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How to Dispute Health Insurance Errors

Board care for elderly can cause medical bills to pile up.

Photo used under Creative Commons from attercop311.

With the possibility of multiple bills being generated from a single visit – along with discrepancies in the diagnosis and treatment necessary – there’s no wonder that medical bills sometimes have errors. In fact, a recent study conducted by the American Medical Association revealed that even with the recent improvements in billing accuracy, a full 10% of bills paid by private insurance companies do, indeed, have errors. Added to that is the fact that next year, in 2014, a much greater number of Americans will have health insurance coverage under the Affordable Care Act, thereby increasing the possibility of errors. There are ways consumers can dispute any health insurance billing errors they find. The following are just a few suggestions to set things right and possibly save yourself quite a bit of out-of-pocket expense in the process. First, make sure your insurance provider has the most accurate and up-to-date information about you. Though it sounds entirely too simple, such discrepancies as your date of birth, the spelling of your name or whether or not you regularly utilize your middle initial on your paperwork can create problems. A great example of how this can happen is when a person is admitted to the hospital. A hospital patient can be seen and tested in a number of different departments, and unfortunately, all the departments create separate billing for the work performed. Thus, it can be tricky to keep up with all of this and to remember it all at the time your bill is actually received. It is always best if you have a friend, family member or other patient advocate available to double-check the information while you’re being seen at the hospital. Second, review your bill. Generally, your bills come with an explanation of benefits – read them over and be sure you understand them fully. This statement will indicate what services are being paid for by your insurer and which ones are not. This is a great way to get a clear, concise explanation if your insurer doesn’t cover a particular service. Third, be sure you have a good understanding of your insurance benefits. Have a working knowledge of your deductible and your co-pays. If you have to be referred to a doctor outside the network, understand what percentages are covered for these types of visits. In the case of pricey specialists, you should know that insurance companies often work with average “industry standard” costs for certain services and often will not bend if your specialist charges significantly more than the average. Fourth, after reviewing your bill and truly understanding your benefits, don’t be afraid to ask questions if you do not understand. Challenge the charges if you deem it necessary. Be sure you keep detailed records of who you spoke with and their responses. Keep a copy of anything you fax, mail or email to your insurer. Fifth, check the medical coding information. Much of the medical billing information you receive works off of specific coding from your doctor’s office, submitted directly to the insurance company. In certain cases, you may need to go back to the doctor’s office to request a “run-down” of the medical codes associated with your visit. Compare this information to your bill. If there is, indeed, a discrepancy, you can go back to the doctor’s office and ask that the information be corrected and resubmitted. A simple error in coding the diagnosis can make a huge difference in the payment of services associated with that visit. Sixth, get agreements in writing. Promises are no good without written confirmation, preferably via email. Finally, if the dispute process seems entirely too consuming, you may consider getting a medical billing advocate to help. A growing number of consumer advocate services and software programs are now available to assist in detecting and disputing medical billing errors.  
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Coping with Dementia Behavior

Los Angeles Demetia care understands, we can help.Of all the diseases that can affect our loved ones, dementia is one of the most difficult. Your loved one may have been an intelligent individual who you enjoyed interacting with, but the effects of the disease on the brain may cause that person to become an almost distant stranger you barely know. People facing the early stages of dementia generally understand that something is awry. They may become forgetful, have difficulty remembering names or performing ordinary tasks. Initially, your loved one may attempt to hide the challenges they face by offering a myriad of excuses. Eventually, though, as the disease progresses, your loved one’s frustration is likely to mount as he or she realizes things are getting worse and not better. The loss of independence and often the lack of understanding about what is actually happening becomes very frightening. Anger is sometimes an expression of fear, and as the closest individual to your loved one, you may bear the brunt of the angry outbursts often associated with dementia patients. It is also important for family caregivers to recognize that dementia patients often lose the ability to reason, so what makes perfect sense to them can seem outrageous to others. Sometimes wanting to prove their abilities to maintain their own independence, a dementia patient can, and will sometimes, defy the instructions given by family and physicians. In these moments, it’s important to remember that your loved one does not have the full control or understanding of their actions that they did ten or twenty years ago. So how do you, as a family caregiver, maintain a peaceful, positive relationship with your loved one? First, patience. Yes, mom or dad may ask the same question 25 times a day. Yes, they may tell stories so off-base you’re tempted to lose it. Don’t. Your loved one sees the world through an entirely different filter, and losing your temper benefits no one. So, answer the questions repeatedly. Change the subject. Refocus your loved one on the flowers or animals in the backyard or on music. If those tactics are ineffective, remove yourself temporarily by taking a 10 minute walk or enjoying a calming cup of tea. Praying or venting with a friend (far away from your loved one, of course) can also help reel you back in and shift your perspective. Second, do your best to avoid arguments. Your loved one’s stories may be driving you crazy, but arguments fuel tension at a time when your loved one needs reassurance that you will actually be there for them. Further, dementia patients can be quite stubborn, so they are less likely to back down in the face of conflict. Third, do not take things personally. Dementia patients often lash out at the very loved ones who are attempting to help. Harsh statements can be hurtful coming from anyone, but absolutely devastating when said by your loved one. This is when it is critical to understand the effects of the disease on a person’s behavior and memory. Blame it on the disease, not the person, to reduce your stress and enable you to maximize your time with your loved one. Fourth, get help. Your parent’s doctor can often prescribe medication to reduce their anxiety, so discuss the challenging behavior with them. They may have solutions you are not yet aware of. Also, your emotional and physical health is vital, too, so join a support group to connect with others going through similar experiences. Take care of yourself and see your doctor regularly.
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Preventing Problems with Medication

Los Angeles Alzheimer care facilities prevent problems with medicine.If the healthcare industry actually tallied the numbers and assigned a price tag to medication-related illness, the numbers would place it fourth-highest among “diseases” – behind cancer, Alzheimer’s and cardiovascular disease. A recent study published in the Journal of the American Medical Association, entitled: “Use of Prescription and Over-the-counter Medications and Dietary Supplements Among Older Adults in the United States,” revealed that 91% of adults over the age of 57 are taking some type of medication on a regular basis, with 81% taking a prescription medication regularly. Prescription medication was only one type of medication studied. The researchers also looked at over-the-counter medication, herbal supplements, and vitamins and minerals. The JAMA study concluded that at least half of the survey respondents were utilizing at least 5 medications regularly, which translates to a lot of chemical and natural compounds entering the body routinely. While medications are designed to assist the body in dealing with particular challenges, certain compounds react with others in a manner that can, and does, create harmful interactions. These harmful drug interactions account for an average of 175,000 trips to the emergency room each year for seniors. It is important to take into account age-related differences in the body which may affect the way a medicine reacts for a senior versus younger adults. Older adults tend to lose muscle and store more fat, and the fat balance can alter the effects of medication in the body. The health and overall functioning of the person’s eliminative organs (i.e., the liver and kidneys) has a tremendous effect on how well the medication is removed from the body. Poor elimination can spike the presence of the medication in the blood levels. Hydration (or lack thereof) can be a huge issue that seniors must guard against, since it definitely affects the way the stomach absorbs a particular substance. And what we eat, the effects of certain foods and liquids on our absorption, side effects, etc. are critical. To prevent medication-related challenges, all your healthcare professionals should be aware of every medication you are currently taking. This is not simply related to prescription medications, but should include all compounds you take on a regular basis, even the seemingly innocent ones. Antacids, aspirin regimens, vitamins, minerals, herbal supplements – if you take it regularly, every person who contributes to your healthcare in any manner should be aware of it. Ask your healthcare professionals questions. In addition to problematic drug interactions, certain combinations can deplete important nutrients from the body, so it is best to be aware of the possibilities. Your pharmacist is also your secret weapon in the fight for the prevention of medication-related challenges; he or she is often able to research the various medications you take for possible interactions. Be sure you contact them at a slower time of day so you can get the focused attention you will need. Because the needs of seniors are different, there is a specialized field of pharmacists called “Senior Care Pharmacists” which may be of particular benefit. Find one utilizing the website of the American Society of Consultant Pharmacists. Finally, you can conduct your own research by browsing through the “Beer’s List” of potentially inappropriate medications for senior adults.
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Tips for Getting Cozy in Assisted Living

Our assisted living facilities in California make like comfortable.While many of us dislike change, for an elderly person, change can be especially difficult. Dealing with changes in their body, family dynamics and the like is already a tough process, but the notion of leaving home – their home – is probably amongst the toughest transitions an elderly person may face. As the adult child of an elderly person, you may feel strongly that a move to assisted living is in the best interest of your loved one. For example, safety may have become an issue. However, your opinion may not be readily shared. Your loved one may be leaving a home where they’ve lived for decades – the birthplace of countless years of memories. Moving away is a significant loss, and even if health and safety concerns necessitate the change, it is best to remain sensitive to the emotions that come along with it. So, how can you create the best possible transition? The following are a few tips that may help make the assisted living facility feel a bit more like home. First, take an inventory of the personal effects your loved one feels strongly about. While this could include any number of items, from bed linens to a comfortable chair or a painting, having the comforts of home always makes a person feel better. If you are questioning the items you should take, simply ask your loved one which items they feel strongest about. Their answer can, sometimes, truly surprise you. In the midst of these conversations, you may learn about the significance of certain items they cherish (i.e., could be a family heirloom, an item received in their “courting” days, etc.). In any event, it is important you do not simply assume, but that you truly get this part right. The only way to know is to ask. Second, spruce up their new home with colors, treasures and other items that make the space feel like their own. Photo albums, pictures on the walls, window dressings, etc. are all inexpensive upgrades that can make a world of difference. If your loved one enjoys hosting others at home, sometimes the very simplest gestures (like a candy bowl or other treats) can make this new space feel more like the home they left behind. Third, begin calling the assisted living center their home. If the place feels like, and is referred to as, a temporary dwelling, your loved one may resist getting comfortable there. You don’t want the assisted living center to feel like a hotel or worse, a hospital – you want your loved one to embrace this new community and to enjoy being in thier new space. Fourth, speak with the staff about your loved one’s unique personality and how to engage them in this new community. This conversation may actually turn into a brainstorming session, but this will give the staff a better feel for your loved one and what resonates with them. Just like your parents did when you were younger, help them find a peer group with which they can relate. For example, if your parent has relatively little trouble moving around, make sure they meet others who don’t have major mobility issues. Positive social connections are important, and you are his or her best advocate for that. Finally, nurture and encourage – don’t force. Give your loved one a chance to adjust, but be careful that the transition isn’t taking too long or met with excessive resistance. Watch also for signs of depression, and take the appropriate steps to get help if he or she seems to be falling into a depressed state.  
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What to Do When Your Parent Refuses to See the Doctor

Los Angeles Alzheimer care has healthy options.Among the challenges you may face as a caregiver for an aging parent is the refusal to see a doctor. Most people assume a person who has the financial means to get medical care will do so  – just simple scheduling, right? Not always. So what do you do? First, go for backup. While it may sound silly, if you have been a caregiver (or in contact with other caregivers) for any length of time, you understand that family dynamics can often come into play in these situations. Your parent took you to the doctor as a child, and in your adulthood has been offering you advice over the years. Having those tables begin to turn – even if it is ever so slightly – can cause some resistance. As their loved one, the caregiver often thinks their advice is first to be considered, but the nature of family dynamics sometimes proves otherwise. Often, you can enlist the help of an objective third party, such as a doctor or nurse. Preferably, this person is already known to and trusted by your parent. He or she is likely to be viewed very differently since they’ll be seen as a professional and not subject to the parent-child power struggle. If possible, a geriatric physician is even better, because he or she deals with patients in their age range every day and can often hint at possibilities that others (loved ones or not) may miss. They can often be your best advocate. Second, if the objective third party doesn’t work, or if you cannot secure one easily, getting one of your parent’s friends on board may work wonders. The friend may have already seen a geriatric physician or know someone who has similar symptoms who sought medical attention. Cast your net to include relatives (perhaps your parent’s sibling) to weigh in on the subject as well. Though the friend or sibling definitely has an interest in the matter, they also have more life experience and can relate to your parent on an entirely different level. Third, create a positive reward. As a person ages, the “stuff” of life becomes less important than the experiences of life. So, perhaps the two of you can have breakfast or lunch at their favorite diner after the appointment. It becomes a positive memory for your parent and it creates a convenient focal point should another doctor’s visit be necessary. Fourth, be aware of the time span between appointments. Often, when we are scheduling appointments at the front desk, the scheduler may offer you the very first appointment available. If there is no medical emergency, some time between appointments may make the experience seem less invasive and unpleasant. As a caregiver, you will often need to gain a greater level of perspective in order to relieve frustration. For example, your parent may give you what you deem an absolutely ridiculous reason for not wanting to go to the doctor. For some people, aging brings with it a fear (albeit sometimes irrational) of doctors or hospitals. It may create a very unpleasant association – for example: it may conjure up memories of time spent with their loved ones following an illness or it may bring to the surface fears of hearing that he or she may need to have a surgical procedure. For an elderly person who has been relatively healthy and independent all their lives, the thought of losing that independence can be extremely bothersome. Though younger generations have embraced pharmaceuticals, many older adults have relied heavily on the home remedies and tinctures their mothers and grandmothers used on them. Certainly, a level of distrust can exist toward these “newer” treatment options (and their side effects). Either way, try to assure the discussion (and the trip) is as pleasant as possible… but do schedule that appointment at the first sign of an okay…. okay?
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Financial Mistakes to Watch for in Retirement

Board care for elderly can lead to financial mistakes during retirement.

Photo used under Creative Commons from bradipo.

While some people work and save for years so they can have a very comfortable lifestyle during their retirement years, others find  keeping their retirement nest egg intact to be a challenge. A 2010 survey conducted by Wells Fargo Bank revealed that more than a quarter of the American population has concerns about their finances for retirement. Thus, we’ve put together a short list of common financial blunders to avoid when you’re working to protect your valuable assets. Have a Clear Understanding of Medicare and Medicaid: While Medicare is a very valuable healthcare management program, many retirees do not have the best handle on what is – and is not – covered by Medicare. One of the most financially devastating challenges to your financial health in retirement years is the need to enter an assisted living facility. While Medicare does, in most instances, cover a short-term stay in a rehabilitation center, Medicare will not cover a long stay in assisted living since assisted living is not medical care. Unlike Medicare, the federally funded Medicaid program will cover long term care, but Medicaid is a program designed for seniors who have exhausted all their assets (for a considerable period of time) and is generally considered an absolute last resort option. Many assisted living facilities do not accept Medicaid. Make no mistake – just one serious health challenge faced in the absence of a long term care plan can wipe out years of financial planning. It can also leave you with little options should you face a second, or third, health challenge. If you do not have a long-term care plan, or if yours is not comprehensive enough, start planning for that rainy day now. Beware of Con Men: Today’s seniors grew up in a world that was more trusting and more caring. However, that innocence, along with the availability of funds and assets, makes them a huge target for the unscrupulous (to the tune of $2.6 billion annually). A good rule of thumb: if it sounds too good to be true, it is. Estate Planning 101: Most individuals recognize the importance of having a will in place to leave their assets to the beneficiaries they hold dear. However, wills are not a set-it-and-forget-it type of document, and depending on when the will was initially drafted, it may have to be amended more than once. Pay attention to major life changes you experience, such as divorce, the death of a beneficiary, a birth in your family, or adoption. Note: if your will’s executor passes away, run (don’t walk) to have a new one appointed. The general rule of thumb is to review and update your estate plan portfolio at least once a year (with, of course, revisions done in between when there’s a major change). Doing so will help you notice when your documents have become outdated. Enlist the Help of Professional Estate Planners: While most family members mean well, the fact is that retirement planning is a specialized field best handled by professionals. Unless you have a family member who is both trained and experienced in this field, not just dibble-dabbling and reading market trends, it is best to maintain a relationship with a trusted advisor. Having the input from family members is fine, but before acting on their opinions, be sure your financial planner agrees.
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How to Talk with Someone Who Has Alzheimer’s

Our assisted living facility in California has items to comfort.

Photo used under Creative Commons from Karen Roe.

As human beings, we are created for meaningful relationship with one another. Healthy communication is a vital part of remaining connected in any relationship – even when the person you’re communicating with has been diagnosed with Alzheimer’s disease. While cognitive decline puts a tremendous toll on your loved one’s ability to remember significant people, places, and things, it can also severely impact your ability to communicate with them. There are, however, a few important tips to bear in mind as you are working to maintain healthy communication with your loved one. It is also vitally important that you remember no matter what stage your loved one is in, human connection is essential to his or her overall well-being. That said, the following are some suggestions to make this challenge a bit easier for the both of you.
  • Create A Distraction-Free Zone: Background noises can distract anyone – even those with no cognitive challenges at all. But for a loved one suffering from Alzheimer’s disease, the television, radio, or other device can easily compete with your conversation. Give your loved one’s conversation your full – and undivided – attention in a peaceful environment.
  • One-On-One Conversation: While it may sound silly, having multiple individuals gathered together for conversation can create an overwhelming and highly confusing environment for your loved one. After all, the more individuals who are present, the more apt each party is to contribute to the conversation. It can prove to be extremely agitating to your loved one, whose brain may still be trying to process what has been said as well as who has offered the input. Keep the conversations simple – one person at a time.
  • Simple, Lighthearted Conversation: There’s always something to be said for small talk, but especially so when your loved one is experiencing cognitive decline. Most of us are taught to converse with others using open-ended questions to spark conversation. However, for an Alzheimer’s patient, this leaves entirely too many choices. Remember, your loved one may not remember the significance of certain titles, such as “nurse.” Therefore, he or she may ask questions like, “What’s a nurse?” Combat these challenges by simply referring to your loved one by name, and referring to yourself (or another person) by name. It helps the Alzheimer’s patient to orient themselves. If you’re speaking to your loved one about an animal, address the animal either by name (if it’s a pet) or by species (for example, “cat”) instead of saying “it.” Again, it helps your loved one keep track within the conversation.
  • Be Patient and Non-Combative: It is easy to understand how difficult it becomes for you, as the loved one of a person suffering from such a debilitating disease, to repeat yourself or explain the who-what-and-where’s of very familiar things. But engaging in arguments will most likely end in one result – agitation for yourself and your loved one. Stay calm and repeat yourself if necessary. If your loved one seems to be having difficulty in making a request, do your best to state the question you feel he or she is attempting to ask. For example, if your loved one is fumbling around for something on a table nearby, you may say, “Are you looking for a tissue? Are you looking for your glasses?”
  • Watch Yourself! Everyone understands that non-verbal communication is as important as, if not more than, verbal cues. Cognitive decline, especially as it progresses, will undermine a person’s confidence as simple, routine tasks become increasingly more difficult. Thus, your loved one is likely to be highly sensitive to everything you say and do. The tone of your voice and your body language is important. Expressing your acceptance with friendly eye contact and kind facial expressions is important. After all, the goal is to maintain positive communication with your loved one and to minimize feelings of confusion or distress which may lead to negative, hostile reactions or to your loved one “shutting down” due to feelings of isolation.
 
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How Seniors Can Avoid Falls

Our board care for elderly locations are in safe enviroments.

Photo used under Creative Commons from ericrichardson.

Susceptibility to falls increases with age. Every senior and every person caring for a senior must have a keen awareness of this as the leading cause of injury for this age group. This one type of injury is responsible for a large number of seniors losing both mobility and independence.  Post-menopausal women with osteoporosis must take extra care in fall prevention because of the danger of broken bones due to decreased bone density. Studies show if you have fallen, it is very likely for it to happen again in the next six months. When considering fall prevention measures for seniors, take into account medication, exercise regimen, and environmental factors. When visiting the doctor, ask about health issues that may increase the likelihood of taking a spill. Is there an underlying physical problem with vision, or in the ear? Do any of the prescriptions the senior is taking inhibit balance? If so, can the doctor adjust the dose? Is lack of exercise a contributing factor? All the current medical knowledge on the subject points to the fact that active seniors are a lot less likely to fall than those who don’t get any exercise. Doctors recommend gentle workouts such as water exercises in a pool, tai chi (because of its slow graceful movement), or just walking. But the particulars are not so important; what’s key is to stay active and keep moving. Also look at trip hazards around the home or apartment. Some tips for making a residence a safer place for seniors include:
  • Moving tables and furniture out of high traffic areas to keep travel areas free of obstructions.
  • Securing throw rugs or taking them up if that’s not possible.
  • Making sure walkways are properly lit (this will especially help those with vision impairments).
  • Adding non-skid mats to bathrooms and bathtubs, along with hand rails.
  • Buying a raised toilet seat with hand rails.
  • Installing grip rails where they’re needed.
  • Insuring that there is room for the use of mobility aids such as a walker.
Increasing the safety of the yard or immediate surroundings can be a little more difficult. Outside walkways need to be kept free of debris, and you should also fix breaks or cracks that may not be seen by someone who is vision impaired. Shrubbery should be kept trimmed and off the walkway. An occupational therapist can help identify additional fall prevention measures you can take. Making big changes may be expensive and require professional installation, but remember that this is an investment in independence. Anyone who is no longer mobile will tell you that that’s a priceless benefit.  
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Signs of Caregiver Burnout

Our Los Angeles Dementia care staff helps ease your stress.Caring for an ailing loved one is demanding, time-consuming, and quite stressful. Often, caregivers spend a great deal of time making sure their loved one’s needs are met and their affairs are on track. What often goes quickly out the window? The caregiver’s own needs. The following are ways to detect if you, as a caregiver, have neglected yourself to the point of burnout. Isolation. As human beings, we thrive upon healthy relationships. When you find yourself regularly failing to engage in healthy social interaction–even with your own friends and family–this may be a huge signal that caregiving has begun draining you. Avoiding calls from people you enjoy, making excuses for not going out, etc… can indicate you may be well on your way to isolating yourself from others, which is never good. Feeling Overwhelmed. Caregiving can be an emotional rollercoaster for sure. There is the physical toll of spending so much time attending to the needs of your loved one. Further, there’s an emotional toll that comes with facing the shift in relational roles, seeing both physical and emotional decline in your loved one, and having to face day-to-day tasks which reinforce that life as you have known it has changed. It is natural to grieve, especially at the beginning of your caregiving experience. Frustration can arise. Anxiety and exhaustion can arise. But over time and left untreated, those feelings can lead straight into depression. If you become angry to the point of wanting to hurt your loved one or even yourself, get help fast. Your doctor should be able to diagnose whether there is a medical condition driving these symptoms. If medical challenges have been eliminated as a probability, you may have reached the point of extreme burnout and may possibly be experiencing depression. It is important to remember that while you serve as a support system for your loved one, you will also need to create a team of others who can step in to help. Being kind to your loved one is important, but it is also important for you to be kind to–and eliminate excess pressure on–yourself. Loss of Interest. One of the biggest warning signs of depression is loss of interest, especially in things that were once a huge source of happiness and enjoyment. When your hobbies, big and small, no longer inspire you… you may need help. Significant Changes in Your Sleeping or Eating Patterns. Can’t sleep at night? Can’t get enough sleep, no matter how long you’ve been in bed? Binge eating or hardly eating at all? Major shifts in your habits generally indicate huge shifts in your stress levels and turmoil in your emotions. Ceasing Your Exercise Routine Despite Enjoying It Before. Exercise is one of the best stress-busters available. It leaves a person invigorated and energized. So, when you used to enjoy exercise and suddenly stop, start again! The endorphins released while you’re exercising will relieve tension and help elevate your mood, plus you will get a better night’s sleep. Failing To Keep Up Your Appearance. Unfortunately, many caregivers fall into the mode of caring for a loved one so much that simple grooming (haircuts, manicures, etc…) become neglected. Some who once were fashion-conscious and took particular efforts to care for their appearance can suddenly become apathetic in this area. Generally, your outward appearance reflects what’s happening inside. This challenge may require some input from others you trust–close confidants, social workers, or healthcare therapists can help you sort things out to decide if you’re experiencing burnout and if additional help is necessary. Frequently Susceptible To Illness. If you catch every cold or flu that comes your way, and especially if you cannot shake the cold once you get it, your immune system is likely compromised. Our bodies are not created to handle excessive stress for long periods of time. If this is you, caregiving could be getting to you. Take these symptoms seriously. You can only be a good caregiver for your loved one if you yourself are healthy and happy.
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Problems with Living Wills

Our LA home for the aging is there to guide your way.Many of us know that living wills are a smart decision, but even with this document in place many find that making medical choices for a loved one is still complicated in practice. This post discusses some of the common problems with living wills and steps that you might be able to take to make sure that your wishes are followed. The living will document was designed to give the patient the right to determine–ahead of time–the type of medical care desired in the event he or she is unable to communicate those wishes. However, the language commonly used within a living will (which is also referred to as a substantive or instructional advanced directive) tends to be rather vague, often lending itself to interpretation. For example, in this age of advanced medical technology and cutting edge treatments, verbiage such as “little to no chance of recovery” is becoming obsolete. Some living wills, indeed, spell out possible scenarios and the patient’s desired outcomes for each scenario. While this is helpful, with medical technology evolving at its current rate, listing every alternative is virtually impossible, which then forces medical professionals and/or family members to then determine what’s best for the patient. Making matters even more difficult is the fact that for many what they want changes following an illness or hospitalization. One research study on medical decision-making revealed that three of every 10 patients change their minds about the type of care they desire, but those changes are not often reflected as quickly on the living will. So then, we’re back to the challenge of interpretation. It’s important to note that even when the patient’s wishes have been clearly written out, family members are still faced with making these decisions at a very emotional time. Arguments often arise between family members in the midst of the crisis about what their loved one really wanted, when their energies would often be better utilized in coming together to support one another as well as the patient. According to a February 2001 study published in the Archives of Internal Medicine, family members presented with various health crisis scenarios were about 70% accurate in predicting their loved one’s desires if faced with the scenarios given (whether the patient had a living will or not). That’s good news because three out of five patients who have living wills in the first place never give them to their doctors or to family members. While that fact is baffling to most, it leads directly into the necessity for medical doctors to exercise their professional opinions regarding care that is in the best interest of the patient. Family members must often draw from their knowledge of their loved one’s lifestyle and wishes, perhaps even going back to conversations that happened before a crisis ever arose. Sometimes, though, the decisions made can go directly against the wishes of the patient. Having a living will does not always negate a medical team’s decision to perform invasive procedures on the terminally ill. And again, family members who are facing difficult decisions are often reluctant to accept a diagnosis of imminent death and will, in some cases, fail to follow the instructions in a living will (hoping for a turnaround). A number of legal and health care professionals who once championed the idea of each patient having a living will are now suggesting that patients designate a health care advocate. Generally this would be a family member or perhaps a close friend who would exercise what the legal community calls “substituted judgment.” In short, the health care advocate is responsible for making the decision you would make if you were able to. To protect that individual, a patient may even record verbally or write out their wishes, to confirm that the decision made–no matter how difficult–was in accordance with the patient’s desire. There’s really no way to guarantee that what actually happens during a serious medical situation is what you would have chosen for yourself. But you can increase the chance of receiving the care you desire by communicating with your loved ones, with your doctor, and in writing the outcome you would want.
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