TALKING ABOUT IT DOESN'T MAKE IT HAPPEN . . . . . . .

Perhaps you read the article in the Star Tribune of April 23, 2017 by Gail Rosenblum
“Tackling a once taboo topic.” It is the first in a series of three articles addressing end of life issues, with information on how people are approaching this topic in today's information climate. Let me suggest you read this series of articles.

Every major healthcare provider group in Minnesota has encouraged such preparation of documents over the past five or six years. Perhaps you noticed the promotion on Twin Cities Public television around Thanksgiving and Christmas, called “The Convenings.” This program was hosted by Cathy Wurzer, describing how to conduct this sort of discussion with families, as we generally gather (convene) at holiday time. Certain individuals have said “I leave all that up to my doctor, I trust him/her totally.” Except, be mindful that the physician's practice is focused on cure and healing . . . in almost all circumstances. Additional resources for information may be a medical social worker at your healthcare clinic who is equipped to navigate the options for care on your behalf. An attorney and/or a financial advisor may also assist in creating such end of life documents, as well the legal aspects of property and finance. Pastors and parish nurse may also be good resources on how and when to prepare spiritually and physically for the end of life.

There is a broad spectrum of circumstances that may prompt discussions with those closest to you. While many assume this is a topic of conversation for later in life, there are those who have chosen to be proactive at a younger age due to frequent extensive travel in parts of the world with different medical services available. There are those who enjoy sports that present a degree of risk of serious injury who wish to plan for the “what if” circumstances. Motor vehicle accidents can involve much traumatic injury, which is more common in young adults. Morbid? Perhaps so, but consider creating a legal document that clarifies personal wishes. If the person who is injured is a minor, there may be questions of role of custodial and non-custodial parents; for individuals who are single with no next of kin nearby, it is recommended to appoint an agent for end of life decisions; furthermore, if one's next of kin is unable to make decisions, it is recommended that a trusted friend be identified to make legal decisions.

Talking about it does not make it happen. Talking about it does give everyone an opportunity to discuss healthcare options, quality of life, and other things that are important to you. This brings up the question of whether these decisions can be changed over time. Yes, they can. The documents related to end of life decisions are signed and notarized. It is recommended that these documents be amended and changed when either you or your designated agent for medical decisions experiences a new diagnosis or change in status of a chronic condition, if there is a divorce in the family that would impact which family members can speak for you, if an agent should pass away or even move a great distance away, or when there is a significan health or social status change for you or your designated agent.

There is no cost to you for completing these documents that are available from your healthcare clinic or online at www.honoringchoices.org. It is recommended that you provide a copy to your physician to have them included into your medical records. Copies should also be provided for your agent, for your immediate family, and perhaps for your attorney.

Because of the close relationship between Lutheran Church of the Good Shepherd and Fairview Healthcare, there is initial and ongoing training for our parish nurse at Fairview. The information and forms are standardized for all healthcare providers and recommended by the MN Department of Health. There are many other resources to assist in making these decisions; MN Agency on Aging has an extensive roster of information: 800-333-2433. It is recommended that this discussion, and these decisions, be made well in advance of a health crisis. . . .as the title here says “talking about it doesn't make it happen.”

HEALTH SMARTS FOR EVERYONE

from Dorothy Ellerbroek, your parish nurse

Signs of stroke: FAST, that is facial drooping, arm weakness, sudden speech difficulty. Time to call 911.

Signs of heart attack (symptoms vary from mild to severe; some or several of the symptoms listed here may or may not occur): chest pain or discomfort (fullness, pressure, squeezing); discomfort in other parts of the upper body including but not limited to pain in arm, jaw, upper back between shoulder blades; shortness of breath, cold sweat, nausea, dizziness. For some people, they describe chest pain “like an elephant sitting on my chest” while other symptoms are more mild. DO NOT IGNORE THESE THINGS.

The seven warning signs of cancer: To remember the seven early warning signs of cancer, think of the word CAUTION: Change in bowel or bladder habits; a sore that does not heal; unusual bleeding or discharge; thickening or lump in the breast, testicles, or elsewhere; indigestion or difficulty swallowing; obvious change in the size, color, shape, or thickness of a wartmole, or mouth sore; nagging cough or hoarseness.

SUICIDE HOTLINE # 612-379-6363

CPR/AED: take a class through American Red Cross or American Heart Association; load the app to your smart phone

Heimlich maneuver for choking: same as above for CPR as well as the app for phone

Discard out-dated Rx

Wear seat belts

Have regular dental check-ups and care

To supplement most physical and mental health therapies: maintain a reasonably healthy diet, exercise regularly, sleep seven-nine hours/night, maintain social connections and community participation

Advance planning: medical, legal, environmental/housing, social/community – resources available upon request. READ the book “Being Mortal,” by Dr Atul Gawande

Signs and symptoms of Alzheimer's disease:

  • Memory loss that disrupts daily life
  • Challenges in planning and/or solving problems
  • Difficulty completing familiar tasks
  • Confusion about time or place
  • Trouble understanding visual images or spatial relationships
  • New problems with words in speaking or writing
  • Misplacing things and losing the ability to retrace steps
  • Decreased or poor judgment
  • Withdrawal from work or social activities
  • Changes in mood and personality

Who Cares?

By Dorothy Ellerbroek, RN, Parish Nurse, Lutheran Church of the Good Shepherd, Minneapolis MN

Kind of sounds like part of a kids' argument, doesn't it? I want to get your attention for something really important. It is very likely that each of us has been a caregiver at some time in our lives, and quite likely that was for a short period of time, like caring for a child with a bad cold, or someone after a broken leg. While we were busy with other adult responsibilities over the past couple of decades, something happened . . . . there came to be a whole lot of people in our communities who are living a whole lot longer than people used to, it seems. Indeed, public health statistics show that we are living longer, and not entirely in excellent health.

There are opportunities to serve the role of caregiver for the entire age spectrum of the population, There are children with special needs that continue throughout their lives; there are healthy adults who develop chronic illnesses that are debilitating; there are persons of all ages having suffered permanent injury and disability from motor vehicle accidents; and then there are the needs of our aging population with limitations in a variety of ways, needing assistance and support in daily activities. The physical needs of these people are persistent, daily needs for which someone depends on a caregiver, sometimes a family member, sometimes a paid home health care professional, sometimes a combination of care givers to meet multiple needs. Some of the tasks include assistance with bathing, dressing, transferring, ambulation, eating, and toileting; in some circumstances the caregiver must be responsible for medications, treatment procedures, managing medical equipment, and household environmental care. As care-giving situations become necessary on an on-going basis, other concerns arise such as safety, emergency planning (fire danger, equipment failure), and so very commonly, caregiver fatigue, and “burnout.”

Often it is family members who are providing the care, without regard for their own health, fatigue, perhaps illness of their own, and they faithfully continue providing care until they are physically and emotionally exhausted, neglecting their own health. As the physical demands of care giving increase, so can the emotional toll; as illness worsens, the need for more care can challenge the coping skills of the most dedicated caregiver!

There is a new six-week course coming to Good Shepherd called Powerful Tools for Caregivers, beginning March 28, 2017. This class will meet each Tuesday from March 28th through May 2 from 6:30 – 8:30 p.m. This program is facilitated by individuals who have completed training with the Metropolitan Area Agency on Aging to provide you with the highest quality of information and experience. The classes are designed to provide the caregiver with a wealth of tools that will help foster self-care, reduce stress, improve confidence, contribute to life balance, and find helpful resources. Lutheran Church of the Good Shepherd is partnering with the Normandale Center of Health and Wellbeing in offering these classes. Registration is required.

For additional information and to register please contact Mary Cordell or Zach Greimann at Normandale Center at 952-977-9363 or 952-977-9374 respectively.