When your loved one is incapacitated, who will make his or her decisions?

Who should make the decisions when this person can’t? The answer to this question could be any one of the following:
Person specified on the Advance Directive
Conservator or guardian
Spouse
Significant other/partner
Adult child of patient
Parent
Adult sibling
Relative
Friend
Family
Healthcare team
Administrator of the nursing home (in some states)

While this is a general list, the answer really depends on where you live, what the patient has specified and if the court has gotten involved. Each state calls the decision maker by a different name: surrogate decision maker, agent, proxy or durable power of attorney for healthcare. The laws that determine who should make the decisions also change state by state. For example, the administrator of a nursing home may be allowed to make the decisions in one state, but can’t in a different state.

Another rule that varies is the law that dictates a specific hierarchy of decision makers. A hierarchy means there is a legal order to who will be allowed to make the decisions for someone who has lost capacity. You may need to ask the social worker, the bioethics committee or the legal department at the hospital to help you figure out the appropriate laws in your state.

Here are some tips to consider when choosing your decision maker.
1. Pick someone who will understand what the doctor is saying.
2. Pick someone who knows you well and has listened to what you want.
3. Pick someone who won’t fall apart in a crisis.
4. Pick someone who will do what you have asked, even if it difficult to do.
5. Pick someone who is close by geographically.
6. Write down whom you don’t want to be involved in the decision making.
7. You can pick two or three people to work together as your decision makers.
8. Your spouse, significant other or partner may not be your best choice, and you may want to choose someone else.
9. In the “Other” section of the form, state whom you do and don’t want to be told your medical information.

Have a kind and respectful day.

Making Difficult Life & Medical Decisions presentation at the FSGA Annual Conference 7/17/10

Viki will be giving a presentation at the Florida State Guardianship Association’s (FSGA) Annual Conference on 4 Tools for Making Difficult Life and Medical Decisions on 7/17/10 at 10:50am.

FSGA is a nonprofit corporation founded in 1983 for the improvement of guardianship services. Governed by a Board of Directors representing five geographical areas of the State, FSGA is dedicated to promoting the protection, dignity, and value of incapacitated persons through ethics, advocacy, and the dissemination of information.

FSGA’s mission also includes a focus on furthering the professionalization of guardians as accountable court representatives through education, networking, and legislative action.

Guardianship is the management of the affairs of someone who has been judged unable to manage their own affairs. Generally guardianship is ordered by a court on behalf of someone who is called a ward of the court. A guardian assumes the rights of the ward to make decisions about many aspects of daily life. A guardian is directed by ethics and statute to make decisions in the best interest of the ward.

FSGA members include professional private guardians, corporate guardians and fiduciaries, attorneys, social workers, care managers, government agency and court staff and others interested in the support and advancement of guardianship services and alternative protective services.

Have a kind and respectful day.

n4a Annual Conference & Tradeshow 7/18/10 and 7/19/10 in St. Louis

Viki will be attending the n4a’s Annual Conference and Tradeshow all day on July 18th and will be presenting on July 19th from 3:15-4:15pm.

The National Association of Area Agencies on Aging (n4a) is the leading voice on aging issues for Area Agencies on Aging and a champion for Title VI Native American aging programs. Through advocacy, training and technical assistance, they support the national network of 629 AAAs and 246 Title VI programs.

They advocate on behalf of their member agencies for services and resources for older adults and persons with disabilities. Action characterizes how they move their agenda forward, and when there is a question about aging, they have the Answers on Aging. They work with their members in achieving their collective mission of building a society that values and supports people as they age.

The n4a 2010 annual conference and tradeshow that runs from July 17-21, 2010 at the Hyatt Regency St. Louis at The Arch in St. Louis, MO will celebrate, showcase and facilitate the replication of the most innovative policies, programs and services that assist older adults and people with disabilities.

Have a kind and respectful day.

The Cancer Support Community-Miami will be hosting a breast cancer lecture 7/14/10 6pm EST

Viki will be hosting a breast cancer lecture at The Cancer Support Community in Greater Miami on July 14, 2010 from 6-8pm EST.

The Cancer Support Community-Greater Miami (formerly known as The Wellness Community-Greater Miami) is part of a national organization that has been providing free services to adult cancer patients and their loved ones for 28 years. The first Wellness Community opened in Santa Monica California in 1982. In July 2009, The Wellness Community-National and Gilda’s Club Worldwide joined forces to become the Cancer Support Community.
Today, the Cancer Support Community provides the highest quality emotional and social support through a network of nearly 50 local affiliates, more than 100 satellite locations and online. To find a community-based center in your area, visit www.cancersupportcommunity.org. the Cancer Support Community can help.

It’s a place where both patients and family members will find support, education and hope. Support groups address emotional issues for patients and families. Educational workshops get important questions answered in a non-clinical setting. Stress management programs enhance health and well being. Every program is offered free of charge. All are lead by professionals licensed in their fields of expertise.

The comfortable, homelike environment at the Cancer Support Community makes sharing and mutual support easy.

They do not offer medical treatments, alternative treatments, or hospice care. Their services are offered as a compliment to conventional treatment, although anyone undergoing any kind of care is welcome. People come at diagnosis, during or at the end of treatment, at recurrence or several years out of treatment. They all come to learn they are not alone in their fight–whether for physical, emotional or spiritual recovery. Together, they regain a sense of control over their lives and ultimately discover that hope is a valuable tool irrespective of the stage of disease.

Have a kind and respectful day.

Patience – Lessons Learned – Viki’s Journey

Patience – Lessons Learned –  KindEthics.com Newsletter

Quote of the Month:

The individual is capable of both great compassion and great indifference. He has it within his means to nourish the former and outgrow the latter.
Norman Cousins

I love when life reminds me of the lessons that I thought I had learned, but then I find out I need a refresher course. This month’s newsletter is about having patience, but not just your average patience, instead good-natured and seeking to understand patience. There are two parts to this story.

The second part first:

Two weeks ago I had to make about 50 phone calls to set up the events for my book tour in July. As I was contacting different groups and reaching out to the community organizations that help those with differing levels of capacity, I was on a roll. Each call was a wonderful opportunity to connect with like-minded people about our common goals. I tend to be a quick person and was enjoying the speed with which I was accomplishing my tasks. Then it happened, I contacted some organizations that focus on helping those who communicate more slowly or differently, and all of a sudden, my world slowed down. The reason being, the people I needed to talk to also suffered from the same issues of communicating differently. What had taken me 10 minutes to accomplish on other calls, now took me 25 minutes.

I had a choice. I could politely excuse myself from the call and just move on to someone else. I could get frustrated or start multi-tasking while I waited for them to say what they needed to say. Or, I could be present, slow myself down, listen differently and be patient. I realized that patience was not about “waiting it out,” but it was about staying connected with an open heart as I remembered I needed to listen differently.

When I did this, I heard amazing things. One gentleman with bipolar disease told me that he hoped others would understand when he said, “I can do it – Until I can’t.” I had never heard this phrase but it was a gift to me because it so clearly explains the needs of someone with a fluctuating mental illness. I had understood the concept as this is exactly what I talk about throughout my book. Keeping people included and empowered, despite their limitations, until those instances when they need us to step in and protect them. But I hadn’t had such an easy way to say it. I am so grateful he shared it with me.

Part 1 of the story:

Back in March, when it was Brain Injury Awareness Month, I was fortunate to connect with a wonderful woman named Tammi Diaz. She suffered a traumatic brain injury when she was hit by a car, but she has overcome her injury, found a new way to be, and is a wonderful advocate for those in her community. I contacted her because I wanted to interview her on my online radio show because I thought it would be great for my listeners to hear first hand from someone who still deals with the effects of a brain injury. When I first spoke with her, I was acutely aware of her slightly slower speech. Not much slower, but just enough to notice. She shared with me her stories about the amazing way she advocates at the state legislature and her passion for improving the public transportation in her community. Coming from a show biz background as a child, I wondered if my listening audience would keep listening once they heard her voice. I realized I might lose some listeners but that was the whole point of the show, to get people to hear from people struggling with brain injuries. (You would have thought that a few weeks later, I would have known that I needed to be patient when I was making all those phone calls. But my own agenda and schedule got in the way. Lesson re-learned.)

I booked her on the show along with the director of the Brain Injury Association in Utah. What a wonderful and inspiring interview. I realized that we don’t hear these types of voices in the media or on television shows. This is a silenced community like so many who struggle with mental illness, dementia, developmental delays etc.

So what is in this message for all of us? I hope that you can remember to slow down and to listen differently when you are talking to someone with a speech or brain disorder. Don’t rush, don’t complete their sentences, don’t get annoyed and don’t think it isn’t worth your time. The gift of understanding that you may receive from someone who experiences the world differently is inspiring. I am so grateful that I got the opportunity to practice what I teach. Each phone call brought a gem of knowledge and a connection with a terrific person. Please role model this kind of behavior for your kids, your colleagues and for others in the public when you can see a store clerk growing impatient with someone with a disability. We can make a difference in the lives of others, by listening with a generous heart and a good-natured attitude.

Have a kind and respectful day.

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