National Healthcare Decisions Day Set for April 16, 2010

National Healthcare Decisions Day Set for April 16, 2010

KindEthics.com, along with other national, state and community organizations, are leading a massive effort to highlight the importance of advance healthcare decision-making—an effort that has culminated in the formal designation of April 16, 2010 as National Healthcare Decisions Day (NHDD). As a participating organization, KindEthics.com is providing information and tools for the public to talk about their wishes with family, friends and healthcare providers, and execute written advance directives (healthcare power of attorney and living will) in accordance with your state laws. These resources are available on the KindEthics.com Resource Page.

For a free handout about advance care planning and advance directive forms, email Viki at viki@kindethics.com

“As a result of National Healthcare Decisions Day, many more people in our community can be expected to have thoughtful conversations about their healthcare decisions and complete reliable advance directives to make their wishes known,” said [List spokesperson name, title and organization]. “Fewer families and healthcare providers will have to struggle with making difficult healthcare decisions in the absence of guidance from the patient, and healthcare providers and facilities will be better equipped to address advance healthcare planning issues before a crisis and be better able to honor patient wishes when the time comes to do so.”

For more information about National Healthcare Decision Day, please visit www.nationalhealthcaredecisionsday.org.

Have a kind and respectful day.

National Social Worker’s Month — Thanks from Viki

I want to send out a big hug to all the social workers out there making a difference in people’s lives. Thank you for doing all that you do to make sure people get what they need, are protected and empowered to live their best lives. This may be the last day of National Social Workers Month but the value of social workers lasts all year long. If you are ever in the hospital and need a person to help you get what you need, the social worker is your best ally.

Here is some information from the National Association of Social Worker’s website: http://www.naswdc.org/

* Social workers inspire community action to improve lives.
* Social workers are integral parts of a vibrant community.
* Social workers know the full range of challenges facing families of every description.
* Social workers advocate for inclusion, fairness and non-discriminatory access to services that help people reach their full potential.
* Social workers make a wide range of social contributions throughout their careers.
* Many social workers work to resolve systemic issues that negatively affect a community. Some work in education or research, and others work as elected officials, in government or as heads of nonprofit organizations to create positive sustainable change in communities.
* Most social workers serve individuals and families. Working through private practices, agencies and organizations, they provide resources and guidance that support social functioning.
* People who become professional social workers believe that there are no limits to human potential and use their talents to help others lead rewarding lives.
* Social work is a profession of hope, grounded in practical problem solving expertise.
* Social work is a desirable field of study for bright and socially engaged people of all ages.
* Professional social workers have a bachelor’s, master’s or doctorate degree in social work from a program or school of social work. Social work practice is guided by the NASW Code of Ethics.
* Social workers are employed in schools, courtrooms, drug treatment clinics, hospitals, senior centers, shelters, nursing homes, the military, disaster relief, prisons and corporations.
* Social work is relevant to the successful functioning of American society.
* Social workers are on the front lines, developing social programs that are responsive to such human needs as homelessness, poverty, family break-up , mental illness, physical and mental disability, alcohol and substance abuse, domestic violence and many other issues.

Have a kind and respectful day.

Speaker phone, conference call or webcam your patient’s condition to their family.

Are you frustrated when the patient goes home and doesn’t follow your instructions or when the family member calls you and wants you to repeat everything you said to the patient?

A great way to solve this is to use technology. And I don’t mean fancy technology, but using either the speaker function and/or conference call feature on everybody’s cell phone. Then the loved ones can give you more information, ask questions and can listen to your update about the patient’s health and treatment plan. This is also an opportunity for you to build a relationship with the family in case the patient can’t speak for him- or herself in the future.

Using technology can be especially important in the hospital. For those who can not travel, use a laptop with a webcam to help the family see how their loved one is doing. There is nothing like seeing the person with their own eyes to help them picture what you are talking about. An image, either by webcam or cell phone picture can give the family understanding of the condition of the patient and how his or her health has changed.

Have a kind and respectful day.

Speaker phone, conference call or webcam your loved one’s doctor appointment.

If you can’t go to the doctor’s appointment with your loved one, whether it is because of work or distance, you can go by speaker phone. Have your loved one take their cell phone or use the doctor’s phone and put it on speaker in the exam room. You can give the doctor more information if your loved one isn’t a good communicator and then listen as the doctor tells you both the treatment plan. You can also use the conference call function to make sure the other family members are included. Communication is essential to understand the situation and to make good decision making.

If your loved one is in the hospital and you can’t make it, have someone bring in their laptop or ask someone at the hospital to set it up so you can use your webcam to see how your loved one is doing. There is nothing like seeing the person with your own eyes to help you understand what the doctor is talking about. Too often we can’t imagine what the doctor is telling us as we still picture our loved one like they used to look. An image, either by webcam or picture can give you a better picture of the condition of your loved one and what he or she is going through.

I am not saying that you shouldn’t come in person to see your loved one or to the doctor’s appointment, but for those times when you can’t be there, use the technology available.

Have a kind and respectful day.

http://www.pallimed.org/ — For Great Palliative Care articles

I would encourage you to read http://www.pallimed.org/ if you are interested in up-to-date information about Palliative Care.  The writers bring new insights and updates about the good, the bad and the ugly of end-of-life care.  Today’s article about the media’s portrayal of cancer (and it’s lack of talk about cancer and end-of-life care) is startling but true. What I really like about this site is it commitment to facts. The writers are palliative care specialists who are dedicated to bringing you the latest in research, best practices and stories about the humanity of patients, families and doctors facing end-of-life situations.

Thanks Pallimed.org for being such a great resource. Thanks Dr. Christian Sinclair.

Have a kind and respectful day.

Putting The Human Back Into Nursing Homes

KindEthics Newsletter November 30, 2009
Sign up on the lower right side of KindEthics.com

Quote:

The great secret that all old people share is that you really haven’t changed in seventy or eighty years. Your body changes, but you don’t change at all. And that, of course, causes great confusion. Doris Lessing

Putting The Human Back Into Nursing Homes:

One day when I was visiting my aunt at the skilled nursing facility, the woman that shared her room was complaining to the nurses aide that she was tired and she wanted to put on her nightgown and go to bed. The aide told her that she couldn’t go to bed, because it wasn’t allowed until after dinner. I remember at the time thinking how strange this was. Why couldn’t this woman go to bed? If she was tired, why couldn’t she take a nap? My dad took naps, I take naps and lots of other people take naps. I realize looking back that what this woman wanted/needed didn’t fit in with the schedule of the nursing staff or the institution. When did the needs of the staff become more important than the needs of the resident? When did the nursing home staff become the boss of the resident? When did the residents lose their right to having their basic needs and decision making power taken away from them?

(This bothers me a lot as I am writing this. I can imagine the day when I am living in a long term care facility and someone won’t let me nap. I love to nap and can’t imagine that this would be taken away from me just because I am old. But it isn’t just about the nap, this is about our human need to be listened to and to be respected while we receive the care we need.)

I have been reading The Erosion of Autonomy in Long-Term Care written by Charles W. Lidz, Lynn Fischer and Robert M. Arnold. This book takes a look at the history of long term care facilities and where we are today. As you can tell by the title, the right of the patient to be heard in these facilities is slipping away.

The authors write that what once was a home-based environment to serve the needy in our small communities, has morphed into a hospital-like institution where the rules dominate the humanity. The residents who “behave” and are “compliant” are good and those who want something that isn’t on today’s schedule are “bad”.

This makes me wonder if the people we store in nursing homes are as impaired when they get admitted or if the institution itself, takes away their voice and their interest in life. (I know I just said store in nursing homes. Perhaps that is too harsh a word, but have you visited a nursing facility lately? Have you seen what kind of life these people are living? If you haven’t, I would suggest that you visit your local care facility.) Another concern I have is the growing number of people being abandoned by their families in nursing homes. There are laws against abandoning your pet, but we allow people to be disposed of and forgotten in these institutions. Something has to change and it has to change soon.

Now I am not saying that people are being mistreated in care facilities, (of course a few are and that is why we have ombudsman to protect them), but what I am saying is that it is no kind of life for the residents at most of these places. But this doesn’t mean it can’t be improved and that some people know how to get it right. I recently talked with a woman who raved about the place where her mom was staying. Her mom had been admitted to one facility and when it became evident that it wasn’t a good place, she took the time to find a better place for her mother. Advocacy and effort matter when it comes to our loved ones.

So, here are some organizations that are helping to get it right.

The Pioneer Network http://www.pioneernetwork.net/
The GreenHouseProject Homes http://www.ncbcapitalimpact.org/default.aspx?id=148
The Eden Alternative http://www.edenalt.org/
National Consumer Voice for Quality Long Term Care http://nccnhr.org/

There are four states receiving financial incentives from Medicare to change the culture of nursing homes. Arizona, Mississippi, New York and Wisconsin. If these incentives work, then these programs will be spread to other states.

The Nursing Reform Act is also working to promote and mandate the changing of nursing facilities from institutions into a more home-like environment. Where people can live without hearing bells and alarms going off or being told when they are tired. Where people can get up when they want to, eat when they are hungry and be treated as an individual. You can download information about the Nursing Home Reform Act at http://www.resource4nursinghomeabuse.com/images/pdf/nursing_home_reform_act.pdf

I think if I was granted one wish, this is what I would wish for. That long term care facilities could become home-like and that people wouldn’t be abandoned in them. I don’t have the answers but I do know that others do. If you are interested in being part of the change, volunteer at your local nursing home. Connect with one of the organizations that are making a difference. And if you are a healthcare professional, make sure you visit the facilities you are recommending to your patients. Don’t take someone’s word for it that it is a nice place, go there yourself. See what is being served for dinner and sit and watch what is happening. You will be surprised by what you see.

Have a kind and respectful day.

3 Secrets to Getting the Most Out of Your Dr.’s Appointment

Do you feel like the doctor doesn’t have enough time to listen to your complaints? Is it frustrating to leave the doctor’s office and realize you didn’t get your questions answered?

Let me tell you what is going on and you aren’t going to like it. The doctor has about 12 minutes to listen to you, exam you, figure out what is wrong with you and put together a plan to help you get better.

I can hear you saying, “But 12 minutes isn’t enough.” Of course not, but that is the reality of medicine today.

You can complain but if you are smart, you can learn the three simple steps below to get the most out of your doctor’s appointment.

Here is Secret #1. You have to think like a doctor. Doctor’s think in an organized manner, so we have to give them our information in an organized way. Doctors usually play a guessing game with us as they try to figure out what is our “chief complaint”. But these questions are just wasting our precious minutes. The more organized and prepared you are for your appointment, the better.

Here is Secret #2. The doctor will make more time for you if he likes you better. And if your doctor likes you, you will get better care. I know it doesn’t seem fair but that is just the way it works.

Secret #3 is to make sure you are nice to all of the office staff. They can make it easier or more difficult for you to get in to see the doctor. They control his schedule. So, be kind to them and say, “Thank you.”

Now let’s make it easy for the doctor to help you.

Step 1. Write down all of your medications, occasional cold medicines, vitamins, herbal medicines, natural supplements, etc. And I mean everything. Even things you don’t think are important may be very important to your health. The doctor can’t protect you from things that he doesn’t know about, so write them down. If you don’t want to write them down, then bring all of them to the appointment with you.

Step 2. Write down how you are feeling. Why are you coming to see the doctor? Tell him what is hurting you, bothering you or any other physical complaints? Write down the new symptoms first and then write down the problems that are ongoing.

Step 3. Write down your questions and then circle the 2 most important questions. The doctor doesn’t have time to answer all of your questions so it is up to you to keep the doctor focused on what is most important to you.

And a Bonus Secret, if you want to make the doctor angry, keep your most important question a secret until the end of the appointment, and as the doctor is walking out the door say, “I have one more question …” If you wait until the end for this “Oh by the way” question, the doctor will only have one minute left to answer it. Please, write down this most important question so the doctor can spend time helping you.

If you would like, I have created a form for you to use each time you go to the doctor, Viki Kind’s Office Form for getting more from your doctor. Sign up for my newsletter and I will send you new support tools once a month.  Print out a couple of copies so you have them ready before your next appointment.

Have a kind and respectful day.

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