LOCAL SPOTLIGHT - KENTUCKY HEALTH SOLUTIONS

It is that most wonderful time of the year—no, we are not talking about Christmas. It’s Medicare’s Annual Enrollment Season. Yes, it’s the time of the year when we stress and spend hours on the phone or online shopping for health coverage. The pain of having to shop health coverage, spend hours on the phone or online with one company vs another for our health insurance can be a daunting task. It does not matter if you are on Medicare or looking for your personal insurance, this can be one of the most dreaded….

REDEFINED SENIOR LIVING

This senior living community, the latest on the Lexington landscape, offers numerous amenities and top-class touches that make it a vibrant, exciting community.  “We are redefining senior living,” said Jacqueline Kennedy, Director of Sales and Marketing at Legacy Reserve. “If someone has a notion of what senior living looks like, we ask them to tour Legacy Reserve.”  On your visit, you certainly won’t find Legacy Reserve residents just sitting around watching life go by.

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ADULT GUARDIANSHIP: FROM DEMENTIA TO ADDICTION

Guardianship has been a hot topic in Kentucky the past year.  Between the increase in dementia diagnoses and the growing drug epidemic, the court system has had a great influx in the number of guardianship filings over the past few years.  In Kentucky, a guardianship is a legal proceeding during which a jury determines whether an individual is wholly or partially disabled, the court appoints a guardian, thus officially creating a legal relationship between the guardian and the ward.

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advocate. Have an alternative if possible. It doesn’t have to be a family member; it can be a friend.


•  Be sure to check your state laws to see if your doctor can go against your wishes.


•  Give a copy of your directives to people close to you as well as your doctor.


•  Review your instructions every year.


•  The simpler it is, the better.


Your list of wishes does not have to be notarized, but it does help if it is written down so when the time comes, your loved ones can consult it and ensure they are fulfilling their promises to you. If anyone protests a decision made on your behalf, the list can placate them and assure them that what is being done is what you wanted. A directive makes it easier to practice rational decision-making. And you can always change the document.


“It’s a living plan, not a dying plan, so your doctor knows your goals and how to manage your care,” Aziz said. “We are working from the goals of living – how you want to live and how you don’t want to live.”

While it is difficult to talk about end-of-life issues, it’s vitally important that you communicate your wishes to your loved ones well before you need to.


“It’s called having ‘courageous conversations,’” said Dr. Shahid Aziz, a medical ethicist and hospice and palliative care physician currently working with adults and children in multiple hospitals and hospices in the Baltimore/ Washington, D.C. area. Aziz says advanced care planning is part of palliative care.


“Patients say, ‘Why do I have to talk about this now? Ask me when the time comes,’” Aziz said. “The fallacy in that is you never know what will happen or when it will happen, and a majority of people will not be able to talk when it does. There are diseases where you lose the capacity to make decisions. You don’t want to get stuck in that situation.


How do you start the conversation with family and friends who are reluctant to discuss death and dying? Aziz says it’s as simple as sitting down together and showing them an article like this. You can discuss medical ethical questions about having your life prolonged by artificial means such as dialysis and IV nutrition. You can talk about DNRs (do not resuscitate in case of cardiac arrest) and other types of directives. These decisions about how you want to live – and die – are best made when you are still mentally capable and clearheaded.

COURAGEOUS CONVERSATIONS: TIME TO HAVE A TALK

The bottom line is, only you can decide what living fully and consciously means to you. Aziz offers the question: “What is the lowest level of existence that is OK for you?” You alone can answer that.


Your physician’s role is to guide you through your illness and to be honest about the outcomes. He or she should ask: “Are you enjoying your life? Is it good? What do you want?” And he or she should respect and enforce your wishes.


Out of his 20 years of experience in this discipline, Aziz offers some advice for creating a medical directive:


•  Make clear what is important to you. If you want doctors to stop treatment when it’s no longer beneficial, say so.


•  Note which artificial treatments you don’t want to prolong your life. You can also specify a time limit to artificial treatment.


•  Choose someone who knows what you want and don’t want to be your

TANYA J. TYLER

Tanya J. Tyler is the Editor of Living Well 60+ Magazine

more articles by tanya J. tyler