rutgers and RWJ.<br />
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By translating wishes expressed in an advance directive into actionable medical orders, POLST allows patients with serious chronic illness, terminal illness, or those who are elderly and frail to dictate the way that they want to live their remaining days. <br />
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“For physicians, POLST offers an actionable approach for managing the fragile balance between ‘quality’ of life and ‘quantity’ of life,” says Dr. Frieman. “For patients, it provides an attainable, clinical solution to a universal question: ‘How do you want to live out the rest of your life?’ ”</div>
Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0tag:blogger.com,1999:blog-2870903224803601104.post-48283113561121092362017-03-30T08:30:00.000-07:002017-03-30T08:31:11.564-07:00Health Care ProxyBy: Celena Romero<br />
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Lehigh Valley Health Network</div>
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It is very easy to get caught up in day-to-day routine activities. Rarely is there time to think about the “what if” questions until it’s too late. I’m specifically referring to advance care planning. I’d like to share my personal experience that triggered my thoughts of advance care planning at 35 years old. <br />
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My husband and I were healthy newlyweds taking our ordinary life for granted until my husband became critically ill with the Swine flu and MRSA pneumonia. Suddenly, I was making health care decisions and signing consent forms on his behalf, as he remained intubated in a medically induced coma. I asked myself, “If we weren’t married who would be making his healthcare decisions? Would it be my husband’s parents; his 18 year old son? Who would these decisions be legally deferred to? Would I be left in the dark as far as his medical care or prognosis?” Fortunately, my husband made a full recovery and is doing exceptionally well thanks to the care he received at Lehigh Valley Health Network. But, I still wonder what things would have been like if we weren’t married during those crucial moments in the intensive care unit. <br />
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I also question, “What if I were the one in a coma? Is my husband comfortable making medical decisions on my behalf?” As it turns out, he’s not best suited for the task. I defer my healthcare decision making to my mom. My mom is my health care proxy. Everyone over 18 years old needs a health care proxy - a person who knows your care wishes and will express them to doctors in the event you cannot speak for yourself. This is an example of advance care planning. <br />
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The Conversation Project's user friendly guide, How to Choose a Health Care Proxy and How to Be a Health Care Proxy offers facts and tips to make sound decisions about choosing, and being, a health care proxy. This guide can found at <a href="http://theconversationproject.org/wp-content/uploads/2017/03/ConversationProject-ProxyKit-English.pdf">http://theconversationproject.org/wp-content/uploads/2017/03/ConversationProject-ProxyKit-English.pdf</a>. For more information about advance care planning, please visit <a href="http://yourlifeyourwishes.com/">http://yourlifeyourwishes.com/</a>.</div>
Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0tag:blogger.com,1999:blog-2870903224803601104.post-88443245738916297162016-10-24T08:06:00.000-07:002016-10-24T08:06:23.571-07:00Giving the Gift of Life Giving the Gift of Life
Jersey Shore and the NJ Sharing Network hosted its biennial Zan’s Garden of Life ceremony – a tribute to those who have donated their organs and given the gift of life to others. Families and caregivers attended the moving ceremony and visited the garden, where individual bricks honor their loved one’s sacrifice.<br />
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This year’s ceremony was especially poignant, as Caroline Duerr, a Neptune High School student who played the violin beautifully at 2013’s Garden of Life ceremony, was honored for her extraordinary gift of life.<br />
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A talented musician, Caroline was so impacted by the message she heard, she discussed the power of organ donation with her parents. When Caroline passed in March of 2015, her parents immediately knew what Caroline would have wanted and donated her organs, ultimately giving hope to so many other families. For more information about giving the gift of life, please visit <a href="http://njsharingnetwork.org/">NJSharingNetwork.org.</a><br />
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Watch her touching story here:<br />
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<iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/4vqNMuFWGqU" width="560"></iframe>Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0tag:blogger.com,1999:blog-2870903224803601104.post-37561145930476860772016-10-04T07:44:00.000-07:002016-10-04T07:44:43.953-07:00Knowing a Patient’s End-of-Life Wishes is Just the Beginning<div class="separator" style="clear: both; text-align: center;">
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By Vipul Bhatia, M.D.<br />
Medical Director for Post-Acute Services<br />
WellSpan Health<br />
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Advance care planning is not just about old age. At any age, a medical crisis could leave you too ill to make your own health care decisions. Even if you are not sick now, making health care plans for the future is an important step toward making sure you get the medical care you would want, even when doctors and family members are making the decisions for you.<br />
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As a doctor and trusted partner in my patients’ health, it’s my job to help them understand why it’s important to think about advance care planning now and inform family members of their decisions. Research shows that patients want their physicians to talk with them about end-of-life decisions.<br />
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The depth of conversation required for effective advance care planning differs from patient to patient. For example, the conversation and level of planning with a healthy 18-year-old patient will not be the same as the one with a patient who has chronic illnesses. However, the basic approach can be the same—ask the patient who should make medical decisions in the event of an unexpected accident.<br />
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There are various phases in your health that might trigger a conversation about advance care planning. As an adult, you are never too young or too old to discuss your plan.<br />
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•<span class="Apple-tab-span" style="white-space: pre;"> </span>Phase 1 – An adult patient at any age who is healthy or has a curable condition<br />•<span class="Apple-tab-span" style="white-space: pre;"> </span>Phase 2 – A patient with a new, chronic condition diagnosis<br />•<span class="Apple-tab-span" style="white-space: pre;"> </span>Phase 3 – A patient with progressive, frequent complications<br />•<span class="Apple-tab-span" style="white-space: pre;"> </span>Phase 4 – A patient who is hospice eligible<br />
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Supporting documentation in the absence of a conversation is less valuable compared to a conversation and no documentation. A family may not remember the contents of a signed document, but they will remember words their loved ones have said to them. However, the next step of effective advance care planning is to complete documents such as living wills.<br />
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There are many resources for documenting your plan. Just as the conversations about advance care planning fall on a spectrum, some documents are more appropriate than others at various stages of care. A stepwise approach based on your health status and the use of formalized documents will structure advance care planning to better serve you.<br />
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But the conversation doesn’t end once you’ve documented your wishes. Make sure you share your documents with your primary care physician and local hospital, if appropriate. Also, share the documents with the family member or friend who will speak for you when you cannot. Make sure they do not have any questions.<br />
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Advance care planning involves learning about the types of decisions that might need to be made, considering those decisions ahead of time, and then letting others know about your preferences. Everyone has a health horizon. You should plan for it.<br />
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<i>Vipul Bhatia, M.D., is the Medical Director for Post-Acute Services at WellSpan Health. He is also the director of WellSpan’s Horizon Planning program. Additionally, Dr. Bhatia holds a MBA in Medical Services Management from Johns Hopkins University. Education: Medical School—BJ Medical College, India; Residency—WellSpan York Hospital; Board certified in Internal Medicine.</i><br />
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<i>For more information about WellSpan Health, visit WellSpan.org. To learn more about WellSpan’s Horizon Planning, visit WellSpan.org/HorizonPlanning.</i>Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0tag:blogger.com,1999:blog-2870903224803601104.post-91950956952510525062016-09-08T13:02:00.003-07:002016-09-13T08:11:32.501-07:00Advance Care Planning is as Fundamental as Family Itself <div style="text-align: center;">
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Advance care planning may sound overwhelming, but the heart of it is a concept as fundamental as family itself.<br />
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“You wouldn’t make an important decision about your education, career, finances, relationships, or lifestyle, without thinking carefully about your intentions, available resources and possible outcomes,” explains Linda Farber Post, JD, MA, BSN, Director, Bioethics, Medical Affairs, at Hackensack University Medical Center.<br />
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“Life's most important decisions require you to identify your goals, values and preferences, gather information, map out a plan with alternatives, and coordinate with others to make sure your plan turns out the way you intended," she adds.<br />
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Your health is no different, according to Farber Post.<br />
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“Preparing for health care decisions that might one day be necessary is every bit as important as saving for college, starting a family, or planning for retirement,” Farber Post adds.<br />
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Learn more as Linda Farber Post JD, MA, BSN discusses the fundamentals of advance care planning. Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0tag:blogger.com,1999:blog-2870903224803601104.post-71599565229360592212016-07-25T11:11:00.001-07:002016-07-27T07:32:31.363-07:00The Hardest Decision<div style="text-align: left;">
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<span style="font-family: inherit;"><span style="font-size: small;"><span style="font-family: "trebuchet ms" , sans-serif;"><i><b><i>"In elementary school, I met a strawberry blonde named Hannah. She was a total spitfire with a constellation of freckles on
her cheeks and eyes that reflected her soul – full of life. Our
childhoods were bliss. We were little girls as naive as sprouts whose
roots were hardly established in the garden of this world<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;">.</span>"</span> </i></b>- Caroline Collins, <i><a href="http://theodysseyonline.com/monmouth/what-no-one-tells-you-about-terminal-cancer/310621?fb_action_ids=10153354017031931&fb_action_types=og.comments" target="_blank">What No One Tells You About Terminal Cancer</a></i></i></span></span></span></div>
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<span style="font-family: inherit;"><span style="font-family: inherit;">She was born on a Thursday in March</span><span style="font-family: "trebuchet ms" , sans-serif;">. </span><span style="font-family: inherit;">1999. </span></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">And f</span><span style="font-family: inherit;">rom that day forward, </span><span style="font-family: "trebuchet ms" , sans-serif;">the</span><span style="font-family: inherit;"> world was an open book for Hannah Rose.</span><i style="font-family: inherit;"> </i></div>
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<span style="font-family: inherit;"><span style="font-size: small;"><span style="font-family: inherit;"><i><span style="font-size: medium;"><span style="font-size: small;"><b>"It
seemed as
though she had a job to do. Curious from her first moments, her zest for
life from a very young age was incredible. As she grew, that
spirit
never left her. Hannah was an incredible young woman - funny,
wicked smart, fiercely loyal<span style="font-family: "trebuchet ms" , sans-serif;">.</span>"<span style="font-family: "trebuchet ms" , sans-serif;"> </span></b></span></span><a href="http://www.hannahduffy.org/hannahs-story.html" target="_blank"><span style="font-family: "trebuchet ms" , sans-serif;"></span>- Our Beautiful Hannah Rose</a></i></span></span></span></div>
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<span style="font-size: small;"><span style="font-family: inherit;">But at an age when "tough decisions" should be limited to dating, driving and summer jobs, Hannah Rose Duffy found herself facing a set of choices most could hardly fathom.</span></span></span><br />
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<span style="font-family: inherit;"><span style="font-size: small;"><span style="font-family: "trebuchet ms" , sans-serif;">At 14, Hannah was <span style="font-family: "trebuchet ms" , sans-serif;">living </span>with brain cancer - and <span style="font-family: "trebuchet ms" , sans-serif;">a</span> rushing onset of decisions <span style="font-family: "trebuchet ms" , sans-serif;">t<span style="font-family: "trebuchet ms" , sans-serif;">hat would </span></span>determine how she and her loved ones <span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;">would</span> </span></span>mov<span style="font-family: "trebuchet ms" , sans-serif;">e</span> forward<span style="font-family: "trebuchet ms" , sans-serif;">.</span></span></span></span></span><span style="font-size: small;"><span style="font-family: "trebuchet ms" , sans-serif;"> </span></span><br />
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<span style="font-size: small;"><span style="font-family: inherit;"><span style="font-family: "trebuchet ms" , sans-serif;">Her determination</span>, <span style="font-family: "trebuchet ms" , sans-serif;">you </span>might say, was "Pure Hannah."<span style="font-family: "trebuchet ms" , sans-serif;"> </span></span></span></span><br />
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<span style="font-size: small;"><span style="font-family: inherit;">Her decision? A cancer diagnosis was no match for her lifetime of dreams yet to chase, stars yet to follow, and wishes yet to be fulfilled.</span></span></span><br />
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<span style="font-size: small;"><span style="font-family: inherit;">Hannah's <span style="font-family: "trebuchet ms" , sans-serif;">close<span style="font-family: "trebuchet ms" , sans-serif;">st</span></span> friend<span style="font-family: "trebuchet ms" , sans-serif;"> </span>and trust<span style="font-family: "trebuchet ms" , sans-serif;">ed </span>sidekick, Caroline Collins,<span style="font-family: "trebuchet ms" , sans-serif;"> <span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;">recalls</span> </span></span>the <span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;">day </span></span>she vowed</span> t<span style="font-family: "trebuchet ms" , sans-serif;">o carry on the </span>wishes of Hannah Duffy <span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;">as </span>the legacy of</span> "Hannah the Warrior.<span style="font-family: "trebuchet ms" , sans-serif;">"</span></span></span></span><br />
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<span style="font-family: inherit;"><b><span style="font-size: small;"><span style="font-family: "trebuchet ms" , sans-serif;"><i>"I laid beside Hannah in that hospital
bed. We put together
a list of her wishes that evolved into a legacy of our friendship, the
beauty of life, and death. That list holds an explanation for why I wore
hot pink stilettos to the funeral and why the name “Hannah” will
definitely be embroidered on my wedding gown<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;">.</span>"</span></i></span></span></b><span style="font-size: small;"><span style="font-family: "trebuchet ms" , sans-serif;"> - Caroline Collins</span></span></span></blockquote>
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<span style="font-size: small;"><span style="font-family: "trebuchet ms" , sans-serif;">Hannah passed away on September 26, 2013<span style="font-family: "trebuchet ms" , sans-serif;">. </span></span></span><b><span style="font-size: small;"><span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;">Her story, however<span style="font-family: "trebuchet ms" , sans-serif;">, </span>is just <span style="font-family: "trebuchet ms" , sans-serif;">beginning</span>.</span> </span></span></b></span><br />
<span style="font-family: inherit;"><b><span style="font-size: small;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></span></b>
<b><span style="font-size: small;"><span style="font-family: "trebuchet ms" , sans-serif;">Read Caroline's blog<span style="font-family: "trebuchet ms" , sans-serif;">:</span> <a href="http://theodysseyonline.com/monmouth/what-no-one-tells-you-about-terminal-cancer/310621?fb_action_ids=10153354017031931&fb_action_types=og.comments" target="_blank">What No One Tells You About Terminal Cancer.</a></span></span></b></span><br />
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<b><span style="font-size: small;"><span style="font-family: inherit;">Explore the le<span style="font-family: "trebuchet ms" , sans-serif;">gacy o<span style="font-family: "trebuchet ms" , sans-serif;">f "Hannah the Warrior" here: </span></span><a href="http://www.hannahduffy.org/" target="_blank">The Hannah Duffy Foundation</a></span></span></b></span>Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0tag:blogger.com,1999:blog-2870903224803601104.post-49049360359075227172016-07-25T07:34:00.003-07:002016-07-25T11:12:23.424-07:00The Evolution of Advance Care Planning By: Celena Romero <div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi8cF65VZEJAdK1uD8yNqtu4CTh9EGi6YUwofpko5ar7NJ-H_AAWlGU49ZPix_H0OSg5PPmBzv_x2C9nF7M-34WAI5Yj0tmAfnbpbm_HsrKikCgDr53oXaJE_hK07lAgxrAfvf9Z2iAg_yn/s1600/Family-+Generations.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi8cF65VZEJAdK1uD8yNqtu4CTh9EGi6YUwofpko5ar7NJ-H_AAWlGU49ZPix_H0OSg5PPmBzv_x2C9nF7M-34WAI5Yj0tmAfnbpbm_HsrKikCgDr53oXaJE_hK07lAgxrAfvf9Z2iAg_yn/s320/Family-+Generations.jpg" width="320" /></a></div>
<span style="font-family: inherit;">In the summer of 1969 Luis Kutner wrote an article titled Due Process of Euthanasia: The Living Will, A Proposal. The article summarizes the outcomes of several trials involving family members ending the life of an ailing loved one who is suffering from a debilitating, terminal disease. He referred to the acts as “mercy killings.” Kutner, a human rights lawyer, represented society acknowledging that common law was written to treat mercy killings no different than any other acts of murder; however prosecutors, judges, and juries approached mercy killings with sympathy rather than punishment. Given the fact that law does not condone suicide or permit one to assist in suicide, Kutner proposed A Living Will as an alternative solution to relieve great pain and suffering from an incurable fatal disease. </span><br />
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<span style="font-family: inherit;">Kutner knew that law honored a patient's right to consent to or to refuse treatment; whether it be an injection or an operation. A patient’s consent must be voluntary and well informed. The Illinois Supreme Court refused to condone the authorization of blood transfusions to a competent adult who had steadfastly refused due to religious beliefs. The problem remains if a patient is unconscious, cannot give consent, or is completely unresponsive, how far should a physician go to preserve life? It was presumed that physicians applied an ordinary means to preserve life but no extraordinary means if the patient was not expected to recover from the comatose state. Ordinary and extraordinary are terms subject to personal interpretation.</span></span><br />
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<span style="font-family: inherit;">Kutner questioned how an individual patient can retain the right of privacy over his or her body if the law clearly prohibits mercy killing, even at the patient's request. On the contrary, the law allows an individual the right to refuse treatment even if it would prolong life. If a doctor does not respect the patient’s refusals, he or she would be subject to liability.</span></span><br />
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<span style="font-family: inherit;">The suggested solution proposed by Kutner is that the individual, while fully in control to express himself or herself, indicate to what extent he or she would consent to treatment. The document indicating such consent may be referred to as A Living Will:</span></span><br />
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<span style="font-family: inherit;">The document would provide that if the individual's bodily state becomes completely vegetative and it is certain that he cannot regain his mental and physical capacities, medical treatment shall cease. A Jehovah's Witness whose religious principles are opposed to blood transfusions could so provide in such a document. A Christian Scientist could, by virtue of such a document, indicate that he does not wish any medical treatment.</span></span><br />
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<span style="font-family: inherit;">Nearly 50 years later, end of life care, shared decision making, informed consent, and advance directives, such as A Living Will remain at the forefront of ethical and legal debate, and public policy. Americans are living longer and are healthier than previous generations but due to advances in medical treatments and technology it is extremely difficult to predetermine the timing of death. Federal policy, state legislature, physician groups, bioethicists, and society at large impact health care decisions. Don’t let them impact yours. Take control of your life decisions regarding medical treatment and end of life wishes. It starts with a conversation. Find out more by visiting <a href="http://yourlifeyourwishes.com./">yourlifeyourwishes.com.</a></span></span><br />
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<span style="font-family: inherit;">Reference:</span></span><br />
<span style="font-family: inherit;">Kutner, Luis (1969) "Due Process of Euthanasia: The Living Will, A Proposal," Indiana Law Journal: Vol. 44: Iss. 4, Article 2</span><br />
<br />Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0tag:blogger.com,1999:blog-2870903224803601104.post-43176856679580656782016-06-03T15:08:00.000-07:002016-07-25T11:12:10.711-07:00Four Things You Need to Know About Advance Care Planning<span style="font-family: inherit;">By Leon S. Kraybill, M.D.</span><br />
<span style="font-family: inherit;">Lancaster General Health/Penn Medicine</span><br />
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<span style="font-family: inherit;">As a geriatrician, I work with individuals to discuss their changing health every day. Discussions of disease, functional changes, clinical decline, and end-of-life care are very common. I routinely encourage people to consider health options, make treatment choices, and share these through discussion and <a href="http://lghealth.org/advancecareplanning" target="_blank">advance care planning documents</a>.</span><br />
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<span style="font-family: inherit;">Here are <b>four tips to guide you through the advance care planning process</b>:</span></span><br />
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<span style="font-family: inherit;"><b>Start the conversation. </b>A conversation about advance care planning is about life and how you want to live; not about death. It is a perfect time to express your wishes, identify what is most important to you, and connect to your loved ones. Start your discussion by asking yourself what you value most about life and health, and how you would like to accomplish that.</span></span><br />
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<span style="font-family: inherit;">Advance care planning discussions are for everyone. The choices you make may change during different phases of life, but even young healthy individuals should make choices about their future care.</span></span><br />
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<span style="font-family: inherit;"><b>Just do it! Complete an advance healthcare directive.</b> The right time to complete your advance healthcare directive (healthcare power of attorney and living will) is when you think about it. Don’t wait for the perfect moment, the right words, or a medical change. The advance healthcare directive expresses your wishes and instructions for medical care if you are unable to make decisions for yourself during a terminal change. <a href="http://www.lancastergeneralhealth.org/LGH/ECommerceSite/media/LGH-Media-Library/Documents/Resources/Before%20You%20Arrive/AdvanceHealthcareDirective_form.pdf" target="_blank">Click here</a> to download and complete an advance healthcare directive.</span></span><br />
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<span style="font-family: inherit;"><b>Share your advance directive</b> with loved ones, medical providers, and anyone who will help you make future choices. Your wishes cannot be honored if others don’t know about them.</span></span><br />
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<span style="font-family: inherit;"><b>Consider POLST</b> if you have serious health conditions: POLST (Pennsylvania Order for Life-Sustaining Treatment) is a form printed on bright pink paper that allows documentation of your specific wishes for end-of-life care. It guides medical providers and family if you are unable to participate in moment-to-moment decisions. The form is kept near you at all times, usually on your refrigerator or by your bed if you are at home. It should be documented in your electronic medical record. <a href="http://www.lancastergeneralhealth.org/LGH/ECommerceSite/files/85/8533d6c8-086f-42ae-8016-3e473a2a7354.pdf" target="_blank">Click here</a> to learn more about POLST.</span></span><br />
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<span style="font-family: inherit;">Through ongoing conversations, your loved ones and healthcare professionals are far more likely to be able to understand the medical treatment you desire, and most importantly, honor your wishes.</span></span><br />
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<i><span style="font-family: inherit;">Leon S. Kraybill, M.D., is a physician with LG Health Physicians Geriatrics and Chief of Geriatrics for LG Health/Penn Medicine. He also serves as the Medical Director at Mennonite Home Communities in Lancaster and at Luther Acres in Lititz, PA. Education: Medical School—Temple University; Residency—Lancaster General Hospital Family Medicine Residency Program; Fellowship—Lancaster General Hospital Geriatric Fellowship.</span></i></span>Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0tag:blogger.com,1999:blog-2870903224803601104.post-34494193126909072292016-05-16T11:58:00.003-07:002016-05-16T11:58:37.596-07:00Your Life Your Wishes - Hannah's Story <iframe width="560" height="315" src="https://www.youtube.com/embed/W3y3IaBIkyg" frameborder="0" allowfullscreen></iframe>Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0tag:blogger.com,1999:blog-2870903224803601104.post-39460001023772911492016-04-07T10:42:00.000-07:002016-07-25T11:09:31.859-07:00Family: The Heart of Advance Care Planning<div style="text-align: left;">
<span style="font-family: inherit;"><i><span style="font-family: "georgia" , "times new roman" , serif;">Welcome t<span style="font-family: "georgia" , "times new roman" , serif;">o the "Your Life, Your W<span style="font-family: "georgia" , "times new roman" , serif;">ishes" blog<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">. <span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">Join us here</span> regularly <span style="font-family: "georgia" , "times new roman" , serif;">as we share</span> testimonials, articles, videos, and important information related to advance care planning. <span style="font-family: "georgia" , "times new roman" , serif;"></span></span></span></span></span></span></span></i></span><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><br /></span></span></span></span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: inherit;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><b><span style="color: #073763;">The Conversation Starts Today</span></b></span></span><br /><br />The <span style="font-family: "georgia" , "times new roman" , serif;">foundation</span> of <span style="font-family: "georgia" , "times new roman" , serif;">a</span>dvance care planning is, to put it simply, <span style="font-family: "georgia" , "times new roman" , serif;">family <span style="font-family: "georgia" , "times new roman" , serif;">preparedness</span> in the face of</span> what<span style="font-family: "georgia" , "times new roman" , serif;">ever life brings. <span style="font-family: "georgia" , "times new roman" , serif;">To be more specific, </span></span>it's about taking steps <b>today</b> to <span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">establish</span> a </span>care plan that suits your needs, values, and preferences</span><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: inherit;"><b> tomorrow, </b>and <span style="font-family: "georgia" , "times new roman" , serif;">onward</span>.</span><b style="font-family: georgia, "times new roman", serif;"><br /></b></span></span>
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<span style="font-family: inherit;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><b><br /></b></span></span><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"><br />Communication <span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;">is </span>the key to advance<span style="font-family: "georgia" , "times new roman" , serif;"> care planning</span></span>, a<span style="font-family: "georgia" , "times new roman" , serif;">n<span style="font-family: "georgia" , "times new roman" , serif;">d</span> it all starts with a conversation.<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia" , "times new roman" , serif;"> </span>By taking</span></span></span></span></span></span> that first<span style="font-family: "georgia" , "times new roman" , serif;">, simple </span>step, you’ll be taking control of what matters most<span style="font-family: "georgia" , "times new roman" , serif;">:</span><b> <br />Your life. Your wishes. </b> <br />
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<span style="color: #073763;"><span style="font-family: inherit;"><b>Your advance care plan comes down to three easy steps:</b></span></span></div>
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<li><span style="font-family: inherit;">Understand what, and when, certain medical decisions <i>might</i> need to be made</span></li>
<li><span style="font-family: inherit;">Consider these decisions ahead of time<span style="font-family: "georgia" , "times new roman" , serif;">, and how they <span style="font-family: "georgia" , "times new roman" , serif;">may be </span>impacted by </span>your goals, values, and preferences</span></li>
<li><span style="font-family: inherit;">Communicate<span style="font-family: "georgia" , "times new roman" , serif;"> your</span> choices, needs<span style="font-family: "georgia" , "times new roman" , serif;">, and </span>wishes with loved ones</span></li>
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<span style="font-family: inherit;"><span style="font-family: inherit;">By generating a dialogue with loved ones in anticipation of long-term medical decisions, you'll be ready for tomorrow, confident <span style="font-family: "georgia" , "times new roman" , serif;">in</span> the future, and boldly at the helm of </span><span style="color: #073763;"><b><span style="font-family: inherit;">Your Life, Your Wishes</span>. </b></span></span><br />
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<b><span style="font-family: "georgia" , "times new roman" , serif;"><span style="color: black; font-family: inherit;"><a href="http://yourlifeyourwishes.com/index.html" target="_blank">Start the conversation today.</a></span></span></b></div>
Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0tag:blogger.com,1999:blog-2870903224803601104.post-47619837408330716272015-08-13T10:41:00.002-07:002016-07-25T11:08:30.819-07:00Advance Directive <span style="color: #222222; font-family: "lato" , sans-serif;"><span style="font-family: inherit; font-size: 14px;"><b>Advance directive </b>— A document that enables an individual capable of making decisions to articulate preferences and authorizations regarding health care. </span></span><br />
<span style="font-family: inherit;"><span style="color: #222222; font-family: "lato" , sans-serif;"><span style="font-size: 14px;"><br /></span></span>
<span style="color: #222222; font-family: "lato" , sans-serif;"><span style="font-size: 14px;">•<b>Appointment directive</b> <i>(health care proxy, power of attorney for health care) is a document in which you legally appoint a health care agent/representative/proxy/power of attorney for health care)</i> and authorize that person to make treatment decisions for you if you are ever temporarily or permanently unable to make these decisions for yourself. Your appointed agent will have the same decisional authority as you and will be able to confer with your care team in real time and make any decisions you would be able to make. The appointment of an alternate agent is recommended as a back-up in case your primary agent is unavailable or unable to make decisions for you.</span></span></span><br />
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<span style="color: #222222; font-family: "lato" , sans-serif;"><span style="font-size: 14px;">•<b>Instruction directive</b> <i>(living will)</i> is a set of instructions about specific tests or treatments that you would or would not want under specific conditions. The weakness of the instruction directive is that it requires you to anticipate future medical conditions that you may or may not experience and predict what types of care you would or would not want. </span></span></span><br />
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<span style="color: #222222; font-family: "lato" , sans-serif;"><span style="font-size: 14px;"><b>Decisional capacity—</b>The ability to understand your medical condition and its likely course; the benefits, burdens and risks of the proposed treatment options and alternatives; and their likely outcomes; and make informed care and treatment decisions based on the information. If you temporarily or permanently lose the capacity to make your own medical decisions, a surrogate (either an agent you have appointed in an advance directive or a close relative) will make decisions on your behalf.</span></span></span><br />
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Meridian Healthhttp://www.blogger.com/profile/07988725322241117623noreply@blogger.com0