Virtual Dementia Tour

Second Wind Dreams Virtual Dementia Tour

When a loved one is diagnosed with Dementia, it affects everyone in the family, friends and the community. The Alzheimer’s Association states that Alzheimer’s is being diagnosed every 72 seconds in the U.S. alone, and 7 out of 10 Alzheimer’s patients live at home where family and friends provide 75 percent of the care. Yet studies show that these caregivers are not formally trained to provide the support needed for those living with dementia. The purpose of the Virtual Dementia Tour™-I for Individuals (VDT-I) is to help families better identify with their loved one’s day-to-day struggles, thereby improving their ability to provide care.

This six minute film tracks the life of a man, who at age 80 is living with Alzheimer's; and a son who is trying to understand what it is like to live with the disease. Virtual Tour allows you to see and feel what it is like to live with dementia.

Choices about Life-Sustaining Medical Treatments

Jena Bauman Adams, MPH MOLST Project Director Hearing that you or a loved one may be nearing the end of life because of a serious illness or injury is very difficult. It often takes time to adjust to the situation and to consider what it may mean. In addition, medical information – especially about one’s health status, what can happen next and the potential benefits and risks of treatment – can be confusing or overwhelming.

All adults have a legal and ethical right to make choices about medical treatments they want or do not want to receive when they are nearing the end of life. However, patients’ wishes are often unspoken, unknown, or unavailable to health providers at the time treatment decisions are made. That is why it is so important for individuals to have conversations with their loved ones and doctors about all of these matters – not only when they are very sick, but also before an unexpected illness or injury may occur.

In Massachusetts, all adults ages 18 and older are encouraged to fill out a health care proxy form to appoint a person they trust as their “health care agent.” In Massachusetts, if an individual is not capable of making medical decisions as determined by their clinician (e.g. because they are unconscious or due to dementia or other mental limitations), it is their “health care agent” officially named in a health care proxy who is authorized to make medical decisions on their behalf. It cannot be assumed that a family member or next of kin will be authorized to make medical decisions in every situation or setting.

Therefore, appointing a health care agent is the first essential step in advance care planning for every adult after they have turned 18 years old, even if they are perfectly healthy. The next step is to have conversations with your health care agent about your values and goals for medical care, so he or she can make the medical decisions you would have wanted should the need occur.

For individuals with serious advancing illnesses, especially those who may be nearing the end of life, physician-patient conversations about life-sustaining treatment preferences are of particular importance. Such conversations are often difficult for everyone involved; however, they serve to help patients, their loved ones and health care providers better understand the patient’s medical condition, treatment options and goals for care. In fact, these discussions have proven to improve quality of life scores for patients near the end of life and bereavement outcomes for their caregivers. (1)

To assist seriously ill or injured individuals communicate their wishes about end-of-life medical treatments, a new process is being tested in several Worcester-area health care institutions. Called Medical Orders for Life-Sustaining Treatment, the process entails conversation between a patient and the patient’s loved ones and doctor to explore and establish the patient’s treatment goals and preferences. One possible outcome of these discussions is completing and signing a “MOLST” form. A MOLST form is filled out and signed by a patient and doctor together to communicate the patient’s treatment wishes. MOLST instructions are honored by all health professionals across health care settings (e.g. at home, by emergency responders, in nursing homes, at hospitals).

The MOLST process involves:

1. Discussing your medical condition, treatment options, and your values, hopes, expectations and goals for care with your doctors and loved ones
2. Learning about the types of medical treatments you might be given if your heart or breathing stop – including the benefits or risks of such treatments and how effective they might be
3. Identifying any preferences you may have about receiving or not receiving certain types of life-sustaining treatments
4. Deciding whether or not to document your preferences by completing a MOLST form with your doctor
5. Completing the MOLST form with your doctor and signing it to confirm that the form reflects the treatment preferences you expressed to the doctor (the doctor also signs the form)
6. Keeping the MOLST form with you in a location where it can be easily seen or found by your loved ones and health professionals
7. Telling your loved ones, health care agent and caregivers about your MOLST instructions and the location of your MOLST form

Completing a MOLST form is voluntary and individuals may decide to wait until another time to consider MOLST, or not to complete a MOLST form at all. Individuals can also change their minds about treatments any time, even after signing the MOLST form.

For more information about Medical Orders for Life-Sustaining Treatment, you may ask your doctor, visit: www.molst-ma.org, or call the MOLST program at 508-856-5890.
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(1) Wright, A.A., et al., Associations between end of life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA, 2008. 300(14): p. 1665-73.

Congressman McGovern Holds Press Conference in Worcester

FOR IMMEDIATE RELEASE:
Seniors, Advocates criticize Marty Lamb’s ‘radical’ stance on Medicare, Social Security

Local seniors and senior advocates criticized Marty Lamb today for his “radical and dangerous” stances on Medicare and Social Security.

Citing experts, the McGovern Campaign said that Mr. Lamb’s “10th Amendment Pledge” would undermine the very basis of those vital programs.

“Despite his disingenuous claims of sticking up for seniors, Mr. Lamb is actively working to destroy the constitutional underpinnings of the programs most important to them,” said McGovern spokesman Scott Zoback.

In a statement, University of Chicago Constitutional Law Professor and former Supreme Court Clerk Geoff Stone said that Lamb’s pledge would “threaten the very premise of constitutional government.”

“If American constitutional law had embraced the position now asserted in the Tenth Amendment Pledge, the federal government could not charter federal banks, it could not enact laws prohibiting racial and religious discrimination, it could not establish minimum national standards for protecting the public health and safety,” wrote Stone.

Similarly, Ian Millhiser, a legal research analyst with the Center for American Progress Action Fund wrote in American Prospect last year that “tenthers” read the constitution “too narrowly...to permit much of the progress of the last century.”

Bob Dwyer, Executive Director of the Central Massachusetts Agency on Aging, said that seniors’ “quality of life would be irreparably damaged,” by Lamb’s pledge.

At the press conference at the Worcester Senior Center, McGovern pledged to fight for Social Security and Medicare.  “I have always stood up for seniors, and I pledge to you today that I will continue to do so.”

Governor Signs FMAP Bill With $7.1 M in Home Care Funding

Patrick Signs Budget Bill,
Sticks To Revenue Estimate
By Michael Norton/Statehouse News Service
http://www.statehousenews.com
GateHouse News Service

Gov. Deval Patrick on Friday signed a $420 million spending bill that adds to the three-month-old $27.6 billion state budget and his administration opted to stick with its estimate of tax collections for the fiscal year, which are running $200 million ahead of budget benchmarks.

Services for the disabled, the state's massive MassHealth budget and the State Police and prison system received funding infusions under the $420 million budget bill that Patrick signed without fanfare, shortly before attending a governor's race candidate forum at Emerson College.

The bill, paid for through federal stimulus funds that won’t be available next fiscal year, deploys accounting methods aimed at putting nearly $200 million into a state rainy day fund that lawmakers and Patrick have drained more than $1.5 billion from during the recession.

Patrick returned with an amendment a section of the bill requiring insurers to reimburse ambulance companies directly for services, regardless of whether the companies are members of contracted networks.

"I am concerned about the impact of this section on health care costs because it lacks guidelines government reasonable charges for ambulance services," Patrick said in a letter to lawmakers.

The amendment would set limits on the costs non-network ambulance companies may charge insurers.

House and Senate leaders steered the bill through the Legislature during informal sessions, overcoming concerns about the bill voiced by Republicans, who ultimately agreed to allow the bill to pass.

A year ago today and only three months into fiscal 2010, Patrick lowered the state’s tax revenue estimate by $600 million, calling for emergency spending cuts over the final eight months of the fiscal year that he said could result in the elimination of 2,000 state jobs, unilateral budget cuts, consolidation of state agencies, collaboration on energy purchases, and broader reductions across government.

This year, with tax collections running $200 million above fiscal 2011 budget benchmarks, the Patrick administration is sticking to its tax collection estimate, officials confirmed Friday.

Administration officials are trying to manage heavy, caseload-driven exposures in this year’s budget, especially in health care.

"Estimated revenues continue to be sufficient to meet budgeted expenditures," Administration and Finance Secretary Jay Gonzalez said in a statement.

State finance law calls for the administration by Oct. 15 of each year to signal to legislative leaders any revisions in anticipated revenues for the year, unless there’s no significant change in estimates.

Fiscal 2009 was marked by a string of supplemental budgets that both added government spending and made changes aimed at bringing outlays in line with available revenues. Additional supplemental spending bills are likely this year.

Fiscal analysts and candidates for governor have estimated next year’s state budget gap at between $2 billion and $3 billion, although Senate President Therese Murray, during a debate this week, pegged it at $1.5 billion. Extra federal funds that were critical to efforts to plug huge budget holes this fiscal year and during fiscal 2010 are not expected to be available next fiscal year.