What Do Advance Care Directives Have To Do With Being a Local Citizen? (Citizens’ Breakfast Notes)

Please see the notes of the March 20th Breakfast below. 

Also, note this week:  

• The next meeting place for “Coffee with a Cop” will be at the Brattleboro Food Co-op, 2 Main St., on Thursday, April 2, from 8 to 10 a.m. Residents are invited to stop by and learn more about what the department is doing in Brattleboro’s neighborhoods. Officers Ryan Washburn and Adam Pelock are scheduled to attend. Those with questions in advance may reach them at 802-257-7950.
• Friday, April 3, during Gallery Walk, another community meeting about the town’s homeless problem will be held at 7 p.m. at The Works Bakery Café at 118 Main Street in Brattleboro  http://www.reformer.com/news/ci_27662576/local-businesses-struggle-homelessness

​Brattleboro Citizens’ Breakfast​

March 20,  2015

Gibson-Aiken Center      

What Do Advance Care Directives have to do with Being a Local Citizen?  

Presenter: Joanna Rueter [1]

www.sustainable-aging.com     802-380-0301  

After her talk,  Joanna added: “Take a moment to think about one death you have experienced or heard about. What was most difficult or what was special and loving about it?”

 As you read this – stop a moment to answer this question for yourself before you read on.

 We never know exactly what will happen but if we allow ourselves to think about this part of life we have a better chance of having an ending that aligns with who we are. Additionally, if we have talked about it and mapped out our wishes, this difficult time will be easier for everyone involved.

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Advance directives are like fire drills, Joanna explained; they help us know what to do. With one difference: unlike a fire which might happen, death will happen. Advance directives give a general map in thoughts and on paper so friends and family have an idea of what to do during a time of upset.

There are Five Major Steps that comprise the advanced directive process:

1) Choose somebody to speak for you if you can’t speak.  This is crucial.  “Choose someone feisty,” advised Joanna. This person is an agent or proxy. [2] This doesn’t have to be a family member, good friends could agree to be agents for each other.

2)  Consider your Wishes – It is important to talk over your wishes with your doctor, your faith person, have conversations with your kids and family and of course your chosen agent. “What do I consider quality of life?” Joanna told of a conversation a man had with his eight year old grandchild, picking out the suit for his funeral together. Make the ending as normal as any other part of life. Everyone dies; what is the plan?  Directives are also important for younger folks; anyone, at any age, can have an accident. Everyone of legal age should have a directive.

3) Write – Vermont is wonderful in that it has an Ethics Network that has worked on this for a long time. As of June 2014 there’s a new bare bones two page advance directive form.  All Vermont forms are available as a download:  http://www.vtethicsnetwork.org/adforms.html  [3]

Consider that having an advance directive is a service to all the people who serve us. Police, Rescue, and Medical providers want to act in our best interest.  If it is not known what you want then providers are committed to doing everything possible. This may not give you the final days you would want to have with your loved ones.

4) Register and distribute.  Register your advance directive through the Vermont Registry, so that in an emergency anywhere in USA people will know you have a directive and can access it.  A tag is provided on your license to indicate a directive is on file. http://www.vtethicsnetwork.org/registry.html   Give copies of your directive to your medical providers and your loved ones

5) Talk talk talk – it takes multiple conversations with loved ones as the choices are much more complex than they used to be. Plus, over time your information changes. Help those you love know what to do. Help others in your life get over their own barriers to having this conversation. [4]

Suzanne Baxtresser RN, M.Ed., CHPN

Certified Hospice and Palliative Nurse

sbaxtresser@bayada.com  802-490-2099

Bayada Home Health Care  – http://www.bayada.com/

As a hospice nurse for many years, Suzanne has come to see that hospice is a way to support advance directives. Hospice takes the emergency out of End of Life Care. She recalled a patient whose family panicked when she started having trouble breathing at home. When she ended up in the hospital ER, she asked: “Why am I here? I signed papers and don’t want to die in a hospital.” If she had been enrolled in Hospice a nurse would have come to her home and managed her symptoms without her needing to go to the hospital. Indeed, 80% of people would prefer to die at home. Hospice Care provides a team of experts to help a patient and family manage end of life care at home.

Hospice, for someone with a life limiting illness can provide for support at home. Hospice specializes in navigating the end of life. A “life limiting illness” is defined as someone  certified as having six months or less to live, but that time frame can be adjusted to nine months or a year, if there is still declining health.

Connie Baxter is the bereavement coordinator at  Brattleboro Area Hospice.http://brattleborohospice.org/ – Hospice volunteers can come into the home, hekp with household duties, equipment and education, two years ahead if someone has an illness and needs the support.

Visiting Nurse and Hospice for VT and NH http://www.vnhcare.org/ is another available resource.

Hospice benefits are covered under Medicare. A home health aide assists in personal care. A social worker can provide more support if needed. A spiritual care provider can assist with funeral arrangements and emotional needs. Covered equipment may include a hospital bed, walker, and bedside commode.

The two takeaways are:

 1. you can get information on how to obtain help at the end of life from Bayada, Brattleboro Area Hospice and the Visiting Nurse and Hospice for VT and NH

2. hospice supports the advance directive process

[1] Joanna Rueter, LICSW comes to this work with the personal experience of the deaths of four elders in her family, each giving her a grass roots understanding of the value of end-of-life planning.  Joanna co-founded Sustainable Aging to help people explore this much avoided topic. She is certified as a  Respecting Choices® facilitator and instructor. She is currently running two open groups on Living Fully, Aging Well and Befriending Death– 1)The Gathering Place 2nd and 4th Tuesdays 6:30 -8pm and 2)The Senior Center  2nd and 4th Thurdays 10:45a.m. to Noon. For age 60+   FREE.

[2] “Durable Power of Attorney” is the historical word for Advanced Directive Agent.

[3] Disability Rights Vermont also provides links: http://www.disabilityrightsvt.org/advance_directives.html

 [4] “Recommended Books … If you can only read two, read these” … : My Mother, Your Mother: Embracing “Slow Medicine,” the Compassionate Approach to Caring for Your Aging Loved Ones,  Dennis McCullough, MD., 2009 and  A Better Way of Dying: How to Make the Best Choices at the End of Life (Why Your Living Will is Not Enough),  Jeanne Fitzpatrick, MD & Eileen M. Fitzpatrick, JD, Penguin Books, 2010.

http://sustainable-aging.com/resources/books/​