Senior Sunrise

Advance directives began to be developed in the United States in the late 1960.

The First Living Wills:

In 1967, the first living will was suggested to facilitate “the rights of dying people to control decisions about their own medical care.”

In 1968, the first living will legislation was presented to a state legislature. It was introduced, and defeated twice in Florida.

In 1974 it was introduced  in California and defeated.

Introduced again in 1976, and CA became the first state in the nation to legally sanction living wills.

The States:

By 1977, forty-three states had considered living will legislation and seven states had passed bills.

Advance directive legislation has subsequently progressed on a state- by-state basis.

By 1992, all fifty states, as well as the District of Columbia, had passed legislation to legalize some form of advance directive.

 NJ 1976 - The first court decision to validate advance directives was at the state level. Patients have the right to refuse treatment even if this refusal might lead to death.

If patients are mentally unable to make treatment decisions, someone else may exercise their right for them.

Decisions that can lead to the death of a mentally incompetent patient are better made not by courts but by families, with the input of their doctors.

Decisions about end-of-life care should take into consideration both the invasiveness of the treatment involved and the patient’s likelihood of recovery.

The case in which Judge Hughes ruled was the request by Joe Quinlan to make legally binding health care decisions for his daughter, Karen Ann Quinlan. As a result of the case, Karen Ann Quinlan was gradually weaned from mechanical ventilation. (NJ 1976)

The Federal Government:

The U.S. federal government has shown its interest in advance directives through two of its bodies, the Congress and the Supreme Court.

The U.S. House of Representatives in 1991 enacted the Patient Self- Determination Act. The Act stipulates that all hospitals receiving Medicaid or Medicare reimbursement must ascertain whether patients have or wish to have advance directives.

The Patient Self- Determination Act does not create or legalize advance directives; rather it validates their existence in each of the states.

Today:
In the United States, four out of every five adults has no advance directive.

In 1950, about half of Americans who died did so at home.

Now, about 85% of Americans die in a health care setting: a hospital, a nursing home or a rehabilitation center.

At least 12% die in an intensive care unit.

As seen by the stats above the idea of a medical directive, and living wills has taken time to evolve. They are timely subjects, and upon their completion they offer both the family, and the requestor a sense of calm that he/she will be cared for as he/she intended.  Take time to think and research your choices for living wills and medical directives.

What do you know about Hospice? 

I know that I was not aware of hospice until the doctors told me that there was nothing more they could do for my father. His heart was only functioning at 20%, yet his mind was clear.  He only wanted to return home. So, I was informed by the case manager that his doctor was recommending Hospice.  After speaking with the case manager, and getting a better understanding of what hospice meant and provided,  I spoke with my dad and told him he qualified for hospice.  I thought he would be happy, but the look on his face didn’t relay that. I found out immediately why he didn’t seem pleased.  In his own words, he thought hospice was,  “a bone factory”. He thought we were simply going to place him in a facility and forget about him.  Well, of course that isn’t what Hospice is, and the more we spoke about what Hospice was the more he liked the idea that he could come home.

Dad returned home from his last visit to the hospital, and Hospice took over. No more visits to the doctor’s office. His meds were taken care by the nurse that visited him 2-3 times a week. That depended on how he was feeling. He knew he was close to death, but he was happy to be at home. All of us knew that Hospice, was only a phone call away if we needed them.  Their response was immediate.

Hospice did what they said they would. They treated the person, not the disease. We cherished each day that we had with him, and he loved being at home.  He was able to put his things in order, and watch each day’s sunrise and sunset that he loved so much.

Yes, Hospice is a philosophy of care. The Hospice philosophy accepts death as the final stage of life, and it treats the person rather than the disease. It focuses on quality rather than length of life.

The goal of Hospice is to enable patients to continue an alert, pain-free life and to manage other symptoms so that their last days may be spent with dignity and quality, surrounded by their loved ones. It is family centered care, and it involves the patient and the family in making decisions.

A funeral is a ceremony marking a person’s death. Customs include the  beliefs and practices used by a culture to remember the dead, from the funeral itself, to various monuments, prayers, and rituals undertaken in their honor.

These customs vary widely between cultures, and between religious affiliations within cultures.

The word funeral comes from the Latin funus, which had a variety of meanings, including the corpse and the funerary rites themselves.

Because relationships never end… only change, the completion of them is necessary for our future health, both mental and physical. We all must complete and heal our emotional relationships with those that have died — and then say good-bye. Planning ahead either for your own or someone else’s can actually helpthe healing process.

Funeral rituals have 3 main parts:  Visitation, Service, and Burial. You may be involved in the planning as much, or as little as you wish.

Adult Protective Services, or APS, refers to publicly funded programs which investigate and intervene in reports of abuse, neglect, and exploitation of adults who are physically or mentally impaired and unable  to protect themselves from harm.

Each of us has a moral obligation to “watch out for our brother & sister”. 

• For those who cannot speak for themselves, we must call out.
• For those who cannot use their eyes, we must see. 
• For those who cannot hear, we must listen and be attentive.
• For those who cannot use their limbs, we must move to assist them.

Physical Signs     Behavior Signs     Signs by Caregiver     Signs of Financial Abuse

If you’re considering the important decision of taking an elderly or sick individual into your home, there are many things to consider with this decision. First and foremost, you have to ask yourself if you’re emotionally prepared for that kind of strain and stress. Senior care can be a rewarding experience, but people shouldn’t underestimate how much of a time commitment and emotional investment it will be. Also make sure you’re competent enough to provide safe care.

This competency requires that you are willing and able to administer all necessary medical care and procedures. From insulin shots to changing an adult diaper, there are many things you’ll have to know how to do before the person ever arrives. You must also consider whether you’re financially ready to take another person into your home. It will be an additional mouth to feed and person to care for, and this can be a big drain on your funds. As such, you should make sure you’re ready for that financial hit.

Deciding to care for an elderly relative means an amazing new responsibility in your life. But just because it’s a huge responsibility doesn’t mean you have to do it alone. There are a tremendous amount of caregiver resources available, all of which contain invaluable information about everything from how to administer medication to CPR training. The most important thing is to never take on more than you can tackle. If you don’t feel like you can care for your mother and your father, don’t try to take on that responsibility.

Elderly care requires the same amount of dedication and attention as caring for very small children. If you can’t be there every minute, ensure that you can arrange somebody to be there. Even if you’re a family member, offering halfway decent care is more detrimental than strangers offering fulltime, competent care. So even if you’re just considering being a caregiver, look into the resources that are available to you. Being prepared and aware of the trials and rewards ahead of you will help you gauge whether you can undertake this challenge or not.