BrattleboroCitizensBreakfast

March20,2015
GibsonAikenCenter

WhatDoAdvanceCareDirectiveshavetodo
withBeingaLocalCitizen?
Presenter:Joa
nnaRueter1

www.sustainableaging.com

8023800301

Afterhertalk,Joannaadded:Takeamomenttothinkaboutonedeathyouhave
experiencedorheardabout.Whatwasmostdifficultorwhatwasspecialandloving
aboutit?

Asyoureadthisstopamomenttoanswerthisquestionforyourselfbeforeyouread
on.

Weneverknowexactlywhatwillhappenbutifweallowourselvestothinkaboutthis
partoflifewehaveabetterchanceofhavinganendingthatalignswithwhoweare.
Additionally,ifwehavetalkedaboutitandmappedoutourwishes,thisdifficulttime
willbeeasierforeveryoneinvolved.

Advancedirectivesarelikefiredrills,Joannaexplainedtheyhelpusknowwhattodo.With
onedifference:unlikeafirewhichmighthappen,death
will
happen.Advancedirectivesgivea
generalmapinthoughtsandonpapersofriendsandfamilyhaveanideaofwhattododuring
atimeofupset.

Thereare
Five
MajorStepsthatcomprisetheadvanceddirectiveprocess:

1)Choosesomebodytospeakforyouifyoucan'tspeak.Thisiscrucial."Choosesomeone
feisty,"advisedJoanna.Thispersonisanagentorproxy.2 Thisdoesnthavetobeafamily
member,goodfriendscouldagreetobeagentsforeachother.

JoannaRueter,LICSWcomestothisworkwiththepersonalexperienceofthedeathsoffoureldersinher
family,eachgivingheragrassrootsunderstandingofthevalueofendoflifeplanning.Joannacofounded
SustainableAging
tohelppeopleexplorethismuchavoidedtopic.SheiscertifiedasaRespecting
Choicesfacilitatorandinstructor.Sheiscurrentlyrunningtwoopengroupson
LivingFully,AgingWelland
nd
th
nd
BefriendingDeath
1)TheGatheringPlace2
and4
Tuesdays6:308pmand2)TheSeniorCenter2
and
th
4Thurdays10:45a.m.toNoon.Forage60+FREE.

2
DurablePowerofAttorneyisthehistoricalwordforAdvancedDirectiveAgent.

2)ConsideryourWishesItisimportanttotalkoveryourwisheswithyourdoctor,yourfaith
person,haveconversationswithyourkidsandfamilyandofcourseyourchosenagent."What
doIconsiderqualityoflife?"Joannatoldofaconversationamanhadwithhiseightyearold
grandchild,pickingoutthesuitforhisfuneraltogether.Maketheendingasnormalasany
otherpartoflife.Everyonedieswhatistheplan?Directivesarealsoimportantforyounger
folksanyone,atanyage,canhaveanaccident.Everyoneoflegalageshouldhavea
directive.

3)WriteVermontiswonderfulinthatithasanEthicsNetworkthathasworkedonthisfora
longtime.AsofJune2014theresanewbarebonestwopageadvancedirectiveform.All
Vermontformsareavailableasadownload:
http://www.vtethicsnetwork.org/adforms.html
3
Considerthathavinganadvancedirectiveisaservicetoallthepeoplewhoserveus.Police,
Rescue,andMedicalproviderswanttoactinourbestinterest.Ifitisnotknownwhatyou
wantthenprovidersarecommittedtodoingeverythingpossible.Thismaynotgiveyouthe
finaldaysyouwouldwanttohavewithyourlovedones.

4)Registeranddistribute.RegisteryouradvancedirectivethroughtheVermontRegistry,so
thatinanemergencyanywhereinUSApeoplewillknowyouhaveadirectiveandcanaccess
it.Atagisprovidedonyourlicensetoindicateadirectiveisonfile.
http://www.vtethicsnetwork.org/registry.html
Givecopiesofyourdirectivetoyourmedical
providersandyourlovedones

5)Talktalktalkittakesmultipleconversationswithlovedonesasthechoicesaremuch
morecomplexthantheyusedtobe.Plus,overtimeyourinformationchanges.Helpthoseyou
loveknowwhattodo.Helpothersinyourlifegetovertheirownbarrierstohavingthis
conversation.4

SuzanneBaxtresserRN,M.Ed.,CHPN
CertifiedHospiceandPalliativeNurse
sbaxtresser@bayada.com

8024902099
BayadaHomeHealthCare
http://www.bayada.com/

Asahospicenurseformanyyears,Suzannehascometoseethathospiceisawayto
supportadvancedirectives.HospicetakestheemergencyoutofEndofLifeCare.She
recalledapatientwhosefamilypanickedwhenshestartedhavingtroublebreathingathome.
3

DisabilityRightsVermontalsoprovideslinks:
http://www.disabilityrightsvt.org/advance_directives.html

RecommendedBooksIfyoucanonlyreadtwo,readthese:
MyMother,YourMother:Embracing
SlowMedicine,theCompassionateApproachtoCaringforYourAgingLovedOnes
,
DennisMcCullough,
MD.,2009and
ABetterWayofDying:HowtoMaketheBestChoicesattheEndofLife(WhyYourLiving
WillisNotEnough)
,
JeanneFitzpatrick,MD&EileenM.Fitzpatrick,JD,PenguinBooks,2010.
cf:
http://sustainableaging.com/resources/books/

WhensheendedupinthehospitalER,sheasked:WhyamIhere?Isignedpapersand
dontwanttodieinahospital.IfshehadbeenenrolledinHospiceanursewouldhavecome
toherhomeandmanagedhersymptomswithoutherneedingtogotothehospital.Indeed,
80%ofpeoplewouldprefertodieathome.HospiceCareprovidesateamofexpertstohelpa
patientandfamilymanageendoflifecareathome.

Hospice,forsomeonewithalifelimitingillnesscanprovideforsupportathome.Hospice
specializesinnavigatingtheendoflife.Alifelimitingillnessisdefinedassomeonecertified
ashavingsixmonthsorlesstolive,butthattimeframecanbeadjustedtoninemonthsora
year,ifthereisstilldeclininghealth.

ConnieBaxteristhebereavementcoordinatoratBrattleboroAreaHospice.
http://brattleborohospice.org/
Hospicevolunteerscancomeintothehome,hekpwith
householdduties,equipmentandeducation,twoyearsaheadifsomeonehasanillnessand
needsthesupport.

VisitingNurseandHospiceforVTandNH
http://www.vnhcare.org/
isanotheravailable
resource.

HospicebenefitsarecoveredunderMedicare.Ahomehealthaideassistsinpersonalcare.A
socialworkercanprovidemoresupportifneeded.Aspiritualcareprovidercanassistwith
funeralarrangementsandemotionalneeds.Coveredequipmentmayincludeahospitalbed,
walker,andbedsidecommode.

Thetwotakeawaysare:

1. youcangetinformationonhowtoobtainhelpattheendoflifefromBayada,
BrattleboroAreaHospiceandtheVisitingNurseandHospiceforVTandNH
2. hospicesupportstheadvancedirectiveprocess