Archive for January, 2009

Doctors Need to Tell the Truth

Monday, January 26th, 2009

Ancestry.com has made some death certificates available online to members, and reviewing these documents sheds light on the way people died within the past century. These documents, however, don’t cover the time when doctors managed to help patients live longer through medicines and machinery. In fact, many of these older death certificates come with the doctor’s admission, “He was dead when I arrived.”

Families then were as profoundly affected by sudden deaths as families today; however, lengthy illnesses held little hope for recovery in the past. Tuberculosis, disease created by insanitary conditions and illnesses such as pleurisy (often describing a lung infection such as pneumonia) all are conditions that belonged to the past in most cases throughout industrialized nations. Those conditions caused thousands of deaths with little hope for recovery.

Even with modern cures and treatments for diseases such as cancer today, every person is confronted with death sooner or later. In fact, a recent news article found that families preferred that doctors tell the truth when it comes to knowing about a loved one’s condition. While doctors worry about erasing hope for patients and their families, those same families stated that avoiding discussions about prognosis “was not an acceptable way to maintain hope.”

Timely discussions about prognosis of a loved one’s health helps to prepare the family for the possibility of death. The findings were based upon interviews with 179 family members of seriously ill intensive-care patients, all whom had been placed on a ventilator because they could not breathe on their own. The study supports the belief that doctors should help families “hope for the best and prepare for the worst.”

On the other hand, people who do not wish to talk about death and dying with their doctor should understand that major decisions often will then be made without their input. In cases where patients and family members know the truth, they can decide what they do and do not want done. They can decide whether they want aggressive treatment that might prolong life or whether they prefer to stop treatment, which could mean dying sooner but more comfortably. These decisions are part of the new focus on death care, a focus that allows people to die with dignity and that leaves the family with the feeling of some competency in a time of crisis.

Undoubtedly, some researchers may be able to read your death certificate in the future as they dig up information on how our culture lived. Hopefully none of those certificates will read, “Dead when I arrived” in the doctor’s notes. Instead, may it read, “died from old age,” a malady that is unavoidable for those who manage to live a long life.

How to Manage Sympathy Flowers

Monday, January 19th, 2009

Lily

Sending sympathy flowers is one way to express your condolences to a grieving family. And, receiving flowers often is a heartwarming gift. But with the rising costs of flowers and shipping, are flowers the best way to express your feelings?

This article might answer your question as you look at both sides of the picture – how to manage sympathy flowers from the sender’s and the receiver’s perspectives.

Sender

When a friend or relative dies, sometimes the first urge is to send funeral or sympathy flowers so you can show you care. Those flowers, then, become your representative. But, before you order anything, think about the following issues:

  1. Which flowers are best? The color is important, as trends come and go. White flowers such as lilies or roses seem to never go out of style. But, you might check with the florist first, as they usually know which flowers are in style for funerals. A second way to ensure that you’re sending the appropriate colors is to contact the funeral home. Sometimes a themed funeral has been planned, and the family may have requested a certain color.
  2. How big should you go? This question can be answered by your budget, but it also is answered by your connection with the bereaved family. If you’re a friend to the deceased and you shared an office space, then send a small arrangement. If you’re a distant relative, be careful. You don’t want to send an arrangement that’s larger or more elaborate than anything ordered by the immediate family or smaller than one sent by a friend. Although this advice may sound ludicrous, many families still follow convention of hierarchy – even with funeral flowers. Check with a florist in the town where the funeral is held – that florist may have answers for your questions.
  3. Guidelines: If you’re unsure what to send, you have a few options that will narrow down your choices: 1) Wreath - the circle represents eternity, and this is an appropriate floral arrangement for anyone to send. Smaller wreaths are more appropriate for friends; 2) Spray - Sprays often are placed on easels. They are more appropriate for family members to send; 3) Floral arrangement - this is a mix of fresh flowers displayed in a vase or other container. This is the best option when in doubt; 4) Casket Spray – this arrangement is designed for the top of the casket. Leave this arrangement to the immediate family to choose.
  4. Family doesn’t want flowers: Don’t override a family’s request, especially during a time of grief. If they request funds to be sent to a nonprofit organization instead of flowers, then take the money you were going to spend on flowers and sent it to that organization. You can send a card to the family and mention that you sent money, but don’t mention the amount. This isn’t about you, after all. But, beware – sometimes that organization will send a list of givers and the amounts they sent to the family of the deceased, so don’t be stingy.
  5. What other options do you have? A sympathy gift basket is a great alternative to flowers. You can include photos of the deceased if you have them, chocolates and a number of other items that are more personal. This gift is more for the living than a memorial for the dead and much more useful in many cases.
  6. Send a plant or flower later: The time that is most difficult for those closest to the deceased is after the funeral, when everyone leaves. This may be the most appropriate time to send a living gift, such as a plant. The reciever might be more grateful for this gift at that time than during the funeral.

Receiver

It is difficult to think about the small issues such as flowers when you have other major decisions to consider after a loved one dies. But, when a friend or relative thinks enough of you and the deceased to send a funeral floral arrangement, you might respond appropriately at an easier time. Here are some other tips:

  1. How to display sympathy flowers: When someone close to you dies, it may seem that all the flowers you receive look the same. But, if you want to show that these floral tributes are appreciated, be sure to display the arrangements. You can use them at the funeral home, in your home or at the grave site, depending upon the funeral arrangements.
  2. What to do with too many flowers: If you didn’t request donations to a charity instead of flowers, you can expect too many flowers. If you end up with too many floral arrangements, send some home with relatives or friends, or take them to a rest home or hospital as soon as possible after the funeral.
  3. Don’t be critical: Many people don’t understand funeral etiquette, and that etiquette is changing. If your neighbor sends a huge and colorful horseshoe arrangement, accept it and leave it at that. Remember that it is the thought that counts. Also, if someone doesn’t send flowers, don’t discount their feelings or intentions. They may be planning other arrangements for you later.
  4. Keep track of floral arrangements: It’s easy to mix up the givers when so many floral arrangements arrive at one time. To ensure that you thank everyone, take the card or tag that arrives with the sender’s name and make a note about the arrangement on that card. Put all the cards into an envelope that you can save for later. If possible, assign the task of looking for mailing addresses so you don’t need to deal with that issue.
  5. Acknowledge the flowers: No matter how innapropriate or insignificant, the point is the sender meant to express his or her feelings about your loss. In some cases, you may see those flowers from a different perspective after the funeral. When you feel up to the task, pull out that envelope filled with gift cards and write thank-you notes for the flowers. Two to three sentences on a simple thank-you card are appropriate for this task. Your friends and relatives will be grateful that you acknowledged them.

The Best Deathcare Sites Online

Monday, January 12th, 2009

If you’re interested in hospice care for yourself or a loved one, where do you seek advice? Hospice or palliative care, has been around for just over a quarter century, so you might not know where to seek information or which questions to ask about death care for yourself or a family member or friend. To that end, we’ve compiled a list of sites that belong to well-organized nonprofit groups or professional organizations or that have been built by professionals in the death care field.

The following list is filled with sites for patients, but a few are geared toward professional caretakers. We included those sites, as they are filled with information that patients and caregivers might want to know. Additionally, the list below is in no particular order. We don’t advocated one site and its information over another.

  1. Hospice is a comprehensive site geared toward educating viewers on death care and hospice and palliative care programs. They focus on the explanation and education of hospice services, help for patients, children and caregivers through articles and links to valuable online information.
  2. Hospice Foundation of America exists to help those who cope personally or professionally with terminal illness, death and with the grief process. Hospice Foundation of America meets its mission by conducting programs of professional development, public education and information, research, publications and health policy issues. Their programs for the public assist individual consumers of health care who are coping with issues of caregiving, terminal illness, and grief.
  3. The National Hospice and Palliative Care Organization (NHPCO) is the largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. The organization is committed to improving end of life care and expanding access to hospice care with the goal of profoundly enhancing quality of life for people dying in America and their loved ones. NHPCO advocates for the terminally ill and their families, develops public and professional educational programs and materials, conducts research and works closely with other organizations that share an interest in death care.
  4. The American Hospice Foundation outperforms most charities in America in its efforts to operate in the most fiscally responsible way possible, according to Charity Navigator. Their mission is to improve access to quality hospice care through public education, professional training, and advocacy on behalf of consumers. They also support programs that serve the needs of terminally ill and grieving individuals of all ages.
  5. International Association for Hospice & Palliative Care (IAHPC) operates to help increase and optimize the availability of access to hospice and palliative care for patients and families throughout the world. IAHPC focuses on program development, education, information dissemination and policy changes to improve availability of good and adequate care of patients with advanced diseases. They support programs, projects and individuals around the world, especially in developing areas in Africa, Eastern Europe, Asia and Latin America.
  6. The Hospice Patients Alliance (HPA) was formed in August of 1998 as a nonprofit charitable organization to serve the general public throughout the United States. It was formed by experienced hospice staff and other health care professionals who saw that hospices were not always complying with the standards of care, and in fact, were in some cases, violating the rights of patients and families and exploiting them for financial gain, or not providing adequate care to control pain or other distressing symptoms during the end of life period. HPA promotes quality hospice services whether a patient is enrolled in a licensed hospice or not, whether residing at home or in a facility. HPA protects the rights of patients, their families and caregivers, the bereaved and staff by providing information about the standards of care governing the health care provided, the services required to be provided by law, standard industry practices and how to obtain the very best hospice care available.
  7. Hospice Directory is more than a directory. This site provides information on how to choose a hospice to hospice stories and a caregiver’s corner. They break hospice care centers down into state hospice organizations and Canadian/Provincial hospice organizations to make it easy to find one near you. HospiceDirectory.org is a subsidiary of its founding sponsor, the Hospice Foundation of America (HFA), and it is the most comprehensive and user-friendly hospice directory around.
  8. Children’s Hospice International’s ultimate goal is to so ingrain the hospice concept into pediatrics that it isn’t considered a separate specialty, rather, an integral part of health care for children and adolescents. CHI works closely with health care professionals  providing technical assistance, educational materials, and other resources. They also help the families and friends of a child with a life-threatening condition by providing literature specific to families, connecting them to local resources, and offering support.
  9. The American Academy of Hospice and Palliative Medicine (AAHPM) is dedicated to expanding access of patients and families to high quality palliative care, and advancing the discipline of Hospice and Palliative Medicine through professional education and training, development of a specialist workforce, support for clinical practice standards, research and public policy. Their core purpose is to improve the care of patients with life- threatening or serious conditions through advancement of hospice and palliative medicine. The Academy is the professional organization for physicians specializing in hospice and palliative medicine. Membership is also open to nurses and other healthcare providers who are committed to improving the quality of life of patients and families facing life-threatening or serious conditions.
  10. Help the Hospices is a UK site that supports hospice and palliative care throughout the UK. The site is geared toward all involved in the death care process, including professionals, patients and families. They also support a directory of hospice services available throughout the UK and Ireland and an international directory for palliative care services outside the UK.
  11. National Association for Home Care & Hospice is the nation’s largest trade association that represents the interests and concerns fo home care agencies, hospices and home care aide organizations. From professional development to fighting for better regulation, from knowing all angles of federal and state regulations to providing the latest information affecting home care and hospice, NAHC stands ready to serve your needs, enabling you to better serve your patients.

Before a Spouse Dies

Friday, January 2nd, 2009

Losing a spouse ranks among the highest-level stress events that can occur during a person’s lifetime. The transition to learning how to live without that significant other often worsens with the added pressure of settling an estate. Fortunately, the best thing you can do in this situation is to avoid hasty decisions and to plan early. There are steps you can take now to ease the financial and emotional transition.

  • Get advice: This item is listed first, as this step should be taken well before a death occurs. Attorneys can help develop legal documents such as wills. They also can help explain estate settlement procedures. You also can larn more about funeral options so you don’t need to make last minute decisions that could cost you. Find out about how to obtain copies of death certificates needed by insurance companies and other benefit applications, and find a financial professional who is willing to help organize your finances both now and after a death has occurred.
  • Make important documents and financial records easy to find: Before an estate can be settled, important documents and financial records must be at hand. You may also need to obtain certified copies of certain documents. For instance, to apply for Social Security benefits, you’ll need to provide birth, marriage and death certificates. Locate them now, so that you don’t have this added stress put on you during your grief.
  • Get organized: Set up a file system that can be reviewed once a year or so, depending upon your situation. Gather all important documents and keep them in one place. Organize them by topic area. Set up a phone and mail system so you’re ready to call the people and organizations that will help you through your transition. This list would include phone numbers for your attorney, insurance agent, financial professionals, and friends – all of whom you can contact for advice. While you can keep much of this information at home, it would be best to keep documents such as a deed, insurance papers or a will in a safe deposit box. Make sure someone knows where an extra key is located in case you’re unavailable.
  • Evaluate short-term income and expenses: Decide now which expenses might need immediate attention after a spouse’s death. Even if you’re expecting money from benefits, those funds may not materialize for days or months. Once you determine how much it would cost to survive and pay bills for three to six months after a spouse’s death, you can begin to save this amount in a special account. This way, you have immediate access to liquid funds that can be used to pay for the funeral, the mortgage and any other pressing bills. If you cannot save this amount of money, you may be able to ask the insurance company for an advance (provided your spouse carried life insurance).

When you make plans in advance to be prepared for emergencies and death, you can avoid hasty decisions. For instance, don’t think about moving from your current home until you can make a decision based upon rational reasons rather than emotions. Plus, don’t spend money impulsively. This is why funeral pre-planning can help, especially when it applies to what your spouse wanted and not what you think needs to be done.

Finally, don’t give in to pressure to give away or sell your spouse’s personal items. Wait until you feel less stressed before you hand that watch over to little Billy or that serving platter over to the family antique hound. If you wait before you give things away or sell them, you’ll make decisions that you can live with for the rest of your life – without regrets.