A Professional Fiduciary is an experienced professional who performs decision-making tasks for another. This may include serving as Guardian or Conservator as well as trustee, agent or as a contract services provider for case management and financial services. Colorado does not license or register Professional Fiduciary's but most fiduciaries belong to a national organization that has a code of ethics and conduct; for example the National Geriatric Association of Care Managers (NAPGCM) or the American Association of Daily Money Managers (AADMM). In addition professional fiduciaries may be bonded, or have liability insurance.You can designate a professional to serve as your financial agent or medical agent or in other estate planning roles. This can come in handy when you don't have family close by or family members are unable to serve or are simply not a good choice. A professional is interested in carrying out your wishes and directions and has no interest in benefiting from your estate plan, as a family member might be, which can cause a conflict of interest for that family member. The professional is focused on you in the most efficient and supportive manner.When our body's age, our mental abilities decline as well. Sometimes this decline is mild and sometimes severe. You do not have to wait until decline occurs to take advantage of the services of your agent. Perhaps you are going on an extended trip to visit family in another state and you don't want to worry about paying your bills or the security of your home while you are gone. Or perhaps you are going into the hospital for a procedure and want to have an experienced professional on hand to advocate for you, your medical agent can temporarily assist you with this support.Your agent can assist you before or as you decline to the degree you request of them. It is a collaborative relationship. A professional fiduciary will keep accurate records, save all receipts and make transactions or decisions for your benefit that are consistent with your wishes and in your best interest. If incapacity occurs the agent can step in completely, but in the mean time you can use the services they provide to make life easier, and more enjoyable, as well as to provide peace of mind, which after all is the whole point of retirement.This article was submitted by Sally Hirsh, Professional Fiduciary Alternatives Financial Services, LLC. Sally can be reached at 303-776-0585 or by email at shirsh9807@gmail.com.

Heart disease is the leading cause of death for men and women in the United States. Its estimated that every40 seconds, someone in the United States has a heart attack.A heart attack occurs when there is a sudden interruption of blood flow within a diseased artery, typically due to a blood clot that forms when the plaque ruptures.Time is muscle.The early recognition of symptoms is vital to limit the damage done to the heart muscle. The less amount of injury the heart sustains, the better the outcome and prognosis.Heart Attack SymptomsThe typical symptoms of a heart attack include:Chest pain that can be described as discomfort, heaviness, tightness, burning, squeezing.Pain that radiates across the chest or upper abdomen, up the neck, jaw and shoulders and down the arm.Other associated symptoms may include:BreathlessnessNausea, vomiting or belching (indigestion)SweatingPalpitations (skipped heart beats)Dizziness, lightheadednessFaintingFeeling tiredWomen, the elderly and diabetics may also experience the above symptoms, however theyre more likely to have atypical symptoms such as nausea, vomiting, back pain, abdominal pain, jaw pain and shortness of breath without feeling chest pain.Do not ignore any of these symptoms, especially if they intensify and last longer than five minutes, immediate medical treatment is necessary.Who Is At Risk For Heart Disease?The risk factors for developing heart disease include:High blood pressureHigh blood cholesterolTobacco use (smoking and chewing)DiabetesAgingFamily history of premature heart diseaseSedentary lifestyleObesity or overweightEmotional stress / poor stress managementUnhealthy eating habitsExcessive alcohol consumptionHistory of high blood pressure, preeclampsia or diabetes during pregnancyCOVID-19 infectionWhat Can You Do To Prevent Heart Attacks And Heart Disease?Promoting good heart health starts by:Knowing and recognizing the early signs and symptoms of a heart attack, both typical and a typical. Time is muscle.Identifying and understanding the risk factors for heart disease.Seeking medical attention if you develop symptoms suggestive of heart disease or possess significant risk factors.Implementing lifestyle modifications focused on appropriate diet and nutrition, regular activity, weight management, smoking cessation, reduced alcohol intake and stress management.Initiating medical therapy as guided by your care provider.Embracing a positive and joyful attitude.We're Here To Help!The SCL Health Heart & Vascular Institute combines the strength of leading cardiovascular specialists with some of the areas best heart hospitals, including Platte Valley Medical Center in Brighton, as well as regional centers of excellence such as Saint Joseph Hospital and National Jewish Health in Denver. Our team of experienced and highly-qualified cardiologists and vascular specialists provides you with the highest level of care, from heart attack prevention and surgical care, to specialized rehabilitation, all to keep your heart healthy and strong.For more information visitSCLhealth.org/heart or call 303-659-7000 to make an appointment with a cardiologist.

Do you know the differences between Home Care Agencies, Home Care Placement Agencies, and Independent Home Care Workers? Knowing these key differences can help you, or your loved one, get the care you need while protecting yourself from liability. First, some definitions: Home Care Agencies employ trained staff who provide medical home health or non-medical personal care services in the home care consumers temporary or permanent home or place or residence. Home Care Placement Agencies (a.k.a., registries) make referrals of Independent Home Care Workers to home care consumers seeking services. Independent Home Care Workers are unaffiliated individuals who may or may not have home care training who hold themselves out to the public as providing home care services.In order to better ensure the safety of home care consumers, Gov. Bill Ritter signed legislation in the summer of 2008 requiring all Home Care Agencies to be licensed by the State of Colorado. This new law requires that all medical Home Care Agencies become licensed prior to January 1, 2010 and all non-medical Home Care Agencies become licensed prior to January 1, 2011.In order to become licensed, Home Care Agencies must comply with a significant set of requirements that are designed to protect the rights and safety of home care consumers. These requirements include carrying general liability insurance or a surety bond, and training, scheduling, supervising, disciplining, and performing background checks on all home care workers. Home Care Agencies must also pass an extensive onsite survey by the State of Colorado Department of Health. As the employer of record, Home Care Agencies are also required to withhold and remit federal and state income taxes, Social Security and Medicare taxes, and provide unemployment insurance and workers compensation insurance for all home care workers.By comparison, since they are not legally the employer of the home care workers whom they refer, Home Care Placement Agencies are not required to withhold payroll taxes or provide unemployment or workers compensation insurance for those home care workers. This means the consumer can be held directly and personal liable for any unremitted payroll taxes and any medical expenses should a referred home care worker become injured while providing care for the consumer. Likewise, since they are not the employer of record, Home Care Placement Agencies cannot be required to train, schedule, supervise, or discipline their referred home care workers. Generally speaking, because Home Care Placement Agencies are not able to exercise management and control over the performance of their referred home care workers, the State of Colorado does not currently allow Home Care Placement Agencies to become licensed.While some Independent Home Care Workers choose to accept referred assignments from Home Care Placement Agencies, others choose to work exclusively on their own. For those working on their own, all background checks, training, scheduling, supervision, and discipline become the responsibility of the consumer. And, as in the case of Home Care Placement Agencies, the consumer can be held directly and personal liable for any unremitted payroll taxes and any medical expenses should an Independent Home Care Worker become injured while providing care for the consumer. Caveat Emptor. Consumers are strongly encouraged to request an Agency Disclosure Form, which the Colorado Department of Health requires all Home Care Agencies and Home Care Placement Agencies to provide to consumers, and which specifies whether a provider is a Home Care Agency or a Home Care Placement Agency and lists the consumer safeguards that the home care provider is responsible for as well as the responsibilities of the home care consumer.Editors Note: This article was submitted by Lorin Chevalier, Managing Director of the licensed Home Care Agency, Senior Helpers, and a member of the Home Care Association of Colorado, the National Private Duty Association, and the Colorado Gerontological Society. He may be reached at 303-452-6500 or at www.SeniorHelpersBoulder.com

Bridges Community Home Health and Hospice is dedicated to keeping our patients on track with their recovery and comfort, even when unexpected events or emergencies interrupt our staffs routine.We consider the individual health of each patient and their ability to cope with a specific circumstance or potentially evacuate their home entirely. We also acknowledge the importance of keeping our own staff, who could face risks to their own health and safety during a serious emergency.Our internal emergency planning is coordinated with the individuals, families and communities we serve to ensure a seamless plan of action is laid out and the appropriate measures are taken in a timely manner as they are neededHere are just a few ways we address certain emergency events:Accountability Call SystemShould an emergency occur in the region or community where a patient resides, you can rest assured knowing our team has already been in direct contact to confirm their safety and well-being. If weather conditions or other travel hazards prevent our staff from safely making a routine visit, we immediately reach out to all affected patients and their caregivers to confirm their safety and identify the potential for any additional risks, like a power outage.Our emergency communication plan prioritizes transparency for patients and their loved ones, and helps our team identify which additional measures could be necessary.Tailored Contingency PlanninBecause our home health services are delivered on an individualized basis, we have created specific contingency plans for different home environments that consider each patients level of independence and what type of supervision or assistance they have access to. In a community environment, there might be several individuals affected by one sudden event or emergency, though not all will face an equal risk.When we reach out to a community to confirm patient well-being, we are diligent to confirm, and in some cases prioritize, the status of individuals who may have less ability to move on their own or even communicate with staff. It is in these rare cases that your care team must be prepared to go above and beyond to advocate for those who may not be in a position to do so themselves.Additional SuppliesThe last thing we want you to worry about during an emergency is whether you or your loved one has access to the resources they need to stay safe and healthy. Should a situation prevent a regular visit or service, our patients and their families can rest assured knowing our team has already considered this rare circumstance and have provided patients with the equipment, treatment supplies and instruction they may need.Ongoing TrainingEvery provider, caregiver, volunteer and staff member at Bridges Community Home Health and Hospice is trained on our complete emergency preparedness system as a condition of joining our team. In addition to understanding our own internal plan and system, they must also know the details and plans already in place at the communities or facilities where their patients are staying. Staff go through additional training every year to refresh and update their knowledge on our safety procedures and the communities we serve.