Tag: health care

Elder Living

Be the Best Caregiver You Can Be

SchulzeLawGroup

There is a large number of Americans, 53 million in fact, that are the primary caregivers for family members. About 17 percent of the US population is a family caregiver, and most are losing sleep, worrying, losing income, struggling to balance caregiving tasks with their workload and other family responsibilities. These caregivers are often experiencing ill health of their own and putting their well-being at a lesser priority to their family loved one. The coronavirus pandemic further complicates matters as an October 2020 poll from The Associated Press-NORC Center for Public Affairs Research reveals that family caregivers provide 36 percent more care than one year ago due to the virus. Many family caregivers are exhausted, keeping their older loved ones safe and socially connected, often while working from home and supervising children during home school days. To be good to others, you must first be good to yourself. Making self-care a top priority allows you to be a more effective caregiver to your loved one. Here are ten strategies to implement today to ease family caregiver burnout.

Relentlessly add some “me time” into your schedule. There is time to enjoy life, visit (even if virtually) friends, read an enjoyable book, do some artwork, practice meditation, or just lay down and relax. Whatever it is that brings you joy and peace of mind (and it can be changeable!), put it in your schedule routinely.

Prioritize your healthcare. You cannot be an effective caregiver if you are unwell. It is a trap to spend all of your time managing your loved family member’s doctor appointments and medication while forgoing yours. When was your last checkup? Are you experiencing new symptoms under the stress of caregiving that you are not sharing with your doctor? Make those appointments for your well being today.

Eat a healthy diet and get enough exercise. Neglecting the very basics of a healthy lifestyle encourages health problems to present themselves in you. A healthy diet coupled with exercise will bring balance to your well-being, and from there, all things become possible. Ditch the fast food, drop the daily glass of alcohol, and practice a healthier lifestyle.

Connect with other caregivers. It is so helpful to address your caregiving frustrations out loud to others in a similar situation. You might find they experience similar feelings to your own. It is not a failure on a caregiver’s part to have these feelings. You are human and, as such, have frailties. Never try to be invincible. If you feel you need more help than this, seek professional counseling. A counselor can help you sort through the complexity of your situation and feelings, providing tools to navigate family caregiving’s complex emotions. Select a therapist who specializes in helping those who are caregivers and the associated dynamics.

Learn more about your loved one’s health condition to better prepare for what lies ahead. You can’t know the future, but a medical prognosis and additional research can go a long way to addressing uncertainty that increases stress levels. Understanding possible future scenarios will let you plan and reduce the number of surprises that can catch you off guard.

Learn to set boundaries and don’t let old family dynamics dominate today. As your aging loved one requires more care, your downtime can become non-existent. Stay true to your schedule and your needs. If your loved one requires more help, it is time to call in other family members for financial or hands-on assistance or hire a service to provide additional care. Also, do not fall into child mode and allow your parent to push your buttons as they may have in earlier years. Stay in the present and focus on the task at hand. If you find it hard to separate then and now behaviors with your parent, seek support groups or find a counselor to learn ways to combat falling into old patterns.

Get help and get it sooner than later. It is not your destiny to go through this alone. Talk to your family or your doctor to strategize about ways to reduce your workload and stress. Bring in professional care, even if just a couple of times a week for some relief. Ask for help and then accept it! Your family members may be willing to help financially and spend time remotely with your loved one while you take a well-deserved break. When someone steps in to help, do not hover or micro-manage the situation. Walk away and clear your head. The world will spin without you being the family caregiver for a few hours or even a few days. Do not delay. Take good care of yourself to be your best for others.

Make sure you have a plan. If something should happen to your health, have you put into writing who should make decisions for you, who should manage your affairs, and what your wishes are regarding your care? If not, the time couldn’t be better. We can help, and would welcome the opportunity to make sure your wishes are properly documented. If you’d like to discuss your particular situation, please contact our Reno office by calling us at (775) 853-5700.

Healthcare

Virtual Care: The Changing Face of Telemedicine

SchulzeLawGroup

Telemedicine is the digital information distribution of healthcare-related services. Not long-ago telemedicine was an innovative practice, primarily a supplement to hospitals’ information strategy managing patient care and their data more efficiently. During the coronavirus pandemic and its associated urgent healthcare needs, hospitals and medical offices are making telehealth capabilities more available than ever before. Long-distance patient and clinician contact, advice, reminders, care, education, intervention, monitoring, and remote admissions have become the norm.

Increasing Shift to Virtual Medical Care

The push for comprehensive virtual medical care quickly without a standardized platform has left many healthcare facilities struggling to meet demand with technological data integrity and consistent user interface. Just as individual’s panic led to purchasing toilet paper, hand sanitizer, and other essential household items creating shortages, hospitals “pandemic-purchased” telehealth solutions to ride out the crisis led to a hodgepodge of tech solutions. This situation led to medical information security breaches, dropped call and video conferencing, poor audio and video quality, and distorted or incorrect information relayed to patients and health insurance companies alike.

Patients who were sheltering in place and rather fearful at the outset of the pandemic were initially forgiving of technological glitches. Today, however, patients have higher expectations of telemedicine and seek seamless experiences. Patients are also taking advantage of the ability to test-drive options from home, exploring physician expertise, availability, disposition, and price point before committing to a particular doctor, health care practitioner, or hospital facility. Additionally, patients are enjoying the experience and are now more likely to seek virtual care. It turns out that a patient using telehealth is more likely to adhere to prescription and wellness regimes, which is an advantage to public health overall. On average, telemedicine saves a patient more than 90 minutes otherwise wasted in commuting to an appointment and waiting to be seen by a doctor.

Telemedicine Being Embraced by Clinics and Hospitals

Clinics and hospitals are also embracing the benefits of telemedicine. Virtual medicine has played a vital role in quickly flattening the curve by getting to as many patients as possible without compromising social distancing and urgent care only protocols. Patients with chronic conditions and other non-urgent care, including routine follow-ups, can still engage with their physicians, allowing medical care, decreased patient anxiety, and maintaining facility reputation through patient retention. This continuity of care is essential, especially for urgent non-COVID-19 related health issues.

Health care facilities and medical professionals are now able to reach a new demographic of patients through telemedicine, particularly those in rural areas or those who list time, convenience, and proximity as barriers to making an initial consultation. Fully 76 percent of hospitals now employ telemedicine services, and two-thirds of patients report a willingness to use telehealth in the future, even after the pandemic ends.

Telemedicine Saves Time and Money

Telemedicine also yields significant savings of time and money for healthcare organizations and patients. An average in-office visit is 121 minutes, including 101 minutes of commute and waiting time. Therefore, a patient is only experiencing about 20 minutes of interaction with their doctor. A full one-third of patients have left a doctor’s office because the wait was too long. Telemedicine reduces wait times, no-shows, and cancellations saving time and money. There are also flexible insurance benefits to take advantage of when using telehealth.

What Telemedicine Platforms and Service are Right for You?

How can you best assess your hospital or doctor’s office telemedicine platform and service? Medicaleconomics.com cites four questions that you must ask to find the service best suited to your needs. Telemedicine can vary drastically among categories such as compliance, quality, convenience, and features, so keep the following in mind as you search for the right fit.

  1. Look for easy to use technology. As a patient, you should have no trouble downloading and accessing a telehealth app. It should be easy to use and intuitive and be available on multiple digital devices such as a tablet, phone, or laptop.
  2. Is the software provide HIPPA compliant and secure? Privacy issues are a major concern when using non-healthcare specific solutions like Zoom, Skype, FaceTime, and others. Ensure your telehealth provider keeps your sensitive information digitally safe.
  3. Make sure that the platform provides quality audio and video transmission. You will feel more comfortable, and your session will yield the best results knowing that communication is clear. Miscommunication can lead to misdiagnosis and have tragic health consequences.
  4. Shop around before committing. Read online reviews and speak to others about their telehealth experiences. Finding reputable healthcare facilities doesn’t stop with a board-certified physician. Facility reputation can be the difference between ease of interaction, diagnosis, and follow-up regarding insurance.

Embracing telemedicine can open your healthcare to expert physicians, save you time, and maintain the significant benefit of social distancing. Look for a healthcare organization with the right telemedicine framework for you. It will help you stay current with your routine medical care despite the coronavirus pandemic.

If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.

Healthcare

Why You Should Have a Strategy for Your Aging Parents Before a Medical Crisis Hits

SchulzeLawGroup

Many adult children in the US live far away from their parents. Managing aging parents or in-law medical events can be a serious challenge without proper preparation and understanding of what your parents’ strategy may or may not be, no matter where you live. Do you know what legal documentation your parents have in place regarding their medical care? Do they have advance directives that can help guide your medical decision-making process? Do you and your spouse openly discuss the situations of each other’s parents?

Medical advancements facilitate aging Americans’ longevity even with comorbidities such as high blood pressure, diabetes, kidney disease, atrial fibrillation, and other health issues. Hospitals can typically fix non-life-threatening conditions easily enough, but what happens when a parent is released to return home? Are you prepared? Is there a plan? Many adult children tend to practice avoidance, denial, and wishful thinking when thinking about their aging parents’ behalf in a potential medical crisis. It is advisable to organize and prepare for the changes that inevitably come to your parents’ health.

More than ever, seniors are choosing to live independently and with autonomy about their life decisions. Even if your parents are in a well-run continuing care retirement community, there will come a day when their health will force a change in their lifestyle and living arrangements. Many parents will resist “help,” which they may consider more as interference. Whether they believe they are being a burden to you or decline a geriatric care manager’s services due to “cost” concerns, most older people do not want others interfering in their private affairs. 

The goal is to find a way to help while still affording your parents the dignity and respect they want and deserve. To achieve a comprehensive plan on your parents’ behalf, travel to them for an honest discussion. If this is not possible due to COVID-19 restrictions, then virtual meetings are best, followed by phone calls as hearing loss typically makes communicating useful information difficult. Even on a screen, a face-to-face connection allows a parent to read lips, which is a typical strategy for older people experiencing hearing loss.

Review what legal paperwork your parents have and make sure it is in order. Many documents have a signature from many years ago, and things may have changed. If there is no designation of a medical power of attorney, be sure there is a document naming a “personal representative” to address restrictions outlined in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This document allows the waiving of privacy concerns that permits access to a parent’s medical information while the parent is in the hospital.

Create an up-to-date list of all your parents’ doctors. The list should include medical contact information and all medicines (prescription or otherwise) that the parents take. If their general physician is not a geriatric specialist, it will help to find them one. Post-hospital fog and newly prescribed medications from an adverse health event can create confusion in an older parent. A geriatric doctor will know to look for and resolve these types of issues. Ask about the parameters for health care intervention, such as dialysis, post-hospital during the time of COVID-19?

Explain to your parents that being released from a hospital for a non-life-threatening, yet serious health episode is usually followed by the need for a care manager, at-home nursing care, or at least companion care. This additional care should not fall to a spouse if the parents live together. A spouse has their unique role to fill as well as personal health challenges with which to contend. Heaping an increased responsibility for spousal health care upon them may be damaging to their health.

Before an unforeseen medical crisis can occur, identify several qualified agencies in your parents’ hometown. Review each agency and candidate carefully. It is easier to integrate a suitable candidate at the outset than having the chaos of retaining and releasing multiple workers. Remember that a candidate who works for one parent may not be another parent’s preference in the future. Maintain a strong relationship with the agency provider. They are an essential resource, and you will probably need them in the future.

Take the time to learn the specifics of your parents’ healthcare and living arrangements. Coordinating your plan of response is contingent upon whether your parents live independently, in assisted living, or a retirement community. Wherever it is your parents live, their first desire will be to go home after an unexpected hospitalization. The desire to return home is a universal truth. Knowing the agencies that can quickly provide the type of care your parent needs in their home setting will go a long way to a successful transition. The road to recovery may require a few weeks of nurse visits, physical or occupational therapists, or simply companionship. The faster you can meet the need, the easier it will be on your parent.

If a full recovery is not possible, what will be your plan to address the new status of their normal? How much more medical oversight and assistance will they require? Know that in these instances, a parent can quickly spend through Medicare allotments afforded for temporary care. If they do not have long-term care, and many aging Americans do not, you will have to find ways to help them receive the care that they require.

If there are multiple adult children, is there an expectation that all siblings share information and work on the problems at hand, or is one in charge? Is this designation formally documented? Managing sibling relationships is key to avoiding family conflict. Also, understand your parents’ financial arrangements. Most parents will ask about the cost of any new healthcare service being arranged and decline using it. It is hard for a parent to spend down the money they worked their entire life to amass.

Knowing your parents’ aging strategies will not address every issue you might encounter because they may not have all the necessary decisions and documents in order. You can only work within the authority they choose to provide. As attorneys, we can help identify gaps in their planning and recommend ways to fill those gaps so everyone can have peace of mind.  If you’d like to discuss ways we can help, please don’t hesitate to reach out. Please contact our Reno office by calling us at (775) 853-5700 to learn more about your Medicaid planning needs.

Healthcare

Preserving Quality when Planning for End of Life

SchulzeLawGroup

When our clients can no longer act for themselves, powers-of-attorney documents are prepared, the documents will convey on other trusted people the authority to act on our clients’ behalf.

But when it comes to actually using those documents at the time of a health-care crisis, clear and powerful documents are just the beginning. The decision-points can (and must) be put down on paper in advance, but when it comes to end-of-life situations, the clarity on which we lawyers thrive can be very hard to find.

Sitting in her lawyer’s office, the client may have been quite certain about health-care decisions. She does not want her life prolonged by a battery of aggressive treatments, where these would not preserve her quality of life. She does not want blood transfusions, dialysis, repeated courses of antibiotics and chemotherapy, cardiopulmonary resuscitation, or breathing and feeding tubes. She does not want to die inert in the ICU, surrounded by machines and strangers. She wants to die at home, surrounded by loved ones, at a time when she retains presence of mind to make her peace.

But that goal doesn’t just happen from wishing it and stating it. It happens with additional careful preparation for the realities. As the end of life approaches, the clarity we lawyers enjoy can be elusive. When a person gets a prognosis of two to five years (maybe), where, along that continuum, would be the time to start declining aggressive treatment? When there’s always one more intervention that may (or may not) produce a good result? When one decision could create an ever-widening array of complications? When, step by step, the patient becomes less and less able to exercise autonomy, and where treatment decisions by caregivers are not in line with the care the patient was clear about when she was sitting in the lawyer’s office?

No matter how clear the powers-of-attorney documents, with all these imponderables, the patient can end up in a situation many miles away from what she wanted. And there’s no possible do-over.

Powerful and clear power-of-attorney documents are an essential first step and we lawyers are glad to take care of that part. Beyond that, though, thorough preparation is essential.

Consider that the best result may be one that cares for comfort right now, in the moment. The question is not necessarily about how long life can be prolonged. The question may be, rather, how comfort can be maintained – in this moment, and then the next moment, and the next. The question is how life can be made better right now. Watch a video by palliative-care physician B.J. Miller, on why this is so important, here.

Make concrete plans. These include specifying what you want to happen if you’re no longer able to live independently; choosing wisely whom you want to act for you, to make sure your plans will be followed; being ready with your health-care documents before you find yourself deposited in the emergency room or ICU; and seeking the reassurance that your loved ones will be cared-for when you’re no longer there. Judy MacDonald Johnson has prepared simple, forthright worksheets to help with this process, here.  She speaks about these worksheets in this moving video.

There is no doubt that the process in safeguarding quality of life at the end of it is possibly the most challenging of all. But if that process can create as much pleasure as possible through an extremely difficult time of life, and if forthrightly engaging in that process would facilitate a passing more in line with what we would envision, the worth of the process will be felt. The transition will be smoother and more meaningful for the dying person, and a kinder legacy will be left behind for those who accompany us on this journey.

Learn more about your health care planning options and contact our Reno office by calling us at (775) 853-5700.

Healthcare

Understanding HealthCare Power of Attorney: Specific VS. General

SchulzeLawGroup

You have the right to decide what kind of medical treatment you want to receive from doctors and health-care providers. If you can speak up at the time, you can express your wishes yourself. But if you become incapable because you’re ill or injured, you need to plan in advance. Designate a person whom you trust to speak for you. You do this by creating what’s known as an “advance directive” or health care power of attorney.

You also have a choice about the kind of document you prefer. You can ask for a short document that simply conveys general authority on your agent to make health-care decisions for you – or you can opt for a longer document that details the specific powers you give to your agent.

For both versions, we offer a checklist to assist you in discussing your wishes with your agent beforehand.

The General Version

This version is short, clear, and easy to understand. It states, generally, that you have given your agent the authority to speak for you. Your agent knows your wishes, because you have discussed those wishes with him or her beforehand.

The Specific Version

This version goes into detail about what you would like your agent to do for you. For example, it includes the request that providers and your agent consult with you if possible. If not possible, it includes a list of procedures that you authorize your agent to decide on your behalf. Included are decisions about what kind of residential facility you want to be placed in, that an agent can visit you and bar others from visiting if appropriate, can advocate for pain relief, can consent to psychiatric treatment, can decide about anatomical gifts and organ donation, and the document provides procedural details about enforcement.

You will be covered with either version. The choice is yours.

Living Will

You may also want a separate Living Will for end-of-life decisions. This document becomes effective when you can no longer care for yourself, walk, talk, recognize loved ones, or are in the final stage of an incurable illness. At that point, you can decline expensive, high-intensity care that likely would not improve quality of life.

Choosing Your Agent

The person you choose to be your health-care agent must be someone you can depend on to have good communication skills, remain calm in difficult situations, and deal flexibly with complexity that might arise in reconciling your wishes with available medical options. Choose that person carefully.

Health Care Preferences Checklist

We can offer you a checklist, to help you discuss your wishes with your agent. This is not an easy conversation. It’s hard to contemplate a time when our health has declined or we suffer injury or accident. It is also challenging to try to imagine various scenarios involving situations that can be complicated by numerous medical contingencies.

Still, your agent needs to know what you would want in a variety of situations. These include whether to decline or accept life support and mechanical interventions, when you would opt for or decline surgery, and your preferences about blood transfusions, medication, and religious observance.

For certain states, the checklist also contains a signature line that proves you have discussed your wishes as to feeding and hydration tubes. Otherwise, if your agent doesn’t know what you would decide, the law in some states would take away from your agent the right to decide about those kinds of measures.

Don’t hide your documents!

When it comes time to use your documents but they can’t be found, or if your agent or family don’t understand them or ignore them, you will have spent your time, effort, and money in vain. Make sure your documents are readily available. Give a copy of them to your agent and ask your doctors to include them in your medical records.

You will have done your best to see that your values and health-care choices will be honored. We are here to help, please contact our Reno office by calling us at (775) 853-5700.