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Welcome to the FAQ In this area of our site, you will find the answers to the frequently asked questions, as well as answers to How do I and Did you know questions. Please feel free to post a comment on any Q&A.
 Categories summary
Here is a list of the top categories and their sub-categories. Select a category to see the Q&As within.
Category Q&A Last Q&A published
  About ElderHope
Information about ElderHope
1 Is ElderHope for profit or not-for-profit?
About aging in general...
  Medical Care
About the practice and use of medical care...
Edit category  Gender Aspects of Gender that may impact medical care
2 My husband won't share with me when he'...
This category deals with ethical decision-making and end-of-life care.
Edit category  Advance Directives About Advance Directives.
2 Why would I want both a Living Will AND a Medica...
  Long Term Care
About long term care...
1 How do I know when I should put my loved one int...

 Last published Q&A
Here is a list of the last Q&As that were published.
Gender ]
Requested and Answered by Chapster on 18-Jan-2008 00:56 (11467 reads)
As a stereotype, men are often mocked for being big babies when they're sick. When they don't share their sickness, they are also chastised. You can't win.

Not only has our culture often told men that they shouldn't cry, that they're babies when they're sick, we've also been told that we are more manly when we don't show emotions. Now that we're adults, all the rules get changed.

There is also the well-known frequency of denial (which may be part of what we were just talking about), that seems especially the province of men (though we by no means have a full corner on the market).

An additional factor is that some of us didn't have a very respected voice in our family of origin. If that was the case with your loved one, if their were a lot of shut-ups in their childhood, then he will likely continue to shut up. His training has lead him to do so.

Of course, you know and we know that all of this refusal to talk doesn't serve he or you. Of course, counseling can help. But, it may just take some special times where you just sit down together and talk. The reality is that breaking these old familial patterns only happens with practice, with honoring his voice, with mutual respect and with more practice.

Imagine that you're trying to get your husband to get in to see a doctor because he's more lethargic all the time. One approach might be something like this: You sit down alone with your spouse and say, "You know Dear that I love you. I have seen some changes in your health in recent days. You seem more tired and lethargic. I can see that it's not been easy recently. I need you to know that I care and that I'm worried. Please don't tell me not to worry. I need to know that you are taking care of yourself and will take care of yourself. I need you to know that I care. I also really need to know that you're okay. I need you to get a check up very soon (set a date) to see what's going on. We can get through whatever is going on together, if something is going on. I will be with you every step of the way."

Just some ideas regarding this question which I hear often. It frequently goes back to not having been heard in one's family of origin.

Gender ]
Requested and Answered by Chapster on 18-Jan-2008 00:13 (9754 reads)
I am not a woman nor do I play one on TV. All joking aside, I have it from cardiology experts who have made the care of women a sort of specialty (among those experts, Melissa Carry, MD) that women feel a unique connection with their body that men may not share in quite the same way. They feel they know their body, it's rhythms and nuances. Thus, when their heart begins to have problems, it may be a tremendous shock to them and they often feel betrayed and let down. It can be quite a discouraging experience because it feels that the connection that they have had with their body has let them down.

As such, there is an element of adapting to the reality of cardiac illness that may be very much a head game in which a woman has to talk herself through understanding what has gone on and may need to process it. Significant others may be able to help with this process by helping a woman know that this reaction is normal and that the human heart, especially in females, sometimes does not have the ability to forewarn. Self-talk may be very helpful in this process of coming to terms both with a cardiac event and with an understanding of the body connection.

You may also want to look at the following links specific to women and heart disease:

The Heart Truth
The National Coalition for Women and Heart Disease

Requested and Answered by Chapster on 31-Mar-2007 00:51 (8886 reads)
Because in some states, Texas for example, the Living Will allows you to do two things prior to being in a terminal or irreversible condition where you can't make your needs known:

Say what kind of care you would like you would like;
Say whom you would like to make choices for you

See that last thing, "Say whom you would like to make choices for you." Well, the little clause where it allows you to say who makes choices is not really very strong. In most cases you'll be just fine filling it out. But, in families where people have very different opinions about values, ethics, then the whole thing can end up in court faster than you can blink an eye. When that happens, trust me, you'll want a Medical Power of Attorney.

Now, why would that be the case? Because the Medical Power of Attorney (MPOA) spells out everyone's obligations really clearly - the doctor's, the person you name as your agent, your responsibilities - everyone's. And when you end up in court, if you don't have the strongest possible support for your views, guess what? You may well lose and have exactly the care you didn't want.

Now, here's another neat little part of this whole package. If you have BOTH the Living Will and the Medical Power of Attorney, you agent is obligated to follow ALL your choices and values as expressed in that Living Will. If they don't THEN they can be legally removed as your agent. If a doctor doesn't follow your wishes, they must refer you to another doctor who will. So, take our non-legal advice - GET BOTH!

Requested and Answered by Chapster on 21-Mar-2007 07:34 (10640 reads)
Often, if one is not able to make their own wishes known and there is a valid advance directive available previously made, its intent will be honored across state lines. But, one should not presume that this will be the case. Some states go to great pains to clarify that one should not assume that this will be the case.

The upshot of all this is that you should have an advance directive made for the state or jurisdiction in which you live.

As an additional piece of information, we have occasionally encountered people who thought they would try to make an advance directive in each hospital in which they had been admitted. The intent is praiseworthy. But, what they didn't realize was that each new advance directive at each new facility or hospital voided the previous one. OF course, that was in Texas. Other states laws may vary. Here, though, when you a create a new Advance Directive your previous one is voided (assuming its the same kind). It's better to make a bunch of copies of your advance directives and take them with you to the hospital any time you are admitted.

Always discuss any questions about advance directives or legal issues with an attorney who is familiar with the laws of your state or jurisdiction.

Requested and Answered by Chapster on 20-Mar-2007 07:38 (10270 reads)
There is no hard and fast answer to this question. There are several very individual factors that must be weighed before deciding when to place a loved one into long term care. Basically, these factors involve the following: 1) The severity of your loved one's illness process; 2) Your own resources (Can they reasonably and safely be kept at home?); and 3) Your ability to cope with your loved one living at home.

The disease process is often much more severe than people account for. There are several scales together called Activities of Daily Living that break down the impact disease process has on interfering with daily life, such as toileting, eating, etc. Many people have the romanticized notion that they will be able to care for their loved one at home but fail to take into account how debilitated their loved one is. Using a well-defined scale such as an Activity of Daily Living Scale will help to bring reality closer to home and to better assess the impact that disease process has on an illness.

Additionally, the reality is that there are so many multiple demands on people today that you may not have the resources to watch over a loved one, whether they are at your home or their own. Resources refer to time, energy, money, and emotional wherewithal. It is important to keep in mind all of these variables. Yes, you may be able to take care of them at home. But, if you yourself are in poor health or are constantly exhausted, how much stimulus and love and support will you really be able to offer? Many caregivers find that they are so stressed that they constantly snap at their loved one, hurting them emotionally.

We are not trying to make the case for putting a loved one into a long term care facility. We are making the case for keeping them where they can be cared for safely, lovingly, and timely. If this can be done at home, that is most certainly the best place for a loved one to be.