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Advance Directives

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Advance Directives

Who is in Charge of Your Life?

 You may be thinking that this is the last topic about which you want to hear or read. Actually, advance care planning is one of the most important things you can do for yourself and for your family.  Planning for the last stage of life allows us to make informed choices and to share our wishes with our health care professionals and our family. This step allows us to maintain control, achieve peace of mind and assure that our wishes are honored.

Years ago, physicians were the ones who were mainly responsible for determining how aggressively to treat patients at the end of life.   We have come a long way in recent years.  Patients are now well informed regarding their conditions and prognoses. We are educated about the normal progression of our illnesses and we are aware of the available options for care and treatment. With professional assistance from our medical team, we are able to make informed decisions regarding this last stage of life.

When we are relatively young and in good health, we may question the need to have Advance Directives. Unfortunately, we never know when a medical event such as a terminal illness or disease may occur. A stroke, heart attack or an accident may cause a life threatening situation, leaving us unable to voice our wishes for care and treatment. Providing end of life treatment to a person who has not conveyed her/his wishes regarding these circumstances places a tremendous burden on families and medical teams.

You may wish to consider the following Advance Directives.

 The New York State Living Will allows you to state your wishes regarding medical care in the event that you develop an irreversible condition which prevents you from making your own medical decisions.

The Health Care Proxy allows you to appoint someone you trust to convey your wishes, such as a family member or close friend, if you are unable to do so.  The designated Proxy needs to be fully informed of all your healthcare decisions.

The MOLST (Medical Orders for Life Sustaining Treatment) form is a relatively new directive.  This directive is a more detailed and specific form for care at the end of life.  It is completed by your physician and you, often in the later stages of life or for a more serious medical condition.

The DNR (Do Not Resuscitate) order is used to decline resuscitation when your condition does not allow for any reasonable hope of recovery. This order is used when it is determined that resuscitation would only prolong the dying process.

I have just briefly outlined Advance Directives and the importance they play in our lives.  To be fully informed, you need to discuss them with your healthcare team and your family before you make decisions regarding your personal treatment. It is also important to understand that any of these directives can be updated and changed as your situation or your wishes change.

 

This may be an uncomfortable topic for some individuals. However, as I mentioned earlier, it may be the best gift you can give to yourself, your family and your healthcare team. Advance Directives ensure that you will have control over one of the most important stages of your life.

As Administrator of the Farrar Home, it is one of the discussions I have with our residents during the admission process. Over the years, we have seen that our population is more informed. Now, it is rare for a resident not to have Advance Directives in place. I completed my Advance Directives a few years ago. It gives me great peace of mind that my wishes are known and recorded. It is also reassuring to me that my family will not be burdened with difficult decisions during a stressful time.

I wish you good health and happiness as we continue to work to make our lives the best they can be.

Carol McKee, RN, Administrator of the Farrar Home

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I Don’t Want the Flu Shot!! — Really??

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AGING GRACEFULLY

I Don’t Want the Flu Shot!!  — Really??

 English: A White House nurse prepares to admin...

It is that time of year.  Most medical professionals are encouraging their high risk patients to get the flu shot, but why are they doing so?

Every year in the United States, on average, 5%- 20% of the population gets the flu. More than 200,000 people are hospitalized from flu complications. People often are uncertain about  whether to get the flu vaccine or not. Many people often have questions regarding the flu vaccine. What is the flu? Why should I get the vaccine? What is the flu vaccine? Here are some answers to commonly asked questions.

What is the flu?

The flu is a common viral infection that is spread from person to person in secretions from the nose and lungs. (For example, when sneezing.) The flu is a common respiratory infection that develops primarily in the lungs. As opposed to other respiratory infections,the flu usually causes higher temperatures, more malaise and body aches.

 Why should I get vaccinated?

The flu is a serious, highly infectious respiratory infection. With other respiratory infections, the symptoms are usually mild and most people can continue working or going to school while ill. With the flu, the symptoms are severe and prolonged. The infection stresses the body and causes people to miss days of work or school. The flu can be treated with medications. However,the medications are expensive and are not as effective as the vaccine. They need to be started 24-48 hours after the symptoms begin.

 Who should get vaccinated?

-People 65 or older.

-People living in nursing home or other long term care facilities.

-Adults and children 6 months or older with chronic lung or heart disease (including asthma)

-Adults and children 6 months and older who need regular medical care or were in a hospital during the previous year because of a metabolic disease (like diabetes), chronic kidney disease, or weakened immune system (including immune system problems caused by medicines or by infection with human immunodeficiency virus [HIV/AIDS].

-Women who will be pregnant during the flu season.

-All children from 6 -23 months of age.

-People who can transmit the flu to others. For example, healthcare workers, childcare workers, people in close contact with adults 65 or older

 How long does it take for the vaccine to work?

The vaccine is effective 2 weeks after injection. The vaccine is only effective against the strains of the virus that match the vaccine. The strains vary from year to year. This is why it is important to be vaccinated each year! The flu season can begin in October and may last until May. October or November is the best time to receive the vaccine. However, it is still effective if administered earlier or later in the season.

 What is the flu vaccine?

The flu vaccine is an inactivated vaccine, meaning that it contains killed influenza virus. The vaccine is injected into muscles and stimulates the immune system to produce an immune response (antibodies) to the flu virus. When the virus enters a person who has been vaccinated, the antibodies attack and kill the virus to prevent infection.

Each year the flu virus can change slightly, making the vaccine used in previous years ineffective. Every year, a new vaccine must be prepared that will be effective against the expected flu virus. The trick is to be able to predict which flu viruses are going to cause infection. The appropriate vaccine is then developed.

As required by the NYS Department of Health, I strongly encourage all my staff and residents to get the flu shot.  This helps to keep everyone healthy.  Over the years, I have seen a marked decrease in the incidence of the flu at the Farrar Home.  I feel this is largely due to almost 100% of our population receiving the flu shot.

I Do Want the Flu Shot!!  — Really!!

 Submitted by Carol McKee, RN, Farrar Home Administrator

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