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Aging Wisely Linda's Journal - Part 2

How Did My Dad End Up on a Ventilator?

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my Dad days before he ended up on a ventilator

This picture of my 91 year old Dad and his grandson was taken a little over a week ago.  We had just enjoyed a great brunch and visit.  The next day he went to the Hard Rock casino for some fun and enjoyed a delicious dinner.  By Wednesday AM he was experiencing shortness of breath and spitting up blood.  His wife called 911 and he was placed on a ventilator upon arriving at the Emergency Room.

The emergency room did reach out to his wife for consent, however she didn’t understand what type of tube they were talking about and just said “yes, do what needs to be done”.

The last few days have been like riding a roller coaster of emotions.  I’m sharing this story to help others avoid this situation.  I have felt great sadness these last few days and believe my Dad has experienced suffering.  My Dad passed away on Sunday afternoon.

After my Dad was placed on the ventilator in the Emergency Room he was moved to the Intensive Care Unit.  There is nothing that quite prepares you for seeing someone you love on a ventilator.  A million thoughts go through your mind and you can’t help but think about how uncomfortable it must be and that you never want to be in this situation.  Imagining any of the sensations of what a tube down your throat may feel like immediately brings gagging and nausea to my mind.

I do not feel comfortable sharing a picture of him lying in the Intensive Care Unit, with a ventilator next to him, several tubes down his throat and many IV’s connected to him along with a port in his chest to receive medications.  I choose to remember how relaxed and happy he was on Sunday and hope you can capture those feelings with this image of him.

While the health care providers provided constant reassurance my Dad was not feeling a thing and had no pain it did not make me feel any better about the situation.  The sadness of losing your Dad is painful and it is even a greater sadness to see the tube inside his mouth and down his throat, forcing him to breath.  It looked like it enlarged his neck, and the position of his neck and head looked awkward, unnatural and uncomfortable.

My Dad remained fairly stable the rest of Wednesday and Thursday.  On Thursday he had a few seconds of his eyes opening from time to time and we would try to reassure him about what was happening.  It was impossible to tell if he could hear us or understood what we were saying.  He was receiving a continuous drip of Propofol, a sedation medication.  If you have ever had a colonoscopy, you more than likely were given Propofol.  It did bring me some relief to have that comparison as I have had a colonoscopy and do not remember anything of the procedure.  However, I also do not remember if anyone was speaking to me and if they were, what they may have been saying.

Thursday the health care providers collected more information regarding my Dad’s medical history, medications, etc.… and continued to run a variety of tests.  One of the problems we struggled with was gathering his medical information.  Shortly after he got remarried he changed all of his physicians to the nearby Veterans Hospital.  My Dad nor his wife maintained his medical records and the hospital reported they have found it near impossible to access or obtain medical records from the VA Hospital.  We often remind our clients it is their responsibility to maintain their health care records and encourage them to maintain all of their records.  Please take this suggestion and get your medical records organized today.

On Friday my Dad had a bronchoscopy and the physician reported they would attempt to start weaning him off of the ventilator to see if he could return to breathing on his own.  The doctor took a few minutes to explain to us that if they were unable to wean my Dad from the ventilator the next step would be to remove the tubes in his mouth and to do a tracheotomy.  Tracheostomy (tray-key-OS-tuh-me) is a surgically created hole through the front of your neck and into your windpipe (trachea) allowing for the long-term use of a ventilator to help you breathe. The term for the surgical procedure to create this opening is tracheotomy.

Please know, there is a good chance that my Dad could have avoided all of this if his wife would have presented his Living Will to the ambulance as well as if she would have refused the ventilator.

We are fortunate in our area to have our Emergency Medical Services (EMS) recognize the “Vial of Life.”  You can alert EMS to find your health care documents, Designation of Health Care Surrogate, Living Will, Do Not Resuscitate form,  list of medications, emergency contacts, etc.… by placing an “orange colored sticker” on your front door or on your refrigerator/freezer in your home.  This sticker informs them to look in your refrigerator/freezer for your documents.  I typically recommend keeping them in a Ziploc style bag so they can easily be sighted.

When I ask the health care provider what would have prevented them from placing my Dad on a ventilator the provision of the Living Will was the first thing they mentioned along with alerting EMS with the “Vial of Life” sticker.  Please take the time right now and check if your EMS recognizes the “Vial of Life” and collect your medical information and execute a Health Care Surrogate Designation as well a Living Will with your wishes.

On Friday afternoon as our family and my father’s wife gathered around him we were able to review what a Do Not Resuscitate Form involved.  His wife was shocked to hear from the Doctor that the compressions are done with such force that ribs are typically broken and that there would be a significant amount of damage to my Dad’s body due to his advanced age and health status from CPR.  While it was difficult for her she agreed to sign the Do Not Resuscitate form.

On Saturday morning they tried to reduce the amount of his oxygen and the ventilator support, unfortunately it was a short lived experience because his oxygen levels dropped too low and they immediately had to return him to the full strength of the ventilator.  When the Doctor arrived to review his status he informed us that the maximum number of days safely on the ventilator was 10 days and if he was still alive he would have to have the tracheostomy.  Once he would have that procedure and was stabilized he would need to relocate to a nursing home that was medically able to manage tracheostomy patients.  The Doctor reported there was one nursing home in our geographical area that could provide the support needed.  He said he doubted my Dad would tolerate the procedure well due to his breathing issues and congestive heart failure.

With a little prodding the Doctor then addressed Comfort Measures Only, defined as: “Comfort Measures Only refers to medical treatment of a dying person where the natural dying process is permitted to occur while assuring maximum comfort. It includes attention to the psychological and spiritual needs of the patient and support for both the dying patient and the patient’s family.”

If his wife was willing to have the ventilator (life-support) removed my Dad would receive comfort measures only.  The Doctor predicted my Dad would not breathe well on his own and stated they would administer Morphine and Ativan to make him as comfortable as possible.  This was a difficult decision for my Dad’s wife to make, however she ultimately decided it was the right thing to do.

On Sunday morning we gathered at the hospital, around my Dad’s bed, and we each had our final moments with him and then the ventilator was removed.  I wasn’t sure what to expect, however thought he would only survive a short period of time.  After an hour or so of watching him struggling to breathe and listening to the gurgling of his lungs filling up with fluid you start to panic inside.  More medications were administered and after another hour or so he passed away.

A few years ago our 15 year old Labrador “Margo” had a medical emergency.  As a family we took her to the Veterinarian, he said there was nothing he could do to help her survive.  We all had the opportunity to hold her, and sit with her while the doctor injected medication and with two or three minutes she peacefully died.

I wish it would have been as easy with my Dad as it was with Margo.  I understand these are not everyone’s wishes, but I believe it is important for everyone to understand their decisions and the “rest of the story.”  Often when we are provided information regarding decisions to make we are only provided partial information or information someone thinks we can handle.  It is up to us to ask enough questions to make sure we understand our decisions.  There is also new vocabulary to learn, “vent,” “DNR”, “Living Will,” “CMO,” and many more.

While my Dad’s goal was live to 102 years old, the same age his mother passed away – I have no doubt he never knowingly would have wanted to have his last five days as we just experienced.

 

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Why YOU Should Be Outraged over Florida’s Waiting List!

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Florida's LTC waiting list

Recently we received a call from a very anxious out-of-town daughter looking for help to find an assisted living facility for her 78-year old Mom.   After several emergency room visits the doctor let Mom know it was unsafe for her to live alone and highly recommended she move to an assisted living facility.  Daughter reported Mom’s income is $900.00/month and she has one bank account with $12,000.  Mom’s home has a small mortgage and her equity is approximately $30,000.

Helping the daughter calculate how much Mom can spend each month is difficult to calculate since there is no way of knowing how long Mom may need the assisted living care.  It’s even harder to find a facility in the Pinellas County area that charges less than $2,500 per month that you or I would want to live in.  Unfortunately there is no quick fix for this predicament.

Nursing home care is a Medicaid entitlement program in the state of Florida.  What does that mean?  If a physician certifies you need the level of care a nursing home provides and your income and assets fall within the program limits, Medicaid must pay the nursing home after you have paid them your income each month.  The average monthly cost of nursing home care according the State of Florida is $8,346.  This is a safety net if you need nursing home care.

If the physician certifies you need assisted living level of care or home care and your income and assets fall within the Medicaid program limits, you must call the Aging and Disability Resource Center (ADRC) and get placed on a waiting list for financial assistance.  The waiting list is long, there are over 50,000 Floridians on this list.  How much financial help will they get when their slot comes up to number 1?  Medicaid will pay $1,100 per month towards their care costs (not room and board costs).

Our client has the predicament of being extremely careful with funds while hoping they eventually get a slot from the waiting list.  If she runs out of money prior to getting a slot on the waiting list she will need to relocate to a facility that only charges $900 per month or hope she meets the level of care for a nursing home.  What type of choice is that for our elder?

Please join us Tuesday, April 5, 2016 1pm – 2:30pm for a workshop:  How to Pay for Long Term Care.  We look forward to seeing you then.

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What the Tuck?

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working out at pure barre clearwater

What the Tuck?

Is tucking part of your workout?  Can you stand straight, push your navel into your back and tighten your abdominal muscles – if the answer is yes – you know how to tuck!  I recently had the opportunity to attend a Clearwater Pure Barre class, and wow!!  (Thank you to my daughter-in-law Lauren, owner of the Pure Barre studio).  It was a workout as well as an education.  I loved it!

I have to admit, I was a little nervous walking in to the class as it appeared most of the other participants were under 40 (I haven’t seen the 40’s for years :-).  And while it took me a few minutes to catch on I very quickly joined in and started making some moves that were new to my body!  I couldn’t complete every exercise, the instructor said give it time and I will eventually be able to make it the entire hour.  I enjoy the challenge and for now will make this a part of my weekly exercise, at least 3 times per week.  It is one hour that flies by!

Working out has never been fun for me – I have to make myself do it.  I’ve tried everything and the only exercise I come close to loving is snow-skiing – and of course I live in Florida.  I do know from all that I read and from the many clients I have met that moving is vital to healthy aging.  I want to be healthy, it’s just sometimes I don’t use my discipline to stay focused.

Two times per week I meet with an incredible personal trainer who has taught me the proper way to stretch and strength train.  Sometimes the goals are simple, balance on one leg, jump rope without missing.  Often we focus on real life skills, for example the ability to get up off the floor safely while lifting my grandchild’s weight.  She also works each week on my posture – what a challenge that has been.  Between a curvature of my spine (Kyphosis – inherited from my father’s side of the family) and my many years of sitting in front of a computer my body has been trained NOT to stand straight.  The daily stretching of the tissue is helping enormously as well as the strengthening of the weakened muscles. I had no idea how many different ways there are to stretch.  I can’t imagine life without a foam roller.

working out with foam roller

I was shocked initially to see how poor my balance actually was.  Not that I am falling or losing my balance, but how I was unable to bend over on one leg and pick something up?  What year did I stop being able to do that?  I’m not really certain how I quit moving certain directions but since my children have left home I have often let work get in the way and become my grand excuse not to exercise.  Clients and their problems often gain my full attention in the goal of providing great service and solutions (can you hear my justification for not exercising).  While clients are important, many of them have stressed to me how important it has been to them to concentrate on their health and staying fit.  Their reward is less pain and maintaining independence – I want both of those!

Along with getting my Exit Strategy organized this year I am making my health a priority.  Come back and check out Linda’s Journal as I work through my exercise, eating habits, and medical screenings.  I’m happy to share my tips and struggles – I would love to hear all about yours.  Please email me at Linda(at)agingwisely.com.

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Legal Zoom or Lawyer?

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Legal Zoom or lawyer?

One of the best consultations I have ever had with clients went as follows:

Mr. and Mrs. Martin came to see me to inquire about what sort of planning they should do since they are now retired. They were concerned about long term care costs and what they could do to plan for care if and when it was needed. We reviewed their current situation, the home was paid for, they had recently sold their business, and Mr. Martin had just been diagnosed with treatable cancer.

The consultation allowed them the opportunity to think through who they could name to pay their bills and manage their money if they were unable to do so. It provided the opportunity to review which of their children could navigate the health care system, converse with health care providers and insurers, and would truly take the time to understand when “enough is enough” with their treatment. It helped the two of them talk frankly about how much they were willing to spend on “staying in the home” before they would consider moving to an assisted living or nursing home without impoverishing the well spouse. Legal documents were drafted and signed stating their wishes and then a full family conference was coordinated in my office to review the legal plan and care desires with all of the children present.

While the legal documents fully state their wishes and authorizations, the key to completing the documents appropriately was the consultation, conversations regarding options with plenty of time for questions and answers, and guidance in how the long term care system works. I was so proud of this couple for taking the time to think through their fears, wishes, and concerns and to make the decisions they needed to make.

One of the most difficult conversations to have with a family is telling them they have no legal authority to pay Mom’s bills and to access her financial accounts to take care of her because she never completed any legal documents to provide them legal authority to help her. And then have to state that their next step is to go to court and seek legal guardianship over Mom, thus removing all of her rights. It’s even worse to tell them how easy and inexpensive it would have been to prevent this situation from occurring.

The Florida Durable Power of Attorney statute allows each of us to appoint an Agent to manage our financial affairs. It is a big decision to determine who you would like to name as your Agent. The Agent is allowed to manage your bank accounts, savings accounts, stocks, brokerage accounts, and your real property and has authority to do whatever you authorize in the Durable Power of Attorney.

Choosing your Agent is the most important decision. Who is the person who will actually pay your bills on time, help you manage your home, get repairs done, and manage your accounts to ensure you will be able to pay for everything? Naming a child who has financial issues, has not been able to hold down a job, or has filed bankruptcy may not be the best choice. Your lawyer will help you review your choices for your Agent, and help you determine who is the most appropriate for you to name.  If you do not have anyone to name, the lawyer can suggest a professional Agent for consideration. The consultation reviewing selecting an Agent and then determining what authority to include in your Power of Attorney is the value you receive when meeting with a lawyer versus completing a document online. Do you want your Agent to be able to make gifts? To others? To themselves? These are just a few of the questions your lawyer will ask you.

Did you know that the State of Florida has named a Health Care Surrogate Proxy to make health care decisions for you in case you didn’t name one yourself? Your Health Care Surrogate provides medical informed consent for accepting or denying treatment. You can designate in your Health Care Surrogate document who should make your medical decisions, what decisions you would like made and authorize your doctor to disclose your protected health information (PHI) to your surrogate. In the ever changing world of health care it is vital for you to name someone to be your surrogate that will take the time to understand your wishes and manage your care with the professionals you have chosen.

“Terri Schiavo” is the only name you need to say in Florida to understand why you want to sign a Living Will and state your end of life choices. Thinking through how you want to experience your “end of life” is not cocktail conversation. Understanding how the medical system works and interacts with the legal system is important for you to know when deciding what treatment you may or may not want. What is even more important is to ensure your loved ones know what you want and that they will support your decisions.

A Will determines what happens to your property upon your death. Many folks try to avoid probate by using “POD” payable on death accounts recommended to them by the friendly bank customer service agent. While this sometimes works, it often presents a quandary for the Agent under the Durable Power of Attorney when determining which funds to utilize to pay your bills. For example, should they pay the bills out of the POD account for their sister, or should they pay the bills out of the POD account for them?  This is not a situation you want to put your family into.

Often Trusts are utilized to state how you want your money to be spent if you become incapacitated as well as how you want it distributed upon your death. If you have a beneficiary with special needs, a mental health issue, an addiction, or perhaps someone who just can’t manage money, you can set up parameters within the trust to ensure the funds are protected and managed within your guidelines.

Join me on Tuesday, March 1 for our free workshop “Legal Documents Everyone Must Have.” 

We will review how to prepare for your legal consult, decisions to think through prior to meeting with your attorney, and how to “choose” the best person to name on your documents. A Free Tool “Questions you must ask your Attorney” will be provided to all attendees. You will not want to miss. Limited to first 20 attendees.

Call 727-447-5845 today to reserve your seat.

Please share your best/worst Legal Zoom or lawyer story with me and send to Linda(at)agingwisely.com. I look forward to hearing from you.

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I hate going to see the doctor!

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health care and doctor's visit

The last few years (maybe more than five) I have not been diligent about watching my health.  I have not made the doctors’ appointments that are recommended and I have not gotten all of my healthcare screenings completed.  I think about it, and never make the next step.  I have been in plenty of health care locations with my parents, with friends and even with clients. I’ve been in local hospitals, national medical centers, doctors’ offices, assisted living facilities, nursing homes and rehabilitation centers.

What I do know is there have been lots of changes in the health care world and more than ever you must be able to recite everything about yourself, over and over again.  And what you can’t or don’t communicate may effect the medical treatment provided.

So along with getting organized, I need to focus on getting my health care back on track.

I am trying hard to not be overwhelmed with organizing all of my health care records.  The good ole days of your Primary Care Physician (in my day called a GP) maintaining all of your health care records only works until you get sent to a specialist or the hospital.  The entire system has changed, where do you start?

Review your Health Insurance Coverage.  For the most accurate and update information about your insurance coverage you will need to establish an online account.  The online account will confirm and explain your coverage.  You can track your claims and see any payments made on your behalf.  Depending upon your insurance they may have relationships/contracts with particular health care providers that are in your network and only pay for those providers or offer a financial incentive to see those providers.

Maintain your Health Care Records.  Where is the best place to maintain your medical records?  I recommend maintaining the information online as well as paper.  Tack the paper down in a file folder or in a notebook.  Most online records are maintained on a cloud based system but unfortunately not all health care providers will agree to access your cloud based system.  However, for family members and travel l prefer the convenience of the online records.

Family members could find it difficult to help in a time of emergency if asked to report on your medication list and medical history.  It is difficult to remember my own list when visiting the doctor’s office.  I take a large number of vitamins and supplements – the healthcare provider needs to know the complete list and strength of the vitamins and supplements.  There would be no way for my family to disclose this information without a documented list.

Making the most of your Doctor’s visit – what should the doctor be telling you and what should you be asking?  Please join us for a free workshop focused on your health, what records you need to maintain, online tools to make it easier, and a heads up on Medicare changes coming your way.  A FREE tool to “Make the Most of Your Doctor’s Appointment” will be provided to all attendees. You will not want to miss.  Limited to first 20 attendees.

Focus on Your Health Care, February 9th, 1:00-2:30 PM, location: Aging Wisely office

RSVP to 727.447.5845 or lashford(at)agingwisely.com

Please share your best suggestions and tips on how to stay healthy and send them to Linda(at)agingwisely.com.   I look forward to hearing from you!

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Do You Need Assisted Living?

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assisted living

Unfortunately many folks wait way too long to consider assisted living.  They miss the opportunity to enjoy making new friends, maintain their nutrition and health, and prevent injuries from occurring to them by having others take care of the heavy housekeeping and chores.  It’s tough to realize you are unable to prepare a nutritious meal and properly bathe yourself.  You think you are getting by okay, and then you accidently see yourself in the mirror and realize your physical health is taking its toll.

Your caregivers, your family, your neighbors are all trying to help you.  They want to do whatever they can to keep you safe and it’s often more than they can do on a daily basis. (They are just afraid to tell you or feel shame because they can’t do it.)  It’s a terrible quandary to be on either side of this equation.  Recognizing the problem is the first step, and asking for help is the second.

If you are fortunate enough to still have your spouse, moving together is so much easier than moving alone.  Sorting out a life time amount of “stuff” is not easy.  For those that are single, one tip that a client shared with me a long time ago was that her son spent the first night with her in the assisted living apartment and the first day together.  He attended each meal in the dining room with her, and helped break the ice.  From that point forward, she became the assisted living “Welcome Wagon Gal” visiting and scheduling lunch with each new person moving in.  She felt so good making a difference!

We have had many clients whose family is unable to spend that first night or so at the assisted living.  In those cases, many clients have elected to have their caregiver (an EasyLiving caregiver that has been helping around the house) spend the night, help them get to know the new place, and help with the introductions and the conversations flow easier.  There are many creative ways to make the transition a little less intimidating.

Our care managers can help you figure out whether it makes sense for you to stay at home with home care or if the time is right to move to assisted living.  How do they do this?  The care manager will speak with you, your caregiver(s), your health care providers, and put together a care plan that provides guidance as well as realistic expectations of what type of help you need.  A written report is provided reviewing your current health status and specific step by step recommendations.

There are many checklists and tools available online as to whether now is the right time, what type of care is available in the home and at assisted living.  While all of those are very helpful, we have found a conversation with a knowledgeable certified care manager helps you make the right decision and maintain family relationships.

Care Plan/Assessment Package:  The Care Manager will meet with you and your caregiver(s), evaluate your current situation, review healthcare records, and prepare a written care plan with specific recommendations.  Recommendations may include specific assistance needed in the home or recommendations for specific assisted living facilities, Medicare covered services and equipment, Medicaid benefits, and guidance as to when a move may make sense.  No matter who you are, these are tough conversations and working with someone who knows the system and understands the costs is critical.  Our fee is $499 for a step-by-step Care Plan/Assessment.  If you live in Pinellas County or Hillsborough County we can meet with you in person, otherwise, you may schedule a telephone conference with one of our care managers.

Please call today at 727.447.5845 to schedule an appointment with a care manager or contact us online.  We look forward to helping you with Aging Wisely!

 

Related posts:

Hedging Your Bets: Taking Risks in Hopes of Remaining “Independent”

When Is It Time for Assisted Living?

Evaluating Assisted Living Facilities

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Getting Organized with an Exit Strategy in 2016

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Linda Chamberlain, Florida Medicaid Elder Law Attorney

Linda’s Words of Wisdom blog

I can’t plan for 2016 but……I can get organized.

There is no way I could have predicted, thank goodness, the major events in my life over the last five years.  My mother passed away with ovarian cancer, two of my sons got married, we had our first grandchild, my 91 year old Dad got remarried and moved, and one of my best friends died.

I keep a crystal ball in my office.  I often tell clients I meet with it’s not working today.  We will quickly look over at it and see right through it, it tells us nothing.  I’m actually glad about that because there are many events you simply cannot plan for and the anxiety of worrying about them happening is often worse than the actual event.

What I have realized over the last five years is that I can be more organized, and need to be more organized, to be prepared for what life brings my way.  I am tackling the piles of paperwork, documenting the many passwords and websites I use, and physically and electronically filing my documents and paperwork.  This is not a task that is complete in a day or week, and to be honest I am still working on it.

When my friend died I was truly amazed with the time he had taken getting organized and planning for his death.  While many of us glibly will state we are doing it and that we are prepared, in reality I find most people will not complete what is required while they are living. Many of us prefer instead to avoid thinking about it and leave many required tasks to our surviving loved ones.  It is easy to say “if” I die when there’s no doubt about it, it’s really “when” I die.

Getting Organized

Aging Wisely has developed a simple tool to help you start organizing your exit strategy.  We call it our questionnaire.  We have found clients appreciate our help completing and getting their information together.  The questionnaire takes you step by step through your personal information.  It helps you start thinking about “who” may help you. It reminds you of assets you may have to manage, and helps you evaluate your monthly income and expenses, so you will know what you have to spend on a monthly basis.  All information you need to get organized for your future as well as illness or your death.

Exit Strategy

I have to admit, I get tired of hearing about planning for my death.  I do like the idea of organizing my Exit Strategy – something about saying that makes me sort of smile.  I am going to tackle my Exit Strategy this year and get organized.  It will be useful for living and eliminate much stress I bring upon myself not being able to find things when I need them.  There will be many tips to share through the process, stay tuned.  I look forward to hearing your suggestions and comments regarding getting organized at Linda@agingwisely.com.  

Exit Strategy Workshop (aka What You Should Do Before You Get Sick)

Tuesday, January 12, 2016

1:00pm – 2:30pm

Aging Wisely office, 1180 Ponce de Leon Blvd., Clearwater, FL 33756

RSVP: 727.447.5845

Please join us for a free workshop focused on organizing your affairs, what decisions you need to make and how you may want to make them, categorizing and documenting your wishes, and tips and tricks on “really” getting it done.  A free organizational tool will be provided to all attendees. You will not want to miss it!  Limited to first 20 attendees.   

I look forward to you joining me on this journey throughout 2016.    Please stop back and check out my blog (you can sign up for our newsletter to get regular updates!) and as always, feel free to email me at Linda@agingwisely.com.

 

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Florida Healthcare Surrogate Designation: Update Alert!

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Florida Healthcare Surrogate Designation

Florida Healthcare Surrogate Designation Changes

by Linda Chamberlain

You can now authorize your health care surrogate designee to receive your protected health information (PHI) and/or delegate decision making authority even if you are not incapacitated. This provides your surrogate immediate access to your health care information and allows them to assist you with your health care decisions.

If you have been to the hospital in the last year you know that most of the time your primary care physician no longer comes to the hospital to see you. Most hospitals have “hospitalists” on their staff. A hospitalist is a dedicated in-patient physician who works exclusively in a hospital, and the hospitalist sees you daily while you are a patient admitted to the hospital.

The hospitalist does not know you, may not have easy access to your medical records or advance directives (Health Care Surrogate Designation and Living Will), and may not realize they are allowed to speak with your spouse, child, family member or friend about your medical circumstances. This often leads to frustration when your surrogate hears repeatedly, “No, we are unable to disclose this information.”

The new Florida Health Care Surrogate Designation provides authorization for your surrogate to access medical information immediately. Previously, you, as the patient, had to be determined incapacitated by two doctors before your surrogate could access any health information or help you make your medical decisions.

Will the new Florida Healthcare Surrogate Designation be available free at the hospital?

Please note the Advance Directives provided to you to sign upon admission to the hospital do not provide this authorization (yet). All the “free” health care surrogate documents I could find online still require a determination of incapacity prior to authorizing the surrogate access to medical information. You will need to contact your attorney to update your Health Care Surrogate Designation.

Is it worth the $$$ to get an up-to-date Florida Health Care Surrogate Designation?

The simple answer is “Yes!” Many of us have several doctors examining us, making diagnoses, and taking care of us.  Keeping track of your medical records, test results, etc. is your responsibility (NOT your doctors’). When you’re not feeling well it is often difficult to remember to keep all of your information organized and to collect your medical documentation. With the new Health Care Surrogate Designation, your surrogate can now assist you with these tasks as well as make the telephone calls to obtain necessary information and updates, coordinate the information between your health care providers, and access your protected health care information.

***For those of you with minor children the new Florida legislation provides parents and/or legal guardians the authority to designate a person in advance of their absence to consent to essential as well as non-emergency treatment of the minor.

For the latest updates for aging wisely and well, sign up for our newsletter! If you have specific questions or want to learn more about healthcare advocacy services contact us online or at 727-447-5845.

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Linda’s Holiday Gift Ideas for Seniors

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Linda Chamberlain holiday gifts for seniors

Gift giving is fun for me!  When I do have time to go shopping I’m on the lookout for items my family or friends may enjoy.  Ideas for gifts come from all different directions.  I find listening closely to the person helps me identify gifts for them that will be useful and often become items they love.

The recommended gifts below are all gifts I have personally used or have given to someone who has loved it!

I have organized the gifts under headings to help you sort through easily and perhaps find just the perfect gift! Click on each picture to be linked directly to the product page for purchase and more info.

 

Tech and Gadgets

 

sony-headphonesSony Wireless Headphones: This is the gift that saved my marriage. As the years have gone by (all 35 of them), my husband keeps going to bed earlier and while I try to go to sleep earlier, I seem to be a night owl. The Sony Wireless Headphones allow you to watch TV with the volume on mute on the actual TV, allowing others in the room to enjoy their peace and quiet while you get to enjoy watching TV. And… just in case the person you are with doesn’t need the volume as loud as you do to catch every word, the headphones also work with the volume on. You do not miss a word of dialogue with these headphones, they are fantastic. Perfect for those with some hearing loss, for those sharing a room, and those wanting to enjoy the uninterrupted pleasure of a TV show, movie, or music.

iPadEven if your loved one does not use a cell phone, an iPad may win them over to the digital world. Take the time and set the iPad up before you give it to them.  Set your loved one up with a Gmail email address and an iTunes account – and give the gift that keeps on giving. I recommend using an iTunes gift card to access paid apps, movies, etc… to avoid the problem of potential credit card fraud. The next holiday you can pay to reload the gift card.

Load up favorite photos and videos onto the iPad for them to look at over and over, and each time you go to visit you can assist them with saving the new ones or accessing the cloud to get the most up to date photos available. This keeps them with you no matter where you are. Be sure to include photos of them from their younger years with you – allowing them to think back through the decades. I also downloaded some favorite game apps, solitaire, candy crush, and of course a variety of Las Vegas style slot machine apps. This can provide hours of enjoyment for those with limited mobility. As they get used to the iPad they may learn to explore apps available on their own, or recommendations by their friends. Read more…

Open It: Each year my book club celebrates the holidays with a white elephant gift exchange. The goal of the gift is to bring your favorite “find” of the year. This year my gift will be the Open It!

I can’t remember when I first found the “Open It”, but I sure am glad I did. It seems like so many packages today are so hard to open. One of things I’ve noticed is that my hand strength is not what it used to be, or should I say the using the strength in my hands sometimes hurts. The Open It tool prevents any pain from happening. It includes a very stiff scissor function that cuts through fairly thick plastic, cardboard, all sorts of things. The Open It also includes a Utility Knife, which is great for opening packages and a screwdriver when you need it.

The Mommy Hook

The Mommy Hook: Have you heard of the term “milk drunk?” I never had either until my first grandchild came into the world this year. It appears to be a state of almost asleep after they have just eaten, they are very cute in this stage. The terms used to describe babies and their supplies are totally different since my children were young. One of the most useful gifts my daughter-in-law received was a Mommy Hook. This hook is sold to be used on strollers, however the first thought on my mind was to use the hook on walkers or wheelchairs. This hook is strong enough to carry several bags, a purse, and other miscellaneous items. Or handy just to keep your purse right by you.

Self-Improvement Gift Ideas

Tweezerman Tweezers and 10x Magnifying Mirror: Every woman I know worries about the weird eyebrow hair, the random black hair that sometimes shows up on her chin, and whether she has her lipstick just on her lips! The 10x mirror, lighted or not, with Tweezerman tweezers allows you to find even the smallest gray hairs and pluck them when you need to. This 10x mirror helps you not miss a one. This set keeps you pretty and confident.

Clarins Restorative Wake-up Lotion: A few years ago I was walking through Bloomingdale’s and a sales person at a makeup counter called me over and said would you like to have your face perk up and have a younger looking skin tone.  Well it only took about 5 seconds to answer that question.  I’m not sure what the active ingredient is in this lotion, but it definitely wakes up your skin in the morning and brings some light to your face.  The lotion is easy to apply, absorbs quickly and just the perfect moisturizer for under your tinted moisturizer or foundation.

Eminence Strawberry Rhubarb Dermafoliant: While at the Spa of the Rockies in Glenwood Springs Colorado I had the most amazing facial leaving my skin glowing and feeling very clean.  The product they used was an exfoliator you can use daily to clean your pores and over time the pores get smaller.  I have started using this every morning and am amazed how smooth my face feels after I use it.  It only takes a dime size amount so this one container will last a very long time

I typically use it with my Clarisonic Facial Cleansing System each morning in the shower.  While it takes a minute, which actually feels like a long time in the shower, the smoothness you feel on your face is worth it.

 

 

Comforting Holiday Gifts for Seniors

Faux Fur Blanket: I love my faux fur blanket with its fleece backing on the other side.  I love crawling into a cool crisp bed at night, the temperature low so I can breathe well and don’t stay awake half the night.  This fur blanket keeps me warm, not too hot, and the softness of the fur on my hands and up around my face when I sleep feels great.  This blanket is so pretty it can be used on your bed, on your lap wherever you are sitting, or around your shoulders while enjoying an outside fire-pit.

 

 

 

 

Anti-fatigue Kitchen Mat: I love to chop, mix and cook – especially around the holidays.  However, onholiday gifts for seniors ideas: kitchen mat Thanksgiving Day I typically have a backache well before the festivities get started from being on my feet all morning cooking.  This Anti-fatigue Kitchen Mat from Frontgate has helped tremendously in decreasing the pain from standing and often eliminates the pain from starting all together.  The mat is attractive in the kitchen and provides nice padding to stand on, therefore giving your back a break and less chance for pain to develop.  I can’t imagine anyone having to stand in the kitchen not being thankful for this mat.

Dearform Slipper Clogs: There is nothing better than coming home from work, especially if it was a day I had to wear high heels and slipping on my Dearfoam Clogs.  They bring immediately relief to sore, tired feet and feel so comfy.  The padding is thick in the slipper and feels great to walk on as well as very soft to the skin.  Ah…. They feel so good!

 

 

 

 

Gifts for Health and Wellness

PowerBeats Ear Headphones: As you will figure out by the time you get to the end of my list I have some hearing impairment.  My next recommendation allows me to work out and listen to my music or my favorite podcast wherever I am without the earbuds falling out of ears.  What I love about these headphones is that they never fall out of my ear and I do not have to push them in very far (which typically irritates my ear canal).  The sound quality is great too, allowing me to thoroughly enjoy whatever I’m listening to and not miss a beat!  And the over the ear hook does not hurt.

Bose Bluetooth Speaker: My Bluetooth speaker is a gift I use every day.  I love listening to podcasts and my favorite music on Pandora.  The Bluetooth speaker allows me to take my shower and get ready for the day with all my favorites loud enough for me to hear and keep on moving and getting ready for the day.  So instead of having TV on in a different room, straining to hear what it is saying, the blue tooth speaker moves with me from room to room, while I make the bed, prepare our smoothies, and clean the kitchen without missing a word.

 

 

The NiINJA Mega System: Speaking of smoothies, the NINJA has made a huge difference in our diet.  I have to admit, the NINJA mega system is the first item I have ever purchased from watching an infomercial.  And wow, I’m so glad I did.  From making individual smoothies to making coleslaw and macaroni and cheese from scratch – it is an amazing machine, easy to use and best of all easy to clean.

Read more….

 

 

Olly Restful Sleep Blackberry Zen Vitamin Gummies: Are you always hoping for a great night’s sleep – well look no further!  I found Olly Blackberry Restful Sleep gummies earlier this year and they have been a game changer.  As many of you know as we get older our sleep patterns change and well…. There are some nights where it alludes us all together.  We wake up or get up more tired than when we went to bed.  These gummies have made all the difference for me.  If I have a lot on my mind and can kind of predict getting to sleep is going to be tough I will chew two gummies – especially if I don’t have to set my alarm for the next morning.  However, when I have to get up in the AM to go to work or for an appointment I will only chew one gummy so I don’t feel like I’m having to fight myself to get awake!


The Chill Pal: This is an awesome gift for the exercise person in your life.  I have given this to many of my friends and family, it is perfect in the heat.  You can make the Chill Pal cloth wet with cold water, snap to the extra water out and wrap it around your neck to bring you immediate coolness.  This is perfect for when you are outside exercising in heat or at the gym.  This will help you avoid the excuse of saying it is “too hot” to exercise.


The Foam Roller: I can’t believe how stiff and sometimes inflexible my body has gotten over the years.  My trainer has turned me on to slowly stretching in the morning and utilizing the foam roller to help with that process.  I can’t believe what a difference it has made to my body and how much better I feel after rolling my muscles with the foam roller.

 

 

 

The Kozy Kollar: I love my large Kozy Kollar and use it almost every night.  I prefer the unscented Kozy Kollar and love that I can heat it up to my preferred temperature in my microwave.  I like the large Kozy Kollar as I typically start it on my neck, move it down to my lower back and go to sleep with it on my stomach.  It relieves what ails me and helps me go to sleep.  I have a lot of little aches and pains and prefer not to take any medication, the Kozy Kollar brings me pain relief through the heat it provides to my body.

 

Gifts for Foodies


Pure Inventions Pomegranate + Acai Berry Antioxidant Fruit Extract: A few years ago I was visiting the Spa of the Rockies with the natural hot springs.  I can’t tell you how amazing the hot springs are.  One step into the hot springs and any aches and pains you have start to disappear.  I absolutely love going to the hot springs.  Next to the springs is the spa, and while visiting I decided to have a massage.  In the waiting area was a selection of beverages, including a pomegranate flavored water, it was excellent and very refreshing.  Absolutely no bad after taste.  I was so excited to find something to flavor water that I actually liked. Read more…

 

nut mix

Cashew Cranberry Cherry Jubilee: While at the Spa of the Rockies they also provided complimentary trail mix, wow was it yummy.  I’m not quite sure how many times I refilled my little two ounce cup!  I have become hooked on this trail mix for my mid-morning and after-noon snack.  It is a yummy combo of cinnamon toffee peanuts, almonds, pecans, walnuts, cashews, cranberries, cherries, and dried apples. The combination is delicious and it is a very filling and nutritious snack keeping me away from the gummy bears that often tempt me.  This trail mix can be purchased in small or large size for a very reasonable price.


Biscoff Cookies: I remember flying Delta Airlines when I was young and getting to try Biscoff Lotus cookies for the first time.  The light texture and light cinnamon flavor make these cookies delicious.  I love that the cookies are packaged with two cookies packaged together.  This keeps them fresh and crisp and also helps me not eat too many at one time.  It is extremely enjoyable to curl up with a good book, sip some hot tea and snack on my Biscoff cookies.  It makes for a great afternoon.

You can order online and have these shipped to a destination of your choosing.  I promise you will make someone very happy when they open the package and try one.

killer browniesKiller Brownies: My in-laws live in a little town in Ohio called Lebanon.  The Golden Lamb Restaurant/Hotel is the oldest in Ohio and has hosted 12 presidents.  Not too far from Lebanon, in Dayton, Ohio you will find an incredible grocery story, Dorothy Lane Market.  Their baked goods are amazing.  One of my favorites is their Killer Brownies which you can order and have delivered wherever you would like.  As far as I know these Killer Brownies have never killed anyone, but there may be a few fights in the house over who is going to get to eat the last one!  You can choose the Killer Brownie you might like best, the original chocolate caramel, peanut butter, cream cheese, Blonde Ambition, Brookie Killer, German Chocolate, PB&J, and Not a Nutter, or better yet, try them all.  I haven’t’ tried one yet that I haven’t loved.  You can ship these Killer Brownies anywhere and may want to add a few cookies too!

edible arrangementsI love receiving and giving Edible Arrangements.  I have received several arrangements and have sent out many throughout the year.  The fruit has always had a great flavor, not too ripe but not under ripe either, and always very creatively arranged.  I like sending the fruit arrangements when I know someone is working hard to eat healthy and maintain their weight.  It is a nice surprise without them feeling like they are eating something they shouldn’t.  I also love the fact that you can order a variety of size of arrangement, allowing the recipient not to feel like they are going to let part of the arrangement go to waste.  This is a great gift for young or old, especially when it is difficult for them to have time to cut up and prepare fresh fruit.


Truffle Salt was one of my favorite things I found about three years ago.  When I first purchased it my idea was to use the salt on fish and I can tell you it is perfect with fish and the flavor is not too heavy.  Now that I have acquired the love of truffle flavor I have found myself using the salt in a variety of dishes.  One of my favorites is trying to make a Gnocchi Salad I first experienced at Town Restaurant in Carbondale, CO*.  This salad is delicious with a light truffle flavor.  My take on this salad is sort of like this, I usually sauté yellow butternut squash in a skillet with a little truffle oil, once I have crisped the outside of the squash I will add a few sliced mushrooms and gnocchi to the skillet to quickly brown, then pour the mixture on top of a bed of spinach and sprinkle with parmigiano cheese and truffle salt – it is to die for!  Add a grilled chicken breast and you now have a great dinner.

*If you get the chance to visit Carbondale, CO, try Town Restaurant. I haven’t found a bad dish on the menu!

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I hope you have fun shopping this year and that this list helps you make some folks happy on your list.   This list is a new experiment for us, we are trying affiliate marketing, which means we may get paid a commission on items you purchase through our links.  I’m excited to see if you like any of the ideas and welcome any comments or questions.  Next month, gifts to start the New Year right!  Happy Shopping!

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Pure Inventions Pomegranate and Acai Berry Antioxidant Fruit Extract

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I have been working very hard to increase my water intake throughout the day and to stop drinking so much Diet Coke.  A few drops of Pure, currently I’m drinking the Pomegranate flavor, makes my water very appetizing and before I know it I have drank a full 8- 12 ounces.  You can control the amount of flavor by the number of the drops of Pure you put into your water.

I enjoy many of the other flavors of Pure, including the vanilla and the tropical flavor.  This is a great gift for anyone needing or wanting to drink more water and very easy to use, whether at home, on the go, or at the assisted living facility.

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The NINJA Mega System

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Not having to chop for hours, being able to blend and mix recipes, and shredding cheese, vegetables, etc… has expanded our menu at home as well as saved my fingers and back.  We love making the individual smoothies in the morning, this allows my husband and I have to have two different flavors, different proportions and calories, and keeps us both getting our daily nutrients.

The NINJA can be purchased with just the individual smoothie container, or you can order the entire system with a variety of blades, etc…like I did.  Only you know how much cooking you do.  I promise you that I am cooking more, healthier and different things now that I have the NINJA as it has made my life easier.

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iPad

iPad (Black)

…Be sure to document all the passwords, usernames, etc… several places for your loved one so anyone can help them access their iPad.

As time goes by you can get them acquainted with FaceTime and messaging allowing them to keep up with others. We bought the monthly wireless internet package through AT&T for one set of parents who have no interest in cable, streaming or in-home wi-fi. For my 91 year old Dad who has wi-fi in his home we have set up Netflix, Amazon Prime, and Hulu allowing him to enjoy the freedom to watch what he wants when he wants – however at the end of the day it is the Las Vegas style slots that he loves playing the best.

For my Dad who likes to play games and watch movies we got the larger memory iPad. For our parents who only use for pictures and random internet surfing we got them the 16 GB instead of the 64GB.

Regardless, the main tip here is to fully set up the iPad. When you are not tech savvy the thought of setting up the iPad to be useful can be overwhelming which often means the iPad is left in the box or on the counter. Make it a fun experience for the loved one in your life.

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Payment Concerns
Not sure how you are going to pay for elder care?


Is the Time Right?
Find out if its time to seek help for your loved one.


Aging in Place
How to keep a loved one safe at home, and when it may be time to consider assisted living.




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