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BEGIN ADVANCE CARE PLANNING WITH STRATEGIC AGING IN MIND
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At 90, Ben appeared to be complacent
with age and content having others tell him what to do. Every morning, Ben experienced transient vertigo while getting out of bed. He happened to tell his visiting nurse about it, and she detected an irregularity to his heartbeat and elevated blood pressure. She recommended Ben go to the emergency department.
Ben’s son-in-law, Michael, was contacted because his daughter was out of town. Michael was well aware of Ben’s history of hypertension and atrial fibrillation. The emergency physician examined Ben and determined that the vertigo occurred when Ben sat up along the left side of the stretcher (the same side he normally got out of bed). There was no evidence of a stroke and vital signs were essentially "normal."
Ben had exceeded life expectancy, but was it dumb luck or strategic? At what point did Ben realize he had reached old age? Aging tends to creep up on most people and doesn’t occur at one specific birthday. If age has its privilege, can it also be strategic? Like Ben, most people resign to the "come what may" approach. Ben may not care what
happens to him at this point, but Michael and his wife do, and they’re caught in the conundrum of being damned if they do and damned if they don’t care.
The resolution to this no-win situation is to begin advance care planning with strategic aging in mind. Aging is defined as having a chronic
illness with a debilitated, distracted state.
There are three goals tor strategic aging:
STUDY FINDS END-OF-LIFE CONVERSATIONS WITH NON-CLINICAL WORKER BRING PATIENT
SATISFACTION, LOWER COSTS Stanford University School of Medicine researchers enrolled 213 patients who were diagnosed with stage 3 or 4 cancer or with recurrent in a pilot study. Half were randomly assigned to speak with a trained lay health worker about goals of care. Study Highlights: - Patients who talked with the lay health worker were more likely to have
physicians document their end-of-life care preferences in their electronic health records within six months of those conversations starting (92 percent compared with 18 percent in the control group).
- Patients
in the intervention group rated their oncology care higher, giving it an average satisfaction score of 9.16 out of 10, compared with the average of 7.83 from the control group.
- Those who discussed goals of care with
the lay health worker were six times less likely to visit the emergency department or be hospitalized than members of the control group, and twice as likely to use hospice services.
- Their median health care cost within
30 days of death was $1,048, compared with $23,482 for the control group.
The findings suggest that patients with a serious illness are more at ease with discussing their care
preferences with someone other than an oncologist. I might add that "nonmedical personnel" tend to be nonjudgmental. Physicians are trained to judge patients while often appearing
intimidating. In practical situations, the "trained lay health worker" is the palliative care nurse. This "lay worker" demonstrates compassion by offering patients an alternative, nonjudgmental, and de-medicalized care plan. End-of-life discussions are complete when both sides of the conversation (hospital care vs. home care) are equally represented without one being judged better than the other.
JUST WHAT THE DOCTOR ORDERED:
"NEW CAREGIVER" RESOURCE GUIDE
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When you become a new caregiver, there is often a huge learning curve, especially when it comes to performing certain medical procedures. The A-Z Home Care Handbook: Health Management How-Tos
for Senior Caregivers offers tips and how-tos to help guide you through the health management tasks caregivers are most commonly responsible for performing. The book is due out Summer 2018.
I wish Harry’s book had been available when my mother was dealing with visual
impairment as she aged. A sample of Harry’s valuable information is posted on KevinHaselhorst.com
Is Palliative Care Right For YOU?
by Kevin J. Haselhorst,
MD
Click here to purchase your copy
The key to making medical decisions
is
understanding palliative care:
Palliative Care is the
bridge between
advance care
and end-of-life care. When
you no longer have your health,
how will you spend your time and money?
Is quality of life more important than
staying alive at any cost?
This booklet will teach you: - What palliative care means in practical terms
- The value of making your own medical decisions
- How to gain peace of mind with chronic illness
Command respect during your next
doctor visit by saying,
"I receive palliative care."
Learn more at KevinHaselhorst.com
Age has its privilege and at 59 ½, I reached another milestone birthday. As of August 1, I was able to reap what I’ve sown in my IRA and share with others "tax free." I gathered some of my very best friends in Arizona and treated them to a feast at Fogo de
Chao Brazilian Steakhouse.
As President Trump says, I surround myself with the very best people who have shown loyalty through the years: A life coach, a defense lawyer, a funny cable guy, a yoga instructor, and a Mensa geek make up my cabinet of "a few good men." I couldn’t celebrate my accomplishments without honoring
their contribution to my life.
To celebrate a half-birthday party might seem cheesy, but life is good when I show gratitude to others.
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