by Cate Kortzeborn- Medicare’s acting regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories

My mom, 88 stubborn years old, still lives on her own in a big house with a cat that loves to get underfoot. Because I work in healthcare, I have an all-too-vivid recognition of the perils that can befall someone in her situation.

POLST stands for Physician Order for Life-Sustaining Treatment. It’s a document that makes your treatment wishes known to doctors, nurses, emergency medical technicians, and other healthcare providers. Too often, people near the end of their lives get treatment they don’t want. These treatments may not help them live longer or better, and sometimes can cause pain.

Also, family members sometimes have their own ideas about what types of treatment their loved ones would want. POLST makes sure your family members and caregivers know exactly what life-saving treatments you do and do not want.

POLST is different from an advance healthcare directive. An advance directive allows you to choose the advocate you want to speak for you if you’re incapacitated, and provides a general guide to what treatment you want. POLST is different because:

• POLST is a signed medical order that your healthcare team can act upon, whether your advocate is there or not;

• POLST indicates your exact wishes about certain medical treatments.

Although it’s a good idea for all seriously-ill people to have both an advance directive and a POLST, any adult, especially if she or he is unmarried, should have one or both.

You can find the POLST form online or at your primary care provider’s office. Your provider can explain the different options on the form to you. The POLST must be signed by a licensed healthcare provider and by you.

Once signed, the POLST becomes part of your medical record. It stays with you all the time. If you’re at home, put it near your bed or on your refrigerator. If you’re in a hospital, nursing home, or assisted living facility, it’ll be in your chart or file. If you’re moved between locations, your POLST goes with you.

POLST forms vary by state and focus on three types of interventions. For each, you can chose whether or not to have something done or choose a level of intervention.

• Resuscitation (person has no pulse and is not breathing):.

• Medical intervention (person has pulse and/or is breathing):

• Artificially administered fluids and nutrition: This is a way of feeding a person through a tube either in his/her nose or through the skin into his/her stomach.

To find the POLST website in your state, where you can get more information and download forms, go to www.polst.org.

More information on advance directives can be found at: https://medlineplus.gov/advancedirectives.html.

You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

by Lori Harasta

Howard was only 41 years old and was suffering from the advanced stages of esophageal cancer when he was admitted into Livingston’s compassionate hospice care. Within days his pain was under control and he was comfortable enough to leave the house, be with friends and even enjoy a beer. Although he was on hospice care, he was living what appeared to be an ordinary life again.  When the end finally came, his passing was pain free.

Many people think that being on hospice means lying in a bed, barely conscious. Howard’s story proves that is not the case. Hospices are all about providing a comfortable lifestyle for those in their final stages of life. There are many hospices out there that people use such as the Hospice Cincinnati. People want to be happy in their final moments and this is one way to do it. Many of his final moments were anything but ordinary, and they would not have been possible without the help of hospice.

Howard’s experience is not unique. The mission of hospice is to provide specialized care for end-of-life patients and their families.  Hospice care supports living one’s life to the fullest with dignity regardless of how much time remains. They provide support and also give high quality care through professional doctors, and healthcare lighting and equipment.

November is National Hospice and Palliative Care Month.  Here are some of the common myths of hospice that need to be put to rest:

MYTH: Hospice care means leaving home.
FACT:  Hospice is not a place. In fact, hospice services can be provided to a terminally ill patient and his or her family wherever they are most comfortable, or wherever they consider “home.”

MYTH: Hospice means forgoing all medical treatment.
FACT:  With hospice, the focus changes from cure to comfort.  The hospice provider will assess the needs of the patient, deciding which medications and equipment are needed for maximum comfort.

MYTH: Hospice means strangers care for you.
FACT:  Livingston Memorial Visiting Nurse Association strives to educate and support family members to serve as the primary caregivers for an end-of- life patient.  The hospice team comes alongside the family and consists of doctors, nurses, aides, social workers, therapists, volunteers and chaplains, and are available 24/7.

MYTH: Hospice care ends when someone dies.
FACT:  Bereavement support  services that deal specifically with grief and coping after the loss of a loved one are available at no cost for up to a year after someone dies.  In addition, Livingston has bereavement support groups for the general public in various parts of Ventura County.  For more information, visit the website at http://lmvna.org/calendar/index.html

MYTH: People on hospice are in bed, waiting to die.
FACT: Hospice enables special moments and memories at the end of a life that would otherwise not happen.  Howard called hospice because he wanted to live his life to the fullest with dignity, restoring a quality of life that he may have otherwise lost to invasive treatments and surgeries.

Hospice makes more meaningful moments possible.

The California Assisted Living Association (CALA) has announced that Sarah Perez, Memory Care Program Manager with Cypress Place Senior Living in Ventura, has received the organization’s prestigious Outstanding Department Director award at their Fall Conference & Trade Show in Rancho Mirage. CALA chooses recipients of these awards based on their commitment to providing outstanding, quality care and service to residents in the Assisted Living communities where they work. Perez received her award on October 24, 2016.

According to executive director Steve Spira, “Sarah may think no one is watching, but we at Cypress Place can see that excellence and superlatives are simply silent badges she wears every day.”

Perez began working at the community 13 years ago as a caregiver, and is currently in charge of the memory care Vibrant Life program.

Co-workers and family members say that Perez’s greatest talent lies in the fact that she really “knows” residents and takes cues from them to create personalized, engaging activities. She noticed on a recent outing that residents were expressing concern for homeless individuals, so she organized a group to craft blankets for them. She also organized the “Yahtzee Girls Club” after many residents told her they like to play dice games.

This creativity extends to individual residents as well. One resident was continually talking about his WWII experience. Perez worked with his wife to create a slide show of his military life and hold a celebration of his service. Her philosophy of care is, “When residents are laughing and engaged, they’re not experiencing fear or trepidation.”

“This is a well-deserved award for Sarah, and we are thankful she is part of the Cypress Place team assisting our residents in such a loving and dignified manner,” said Spira.