MY HEALTHCARE NOTEBOOK
The impact of this notebook will be found in bringing it and using it for every visit that impacts your health and wellbeing. When your healthcare providers see that you are documenting what is said or done, it makes them accountable, requiring them to be better providers. Documentation is the key to good healthcare. The healthcare mantra “if it is not documented it is not done” can cause havoc when information is missed or misinterpreted.
This notebook will be a living document. It should be maintained and updated at/for every healthcare professional visit. All your clinical and non-clinical questions, insurance information, medications, health history and test results are in one place. This notebook is go with you to every visit to any healthcare professional: MD. specialist, or treatment like physical therapy. This is portable. Plan to divide by professional expertise section for your PC, Orthopedist, Oncologist, Dermatology etc. This notebook will be your commitment to develop personal responsibility and improved your Quality of Life. This notebook is the best Self Advocacy tool to prepare for getting the knowledge that can impact literally the rest of your life. Being prepared to live a healthy life is 75 percent preparation and awareness and 25 percent implementation.
1.Cover age: current Name, Address, Emergency Contact, ICE on phone.
2.Insurance providers, copies of cards, group number and representatives phone number
3.Vital Information ( Vialoflife.com😊
4.Including name, address, Emergency Contact, DOB, insurance providers, card number, group number and representatives phone number.
5.Brief past familial health history, highlight when there has a cancer or cardiac past within family of origin
6.Detailed health history with tabbed dividers by disease or incident i.e. Orthopedic (include contact information) Gynecology (with contact info), Cardiac, internal medicine MD as well as practice contact information. Each section should include test results that have been done in the past i.e. Labs, blood work, Scans, MRI’s. Highlight past complications including anesthesia difficulties as well as drug sensitivities and allergies.
7.Have patient explain what activities they are currently doing to focus on a healthy lifestyle.
8.Current medications including ALL herbal and over the counter. Encourage single sourcing for all medications as well as pharmacy review once a year usually when they get the list of scripts filled for tax purposes. Get confirmation that current meds are being taken as directed or what changes the patient may have felt they needed to make.
9.Signed and notarized copy of Living Will (secure copies for glove compartment and travel suitcases, Five Wishes, HC POA, DNR and MOST form, when available
10.Reminder a PAPER COPY of Living Will is preferred in an Emergency and it is important to keep a copy in glove compartment and travel suitcases.
11.SUBFOLDER KEPT IN SECURE LOCATION IN THE HOME
12.List ALL PASSWORDS used within the family and identify where they are keep
13.Insurance Medicare Supplemental w/ passwords to accounts
HOW TO GET STARTED ………. TO BE ORGANIZED
Here are some important guidelines on how become a responsible partner and learn to control your health decisions. All of us need to be the manager of our own health, or we need a family member or advocate who is familiar with our health situation.
Be Prepared, a three-ring binder will help you keep track of your doctors, nurses, and insurance issues, as well as your medications. Keep all information Current. When you list your medications add Over the Counter as well. Take your up to date note book with you so that when you write down your questions leave space for answers and have the MD stay until you understand his answers
Embrace Your Mortality – When we recognize the process of life we can choose to live our life according to what we value, what is important to each of us? Life is meant to be fulfilling, meant to be enjoyed. By recognizing that life is not infinite, we are able to better focus on what makes life meaningful in each of our lives and living the life we want instead of waiting until “later” to enjoy our lives. Aging with Dignity PO Box 1661 Tallahassee, FL
Decide what is MOST Important To You and what are you willing to give up getting it? When we are active participants in our healthcare, life has more meaning and fulfillment. The Guide to Talk with your Doctor NIH Institute on Aging Brochure number No.05-3452 is a great help. If you are concerned that you may not be able to ask, take a family member of a friend who will be willing to make sure you get your answers.
Ask questions that are focused on the significance of illness or condition. Your physician may focus on the disease process. The more important focus, for you, is likely what is the significance of the illness or condition in your life; how may it impact your ability to do the things your love to do? A helpful Guide is NIH publication NO.08-7105 MD’s Talking with Older Patients
Ask your family what they understand about your wishes. Use advance care directives as a starting point for the conversation – Five Wishes is an excellent resource to open the conversation about what each of us wants for our future. It allows a person to specify what matters to them, in writing, so that there is no confusion in the future. These conversations can be hard and families do not like talking about “bad things” but understanding one another’s goals and wishes can avoid a great deal of stress and uncertainty in the future
FIVE WISHES is available through Aging with Dignity PO Box 1661 Tallahassee, FL 32302 or can be obtained locally (free of charge) from Hospice & Palliative Care Palmetto Region (HPCPR) by calling at 803 548 3708 ask for Melissa. HPCPR is available to provide one-on-one discussion regarding Five Wishes or for small group discussion as well (free of charge).
Decide who will have a say in what happens to you if you cannot speak for yourself….…but only choose person to make decisions for you. Because being the decision maker for a loved one can be difficult; it’s important to choose someone, who understands your goals and wishes and is willing to follow through on what you want. Choose someone you trust to make decisions, on your behalf, should you be unable to speak for yourself. Often times family members disagree on what decisions should be made and allow emotions to speak, having one person named, whom you trust to carry out your wishes, guarantees that what you want is respected. Info available through Education in Palliative and Ed-of-Life Care (EPEC) 750 N Lake Shore Dr Suite 601 Chicago IL 60661
This information is made available by Hospice & Palliative Care of Palmetto Region
To create a detailed health history you should include:
•Individual contact information for each of your physician practices ie.. orthopedic, arthritis, gynecology, cardiac, internal medicine, neurology etc.
•Each section should include test results that have been done in the past such as any lab test, blood work, EKG, scans, MRI’s.
•Highlight past complications to surgeries and include anesthesia difficulties.
•Document activities you are currently doing to focus on a healthy lifestyle.
•Encourage to give a real account of daily alcohol and drug use.
•Specifically document if they are ½ dosing of medications
•Give specific drug sensitivities and allergies
•Be as specific as possible on family past medical history including age and cause of death.
Why do you need to have a Living Will
A living will allows you to document your wishes concerning medical treatments. The most important fact is that paper copy of Your Living Will must be WITH you when you enter the hospital. Not in your safe deposit box, Not with your children and Not as part of your electronic medical record. Your spouse vocally sharing your wishes is NOT legally binding.
Realize if you arrive in an ER unconscious, we have mere minutes to determine what you want done and comply with your intentions.
Your Living Will guides your medical decision-making in the event :
You are unable to make medical decisions
You are in the medical condition specified in the state’s living will law
(such as “terminal illness” or “permanent unconsciousness”)
Other requirements also may apply, depending upon the state.
A medical power of attorney (or healthcare proxy) allows you to appoint a person you trust as your healthcare agent (or surrogate decision maker), who is authorized to make medical decisions on your behalf. Before a medical power of attorney goes into effect a person’s physician must conclude that they are unable to make their own medical decisions. In addition:
If a person regains the ability to make decisions, the agent cannot continue to act on the person’s behalf.
Many states have additional requirements that apply only to decisions about life-sustaining medical treatments.
For example, before your agent can refuse a life-sustaining treatment on your behalf, a second physician may have to confirm your doctor’s assessment that you are incapable of making treatment decisions.
What Else Do I Need to Know?
Advance directives are legally valid throughout the United States. While you do not need a lawyer to fill out an advance directive, your advance directive becomes legally valid as soon as you sign them in front of the required witnesses. The laws governing advance directives vary from state to state, so it is important to complete and sign advance directives that comply with your state’s law. Also, advance directives can have different titles in different states.
Emergency medical technicians cannot ask for a Living Will or medical powers of attorney BY LAW ( 1962 SC) in South Carolina. Once emergency personnel have arrived, they must do whatever they are able to stabilize a person for transfer to a hospital, both from accident sites and from a home or location. Upon review of the Living Will and after a physician fully evaluates the person’s condition and determines the underlying conditions, advance directives can be implemented
North Carolina (CMC Pineville SCCL closest hospital) ) does honor advance directives from another state; others will honor out-of-state advance directives as long as they are similar to the state’s own law.
Advance directives do not expire. An advance directive remains in effect until you change it. If you complete a new advance directive, it invalidates the previous one.
You should review your advance directives periodically to ensure that they still reflect your wishes. If you want to change anything in an advance directive once you have completed it, you should complete a whole new document.
For more information go to : The Vial of Life Program ……..www.vialoflife.com
HCPOA or DPOA understand the differences so you can get the services you require.
What is a Durable Power of Attorney (DPOA) and Why do I Need One, is a question being asked more frequently. It is important to understand how it is different than a Healthcare Power of Attorney. Is it to be effective now or when I am incapacitated? What can you do to make sure it can it be enforced? I have been asked many of these questions and sought out the knowledge of Mallissa Church an expert attorney in this area.
Durable Power of Attorney
What does it do?
Identifies a designated person –an Agent -who may make decisions for you, the Principal, and handle your personal business on your behalf.
It is a flexible document –as Principal, you may designate as many or few powers to your Agent as you wish.
It gives you peace of mind knowing you and your personal affairs will be managed by someone you trust.
Why do I need it?
It provides a seamless process for someone else to help you and help manage your finances and personal affairs if you become ill or incapacitated. It can prevent the need for someone to seek Guardianship and Conservator-ship.
It allows you to make decisions about specific powers you want to grant and the persons to whom you grant them.
South Carolina just enacted a new General Durable Power of Attorney Statute (effective January 2017). The new law is more comprehensive and includes new requirements not previously included in the old statute.
Healthcare Power of Attorney (HCPOA)is power to make healthcare decisions. Note not all healthcare providers honor a General Durable Power of Attorney with healthcare decisions. An HCPOA can be made effective immediately, before you are incapacitated. Healthcare Power of Attorney, designates someone to receive healthcare information about you and make specific healthcare decisions on your behalf. It does not grant any powers regarding financial decisions. It does allow you to make specific end-of life decisions becomes effective only effective after you are incapacitated
Durable Power of Attorney can be used as a Medicaid and Long-Term Care Planning Tool. It will help in qualifying for Medicaid using Spend-Down principal. DPOA allows your Agent to strategically make gifts to decrease your assets. This agent can include spend-down assets by paying “reasonable compensation” to the Agent. DPOA may retain Home Services, Home Health Assistance and Select In-Patient Care for the Principal. The new statute allows you to permit your Agent to retain home services, health assistance if you need it and also select in-patient nursing care for you.
The new South Carolina revision allows you to sue anyone who doesn’t honor the document (and recover costs). Your Durable Power of Attorney must meet the following requirements:
The document must be executed like a Will.
Meet the statute requirements.
Be recorded at the Register of Deeds office in the county where the Principal lives.
The new statute also provides a form your Agent may complete indicating your intent for the Durable Power of Attorney to be effective immediately.
These are some basic facts that will be useful in moving forward to obtain the necessary documents should you or a loved one become unable to care for themselves. This is an area where you really do need to get professional advice before you really need it.
Advance Care Directive – a written statement of a person’s wishes regarding medical treatment, often including a living will, made to ensure those wishes are carried out should the person be unable to communicate them to a doctor.
Living Will – A written document that allows a patient to give explicit instructions about medical treatment to be administered when the patient is terminally ill or permanently unconscious; also called an advance directive.
Health Care Power of Attorney – Legal authorization for one person to represent another’s wishes regarding medical treatment and care should that person become unable to do so for themselves. Health care power of attorney names the agent as a representative authorized to make decisions regarding care and procedures as stated by the individual. Each state has their own HCPOA form and you should update your form to reflect your state of residence. During travel, most states will honor the HCPOA from your home state.
DNR (Do Not Resuscitate) – Do not resuscitate (DNR), or no code, is a legal order written either in the hospital or on a legal form to withhold cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS), in respect of the wishes of a patient in case their heart were to stop or they were to stop breathing. This form DOES NOT address any other form of medical care and does not affect any ongoing treatment options. Each state has its own DNR form and they DO NOT transfer from state to state. The form must be presented as an original, no copies.
SC – South Carolina Emergency Medical Do Not Resuscitate Order (on white paper)
NC – Goldenrod (on bright gold paper)
MOST (Medical Order for Scope of Treatment
A NC (only) form for use by physicians and other licensed healthcare facilities to assist in providing information relating to a patient’s desire for resuscitation or life-prolonging measures. These forms are available only to physicians’ offices or other licensed hospital or healthcare facilities. The form is not transferable to other states and must be an original (bright pink form).
Five Wishes- Five Wishes is America’s most popular living will because it’s written in everyday language and helps people express their wishes in areas that matter most — the personal and spiritual in addition to the medical and legal. It also helps you describe what good care means to you, whether you are seriously ill or not. It allows your caregiver to know exactly what you want. Families also use Five Wishes to help start and guide family conversations about care in times of serious illness. Five Wishes is helpful for all adults – everyone over 18 years old – and anyone can start the conversation within a family. Sometimes it begins with grandparents and other times it is the younger family members who bring up the topic. Regardless of your age, you can bring this gift to your family.
12 Point Medication Check List
1.Learn Before you start taking any new prescription or OTC/herbal supplement by speaking with your pharmacist. Before taking ANY new drug OR supplement have your pharmacist review the impact on the other meds you are taking. Medications and supplements can counteract each other & therefore should be taken at different times of the day, some with food only, some on empty stomach. Do not expect pills to do what they are prescribed for if you take them incorrectly.
2.If you forget to take a single dose medication it is most often OK to take it within the current 24 hours. Do not take two the next day. If you accidentally take a prescription that is NOT yours call a pharmacist with the medication and dosage and follow their instructions. They may suggest that you call the Poison Control Center 1800-222 1222
3.If you take more than one (1) medication or supplement invest in a 7/day a week pill container. If you take meds more than one time a day get an AM / PM container. NOTE: most pill containers are not child proof so keep out of reach of children.
4.Single sourcing of medications can be a life saver. If you get online medications and other prescriptions from local pharmacy(s) make sure that you have one Go-To Pharmacist that has ALL your prescriptions and OTC /herbal supplement listed and use that pharmacist as a control source for questions before filling a new prescription or adding a OTC supplement.
5.Read the warning labels. It is always best to check with your pharmacist to find an OTC that is not contraindicated with your prescriptions.
6.Take meditations only as directed. Always take medications until the prescription is finished. DO not stop taking once you feel better and save the rest for later!
7.If the cost of medications has you taking half or partial dose let your doctor know as many come in larger doses, for the same amount, that can be divided to give you the clinical support your need.
8.Read the ingredients on the label. If you are taking more than one OTC do NOT take 2 that include “acetaminophen” for instance, that is double doses.
9.Annually review expiration date on all household prescriptions and supplement, yep they do expire! Dispose of medications by bagging and dropping at any police station. DO NOT flush down the toilet or toss in trash.
10.Do not share prescriptions. Your prescription may cause another person to have life-threatening results to a similar diagnosis.
11.Always ask for a “starter “2-week supply of new meds before you invest in the money saving 90-day supply, that way you can be assured that the prescription will work appropriately.
12.If you have any allergic reaction to a medication immediately add to your list of contraindicated meds. TELL your pharmacist. Often there are whole classes of meds that may contraindicated for you and you can prevent future problems by making sure it is on your documentation and that both physician, pharmacist know.