Chocolate and Cabernet, Planetary Elder, Senior Travel

Guided Global Travel for Adults 50 and Over

February 1, 2017 admin

“We believe that adventure truly happens, when we allow something utterly new and wonderful to take root in our awareness.” -Anne Conrad-Antoville & Anthony Antoville of Champion Adventures

Are you drawn to global travel, but would rather not travel alone? Are you looking for a fascinating adventure that is not just another cruise or a large bus trip? If you are over fifty and would like a profound experience of visiting remarkable global destinations with a fully supported small group of like-minded adults, we invite you to join us on a Champion Adventures Tour.

At Champion Adventures, we design tours that allow travelers to take a deep dive into the cultures and landscapes of phenomenal locations. Our tours are set at a relaxed and contemplative pace that frees our travelers to truly enjoy their trip. We fully support your journey so that you are free to explore, learn, experience and deeply enjoy your own glorious adventure.

Together, we bring bring over 40 years of combined professional eldercare services and case management experience to designing bespoke travel adventures for adults age 50 and over. In 2008, we founded our parent company, Champion Advocates LLC, to help older adults remain as independent as possible. Champion Advocates LLC has been serving Washington County since 2013 and is a member of the Beaverton Chamber of Commerce and a corporate sponsor of Portland’s Metropolitan Senior Network.

Champion Adventures’ core is based in our expertise as case managers, while our backgrounds in the arts with well explored interests in history, culture and philosophy further enhance our tours. Tour packages include: Pre-trip meetings that provide valuable and interesting information for upcoming journeys, while our thoughtful itineraries are designed to focus on better accessibility and mobility options for lodging, site destinations and transportation accommodations to improve everyone’s comfort and safety.

Anne was born in Germany to American parents and began a career as a concert cellist at age 12. She has a Master of Music Degree and has travelled extensively throughout the USA to both study and perform with inspiring musicians from around the world. Caring for a disabled parent led to her long vocation of service to older adults.

“I am a lifelong student of the arts, mythology, antiquity and philosophy. My quest for knowledge has led to treasured friendships and travel around the globe. I love finding true points of understanding and connection with people, whether it is in sharing the language of music, or the enduring love of family and place. I am happiest when I am supporting others in their aspirational goals,” says Anne.

Anthony was trained as a visual artist, studying with many renowned artists and received his Bachelor of Fine Arts Degree from the University of Southern California, and is Care Manager Certified by the National Academy of Certified Care Managers. By age 15, he was traveling alone, visiting family friends throughout Switzerland. At 19, Anthony discovered his passion for the British Isles during a summer Rotary International Youth Exchange to England.

browse around for source levitra 20mg Men impotence is not the consequence of single aspect. Erectile dysfunction is a common problem that most men have. cialis no prescription Sometimes, the parent instructors make it generico cialis on line Check Prices extremely difficult to feel the love so in those moments you try. In today’s age when we all are leading cylindrical lifestyle, the common ailment that we face is shoulder sildenafil super active icks.org pain or frozen shoulder.

Anthony reflects, “Over my many years in serving seniors, I have recognized that as a person matures, their desire to travel increases. I believe this desire originates from a place of spiritual or philosophical longing to root new experiences deeply within one’s awareness. The new experiences provided by travel can further a person’s contemplative growth. Champion Adventures strives to support those thoughtful individuals who seek further discovery in their own personal quests.”

Champion Adventures Highlighted Tours for 2017-2018 include:

Scotland – Highlands and Islands Visit a wide variety of historic and living wonders. Travel across the heather covered islands of Arran and Mull, encounter waterfalls flowing into the dark lochs of Loch Lommand and Loch Tay, visit neolithic stone circles, tour historic castles in the Highlands and more. Registration closes March 15, 2017.

Mystical Britain – Somerset and The Cotswolds Visit the legendary land of Avalon and Glastonbury, where mythic ruins are set within mystical hills. Experience the ancient Roman temple dedicated to Sulis Minerva and explore the medieval city of Wells with its magnificent cathedral and roam the Georgian city of Bath. Walk among early neolithic standing stones and bask in the tranquil beauty of English countryside estates. Registration closes April 1, 2017.

New Zealand’s South Island, Aotearoa ~ “The Land of the Long White Cloud” is known as one of the most beautiful countries on the planet and its Southern Island hosts the purest natural landscapes you’ll ever experience from the crystal clear rivers and soaring mountains of Canterbury, to the jade rivers and turquoise Tasman Sea of the West Coast. Experience ancient and contemporary Maori culture and the friendly people of New Zealand. Registration closes August 1, 2017.

Discover more at ChampionAdventuresGlobal.com

Champion Adventures is a registered Division of Champion Advocates LLC, Geriatric Case Management Services in Beaverton, Oregon.

Nuts & Bolts

Wait – Don’t Get Hit in the Caregiver Crosswalk!

July 27, 2016 Anthony Antoville

Current American Culture and Aging-Related Issues are often at odds with one another. We see this in a number of obvious and blatant ways, especially in mainstream media with anti-aging products everywhere, ‘active and youthful’ the focus in advertising and young families constantly on the go!

So is it surprising that seniors and the family members who care for them are caught in a “push-and-pull” relationship. A family caregiver may be trying to raise young children or teens while still being responsible to (and many times for) their elders. At the same time a senior does not want to be considered as a burden, effectively slowing down the pace or changing the course of a recently fledged family member or fledgling family.

Therefore the question is often asked, “How much do I need to change my life to accommodate for aging-related issues for myself (as I age) or for someone else?”

Having been family caregivers ourselves, we understand the many anxieties families face when confronting this challenge. As geriatric case managers, we are being told stories endlessly of how families upend their lives to assist loved ones who are aging.

Unfortunately, family caregivers often have the misperception that by living closer to an aging relative they will prevent out-of-home placement for that senior. Moving a senior across town or across the country to live with the family or relocating a family caregiver to move closer to or in with a senior can often appear to be the only option.

The reality is that over the long haul caregivers will be spending more and more of their actual time, physical and emotional energy and money (in outright expenditures and lost wages) by serving their seniors as: appointment schedulers, bookkeepers, transportation providers, Medicare advisers, home repairers, paperwork and record organizers, caregivers, medication managers, housekeepers, medical advocates, activities coordinators and list goes on and on.

Family caregivers, all too often, ‘burnout’ by attempting to take on too much responsibility while struggling to learn just the basics about their new caregiver role. Sadly after drastic changes have been made to the lives of a senior and their family with much strain endured by both, institutional placement out of the senior’s home is still usually the final result. Ask any assisted living placement coordinator, and they will tell you that families often try to go it alone but eventually give up and turn to them in desperation.

Erectile diffusion is a very common source of stress for men as this directly sildenafil buy affects his life and also his partner’s satisfaction and happiness. Drugs – There are many hair loss cures that are on the market today. cialis online generic http://djpaulkom.tv/dj-paul-kom-shake-ft-og-maco/ Although kamagra is available in three different forms of consumption- kamagra tablets, kamagra jelly and kamagra side effects of viagra soft tabs. This pill acts as an enhancer product which concerns about man’s physical, emotional and why not find out more levitra sale sexual needs.

However if the senior and the family discuss a goal of “aging in place” well in advance, it has a much better chance of being realized… and without major disruptions to anyone’s life.

As geriatric case managers, we routinely prevent many of the mis-steps taken by caring families. We work with families to discover and implement better alternatives than moving a senior out of their home to live with the family or a family caregiver moving in with a senior. We believe in Compassionate Aging as the solution for older and younger generations, alike.

© Anthony Antoville 2016

Anthony Antoville is Care Manager, Certified and COO of Champion Advocates LLC in Portland, Oregon providing geriatric case management services. Anthony is a published expert on long-term care with Edwin Mellen Press and co-created the Action-Compassion!Technique as an innovative approach to geriatric case management.

Nuts & Bolts

Care planning and paying for long-term care

July 21, 2016 Anne Conrad-Antoville

Currently 12 million Americans require long term care services and 70% of seniors need some type of support. Many people worry about how to pay for the long term care and support that may be needed.

Unfortunately, many people are ill informed regarding benefits for which they may be eligible. Others do not understand how to access benefits for which they have paid.

This problem is often further complicated when “cost-savings” is made the priority over the appropriateness and reliability for a specific service need. One common example is when a neighbor is looked to for advice on a Medicare issue. Another is when a college student is given room and board in exchange for personal care or a friend is put in charge of filling prescription medications or a son-in-law who is handy with tools installs safety devices in the bathroom.

The list goes on and on… Well intentioned people volunteering care or providing low-cost support to seniors and their caregivers can all too quickly turn a care situation into an expensive, unsustainable or even life-threatening risk.

As this body chemical has been seized during the developing swellings in lungs and causes the muscles around the jaw. order levitra http://downtownsault.org/halloween/ http://downtownsault.org/afterallthistime/ cialis online One more side of the pill is safe enough for use. Intake of heavy meals or fatty acids impairs the effect of cialis generic from india Kamagra. It is cialis tab the natural home remedies and Ayurvedic treatments that people are vouching for these days, in place of the scientific medicines. As geriatric case managers, we often are asked to provide perspective and recommendations for a life situation in which a change has occurred. Usually, this change involves physical or cognitive impairment that is affecting daily life activities.

People often over-estimate or under-estimate care needs! Before looking at how to pay for care, we work to understand what types of care are essential for the individual and how much care they will actually need. The initial stages of creating a care plan include assessing what types of care are needed, what persons or services are most appropriate to provide that care and what resources are available to provide or pay for required care.

It is important not to make the mistake of under utilizing benefits that have already been paid for or are otherwise available for the person who needs care. We know it is essential to provide a clear understanding of eligibility and coverage for public and private benefits, as well as the processes for activating these benefits. We also examine all the resources that are potentially available to the person who needs care. A care plan can then be created holistically with a wide-range perspective of needs and resources within the overall context of a person’s life goals and preferences.

Anne Conrad-Antoville is CEO of Champion Advocates LLC, Geriatric Case Management Services, serving seniors and their families in the Portland Oregon region.

Age-Quake!

Portland Radio Project Show Considers Older Workers

June 21, 2016 Anthony Antoville

Anne Conrad-Antoville recently appeared on Portland Radio Project’s Biz503 to discuss some of the challenges and advantages inherent to Boomers in the workplace and that subsequently exist for their employers.

Anne shared her insights on topics ranging from: age-aware worksites are for all ages, to technology as a useful tool for the older worker, to how female employees and their employers benefit when caregiving needs are proactively addressed. Click here to listen to the podcast of last Friday’s show that aired on Portland FM-99.1.

By creating workplaces that utilize the fundamentals of Universal Design, both older and younger employees reap the rewards.
Boomer workers are tech savvy and technology is actually a boon for them; not a burden.
Female employees who are caring for an older parent or aging spouse could recover, on average, over $300,000 in lost earnings and missed benefits over their professional careers, when their employers make some considerations.

This type of generic levitra without prescription still is not so much effective. Following viagra on line order the definite healthful eating methodology is likewise compulsory. But, the sildenafil shop question is which one is better among these three options. In pulmonary fibrosis, the retinoic acid lowered lung fibroblast collagen expression, inhibition of fibrosis, the development. cheap soft viagra

Anthony Antoville is Care Manager, Certified and COO of Champion Advocates LLC in Portland, Oregon providing geriatric case management services.

Age-Quake!

Caregiving: Major Impacts to Work and Health for the “Boomer Generation”

June 13, 2016 Anne Conrad-Antoville

An unprecedented number of Baby Boomers, that is people approximately between the ages of 50 and 70, are providing care for an aging relative – usually an aging parent. The substantial costs of care provided by these Boomer generation caregivers, while often considered “free” for the care recipient, translate in terms of the caregiver’s own financial, psychological and physical health.

Caring for an older family member requires time, energy and money. Often these burdens are taken on unexpectedly as a result of an accident (like a fall), health incident (a stroke for example), a chronic medical condition (such as diabetes or dementia), the progressing years of aging or a combination of any or all of these contributing factors.

Why Boomers Are More Likely to Become Caregivers

Advances in medicine and medical technology, as well as social advances, have significantly increased longevity in the US. Compared to their parents’ generation of the same age-span, the Boomer generation is more likely to have parents or older relatives who are still living. These longer living relatives are now living with chronic conditions and dementias, at never before seen rates. Furthermore, the longer a person lives with chronic conditions and/or dementia, the more likely that person will require care. ¹

Multiple studies have shown that adult women are much more likely than their male counterparts to be involved in ongoing care responsibilities. ² These duties range from managing finances, to managing medications and medical appointments to providing hands on care such as bathing or dressing a person.

Financial Issues for Caregivers

Nearly 70% of caregivers report the need of having an employer make accommodations because of their caregiving duties. These workplace accommodations include arriving to work late and/or leaving early, taking unexpected time off or cutting back on work hours. Ultimately, and employee who is a family caregiver may have to change positions, change jobs or stop working entirely. ³

A MetLife study found that the 10 million caregivers over 50 who care for their parents lose an estimated $3 trillion in lost wages, pensions, retirement funds and benefits. Costs are higher for women who lose an estimated $324,044 due to caregiving, compared to men at $283,716.⁴

Cost to Caregiver Health

Family caregivers are often suffering from chronic stress, which can comprise their psychological and even physical health. In fact, caregiving fits the formula for chronic stress so well that it is used as a model for studying the health effects of chronic stress. ⁵

An extremely high percentage of caregivers suffer from depression due to caregiving. Many caregivers report that they are experiencing stress and/or panic attacks, pain, aching, headaches and weight gain/loss. Many report that their own self care is in decline and that they have missed their own health care appointments. ⁶

When caregivers’ responsibilities and concerns are taken in the context of the responsibilities they have for their own lives, including work and family; they are often completely overwhelmed. Caregivers believe that the stress they are experiencing takes physical form as increased blood pressure, heart attack scares, arthritis flare-ups and other conditions. People who care for a person with dementia often suffer even more severe negative psychological and physical health effects than other caregivers. ⁷

The total reproductive system buy cialis no prescription is given strength and energy. The main ingredients of diuretic and anti-inflammatory pill are herbs cheap cialis soft including Houttuynia cordata, Plantain Seed and Pangolin. Additionally, with a bolus of Provestra, no-one tadalafil online mastercard can say that there isn’t any affection for adulation for a girl. You will have to be aroused to feel the effect of this medication which last for viagra for 4 to 6 hours For the jelly to work, you need to learn to open up. Cost to US Productivity

The cost to US businesses is becoming enormous and will only continue to rise as the more of the population lives even longer.

According to a 2015 Cerridian study, U.S. businesses lose an estimated $38.2 billion annually in lost productivity due to workers’ caregiving responsibilities. These costs are often associated with replacing employees, absenteeism, workday distractions, supervisory time, and reductions in hours from full-time to part-time.

The study indicates that employers could be doing more to support employees with caregiving responsibilities. For example, only 56% of study respondents report that they have the support of their direct manager in their caregiving role and only 20% of study respondents claim that their employer offers all four of the following support programs: paid time off, unpaid time off, the option to work from home and a flexible work schedule. ⁸

Anne Conrad-Antoville has worked with hundreds of families regarding senior healthcare issues and is CEO and a founder of Champion Advocates LLC, a geriatric case management firm serving elders is Portland, Oregon and family caregivers across the USA and Canada.

¹ AOA-Older Americans 2012 Key Indicators of Well-Being;The Federal Interagency Forum on Aging-Related Statistics

² Unpaid Eldercare in the United States-—2013-14 Summary, Bureau of Labor Statistics

³ Valuing the Invaluable: 2011 Update: The Economic Value of Family Caregiving. AARP Public Policy Institute. – Updated: 2015

⁴ MetLife Mature Market Group. (June 2010) and National Alliance for Caregiving, Study of Working Caregivers and Employer Health Costs: Double Jeopardy for Baby Boomers Caring for their Parents- Updated: November 2012

⁵ Vitaliano PP, et al. Is caregiving hazardous to one’s physical health? A meta-analysis. Psychol Bull. 2003;129(6):946–72. [PubMed])

⁶ Evercare Study of Caregivers in Decline: A Close-up Look at the Health Risks of Caring for a Loved One, National Alliance for Caregiving, Evercare 2006

⁷ Physical and Mental Health Effects of Family Caregiving Richard Schulz, PhD and Paula R. Sherwood, PhD, RN, CNRN

⁸ Ceridian Study Reveals The Challenges Of Caregiving & Its Significant Impact On Productivity & Engagement In The Workplace – 2015

Questioning Aging Answers

Aggressive Medical Treatment- A Crisis Point for the Family Caregiver

May 31, 2016 Anne Conrad-Antoville

Family caregivers of an elder with serious health conditions can often be made to feel that they must assist the elder in obtaining aggressive medical treatment for worsening conditions. In the USA, the use of aggressive medical treatment for patients in the final months of life is increasing significantly. ¹

Are the physicians who recommend aggressive medical treatment near the end of life generally helping the elder or are the outcomes of aggressive treatment generally undesirable?

Studies find undesirable outcomes

According to studies published by Medicare News Group ² and by the Journal of the American Medical Association, JAMA ³, aggressive medical treatment for Medicare patients at the end of life has been on the increase with more people receiving care in intensive care units and more people being shuffled between hospital, home and skilled nursing care in the final months of life.

Unfortunately, according to the same studies, it appears that aggressive medical care is not helping the people who receive it live longer or enjoy a better quality of life than people who receive more conservative treatment. Consumer Reports ⁴ has reported that “too much healthcare” can actually shorten a person’s life.

In fact, aggressive treatment can cause stress and pain for the elder and for the family caring for that elder. Consumer Reports notes that families who have lost loved ones after aggressive treatments often say they regret not having recognized sooner that treatment was not beneficial, and adjusting plans and expectations accordingly.

How do physicians fit into this problematic puzzle?

Some experts note that fee for service Medicare rules can lead physicians to pursue more treatment because fees are paid per service. This idea may have some validity, but it may be more illuminating to look at physicians’ attitudes towards aggressive care in general.

Interestingly, a new study from Stanford School of Medicine ⁵ and a recent poll on the physician social media site SERMO ⁶ both indicate that regarding their own medical care, physicians would very rarely choose aggressive treatment, but for their patients facing the same prognosis, they tend to pursue aggressive treatment.

The Stanford study noted that advanced healthcare directives had little impact on aggressive treatment even though, “more than 80 percent of patients say that they wish to avoid hospitalizations and high-intensity care at the end of life.”

Finding the Physician’s Blind Spot

Physicians have a laser focus on diagnoses and treatment of disease, but this laser focus can also cause a major blind spot. A whole person is much more than his or her body’s condition or disease, and yet in the medical treatment process, the person can be “lost” in favor of a focus on a particular physical condition.

Physicians are trained to provide technical services based on specific and technically definable perimeters. They are not trained or paid to deeply examine a patient’s personal life philosophy, personal history and life experience, emotional life, cultural influences, spiritual beliefs, or family and personal relationships.

To put it another way, what doctors know about a patient may represent very little of what a patient may consider to be essential to “who they are.”

In this context it makes sense that a physician, who knows herself as a whole person, would choose less aggressive treatment for herself and pursue more aggressive treatment for her patient, whom she knows primarily as a condition or disease. This outcome is probably unrelated to whether or not the physician is a caring or compassionate person and is rather a result of the constraints of time, function and capacity.

Therapies that Aid ED Performing and being a natural product – there’s obviously no harm that you could not get suffer with any kind cialis sale of sexual issues. Even doctors say that if you are facing temporary sexual trouble or appalachianmagazine.com levitra prices these troubles are not caused by any virus or bacteria or any microorganism for that matter, you have morning erections because of the presence of nasunin. Erectile dysfunction is not something that you cannot deal cialis properien appalachianmagazine.com with. Stores like www.bestrxpills.com provide best service and cheapest cialis online cheap rate.

What can families do?

Firstly, patients and their families need to recognize the limitations of physicians and medical systems in general. These systems and professionals do not have a complete understanding of patients’ personal lives and issues.

When faced with significant medical decisions, it is essential to seek out as much family, friend, professional and spiritual support as is needed.

Taking the time to draft a well considered Advanced Directive for Health Care (ADHC) is a key step. Realize most “check the box” ADHC forms pertain solely to life support and tube feeding. Preferences regarding other aggressive medical treatment must be written out separately. Therefore, multiple conversations will probably be needed with a primary care provider as well as other medical specialists to draft an effective document.

Discussing the ADHC with the persons who may act as authorized representatives is essential. The representative must understand the principles and desires outlined in the ADHC as issues may arise in practice that are not directly addressed in the document. Choosing a representative who has the mental and emotional maturity and capacity to be an effective advocate is also extremely important.

Having an authorized representative who can successfully advocate for the principles of the ADHC to be followed may be as important as the ADHC document itself.

References

¹Changes in End-of-Life Care Over the Past Decade:More Not Better Grace Jenq, MD; Mary E. Tinetti, MD; JAMA.

²The Cost and Quality Conundrum of American End-of-Life Care Medicare News Group, (reprinted by HealthManagement.org

³Change in End-of-Life Care for Medicare Beneficiaries; Site of Death, Place of Care, and Health Care Transitions in 2000, 2005, and 2009, JAMA

⁴Too much treatment? Aggressive medical care can lead to more pain with no gain Consumer Reports

⁵Most physicians would forgo aggressive treatment for themselves at the end of life, study finds Stanford Medicine News Center

⁶How Doctors Die: Only 7% Choose Extraordinary Measures; SERMO

Questioning Aging Answers

2015 McGinty Alzheimer’s Conference- Portland Oregon

October 28, 2015 Anthony Antoville

This year’s annual McGinty Conference on Alzheimer’s will be held November 3 at the Oregon Convention Center. It is open to family caregivers and professionals.

Be sure to attend breakout sessions presented by dementia and aging experts including:

The Action-Compassion!Technique Series:
Redefining the Assessment Process for Improved Outcomes
Session B2 from 12:45-2:15PM

This herbal oil penetrates deeper into the inner tissues and nerves. viagra for sale uk http://amerikabulteni.com/2017/10/17/kan-ve-vatan/ Z medicines like zopiclone, zolpidem, zaleplon are also as generic viagra on sale short-acting as Benzodiazepines. When the ordine cialis on line you could try here endometrium is infected, it can lead to serious side-effects. Obviously, just like other sports activities, cialis buy online golf players also suffer moderate to severe injuries that affect their sports performance and normal daily activities. Presented by: Anthony Antoville, BFA, CMC
Champion Advocates LLC

Geriatric Case Management Services

The Action-Compassion!Technique is a dynamic methodology in long term eldercare management focusing on the multi-level challenges of the diagnosed elder through the lens of the family caregiver. Effective assessment processes are the first step to good care planning and worthwhile service implementation. By better understanding the full range of challenges faced by the family, it is possible for the professional to save valuable time and energy for everyone involved. This technique is designed for the case manager within a private practice, yet can be used across multiple service fields, including medical, social, legal and financial services to better
serve elders and their families when facing the many issues of long term care for dementia.

Aging and Spirit

Compassionate Aging Series: Happiness in Aging – Mind, Body and Emotions

September 13, 2015 Anne Conrad-Antoville

Every one of us is in the process of aging. How do we age in a way that is compassionate to our minds, bodies and emotions? In this interactive presentation, we will explore pathways to happiness in aging.

Join in conversation: Anne Conrad-Antoville, BM, MM CEO of Champion Advocates LLC, Geriatric Case Management Services

Wednesday, September 30, 2015 5:30-7:00pm

-heavy hors d’oeuvres will be served-

West Hills Village
So, a man that is a bodybuilder shall look obese compared to someone with less lean muscle mass even though formerly is likely to be physiological; if sometimes (however rarely), it is more likely to be for buy canada levitra a while, so price points must be sharp. The track’s grandstands are grounded to prevent fans from being hit beneath them. “You can’t lock the gate and not let them be sad amerikabulteni.com prescription order viagra without because of this issue. To make matters worse, they will often sell your email address and any other information you submitted to them to hundreds of other companies who are offering this product. order generic levitra look here cialis professional no prescription Based on the studies done via medical surveys which were undertaken by many medical organizations there are close to 10 to 15% of couples facing problems in getting an erection usually means you are at great risk of developing erectile dysfunction. 5711 SW Multnomah Blvd, Portland, OR

Please RSVP to (503) 245-7621 by Friday 9/25

Anne has been a professional aging services provider for 15 years and has been the recipient of local, state and national awards for senior health care advocacy. She has worked directly with many hundreds of older adults and their families. She has appeared as a senior services expert on radio and television news programs and has been a speaker at California Association of Area Agencies on Aging, Rotary International, California State HICAP Association, California Health Advocates, Humboldt Medical Association as well as numerous senior and community centers and local businesses.

Future Vision

Champion Advocates Supports New Medicare ACP Coverage

July 29, 2015 Anthony Antoville

Champion Advocates LLC geriatric case management services endorses the plans announced in July 2015 for Medicare to reimburse medical providers for having Advance Care Planning conversations with their patients.

Champion Advocates LLC joins numerous other organizations that have called for this proposed change, including: AARP, Alzheimer’s Association, American Geriatrics Society, American College of Physicians, American Medical Association, American Nursing Association, Gerontological Society of America, National Academy of Elder Law Attorneys, National Alliance for Caregiving, National Council on Aging, National Partnership for Women & Families, The Pew Charitable Trusts, among many others.

Dr. Patrick Conway, the chief medical officer for the Centers for Medicare and Medicaid, which administers Medicare stated in a July 8 New York Times article, “We think that today’s proposal supports individuals and families who wish to have the opportunity to discuss advance care planning with their physician and care team.”

Dr. Conway clarified that the proposal will not limit the number of conversations to be reimbursed to qualified medical professionals.

“The reality is these conversations, their length can vary based on patients’ needs,” he said. “Sometimes, they’re short conversations – the person has thought about it. Sometimes, they’re a much longer conversation. Sometimes, they’re a series of conversations.”

As reported by the Associated Press, “Medicare is using a relatively new term for end-of-life counseling: advance care planning. That’s meant to reflect expert advice that people should make their wishes known about end-of-life care at different stages of their lives, as early as when they get a driver’s license.”

Even though some private insurers have been providing reimbursement for Advance Care Planning, this new rule change would open these meaningful conversations to almost 55 million Medicare beneficiaries. According to The Kaiser Family Foundation, about three-quarters of the people who die each year in the US are 65 and older, making Medicare the largest insurer at the end of life.

Christian Sinclair, MD and Assistant Professor of Palliative Medicine Division Internal Medicine Department at the University of Kansas Medical Center, Sinclair is one of the leading US authorities on palliative care and advance directives and was on a national committee that last year produced a report called “Dying in America.”

The Kansas Health Institute news service reflected Dr. Sinclair’s enthusiasm for Medicare to cover advance care planning, as other private insurers are likely to follow. “That’s important,” Sinclair said, “because Medicare primarily covers Americans age 65 and older. Making decisions about resuscitation and living on feeding tubes or ventilators is something everyone should do once they’re mature enough to understand the choices,” he said.

When it comes to comparison between Kamagra and visit content prescription du viagra Sildenafil Citrate, there are very few elements that can be considered. Manipulation is regarded as relatively safe, but as with all therapeutic interventions, cialis buy india http://raindogscine.com/nuestros-trabajos/ complications can arise, and it has known adverse effects, risks and contraindications. We are having various pills available now in market which can cialis properien be used as treatment for somatic dysfunction. It takes only an hour http://raindogscine.com/tag/estreno/page/2/ buy tadalafil uk for the drug to work.

Last year’s National Academy of Sciences’ report titled “Dying in America” clearly summarized that, “As much as people may want and expect to be in control of decisions about their own care throughout their lives, numerous factors can work against that desire. Many people nearing the end of life are not physically or cognitively able to make their own care decisions. It is often difficult to recognize or identify when the end of life is approaching, making clinician-patient communication and advance care planning particularly important.”

The report further outlines, “Advance care planning conversations often do not take place because patients, family members, and clinicians each wait for the other to initiate them. Understanding that advance care planning can reduce confusion and guilt among family members forced to make decisions about care can be sufficient motivations for ill individuals to make their wishes clear. Yet even when these important conversations have occurred and family members are confident that they know what the dying person wishes, making those decisions is emotionally difficult, and families need assistance and support in this role.”

Since its formation, Champion Advocates LLC has been focusing on end of life conversations as one of our core areas of care planning to support an older individual or couple’s ability to aging in place in their own home. Routinely, we discover elders may have documented advance healthcare directives but with no practical or specific understanding as to what life sustaining measures they would actually desire when unable to speak for him or herself at a critical time.

We view this proposed Medicare change to be a good initial step for older persons considering what medical actions they would want to have performed, including the potential ramifications (positive and negative) from such procedures. Therefore, advanced directives will have more worthwhile meaning for everyone involved.

Champion Advocates recognizes that the next significant, yet more complicated, step is to ensure that agreed upon actions are timely and properly taken by creating a process whereby the patient, the medical provider and the designated healthcare agent are all on the same page before the end of the patient’s life is ever confronted.

In a future posting, we will will continue this topic by distinguishing the purpose and effectiveness of Advance Health Care Directives and the Physician’s Orders for Life Sustaining Treatment (POLST).

Nuts & Bolts

New Year’s (re)Solutions: Actions to Take for the Elders in Your Life

January 27, 2015 admin

Did anything alarm you when visiting with older relatives during the recent holidays?

You may have detected any one of the classic red-flag indicators that an accident or injury could be on their horizon.

Perhaps, you saw a trip hazard that can lead to a fall, so consider removing:

Coffee tables and ottomans
Throw rugs
Clutter in pathways
Electrical cords from foot traffic

This syndrome steals away the power from men to achieve or maintain sturdy erections for a longer period of time during intercourse. levitra no prescription The buy viagra from india formation of the prostate stones is closely related to the teeth. The enhancing solution Sildenafil Citrate is an excellent core component that has the ability to succeed in inhibiting the PDE5 enzyme and improves the cGMP substance internally which is one of the major reasons for improved source buying viagra in italy of blood circulation and relaxation of penile muscles. Special ordered medicines are gently handled and are brought out with discount viagra india care.
Also, repair:

Unstable walking surfaces, like loose steps or paving-stones
Handrails that are not properly secured to walls or posts

Maybe, you recognized poorly lit areas that can cause an accident. Light up and brighten up:

Cooking area and surfaces
Sewing, woodworking and other hobby stations
Hallways and pathways

Focus on:

Seasonal Affective Depression with appropriate lighting by introducing bright light therapy and/or using blue or blue-green spectrum light.

Did prescription and non-prescription medications appear to be a source of concern?

Get an updated list of current medications from all prescribing physicians and compare with the medications in the home.
Safely get rid of any outdated medications.
If there is any confusion regarding medications for you or your loved one, request a pharmacological review from the primary physician.

The New Year is a great time to resolve lingering concerns and worries from last year. By acting now, you can head into 2015 with greater confidence that older family members are in a better place to begin another year.

Anthony Antoville is Care Manager, Certified and COO of Champion Advocates LLC in Portland, Oregon providing geriatric case management services. He is a recognized expert in eldercare and home safety, internationally published with The Edwin Mellen Press.

Cherishing the Future of All Generations!