The Chinese American Service League, a nonprofit providing in-home aid and day services to more than 900 Chicago seniors, partnered with Rush University Medical Center for the report. From 2010 to 2013, researchers conducted face-to-face interviews with more than 3,000 seniors between 60 to 105 years old.

“Seniors are our biggest focus,” said CASL President Bernarda Wong, who helped form the organization 34 years ago with her friend and colleague, Esther Wong.

More than 75 percent of the community served at the CASL speaks and reads Chinese only at home, according to the report. Another 20 percent prefers Chinese. The league devotes resources to new immigrants who do not understand English. ”Sometimes the elderly come in with federal documents and mail they cannot understand, so we help them,” said Bernarda Wong.

More than half of the community’s seniors suffer from one or more limitations to carrying out instrumental activities of daily life, such as managing money, preparing meals or housework. ”We train volunteers to do household chores and go into the homes of the seniors” Bernarda Wong said. About two-thirds of the seniors served suffer from more than one chronic illness.

But despite the league’s vast assistance to thousands of Chinese Americans, many of them still sidestep discussions about end of life and advance care planning, said Debra Chow, an elderly service social worker with the nonprofit’s in-home care services. “It is too taboo for them. End of life is something very scary to all of us.”

“That is not a topic that we have touched on a large scale,” Bernarda Wong said, although noting the growing need for such discussions. “We are eager to work with Life Matters Media, to plan a seminar and allow our clients to ask questions and soak in information,” Chow said.

“Many seniors do not want to bother their families, so they keep it to themselves,” Bernarda Wong said.

More from Life Matters Media:

Pain should not be a symptom of aging, says Rainbow Hospice Medical Director

POLST Illinois moves forward

Vermont votes to allow “Death with Dignity”

The post Helping Chicago’s Chinese American senior community appeared first on The Life Matters Media Newswire.

The Patient Choice and Control at End of Life Act awaits approval from Gov. Peter Shumlin, a Democrat and supporter of the bill.

“By a 75-65 roll call vote, the House approved a bill largely that copies a law passed by Oregon voters in 1997 for three years and then shifts to a system with less government monitoring,” The Associated Press reports.

This marks the first time this type of legislation has been moved to passage by a legislature. With safeguards similar to the Oregon bill, patients seeking the prescription barbiturates must first state their intentions three times- once in writing. A second opinion from a physician indicating a patient has less than six months to live and proof of sanity, are mandatory. Patients must wait 48 hours before filling the prescriptions.

“It’s an important step for terminally ill Vermont patients,” Dick Walters, president of Patient Choices-Vermont, said after the vote. “It’s a big step forward for the region and for the country as a whole,” the AP reports.

Come 2016, changes advocated by some of the state senators seeking less government involvement during the process will go into effect, including less monitoring from physicians.

“It’s huge,” said lobbyist Michael Sirotkin, who for years has been involved with the issue in Vermont. “I think it’s going to have a major effect on other states’ willingness to vote on this,” he told USA Today.

But not all lawmakers approved of the bill’s passage. ”There can never be a dignified death using a handful of pills or a lethal cocktail,” said Rep. Carolyn Branagan, a Republican from Georgia, VT.

Other opponents were concerned about the radical changes the bill underwent while in the Senate. ”We are passing a bill that has not been vetted,” said Rep. Paul Poirier, an Independent from Barre. “Do we want to pass a bill … just accepting 100 percent what the Senate did overnight?”

More from Life Matters Media:

Many seniors still unfamiliar with social media

Buehler Enabling Garden, an outlet for aged and ill

Unreasonable optimism among physicians common during end of life care

The post Vermont votes to allow “Death with Dignity” appeared first on The Life Matters Media Newswire.

Pain in the absence of disease is not a normal symptom of aging, but is still a daily experience for many older adults, said Dr. Timothy McCurry, medical director of Rainbow Hospice and Palliative Care, at the 15th Annual Aging Well Conference in Evanston, IL.

“As we get older we get more diseases, so we have come to associate aging with pain,” McCurry told a room of seniors gathered at the Three Crowns Park retirement community. “Chronic pain is constant in a lot of people. The data shows 100 million people in the U.S. with such pain.” He suspects arthritis is the most common chronic disease.

Because chronic pain is episodic, clinicians should mind how patients’ pain changes throughout a week and over time. For example, patients suffering from arthritis can exercise to help reduce symptoms. McCurry recommends aerobic and strength regimens. “When you become weak, your muscles become vulnerable to injury- falling and breaking a hip.”

But exercise only does so much, as medication usually accompanies chronic pain. “Sometimes you have to make changes and take medications that are a little stronger, a little strange, but help you be able to do stuff,” said McCurry. He knows many choose not to take medications, and they subsequently become “used to pain.” These seniors have a higher risk of falling and a lesser quality of life.

Sometimes, those suffering from chronic pain hide their pain from clinicians, family and friends. Over time, these patients learn how to better mask their discomfort, unlike patients suffering from sudden and intense acute pain.

“We can help people in severe pain,” said McCurry, noting morphine and other opiodic drugs common throughout hospice. “No chronic patient should be in pain.” But some patients shy away from these treatments out of fear of addiction or social judgements. “Although these pain medications can help you function, these myths are very strong and very scary. But at the same time, the alternative is worse.”

Even though hospice care helps many manage pain, findings show most seniors utilize such care too late.

More from Life Matters Media:

Many seniors still unfamiliar with social media

Buehler Enabling Garden, an outlet for aged and ill

Unreasonable optimism among physicians common during end of life care

The post Pain should not be a symptom of aging, says Rainbow Hospice Medical Director appeared first on The Life Matters Media Newswire.

While social media is second nature to millions of Americans, many seniors are still learning the basics of popular Web sites such as Facebook, Skype and Twitter. However, older adults are the fastest growing segment of the online community, said the North Shore Senior Center’s George Lowman at the 15th Annual Aging Well Conference in Evanston, IL.

“Social media is a brain game, it keeps seniors connected,” said Lowman, who built his first computer while in high school during the 1950s. Now, some 20 million Americans 65 and older are “online,” and 10 million seniors use social media.

Lowman spent much of his presentation warning seniors about the dangers of social media. “Seniors grew up in a world that was very private. They did not share information the way their grandkids do,” said Lowman. He suggests careful consideration of privacy agreements on sites such as Facebook and Google, because they mine personal data from users to sell targeted ads.

“Unfortunately, you will be hacked. It is not if, you will,” said Lowman. While seniors should not be afraid of social media, “since it’s not contagious,” seniors should be aware of scams and never give out their online passwords to “friends” over the Web.

Sometimes Lowman’s lecture seemed like a high school assembly. “Always remember that if you take a picture with a drink in your hand, it will end up on Facebook. Put down the drink,” Lowman told more than a dozen seniors. “Think of what your religious leaders and friends would think of your pictures.” The audience dutifully took notes.

Overall, the benefits from social media outweigh the risks, Lowman argued, since it is an easy and fun way to interact with grandkids, nieces and nephews who now view letters, phone calls and even email as “outdated.”

More from Life Matters Media:

Buehler Enabling Garden, an outlet for aged and ill

Being a friend to someone sick: Advice from author Letty Cottin Pogrebin

Unreasonable optimism among physicians common during end of life care

The post Many seniors still unfamiliar with social media appeared first on The Life Matters Media Newswire.

About twenty miles north from the Chicago Loop, the Enabling Garden is just one portion of the nearly 400 acre living botanic museum. While the other reserves and bigger gardens require lots of walking and even some climbing, the Enabling Garden caters to seniors and to the ill.

“We try to make this area as accessible as possible,” said Julie McCaffrey, the garden’s media relations manager. Most of the flower beds are raised to both provide easy access to visitors in wheelchairs and so that the elderly do not have to bend down to smell the flowers. Hanging baskets can also be lowered by pulleys.

Less obvious accommodations include smooth paving for wheelchairs, vertical wall gardens and miniature raised water fountains for “sensory enjoyment.”

“Many of these same ideas can be adapted in home gardens to create enabling gardens for a lifetime of easy, enjoyable gardening,” the garden Web site states. McCaffrey said some of the hospice patients who visit are inspired to garden at home. “It gives them something to take care of,” she said.

Hospice Dreams, a nonprofit that grants wishes to some hospice patients, recently sent an individual to the Enabling Garden. “It is so therapeutic for them to interact with plants and be with family,” McCaffrey said. “It would be great if hospitals started recommending this garden to their patients.”

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National Institute of Medicine recommends improving end of life care

Google “Death Manager”: A will for your digital data

Bed sores: New technology decreases occurrence

The post Buehler Enabling Garden, an outlet for aged and ill appeared first on The Life Matters Media Newswire.

Haider Javed Warraich,  a resident of internal medicine at the Beth Israel Deaconess Medical Center, recounts his optimism when he first met a woman suffering from heart failure and a condition preventing blood from flowing out of her heart.

“While learning her medical history, I also got to know her,” Warraich writes. His patient was a 50 year-old former artist, derailed by addiction. “At this point, she wasn’t a suitable candidate for heart surgery. But I felt there was still hope,” he recounts in The New York Times Sunday Review.

With perseverance, Warraich convinced his colleagues to order a procedure called alcohol septal ablation. Though the procedure could potentially reduce her symptoms, it came with many risks. His patient died the next day, after a complete heart block and aggressive attempts to revive her.

Warraich explains that he was victim of “irrational optimism, a condition running rampant in both doctors and patients, particularly in end of life care.” These physicians may push for costly and more aggressive treatments as a last resort, even when there is little hope of recovery.

As a study published in 2000 for the British Medical Journal shows, about two-thirds of doctors overestimate the survival of terminally ill patients. ”Doctors are inaccurate in their prognoses for terminally ill patients and the error is systematically optimistic,” concluded the researchers, headed by Nicholas A. Christakis, then of the University of Chicago.

Many times, those poor estimates are never fully communicated to the patient. A 2001 study of cancer patients published in the Annals of Internal Medicine found that physicians only told patients their estimated survival 37 percent of the time. No estimate was given 23 percent of the time. “Around 70 percent of the discrepant estimates were overly optimistic,” Warraich notes.

A 2012 study published in the Journal of Clinical Oncology found that cancer patients who talk with their physicians about how they want to die are less likely to opt for aggressive end of life treatments in the last two weeks of life, and they have much more comfortable deaths.

“Aggressive care at the end of life for individual patients isn’t necessarily bad, it’s just that most patients who recognize they’re dying don’t want to receive that kind of care,” said lead author Dr. Jennifer Mack of Harvard University Medical School.

Similarly, Warraich suggests more palliative care for patients unlikely to survive a serious illness. “Modern palliative care originated in response to the proliferation of new treatments and resuscitation technologies,” he writes. Palliative care not only provides more comfort alongside standard treatments, but it has been shown to help patients live a little longer.

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Illinois POLST form released to public

In America, death is taboo

The post Unreasonable optimism among physicians common during end of life care appeared first on The Life Matters Media Newswire.

“The Illinois POLST form is a step in the right direction,” said Mary F. Mulcahy, a co-founder of Life Matters Media and practicing oncologist at Northwestern University, while lecturing physicians about the form Thursday at Northwestern Memorial Hospital.

In March, the Illinois POLST form was released to the public, an effort headed by the POLST Paradigm and the Chicago End-of-Life Care Coalition. This update to the Illinois DNR advance directive aims to improve the quality of life for patients at end of life.

POLSTs, Physicians Orders for Life Sustaining Treatment, are more detailed than conventional living wills and advance directives. These forms give patients the freedom to indicate preferences regarding resuscitation, intubation, intravenous antibiotics and feeding tubes. Such forms are intended for patients in their last year of life, and they can follow patients across state care settings and direct doctors to provide or withhold lifesaving treatments.

The form should be adjusted over time to fit each patient’s prognosis. “This is not a one-time thing, as patients progress the form can change,” Mulcahy said. “There should be shared decision-making between physicians and patients.” To be valid, the form must be signed by the attending physician.

In the U.S., the average patient visits the hospital more than 30 times and meets nine different physicians during the last six months of life. These patients could benefit from having their medical wishes written down and on hand; the convenience helps cut through the chaos and confusion prevalent in care settings.

POLST was developed in Oregon in the 1990s, and now 14 states have POLST programs. Twenty-eight states are considering the use of such forms.

“Hopefully this form will change the culture and get people talking and preparing for the end of life,” Mulcahy said.

Palliative care expert Andrew Thurston, M.D., agreed. “I think this is great. My hope for the POLST form is that it will clarify patients’ wishes for their end of life care, and that it helps doctors more effectively communicate with their patients,” said Thurston. “We need more open discussion, and with easier language, this form helps.”

More about POLST

Washington POLST form: A new bill aims to close loophole

Illinois POLST form released to public

How POLST forms clarify wishes: Three scenarios

More from Life Matters Media:

Death with Dignity: Vermont House to vote amended end of life bill

Google “Death Manager”: A will for your digital data

Being a friend to someone sick: Advice from author Letty Cottin Pogrebin

The post POLST form presented at Northwestern Memorial, a seminar from LMM co-founder Mary F. Mulcahy, M.D. appeared first on The Life Matters Media Newswire.

Several weeks ago, the Senate whittled down its 22-page bill to just two pages, simply granting doctors immunity from prosecution for supplying life-ending drugs to any terminally ill patient with less than six months to live.

But with a 7 to 4 vote, the House Human Services committee backed a new bill restoring much of the process the Senate version eliminated, such as the requirements for both oral and written requests, and a 48-hour waiting period before filling a prescription. Furthermore, it requires every prospective patient to have an advanced directive and be enrolled in hospice, VPR’s Bob Kinzel reports.

“We have all of the safeguards that they have in Oregon. We have a 15-year track record in Oregon with this law,” said Rochester Rep. Sandy Haas, a Democrat who helped overhaul the Senate’s bill.

Oregon mandates patients verbally request life-ending drugs to their physicians, followed by a 15-day waiting period and then another verbal request. Patients also must submit written requests. Then, they wait 48-hours before picking up the barbiturates.

“That bill was about doctors. The bill we passed this morning is about patients,” Haas said. “The Senate bill purports to be immunity for doctors for malpractice, basically for misprescribing, for confusing patients about what happens.”

Republican Rep. Anne Donahue from Northfield, said she worries the new version will make it easier for families to coerce loved ones into committing suicide. “A person can then wait a month or two or three or more before actually taking (the drugs),” Donahue said. “And at that point there’s absolutely no protection about coercion, family pressures, financial pressures and even whether a person still has the capacity to make that decision.”

Donahue said she favors how the Senate version limited the ability of the state to intervene once an individual committed to end his or her life. “I think that the direction that the Senate went made a huge amount of sense and didn’t have the intrusion on rights and the intrusion of the state actually sanctioning suicide,” Donahue said.

A possible vote is set for Tuesday. If passed, the bill would be kicked back to the Senate for a vote. This is the farthest this Oregon-style legislation has advanced in Vermont. Last year, a bill came before the full Senate, but it failed.

More from the Life Matters Media Newswire:

Google “Death Manager”: A will for your digital data

Being a friend to someone sick: Advice from author Letty Cottin Pogrebin

Keeping the dead among us

The post Death with Dignity: Vermont House to vote amended end of life bill appeared first on The Life Matters Media Newswire.

The new Google Inactive Account Manager, or “Death Manager,” allows Google users to easily indicate what should happen to their digital contacts, emails and Web history once they no longer actively manage their account. In doing so, Google is pioneering a way to address an increasingly pertinent concern in comprehensive end of life planning- digital data management.

As many as 10 approved family members or friends may have access to data from an account, or the account can be terminated and data erased.

“What should happen to your photos, emails and documents when you stop using your account?” the Google setup page asks euphemistically. “You might want your data to be shared with a trusted friend or family member,” or want your account totally deleted. If deleted, Gmail, Google+ and YouTube data would be lost.

This new feature aims to give users more control over their digital file cabinet, and it may be appealing to those suffering from terminal illness or advanced age. The onset of dementia, for example, could prevent users from logging in.

Users indicate how their loved ones are to be notified; an automatic message can be typed and saved for future delivery. Users also indicate when others are to gain access to account information- at any time between three and 18 months of inactivity.

“Not many of us like thinking about death — especially our own. But making plans for what happens after you’re gone is really important for the people you leave behind,” a blog post by Google product manager Andreas Tuerk read. “We hope that this new feature will enable you to plan your digital afterlife.”

As receipts, tax information and personal notes are increasingly being sent via email and archived, this new feature is a logical step forward.

More from the Life Matters Media Newswire:

Hope or denial in the face of death?

Keeping the dead among us

The future of caregiving could be a talking dog

The post Google “Death Manager”: A will for your digital data appeared first on The Life Matters Media Newswire.

Feminist writer Letty Cottin Pogrebin discussed her new book,  at Chicago’s Tribune Tower Monday, as part of the Printer’s Row literary series.

Pogrebin, a breast cancer survivor, spent most of her presentation telling the emotionally-charged room of fans, caregivers and journalists what not to say or do when friends first learn of a serious or terminal diagnosis.

“The thing that bothered me the most was the gossip,” Pogrebin said, recounting her own diagnosis at age 70.

Upon learning of her cancer, Pogrebin told only her family and 12 “uber-pals.” Humans have concentric circles of intimacy, Pogrebin said, and she told only those she completely trusted.

However, word of her diagnosis eventually reached Pogrebin’s outer circle of friends and acquaintances. Someone let the secret slip.

Pogrebin soon became inundated with concerned calls from acquaintances and colleagues. With each conversation, Pogrebin felt forced to once again explain her diagnosis, and in turn, she relived painful emotions. ”My advice: Tell everyone so you can tell them all at once.” If she could rewind and do it a different way, Pogrebin would have sent a mass email to both explain her diagnosis and ask not to be disturbed.

Furthermore, Pogrebin insisted these phrases should never be uttered to a sick friend:

“Oh my God!”

“How are you?”

“You look great!”

“It’s God’s plan.”

These phrases, she said, can sound both fake and cliche. “Do you really want to know how I am? Did I not look good before?” Pogrebin laughed.

Instead, she advised that it may be more prudent to say something such like, “I’m so sad for you” or “I will be here for you, the moment you need it, and I mean it.”

Sometimes, Pogrebin said, family and friends visit just to make themselves feel better. “But what about the patient?” The sick person has to entertain the guests, get dressed, explain their most traumatic moments, and wonder if the person really even cares to know the full story. She suggested friends call before a visit, or plan a future date for dinner- once the patient starts feeling better.

Read the Chicago Tribune’s review of ”How to be a Friend to a Friend Who’s Sick”

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Keeping the dead among us

Life Matters Media participates in “Great Challenges”: Caregiver crises

Life Matters Media participates in “Great Challenges”: End of Life Care

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