My New Quality-of-Life Statement to Attach to My Advance Directive


The goal of writing a quality-of-life statement is to have it express your personal preferences and to have it sound like you. One of the problems with many of the legal/medical forms is that they all sound alike and they don’t allow your voice to be heard. I encourage you to use the categories I have listed below to express what you would want people to know about you if you were too sick to speak for yourself. You can use some of my language from my document below if you would like but my goal is for you to make it personal and meaningful to you. You will know you have gotten it right if people say to you, “Yes, this is sounds like what he/she would say.” By making it feel personal, you will help your family/friends feel more confident that they are truly honoring your wishes.

Sections of QOL Statement to Consider Including in Your Directive:
? Types of illnesses where this advance directive would apply.
? What is important to me?
? What conditions would I find reprehensible to live with long term?
? CPR, ventilator and feeding tube preferences.
? Reassurances for the decision maker.
? What is a good death in my opinion?
? What I want the doctors know about honoring my religious/cultural beliefs both while I am sick and/or dying?

Here is my new quality-of-life or meaningful recovery statement. My wishes haven’t changed but how I am saying it is much more complete. Feel free to take any part of it you would like. Use the basic headings and then make it personal and meaningful for you. I would recommend attaching it as an addendum to a basic advance directive form that works in your state.

Advance Healthcare Directive for Viki Kind – dated 11/1/2012

Types of illnesses where this advance directive would apply whether I am terminal or not terminal.

I can never list every type of disease that might make me begin to lose my mental capacity but the list might include, but not be limited to: all types of dementias, stroke, brain injury, mental illness, anoxic event, etc. I don’t have to be completely out of it like being in a coma, persistent vegetative state, or minimally conscious state for this document to go into affect. And I don’t have to be terminal. The point is that I don’t want to have my life prolonged/sustained if my brain no longer works well enough to enjoy what is important to me.

What is important to me? (The loss of any of these might be enough for my decision maker to implement my wishes documented in this advance directive.)

To make a difference in the world.

To be able to communicate with those I love.

To receive the joy that comes from personal relationships.

To have some independence.

To be able to give love, not just receive people’s kindness.

To not be a burden on my family/friends – financially, emotionally or physically.

To have a good death as defined by me (see below).

What conditions would I find reprehensible to live with long term? (Please give me the chance to recover if recovery is possible, but if I am not recovering to a level of functioning that I would think is worthwhile, whether terminal or not, then choose comfort care and hospice which I understand will lead to my death.)

All of the following conditions do not have to be present at the same time for the decision to be made to allow me to die from my illness/injury. Any one of these conditions may be sufficient enough to change my course of treatment from prolonging my life to comfort care and allowing a natural death.

This list of “Conditions I would not want to live with” includes but is not limited to:

Not recognizing my loved ones.

Not being able to communicate by voice, computer or sign language.

Wandering around aimlessly.

Suffering that isn’t necessarily pain related.

Significant pain that can not be controlled.

Significant pain that requires so much medicine that I am sleeping all the time.

Having to live in a skilled nursing facility or sub-acute facility permanently with my cognitive impairment. Nursing homes create such sadness in me every time have I visited or have stayed overnight with a loved one. I am too empathetic and take in people’s suffering too easily to be in that environment. It would destroy me long term. A short-term stay in a SNF/rehab/sub-acute is okay if I can recover to a life that I would consider worth living. (I understand that with certain types of traumatic brain injuries, they take a longer period of time to evaluate whether or not recovery is possible.) But if it looks like I am not recovering, then no thank you.

Okay, now the CPR, ventilator and feeding tube conversation.

My overall guideline is that if CPR, ventilator support or a feeding tube/TPN can return me to what I would consider to be a meaningful existence, (what is important to me), then please give me CPR, ventilator support and/or a feeding tube/TPN. But there has to be value in these medical options and any other medical treatment choices that are being considered. Don’t do things, including but not limited to, antibiotics, etc., that are just to sustain my poor condition.

I am not opposed to living with a feeding tube/TPN if it gives me many years of being able to enjoy what is important to me. But if the feeding tube/TPN is just to sustain my miserable condition, (what I would consider reprehensible) then don’t put it in or give me feedings through it; and please take the feeding tube out if it is already in. (Okay, if I am on hospice and the feeding tube gives you access for administering the pain and suffering meds I need, then you can leave it in. But don’t put food or additional liquids in it.) The feeding tube, like all medical decisions, needs to create value in my life, not just sustain my life.

If I am still healthy and can still experience lots of the things that are important to me, then give me CPR. But as my health declines and CPR becomes less statistically successful, then make me a DNR. Just like many doctors, I don’t want to die by CPR. I want to die peacefully without life-prolonging medical interventions. (Doctor, please ask yourself the surprise question: Would I be surprised if Viki died during this hospitalization or died in the next 6 months? If the answer is “No, I wouldn’t be surprised,” then talk to my decision maker about end-of-life choices, including putting me on hospice.)

Reassurances for the decision maker

You are allowed to make the best decisions you can based on the circumstances and what you know at the time. You do not need to know for certain or absolutely that you have all the answers. The decision doesn’t have to be perfect. Use your heart and your head. I trust you to do the best you can. (Ed, you don’t have to go into super-perfectionist mode.)

I believe love does not obligate a person to sacrifice themselves to be the caregiver for another. The damage done to the caregiver, emotionally, physically and mentally is too costly. I do not expect someone to give up their mental, emotional and physical health for me. Look at the MetLife studies. Caregiving sucks. And I love my decision maker and alternates too much to impose such a burden on them.

(Ed, if you need some time to make peace with what has happened, then you can take the time you need. I don’t want the decision to feel rushed or uninformed, which would cause you a lifetime of regret.)

For you doctor, your role is to give my decision maker as much information as you can so he/she can make an informed decision. I encourage you to share your wisdom, guidance and experience but ultimately, it is my decision as expressed through my decision maker and this document. Remember, this document is an act of autonomy and should not be ignored by my decision maker/s, other family members, doctors or worst case, the courts. (I will definitely come back and haunt a judge who isn’t respecting my wishes.)

What is a good death in my opinion?

I would prefer to die at home but I realize that sometimes, a person needs to die somewhere else so I accept that. I would like to have my family/friends with me which includes and is limited to those I interact with on a regular basis. Those family/friends who have chosen to not be in my life while I was living should certainly not be there as I am dying. Because I like control over my life, I would like to be able to clean up my desk and to get my financial information updated. I would like to be able to write love letters, record messages and to say my goodbyes. (I will do my Go Wish Cards and leave a copy for my family.)

I would like to die with reasonable pain control. For the days leading up to the death, I would be willing to tolerate a certain amount of pain if that allowed me to have meaningful time with family/friends. But at the end, there had better be no pain and definitely, no air hunger. (That doesn’t mean ventilator support; it means manage my air hunger with medications.)

And you better not be force feeding me by mouth, by IV or by tube as that would increase my suffering. (And that includes you at the skilled nursing facility, sub-acute facility or other care community if I happen to be dying there. I know you have your regulations but I also know you can’t assault someone with food if they have said no when they had capacity.)

That’s it for now.

Viki Kind ________________________________

Date: 11/1/12

Join me at the Texas NASW – National Association Of Social Workers on Oct. 8

October 3, 2011 by  
Filed under Uncategorized


Join me at the Texas NASW – National Association Of Social Workers on Oct. 8. I will be speaking at 2:15. http://www.naswtx.org

Founded in 1957 the National Association of Social Workers (NASW) is the largest organization of professional social workers in the world, with over 155,000 members in 55 chapters. The Texas Chapter, with about 5,700 members, is the major professional social work organization in the state. NASW is committed to advancing professional social work practice and the profession; and to promoting human rights, social and economic justice, and unimpeded access to services for everyone. Its members work in a broad range of settings including hospitals and other health care settings, community agencies, government, academia, business, nursing homes, schools, and private practice.

The Chapter office is located at 810 W. 11th Street, Austin, Texas 78701-2010. The staff is available to respond to member inquiries regarding social work practice, legislative and social policy issues, continuing education, licensing issues, and other informational requests.

The Chapter has numerous branches, committees and other leadership opportunities that involve members throughout the state, and better serve the social work community. These entities work on professional, social policy, and legislative issues, sponsor conferences, and provide a source of networking for members.

NASW’s goals include improving the quality of life and ensuring that the same rights and opportunities
are enjoyed by all. In addition, NASW strives to:
• Advance the quality of social work practice, improve the knowledge base required for
practice, and promote professional development.
• Promote the strength, unity, and recognition of the social work profession and the use of
standards to protect the consumer.
• Propose and promote sound public policies and programs aimed at meeting human needs
and improving quality of life.

Have a kind and respectful day.

Viki will be speaking at the Dallas Area Agency on Aging, Event SOLD OUT

October 3, 2011 by  
Filed under Uncategorized


Viki will be speaking at the Dallas Area Agency on Aging on October 7.
EVENT SOLD OUT

The Area Agency on Aging of Tarrant County (AAATC) is part of United Way of Tarrant County and receives funding from the Texas Department of Aging and Disability Services. For more information, call 817-258-8081 or 817-258-8082. http://unitedwaytarrant.org/

Our Mission
To be the visible leader and advocate in the creation and delivery of services that promote empowerment, independence and dignity for older citizens, persons with disabilities and caregivers.

Medicare Enrollment Counseling
Medicare beneficiaries have the opportunity to choose their prescription drug and health plans during the Medicare open enrollment period October 15 to December 7, 2011. Whether you are new to Medicare or changing plans, you can receive free one-on-one counseling from a State-certified benefits counselor by calling United Way’s Area Agency on Aging of Tarrant County at 817-258-8125. If you have limited income and resources, you may be eligible to receive extra help with your Medicare prescription drug expenses. Counseling is available to both Medicare beneficiaries and their caregivers.

Have a kind and respectful day.

I will be at the Fearless Caregiver Conference in Boca Raton on Thursday to receive the 2011 Caregiver Friendly Award my book just won!

July 10, 2011 by  
Filed under Ethics In Action


THE CAREGIVER’S PATH TO COMPASSIONATE DECISION MAKE: Making Choices For Those Who Can’t IS THE WINNER OF THE 2011 CAREGIVER FRIENDLY® AWARD FROM TODAY’S CAREGIVER MAGAZINE.

Today’s Caregiver, the first national magazine for all family and professional caregivers, and caregiver.com announce the 2011 Caregiver Friendly® Award recipients. The Caregiver FRIENDLY® Awards are designed to celebrate products, services, books and media created with the needs of caregivers in mind.

About The Caregiver Friendly Awards:
Caregiver Friendly® Awards are presented by Today’s Caregiver magazine to celebrate outstanding books, media, products and services designed with the best interest of the family caregiver in mind. Today’s Caregiver, launched in 1995, is published by Caregiver Media Group, which also produces the Fearless Caregiver Conferences, www.caregiver.com and The Fearless Caregiver book, which teaches caregivers how to become their loved one’s fearless advocates within the healthcare system.
http://www.caregiver.com/caregiverfriendly/2011/2011_winners.htm

“The average caregiver is responsible for over $40,000 in health related expenditures each year, in either personal or directed funds,” says Gary Barg, Today’s Caregiver editor-in-chief. “This award is designed to help family caregivers recognize and reward those organizations who will care for them in as committed a manner as they care for their loved ones.”

Fearless Caregiver Conference in Boca Raton, FL
Thursday July 14, 2011
8:00am – 2:30pm
Family Track and Professional Track with CEUs
Embassy Suites Hotel
661 NW 53rd Street
Boca Raton, FL 33487
http://www.caregiver.com/fearlessconference/index.htm
Have a kind and respectful day.

5 Stars!!! – National Book Critic Review Just In

April 25, 2011 by  
Filed under Ethics In Action


THE CAREGIVER’S PATH to COMPASSIONATE DECISION MAKING: Making Choices for Those Who Can’t
Publisher: Greanleaf Book Group LLC Paperback July 1, 2010 Price: $14.95 USA

“From the front cover which shows two hands in the shape of a heart holding a rock which is also in the shape of a heart, THE CAREGIVER’S PATH to COMPASSIONATE DECISION MAKING: Making Choices for Those Who Can’t no doubt is a rock size lump in the throat to all who deny they will eventually need this book.

THE CAREGIVER’S PATH to COMPASSIONATE DECISION MAKING is a great book and a KIND tearjerker too! Where no tomorrow is guaranteed, our loved ones might get to where they are without full faculties and can?t answer the questions or direct others to who they want to answer questions in their best interests or have documentation which represents such and their convictions. Author Viki Kind?s mastery is in getting the reader through the battling of keeping one?s composure to making the tough choices when a loved one whose outlook is tainted from dying needs support. The fourteen chapters could stand alone, each as a teaching tool, for care givers.

The first part of the book concerns medical decisions and the second part concerns death. “Did I matter?” is a heartfelt question no one wants to be unable to answer at the destination life holds. Anyone with a heart will see through watery eyes reading Author Viki Kind’s The Journey Through The Early Days of Dying and The Final Days of Dying. Kind?s step-by-step process for caregivers to use is simple: 1) a decision making framework of 2) Shared Decision Making Model 3) Sliding Scale for Decision Making 4) The Assent Tool Author Viki Kind provides an authentic knowing voice on the necessities of a compassionate outlook on the growing problem. It is a problem now affecting the whole mass of baby boomers seeking and searching for these very same tough questions and one day will too be faced with the bittersweet answers because they get one to fess up to mortality?s limits, timeliness of determining a loved one’s competency and capacity, and the need to at least have an understanding enough to lead one to valid choices.

Baby Boomers of late are that aging escapes no one. In regencies of “60 is the new 50,? that only goes so far in winning but a mind game not the war of health and longevity. Sooner or later there is no candy-coating that 100 is not the new 90 because that is a mute point; most don?t make it to that age. Likewise, in the best interest of loved ones is this “tell it like it is,? pull no punches, optimal reference guide as a companion to those readers during the tough times they will eventually face; when a test of courage and on what basis the most difficult medical decisions are made. Unequivocally, then the answer to “Did I matter?? is answered by actions of the caregiver and is brought into the present tense. Meaning that, that is when author Viki Kind’s book, and its bittersweet bread and butter and not a lot of fluff, go a long way into making that very last release of a loved one’s grip from your hand be one in which you knew you did the best you could (do) until the end. THE CAREGIVER’S PATH to COMPASSIONATE DECISION MAKING: Making Choices for Those Who Can’t is a rare find with great merit worth (and worthy of) holding onto the rest of one’s life.”

Salvador SeBasco Literary Director and host of THE INSIDE VIEW SHOW (TM) BROADCAST book critic, on staff with a CNN affiliate station.
April 10, 2011

Kim Linder from The Caregiver Hour’s Radio Show in Tampa – Listen on May 2nd 8AM PST

April 25, 2011 by  
Filed under Kind Ethics Radio


Viki will be interviewed on the Caregiver Hour, the radio show hosted by Kim Linder, founder of Senior Holistic Living.

Kim Linder is passionate about helping caregivers listen to their inner voice, be authentic and make conscious decisions during every stage of the caregiving process. In addition to her experience garnered from over 10 years as a professional caregiver, she personally served as primary caregiver to her in-laws for two years. Her career path has provided invaluable insight into the very real struggles, guilt, challenges, joys and sadness that caregivers often experience. And because of her personal journey, she understands and embraces the healing power of self-discovery and empowerment.

As an advocate for seniors, Kim’s grass roots experience as a Marketing Director and Executive Director of an Assisted Living Community helped her become an integral part of the senior living community. Her passion to enhance the lives of seniors motivated her to develop monthly educational and wellness programs to illustrate her belief that many seniors want to be seen and heard rather then become invisible as they age. Her work in this arena naturally led to her passion for helping the many caregivers that she encountered and interacted with over the years.

Recognizing that caregivers often shoulder a burden that they are simply not prepared to handle, Kim is gifted in detecting the warning signs that ultimately lead to imbalance in their lives. She relies on her intuition to guide her as she supports caregivers, encouraging them to feel acknowledged, empowered, centered, and balanced. This holistic approach of focusing on the whole person is gentle yet effective. And most importantly, it results in a de-stressed caregiver who is able to make wise and clear decisions for themselves and those in their care.

Kim enjoys working with professional and lay caregivers, health professionals, holistic practitioners, and all types of well-spirited people. A dynamic speaker, she has presented to a wide variety of audiences, including Regency Oaks, St. Mark Village, and BB&T Bank. In addition to her work with Senior Holistic Living, she is a certified reiki master and member of Better Living for Seniors, Women In Philanthropy, and the Florida Council on Aging (FCOA). Kim wrote a monthly column for the Tampa Tribune called The How To Guide To Graceful Aging, and her writing has also appeared in The Jewish Times newspaper, Jewish Woman magazine, and The Bugle – a senior publication.

Kim resides in Tampa, Florida with her husband, Jack. She has a son, four stepchildren, and two grandchildren – all of whom enjoy her keen sense of humor and penchant for telling a great story. Her hobbies include traveling, black & white photography, biking, yoga and attending art shows and estate sales. She wholeheartedly believes that giving back to the community is essential to creating abundance, so she donates both her time and money to the organizations that she supports. Her volunteer efforts include the Alzheimer’s Association, Suncoast Hospice Foundation and All Children’s Hospital.

If you think Kim’s approach is right for you or you’d like to know more about her, please contact her.
Senior Holistic Living
13911 W. Hillsborough Ave
Suite 113
Tampa, FL 33635
(727) 798-2663
http://seniorholisticliving.com

Four Ways to Listen (For questions, call 877-897-8255)

On the Radio:
11AM to 12PM EST Mondays on
Clear Channel 1250 AM WHNZ Impact Radio in Tampa
.
On the Web via WHNZ, Live:
11AM to 12PM EST Mondays at www.whnz.com
.
On your iPhone, Blackberry, or Droid, download the app at:
www.iheartradio.com
.
On the Web, via Podcast:
Click here to go to our Show Archive.

Have a kind and respectful day.

April 13 – An Evening with Viki Kind – Austin, Texas, 6:30 PM Presentation sponsored by the Alzheimer’s Association of Texas and Austin Groups for the Elderly

April 8, 2011 by  
Filed under Ethics In Action


April 13 – An Evening with Viki Kind – Austin, Texas, 6:30 PM
Presentation sponsored by the Alzheimer’s Association of Texas and Austin Groups for the Elderly.

The Alzheimer’s Association-Capital of Texas Chapter is a non-profit organization that provides family support, community education, public awareness and supports research for the prevention, cure and treatment of Alzheimer’s disease and related disorders.

Their mission is to provide leadership to enhance care and support services for individuals and their families while supporting the advancement of research to eliminate Alzheimer’s disease. Their vision is a world without Alzheimer’s disease.
Austin Groups for the Elderly is a non-profit organization empowering caregivers, the elderly and their families through education, advocacy, resources and support.

RSVP to 512.241.0420 or email
TXPrograms@txalz.org

Have a kind and respectful day.

Dennis M. Sandoval, A Professional Law Corporation Proudly Presents The Sixth Annual Inland Empire Caregiver Symposium on April 1 in Riverside, California

March 22, 2011 by  
Filed under Uncategorized


Dennis M. Sandoval, A Professional Law Corporation Proudly Presents The Sixth Annual Inland Empire Caregiver Symposium

Friday, April 1, 2011
Time: 8:00 am – 4:30 pm
Location:
California Baptist
University
8432 Magnolia Avenue
Riverside, CA 92504
Copenbarger Dining Room

8:00 Registration
8:30 Opening Remarks
8:45 Making Difficult Decisions for Persons Without Capacity – Speakers: Viki Kind, M.A. and Dennis Sandoval, J.D., CELA
9:45 Morning Break
10:00 Palliative Care – It’s Not What You Might Think – Speaker: Gina Mohr, M.D.
11:00 Improving Outcomes for Non-Compliant Patients – Speaker: Viki Kind, M.A.
Lunch Legacy Planning ? Leaving Behind What is Really Important
Speaker: Dennis Sandoval, J.D.
1:00 End of Life Decision Making – Speakers: Viki Kind, M.A. and Dennis Sandoval, J.D.
2:00 Dealing With Life Loss – Speaker: Victoria Stephan, M.A.
3:00 Afternoon Break
3:15 Helping Families with Care Transitions – Speaker: Paul Velen, M.S., MFT
4:15 Closing Remarks

Academy of Florida Elder Law Attorneys presents the ELDER CONCERT 2011 on Friday, March 25, 2011 – Ft. Lauderdale Marriott North Saturday and on March 26, 2011 – Crowne Plaza Tampa Westshore

March 22, 2011 by  
Filed under Uncategorized


Academy of Florida Elder Law Attorneys presents the ELDER CONCERT 2011
Friday, March 25, 2011 – Ft. Lauderdale Marriott North
Saturday, March 26, 2011 – Crowne Plaza Tampa Westshore

7:45 – 9:00am Registration
7:45 – 9:00am Continental Breakfast
(plenary session room)
10:15 – 10:45am Refreshment Break with exhibitors
10:45am – 12:00pm Session Two – Concurrent Workshops
A. Long Term Care Insurance and LTCI “Partnership” Plans: Info and Discussion on
relationship to Medicaid Planning, Financial Planning and Fiduciary Responsibility
B. “Upside Down” Real Estate Problems & Solutions (FT LAUD ONLY)
C. Elder Care Mediation: Learn and discuss this increasingly hot approach for Elder Law
Attorneys, Guardians, Fiduciaries, Health Care providers and Care Facilities to resolve
client problems.
D. Geriatric Care Assessment, Care Plan Development and how Elder Law Attorneys,
Estate Planners, Fiduciaries, Guardians and Care Managers can utilize these tools
E. Funerals, Pre-Paid Plans, Medicaid Planning and Guardianship Issues
12:00 – 1:15pm Luncheon
Speaker: Vicki Kind with Compassionate Care (Sponsored by The Guardian Pooled Trust)
1:30 – 2:45pm Session Three – Concurrent Workshops
A. Medicaid Diversion Waiver Update and Discussion
B. “Upside Down” Real Estate Problems & Solutions (TAMPA ONLY)
C. The New National Health Care Legislation: Update and Discussion
D. Elder Mediation: Learn and discuss this increasingly hot approach for Elder Law
Attorneys, Guardians, Fiduciaries, Health Care providers and Care Facilities to resolve
client problems (FT LAUD ONLY)
E. Types of Guardianship and Transition from Voluntary to Involuntary
F. Understanding Long Term Care Facilities: Gaining Admission, Financing the stay and
Maintaining quality care.
2:45 – 3:00pm Refreshment Break with exhibitors
3:00 – 4:15pm Session Four – Concurrent Workshops
A. The New National Health Care Legislation: Update & Discussion
B. Geriatric Care Assessment, Care Plan Development and how Elder Law Attorneys,
Estate Planners, Fiduciaries, Guardians and Care Managers utilize these tools.
C. Dealing with difficult Elder Law or Estate Planning Clients, Wards and Guardians
8:45 – 9:00am Opening Remarks
9:00 – 10:15am Session One – Plenary Session
A panel of leading experts facilitates a discussion on how to prevent, identify and redress elder
exploitation.
D. Medicaid Diversion Waiver Update and Discussion
E. Challenge of keeping documents up-to-date amongst all support professionals

Association for Gerontology in Higher Education’s Conference, taking place in Cincinnati, OH from March 17–20, 2011

March 10, 2011 by  
Filed under Uncategorized


Association for Gerontology in Higher Education’s 36th Annual Meeting and Educational Leadership Conference, taking place in Cincinnati, OH from March 17–20, 2011. http://aghe.org/833179

Viki will be presenting Empowered Decision Making for Those Without Capacity on Friday, March 18 from 3-4:30.

The Association for Gerontology in Higher Education (aka AGHE) is the international leader in advancing education on aging and is the only institutional membership organization devoted primarily to gerontology and geriatrics education since 1974. AGHE’s mission is two-fold: (1) To advance gerontology and geriatrics education in academic institutions; and (2) To provide leadership and support of gerontology and geriatrics education faculty and students at education institutions.

AGHE and its members are strongly committed to the well-being of older adults. Together, AGHE and aging-studies programs in institutions of higher education strive to:

(1) preparing service delivery personnel who will work directly with older adults;
(2) training educators who specialize in the physical, psycho-social, and policy domains of aging;
(3) educating the society at large about the processes of aging and the implications of an aging society; and
(4) instructing older adults seeking to maximize their options in a complex and challenging age.

AGHE is the Educational Unit of The Gerontological Society of America.

Have a kind and respectful day.

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