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Tuesday, June 25, 2013

Understanding Advance Health Care Directives

We all need to plan for the future. Thoughtfully creating a set of advance health care directives can be one of the most important and rewarding things we can do for ourselves, at any adult age.

Understanding the different kinds and goals of these directives; and having a general knowledge of and ability to discuss the various considerations we might address in the process adds value to any senior advisor and helps the advisor’s client.

Together with Jane Barton, MTS, MASM, CSA , Cardinal Life, LLC, President (Healthcare), I will have the opportunity to discuss these matters with attendees in a breakout session of the 2013 CSA Conference in Orlando (August 7-9, 2013).

We will primarily deal with living wills, health care surrogate designations and durable powers of attorney. A living will expresses your wishes about the kinds and extent of medical treatment you would like in certain specified circumstances, e.g. whether you are in an end stage condition, terminally ill or in a persistent vegetative state.

A health care surrogate designation names who you want to make health and medical decisions on your behalf if you cannot speak for yourself; and provides guidance to the surrogate about what is important to you and how you might have decided for yourself given the opportunity.

A durable power of attorney is a power of attorney that generally remains effective even after you become incapacitated. It is a grant of rights and powers to someone you designate to act for you in business, financial and even health matters. It also provides guidance to your agent or attorney in fact (the surrogate named by you in the power) about what is important to you in these matters so they can best accomplish your overall wishes.

A power of attorney differs from a trust to a large extent in that a trustee (the person administering the trust) has authority to deal only with assets that have been transferred to the trust. While a trustee’s actions must be consistent with the purposes of a trust, the trustee has distinct obligations to the trust beneficiaries and may not necessarily be guided by what he/she thinks you might have done in any given circumstance. There are multitudes of trust types, purposes and issues attendant to trust administration. While the use of powers of attorney is not without necessary regulation and issues, they are sometimes viewed as a less expensive method of planning.

Effective preparation and use of these documents enables you to protect your right to self–determination and to maintain control of how you are treated by health care providers and others despite your (future) incapacity, i.e. if you can no longer speak or act for yourself. In the event of future incapacity without these documents, it is possible that a court will ultimately name a guardian to act and make decisions for you. The judicial determination of who will be designated as guardian and what decisions the guardian makes can adversely impact family relationships and deplete assets.

Thorough advance consideration of these issues encourages people to think about what is important to them, how they want to be treated and what they want to leave behind. It is an opportunity for the advisor to become knowledgeable about what may be important but not considered without assistance; and to participate in a network of care and information providers such as accountants, lawyers, institutional and home health care providers, clergy and spiritual advisors that might be able to help clients in making important decisions.

By adequate planning and preparation, you have an opportunity to let family, friends and loved ones know your philosophy and preferences. This general topic is often referred to as incapacity planning. This does not sound like a very attractive topic to some elders who might fear the loss of personal control or the expense of planning. However, the advisor should be able to clearly communicate how planning allows the client to actually take and maintain control of how they and their property are to be treated in the event they can no longer speak for themselves. This helps not only to maintain personal integrity; but also to preserve family harmony.

Blog posting provided by George H. Aslanian, Jr., Esq.
(954) 779-3611

George is speaking at the 2013 CSA Conference in Orlando, Florida, August 8th and 9th, 2013. Visit his session descriptions below:

Advance Directives – Cross Disciplinary Networking Opportunities
How to Address Common Business Challenges

Friday, June 21, 2013

8 Steps to Break Out of Your Comfort Zone

Life begins at the end of your comfort zone. – by Neale Donald Walsch

I have to admit it. I am one who likes the familiarity of my comfort zone. After all, its called a “comfort zone” for a reason – it’s comfortable there. However, it can also be a deceptive trap that turns “living” into mere “existence.”

Comfort zones are full of routine; you know – the same-old, same-old. Comfort zones develop slowly – almost imperceptibly. Soon, the air in the comfort zone gets stale, the “flow” of life begins to stagnate, and personal growth comes to a gradual halt. In some cases, personal growth can even shift into reverse.

So, if you’re stuck in a comfort zone, ignore that inner voice that vibrates within every fiber of your being saying, “Stop! Danger beyond this point!” Try these eight “steps” to start really living and moving forward again:

1. Step inward. Reconnect with your spiritual side of life in whatever way you find fulfilling. Go back to your place of worship if you’ve been away for a while. Learn how to meditate and practice it every day whether that be before you start your day or at its end. Your spiritual life is there waiting to be developed into a spiritual muscle that will serve you and others in times of need and, of course, in times of thanksgiving.

2. Step forward. Volunteer to help your favorite charity or cause. There are many nonprofit organizations that rely heavily on volunteer support to provide badly needed services. Find that new job you dream of and quit the one you hate. Move from survival to significance.

3. Step more. Get physical and feel stronger. Make it a point to get that 30 minutes of exercise a day, five days a week – even if it’s in 10-minute increments. Move! Feel your body come alive in its movement. Dance! Feel the grace and exquisite motion that your body is capable of. Stretch like a cat and wake your body up from head to toe.

4. Step outward. ”The best way to make a friend is to be a friend.” – anonymous. Be a friend! Do things together and for each other. Go places and share memories. Learn about the variety of personalities and the ones you “click” with and those you don’t. As for the ones you don’t, Abraham Lincoln said, “Do I not destroy my enemies when I make them my friends?”

5. Step outside. That’s right. Open your door and go outside. Smell the fragrances in the air. Close your eyes and listen to the sounds of nature. Fill your lungs with fresh air and use your outside voice. See the colors of nature from brilliant sunrises and sunsets to the deep purples and greens of the forest. Wonder at the nighttime sky. Awaken your senses in the world outside. It awaits just outside your door.

6. Step deeper. Listen to your feelings. Share them with a trusted friend or relative. Life has its ups and downs and having someone to share them with helps us work through the emotions that are involved. Talk to a professional if you’ve been feeling down. Emotions can not be ignored any more than a pain in your chest.

7. Step upward. Stretch that intellectual muscle by learning something new. Take a class at your local college or through community education, usually connected with the school system. Read! Find a mentor who can teach you something new.

8. Step gracefully. Let your innate creativity flow out of your calling. Paint beautiful paintings, write inspirational words, dance the dance of your life. Enjoy the talents of others. Remember healthy family traditions and values and teach them to your children. Venture into the cultures of others different from you. Enjoy their food, learn about their values and traditions. Appreciate the diversity in life and celebrate it in all its glory.

If you try any of these eight steps to break out of your comfort zone, you are awakening the eight dimensions of wellness in your life and becoming refined by age.™ Go on. Get out of that puddle of a comfort zone and into the fast flowing river of life and wellness

Blog posting courtesy of Kathy Sporre, CSA
Certified Senior Advisor

View original blog post and follow Kathy!

Monday, June 3, 2013

6 Tips to Improve Communication with Your Doctor

1. Use the Explain Back/Teach Back method. After the doctor tells you about your disease, explain back to the doctor what was you think he or she said. This will allow you to check to see if you understood the information correctly and for the doctor to clarify anything you got wrong.

2. When the doctor or nurse gives you instructions to follow when you go home, repeat back or explain back what he or she just said. Again, this way you will be able to make sure you got it right. 

3. Ask the doctor or nurse to write the information down for you or you can write it down yourself. Have the person check to make sure you wrote everything down correctly.

4. Bring a tape recorder or use your cell phone to record the instructions and information about your disease.

5. Bring a helpful loved one with you. A second set of ears can help you remember the details that were discussed.  If your support person can’t be there in person, he or she can call in and listen through a speaker phone in the office or hospital.  By using a speaker phone, the support person can also provide additional information and can ask any other questions that might be important.

6. If you have questions when you get home, call and have the person explain it to you again or make a follow up appointment to talk it through again.

Are there any tips you find useful when communicating with your doctor, not mentioned above? We'd love your feedback! 
Have a kind and respectful day.
Viki is a clinical bioethicist, educator and hospice volunteer. Her award winning book, “The Caregiver’s Path to Compassionate Decision Making: Making Choices for Those Who Can't,” guides families and professionals through the difficult process of making decisions for those who have lost capacity.