By Larry Dandridge
This is the last of four articles on end-of-life planning and hospice. The bottom-line message in this column has been, “Do not wait until you are terminally ill to plan for the last years or months of your life.”
It is almost impossible to tell how long we will live or if we will be mentally capable of giving care and other instructions at the end of our life. Not only old people get sick or injured. No one knows if they will be the victim of a car wreck, other accident, violent crime, disease, or natural disaster.
Now is the time, when you are healthy and able to plan in advance for medical and other care. It will not take long to prepare an end-of-life plan and it costs nothing. All you need to do is think through what you want done and not done, at the end of your life, and discuss your wants with your loved ones.
Here are some tips on how to get started and put together a plan that will prevent you, your loved ones, your doctors, and others from stress, confusion, and disagreements, when you are no longer able to make medical decisions for yourself.
Talk to your loved ones and tell them what you want done at the end-of-your life with your health care, property, pets, and funeral services and burial.
Choose a person to make medical care decisions for you, when you can no longer make decisions.
Have your doctor or hospice explain what Advance Directives are and why you need them. Advance directives are legal documents that help doctors and loved ones understand clearly your wishes about medical and mental care. You can read some of the 32 listed resource guides about Advance Directives at www.cdc.gov/aging/pdf/acp-resources-public.pdf and https://www.state.sc.us/dmh/804-97.htm or, if you are a Veteran, you can go to https://www.va.gov/find-forms/about-form-10-0137a/.
Prepare, sign, and date and have witnessed a Durable Power of Attorney for Health Care and a Living Will. If you are a Veteran, the VA has a VA Form 10-0137 that you can use.
Give a copy of your advance directives to your primary care physician, loved ones, specialty physicians, skilled nursing facility, hospice, and the serving VA Medical Center if you are a veteran.
Put all of your important papers in a safe and fire proof place and tell your immediate family where the papers are. This includes your will or living trust, living will, medical advance directive, healthcare power of attorney, general power of attorney, life insurance policies, investments, passwords, DD214 Discharge Record, VA disability award letters, CRSC award letters, and other important documents.
Make your house accident proof by making it fall proof, well lighted, clutter free, and slip resistant, with hand rails installed on stairs, and grip bars installed in your bathroom. Your hospice, skilled nursing facility, home health provider, and home and life insurance provider can help you with this.
Continue to enjoy your life to the fullest. Benefit from the tremendous satisfaction that you have taken care of end-of-life planning, thus saving your loved ones, doctors, and others stress, grief, and confusion at the end of your physical life.
Here are 11 ways to help you pick the best hospice for you.
- Have two hospices brief you and your caregiver(s) on the services they provide. Consider your physicians recommendations for which hospice to use.
- Ask the hospice if they will assign volunteers to assist you and your caregivers. Have the hospice assure you that they will have a volunteer when, where, and how you need them. Make sure the hospice has enough volunteers to meet your needs.
- Ask the hospice if they will send a substitute volunteer or hospice representative if your assigned volunteer is not available.
- Ask the hospice if they have an inpatient hospice facility like the ones in Summerville and Mount Pleasant, SC, in case you need inpatient care and do not want to go to a hospital or skilled nursing facility. In-patient hospice facilities are designed around the needs of the patient and the family. However, they are only used about 3% of the time because patients want to live and die at home.
- Ask the hospice if their social workers and other employees will do all they can to help you and your caregivers to find a way to get the things you need to live the remainder of your life as safe, comfortable, happy, and painless as possible. Social workers are in the business of finding a way and not saying no.
- Ask the hospice if they will interview you and help you prepare a written or videotaped summary of your life and what you want to say to your loved ones.
- Ask if the hospice has any certifications beyond their basic Medicare, VA, and State Certifications. Accreditation Commission for Health Care (ACHC), Community Health Accreditation Partner (CHAP), and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) certifications show a commitment to excellence.
- Ask the hospice if any of their employees (RNs, etc.) have any special hospice certifications. Such certifications are strong evidence of higher quality care.
- Ask the hospice if they will cover the cost of ambulance or other special transport, if needed, to and from hospitals, nursing facilities, and inpatient hospice facilities.
- Make sure the hospice knows that you are aware that you are legally authorized to change hospices once per benefit period and, if you are not satisfied with their care, you will change hospices.
There are at least 15 hospices in Beaufort County, including Agape Care (the largest hospice in SC), Amedysis, Tidewater, Pruitthealth, Friands of Caroline, Caris, Regency Southerncare, Homestead, Crescent, Patriot, Hospice Care of America, Compassus, Island, and others.
The author wishes to thank the Ralph H. Johnson VA Medical Center’s Public Affairs Officer, Wayne Capps and Hospice Doctor John Franklin and Agape Care of SC Director of Operations and fellow volunteer at the terrific RHJVAMC, Mrs. Dana Holtvoigt for the information they provided me.
Larry Dandridge is a past hospice volunteer, volunteer coordinator, marketing manager, administrator, CEO, and board chairman, and the founder of a hospice in Missouri. An accomplished writer and motivational speaker, he writes columns for the ISLAND NEWS, including the Veterans Benefits Column, What Citizens Should Know About Policing Column, and the Hospice Column. You can contact Larry at his email, LDandridge@earthlink.net.
These columns are not meant to replace carefully reading local, county, state, and federal law or the need for a lawyer when seeking legal advice.
Larry Dandridge is not an employee of THE ISLAND NEWS and his opinions are his alone. Readers should rely their Doctor, Physician Assistant, Nurse Practitioner, and Registered Nurse, Medicare, Medicaid, their Private Insurance Company, State Medical Department, the National Hospice and Palliative Care Organization (NHPCO), and the hospice of their choice for advice on hospice. Although every precaution has been taken in the preparation of these articles, the publisher and author assume no responsibility for errors or omissions. Neither is any liability assumed by the author or THE ISLAND NEWS for damages resulting from the use of information contained herein