Posts Tagged "health"

Definitions for POA and Health Care Directives

Posted by on Sep 8, 2010 in Planning, Power of Attorney, Powers of Attorney |

There are two types of “power of attorney”: one for finances and one for decisions about health and personal care. Both documents are drawn up by a person with “capacity”, i.e. the ability to make reasoned decisions, who wants to decide on his or her wishes for future medical care and treatment and personal care – in the event they are not able to give informed consent. This document is also known as a living will or health care directive may, and may contain or include: Appointment of a “proxy” who will assume responsibility for ensuring the person’s wishes are respected Health and personal care wishes that must be followed by health care providers, where the wishes are reasonable, possible, and legal. The first type is called a proxy directive. All provinces, the Yukon, and the Northwest Territories allow proxy directives.The second type is called an instructional directive.  Several provinces allow this type of directive, as well as the proxy directive. Why have a directive? Manitoba Health provides this general suggestion for writing a health care directive, or “living will.” “Due to accident or illness, you may become unable to say or show what treatment you would like, and under what conditions. If you have signed a directive, those close to you and the health care professionals treating you are relieved of the burden of guessing what your wishes might be.”  Each province has specific legislation regarding health care directives. The ElderWise Guide, “Decide For Yourself”, provides web links to the specific details for each Canadian province and territory. You must comply with the legislation in your parent’s province if the directive is being prepared for them. Here is a scenario that is all too common for families who do not have advance care planning in place (names changed to protect privacy):  Clarence was 87 years old and had not named anyone to speak on his behalf. When his niece raised the topic, he said: “You’ll be there for me – and I know you will do the right thing.” But when Clarence had a stroke and was temporarily in a coma, his niece was unable to legally speak on his behalf because she had not been specifically named as Clarence’s personal representative.  Research the information that applies to your province (“Decide for Yourself” includes web resources for all provinces and territories). Discuss medical treatments, such as a “Do Not Resuscitate” order, with your doctor. Decide who will speak on your behalf AND get their consent. Write the directive yourself – or get help from a lawyer. Provide copies of the directive to your family, your doctor, and the person(s) named in the directive. Get full details about the contents of “Decide for Yourself”     Vol. 5, No. 8 © ElderWise Publishing 2009. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise, Canada’s go-to place for “age-smart” planning. Visit us at and subscribe to our FREE e-newsletter.   ...

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Sensitive Conversations

Posted by on Sep 7, 2010 in Family Relationships, Sensitive Conversations |

Many of us have concerns about our parents’ health and well-being, or about their living arrangements. Our concern can lead to anxiety and frustration and we can be tempted to offer advice about “solutions” that seem obvious to us.  But our parents won’t welcome unsolicited advice any more than we did when they offered it to us. Successful conversations depend on two things: the kind of relationship you have with your parents and the nature of the conversation. If you have always been the “wonderful daughter”, you might be able to influence your parents. But if you have had a history of arguments over the years, this pattern will likely continue if you approach your conversation in the usual way.  Many topics are also touchy: For example, money. Many older adults are uncomfortable or even refuse to talk about it. Also, they might find it easier to talk about physical health than emotional well-being.  Is there a sensitive conversation in your future? Consider these approaches: Put aside your own agenda. First try to understand your parents’ needs, their fears, and their hopes. Ask your parents for their thoughts first, before presenting your concerns and suggestions Write them a note. This way, your parents will not feel broadsided when you unexpectedly bring up the topic. If you can’t broach a sensitive subject, get help from a trusted friend, relative, or other objective third party (e.g., a medical professional, family coach or counsellor). Keep your worry and feelings of responsibility in perspective. Parents can and may refuse even the best advice   Here are some more listening and communication tips for more effective family discussions. Listen actively to others. Give them feedback about their opinions. Ask them to confirm your understanding of what they are saying. Make sure that others also understand what you are saying (not the same thing as agreeing!). Suspend your own judgments when listening. Pay attention not only to what is being said, but also how it is said and what is NOT being said. Watch body language (facial expressions, posture, tone, gestures) that might add to the meaning of the message or contradict what a family member actually says. Show that you are paying attention: maintain eye contact, nod, respond. Remove barriers to listening – distractions, preoccupation, and self-talk. Ask open ended questions – those that cannot be answered with a simple “yes” or “no”. Begin your question with “how” or what.” Good communication skills are crucial for sensitive conversations. They help create effective outcomes for sensitive conversations and positive relationships between the generations.   Vol. 3 , No. 15 © ElderWise Inc. 2007. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise Publishing, a division of ElderWise Inc. We provide clear, concise and practical direction to Canadians with aging parents. Visit us at and subscribe to our FREE e-newsletter...

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Action for Common Aging Concerns

Posted by on Sep 7, 2010 in Caregiving, Health Signals, Planning |

In previous newsletters, we showed how you can approach sensitive topics during holiday visits with aging parents. During the visit you may have noticed new areas of concern, or old problems that are calling for action. Now, you may feel anxiety or uncertainty about what to do next. Taking that first step, no matter how small, creates momentum towards positive change. Here are some first steps for common concerns: 1. Health Changes in physical or mental health are usually at the root of all other challenges facing your aging parents.  Many factors combine to keep seniors healthy. Among the most important are good medical care, proper exercise and nutrition, and a sense of purpose and belonging. A good first step is to become more informed about your parent’s health. Educate yourself about normal aging, and learn more about their chronic health conditions. With your parents’ permission, talk with their family doctor about your concerns. 2. Hygiene Personal care may slip when a senior’s eyesight, physical energy, or state of mind are affected. First, gently point out some physical evidence (e.g., stained clothing) and share your concern. Encourage your parent to get a physical check-up and/or an eye exam.  3. Housekeeping Loss of strength or mobility can make household chores more difficult. Start a conversation about getting more help – either from other family members, or by hiring someone. Some seniors are reluctant to ask for help or to invite “strangers” into their homes. Suggest that help with household duties may mean that your parents stay in their own home a little longer. 4. Hazards Safety hazards at home increase when health and strength start to fail. Here are some simple adaptations that make life safer: rearrange cupboards to easily reach things, install grab bars in the bathroom, remove loose scatter rugs, and add brighter lighting, especially over stairways. You can also look into personal emergency response systems. Worn on the wrist or as a pendant, they enable your parent to call for emergency help when they cannot reach a telephone. Initiating some of these changes may require a “community” effort. That can mean recruiting help from other family members, friends, neighbours and/or getting outside help – private or public. In larger towns and cities, families can call on their local seniors’ resource centre for more information on support programs. In rural areas, churches and other members of the community traditionally step up to help neighbours. Concerned families can also ask for an assessment of the senior by their local health authority, to see whether their family member (who must consent to the assessment) qualifies for public assistance. Vol. 5, No. 1 © ElderWise Publishing 2009. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise, Canada’s go-to place for “age-smart” planning. Visit us at and subscribe to our FREE...

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