Low Impact Exercises

A terminal diagnosis brings a whirlwind of emotions and uncertainties, but it also presents an opportunity to take control of the future. Thoughtful estate planning can ease the burden on loved ones, ensure wishes are honored, and provide peace of mind during a difficult time.If an estate plan is already in place, now is the time to review and update key documents. A will or trust should reflect current intentions, ensuring assets pass according to ones wishes. Beneficiary designations are just as important as the documents themselves. Beneficiaries named on retirement accounts and life insurance policies should be checked to avoid unintended distributions. And remember, if you have a trust, ensure it is funded - meaning, the assets you intend are transferred or retitled to the trusts name. Ensuring that powers of attorney for both financial and healthcare matters are in place is critical. A trusted individual should be named to handle financial affairs if incapacity occurs. Similarly, a healthcare power of attorney and living will should clearly outline medical preferences including the types of heroic measures you want taken as your health fails. This reduces uncertainty for family members and medical providers. Depending on the circumstances, certain trusts may be beneficial. A revocable living trust can provide continuity in managing assets without the delays of probate. For those with minor children or dependents with special needs, a trust ensures funds are managed responsibly for their care. Irrevocable trusts may also be beneficial, depending on your familys goals and whether you anticipate needing long-term care. If nursing home care becomes necessary, proper Medicaid planning can help preserve assets for a spouse or family. While Medicaid rules are complex, strategic planning may allow individuals to qualify for benefits while protecting certain assets from being spent down on care costs. A terminal diagnosis also presents an opportunity to shape a personal legacy. Whether through charitable giving, a letter of wishes, or recorded messages for loved ones, taking time to plan for these personal aspects can provide lasting comfort and meaning.While its understandable to feel overwhelmed, delaying these important steps can create unnecessary stress later. Consulting an experienced estate planning attorney ensures that legal and financial affairs are in order, providing clarity and confidence in navigating the road ahead. Taking these proactive steps allows individuals to focus on what matters mostcherishing time with loved ones and finding peace in knowing that their affairs are settled.

The current administration has introduced policies that may significantly affect seniors, particularly concerning Medicare and Medicaid. Understanding these changes is crucial for seniors and their advocates to navigate potential challenges in healthcare access and affordability. Medicare: Shifts Towards Privatization The current administration has expressed intentions to shift Medicare towards a more privatized model, emphasizing Medicare Advantage plans. This approach aims to foster competition among private insurers, potentially driving innovation and reducing costs. However, critics argue that increased privatization could lead to disparities in coverage and access to care, as private plans may not uniformly cover all services essential to seniors. Medicaid: Proposed Budget Cuts and Their Implications Recent budget proposals from the administration include significant cuts to Medicaid, totaling approximately $880 billion over the next decade. These reductions could directly impact services vital to seniors, such as long-term care, personal assistance at home, and nursing home care. Given that Medicaid is the primary payer for long-term services and supports, these cuts may result in reduced access to necessary care for low-income seniors and increased financial strain on families.Regulatory Changes and Potential Consequences The establishment of the Department of Government Efficiency (DOGE), led by Elon Musk, has led to swift actions targeting various federal agencies, including those overseeing healthcare programs. Notably, the Centers for Medicare and Medicaid Services (CMS) have experienced administrative funding cuts and workforce reductions. These measures could hinder the agency's ability to effectively manage and oversee Medicare and Medicaid programs, potentially affecting service delivery and program integrity. Predictions and Considerations for Seniors While some of these policy changes are proposals and have yet to be enacted, seniors should remain vigilant and proactive:Stay Informed: Regularly monitor updates on Medicare and Medicaid policies to understand how changes may affect your healthcare coverage and access.Advocate for Needs: Engage with local and national organizations that represent seniors' interests to voice concerns and advocate for policies that protect essential healthcare services.Consult Professionals: Seek guidance from healthcare advisors or legal experts specializing in elder law to navigate potential changes and make informed decisions about your healthcare options.

By Faith Protsman, MD, Regional Medical Director, VITAS HealthcareVietnam War veterans face unique obstacles throughout the twilight of advanced illness. For hospice care providers to tailor care to meet the needs of veterans who have served in this theater of war, they must consider the tribulations these patients face as they reach the end of their lives.The Vietnam War era was a very tumultuous time to be a soldier. The United States' prolonged involvement in a war of questionable motivation left society with disdain toward the government and its institutions, especially the military.Coupled with horrific images shown on television, constant controversy was a new reality and negative public opinion formed around this conflict, of which those serving the nation were not spared.Careful consideration is necessary when treating patients facing these traumas.Tours of duty proved to be traumatizing in many ways. Young soldiers, some having just turned 18, were drafted into a war that many of them did not believe in. They were not fighting for love of country and God; rather, they were fighting for survival and out of fear for their lives.Intimate battles in the dense jungle led many to be subjected to the horrors that come with fighting in a foreign land that was only familiar to the elusive guerilla enemy soldiers.Servicemembers did not receive a warm welcome when returning home from Vietnam, often being judged and labeled as cruel and even inhumane.Moral Injury Can Impair Mental HealthThis perfect storm of trauma led to lasting moral injury that plagues many veterans for their entire lives. Veterans returning from the war were marginalized and pushed into isolation, often turning to alcohol and substance abuse, which worsened their anxiety and exacerbated their strife.Questions like Ive never spoken about the war, can I now? Was the war moral or immoral? and Was I a good soldier? come bubbling to the surface later in life as their illnesses intensify and their defenses weaken.Careful consideration is necessary when treating patients facing these traumas.The restlessness that can result from post-traumatic stress disorder (PTSD) is often treated with benzodiazepines. In most cases, these medications can bring relief through calming the patient.Yet, there is a common trend amongst veterans who cope with trauma that results in the opposite effect.Benzodiazepines can lower the walls that Vietnam veterans have built up throughout a lifetime of suppressing trauma and negative memories. This class of medications can exacerbate the symptoms of PTSD as traumatic experiences and feelings of regret resurface. Benzodiazepine-induced inhibition of neurotransmission can even lead to agitated toxic psychosis, increased anxiety, hostility, and rage.1The Value of Compassion Along with Clinical CareRemaining considerate does not end with simply staying mindful during the planning of clinical solutions. Providing care for Vietnam veterans requires a high level of empathy.A key to an empathetic approach is taking the time to listen nonjudgmentally. Though seemingly simple, practicing nonjudgmental, open communication with patients facing trauma from war can help avoid the all-too typical responses of Its okay and You did what you had to do.These patients do not need sympathy, because they have been judged enough throughout their lives. When care teams approach them without judgment, they honor the sacrifices these heroes have made.VITAS hospice care provides compassionate care approaches that are tailored to meet the distinctive needs of Vietnam veterans. With the Veterans Administration (VA) offering hospice care as part of its medical package, VITAS team members can provide empathetic psychosocial support, while utilizing clinical solutions that help manage symptoms.The qualifications for veterans to receive hospice benefits include: A life-limiting illness Treatment goals that focus on comfort, rather than curative treatments A life expectancy of 6 months or less, if their illness runs its normal course Veterans also benefit from the option to receive concurrent care through the VA. The VA can provide curative treatments as the patient simultaneously receives symptom-managing comfort care administered by the hospice care provider of their choosing.Offering solace, while remaining compassionate when patients need it most, is too often overlooked in the busy practice of healthcare. Acknowledging the adversity that Vietnam War veterans have had to face throughout their lifetimes and adapting care approaches to meet their needs is the best way for healthcare providers to give back to those who have sacrificed so much for the preservation of freedom.1Paton, C. (2018, January 2). Benzodiazepines and disinhibition: A review: Psychiatric bulletin. Cambridge Core. Retrieved November 2, 2022, from https://www.cambridge.org/core/journals/psychiatric-bulletin/article/benzodiazepines-and-disinhibition-a-review/421AF197362B55EDF004700452BF3BC6