February 11, 2017

What's your health care IQ?

Health literacy is the ability to obtain, process and communicate the health information needed to make informed decisions and to preserve one's constitutional right to privacy and due process. Nonlegalese: Health literacy is knowing what you need to know to protect yourself in today's health care system.

* A national study of health literacy by the U.S. Department of Health and Human Services (HHS) concluded that over one third of American adults have basic or below basic health literacy skills (e.g., difficulty reading a chart or following simple instructions), far less than what’s needed to fully function in today’s complex health care system. 
* Between 1966 and 2010, over 130 studies were conducted on the relationship between health literacy and health care. Not surprising, they concluded that lower health literacy is associated with more emergency room visits and hospitalizations; less preventive care; improper use of medication; and, among seniors, poorer overall health and higher mortality. 
* The lack of health literacy in America is not exclusive to patients. A series of studies have revealed alarming misconceptions when health care professionals are asked to interpret and apply advance directives and Do Not Resuscitate orders in a medical emergency. 

Surprised by any of that? The next time you have a serious conversation with a health care provider--whether concerning your own health or that of a loved one--practice shared decision making:  The provider learns as much as possible about the patient’s lifestyle, personal goals, concerns and values; the provider offers alternatives that respect the patient’s treatment and personal goals; together the patient or proxy and provider consider available options; and, finally, truly informed consent for a treatment plan is granted. 

Be an informed patient. Ask questions. If you don't understand the answer, ask again.


January 13, 2017

You may not have noticed amidst all the yada-yada-yada over the past few days, but President-elect Trump has announced the nomination of Dr. David J. Shulkin as Secretary of Veterans Affairs. Every single member of any president's administration bears the important burden of not only making lofty bureaucratic changes, but also of potentially impacting the lives of real people. In light of the scandals plaguing the Department of Veterans Affairs over the past few years, we know that the actions of its leader can truly be a matter of life and death.

I am pleased to have been invited to share my expectations for this nominee on LifeZette: "Veterans Counting on Trump to Get Their Health Care Right".

We should hold all policymakers to the highest standard, but let us be especially vigilant when it comes to keeping our promise to care for veterans, a commitment we made over 240 years ago. God bless our veterans.  

January 11, 2017

Setting expectations for the unexpected

Have you ever accompanied a loved one to the doctor and heard a diagnosis you just weren't expecting? Or have you had the same experience regarding your own health? If so, you might recall a loud buzzing in your ears and not having a very clear memory of what followed "Well, here's what we know . . ."

First, consider taking an "appointment buddy" with you anytime you visit the doctor. Another set of ears--and a note-taker--can be invaluable. Second, here is a useful tool from The Agency for Healthcare Research and Quality, which is part of the U.S. Department of Health and Human Services:

The 10 Questions You Should Know:

1. What is the test for?
2. How many times have you done this procedure?
3. When will I get the results?
4. Why do I need this treatment?
5. Are there any alternatives?
6. What are the possible complications?
7. Which hospital is best for my needs?
8. How do you spell the name of that drug?
9. Are there any side effects?
10. Will this medicine interact with medicines that I'm already taking?
AHRQ web site

And I would add:
11. Can I call you if I think of any other questions after I leave here today?

There's a reason we call it Advance Care Planning. Print this list of questions, put it in your wallet and I hope you never need it. But, just in case you do . . .

January 5, 2017

January: A time to review and renew

There's something about January that makes it the best time to take a look at your important legal documents, consider whether there are any changes that need to be made and start the year by checking that off your to-do list.

Estate Planning:  Any changes to your financial situation or named beneficiaries that need to be addressed? And, yes, that includes the fact that your existing Last Will & Testament provides for a guardian for your now 37-year-old son. It's time for an update.

Health Care Advance Directives: The simple rule of thumb is that if there is any change to your wishes for care in the event of incapacity or your appointed health care proxy is no longer able, willing or available to fulfill that role, it's time to replace. Don't try to make changes to existing documents, it gets too messy and probably won't comply with witnessing or notarization requirements. Just execute a new document and distribute to your proxy(s), primary physician and anyone else who might be around in a medical emergency. Go to Jo's Health Care Advance Directive forms.

Happy New Year!


December 29, 2016

New Year's resolution: Have a Brown Bag Checkup!

Read my most recent article on LifeZette to learn about "polypharmacy." That's when someone takes five or more prescriptions at the same time. The shocker:  Folks aged 65-84 take an average of 14 to 18 different meds in a year's time. Yikes.

It may be time for you or a loved one to have a "Brown Bag Checkup": "The Problem with the Pills You're Taking" on HealthZette.


When a new year's resolution focuses on making life happier and healthier and can be accomplished in a few hours with the help of others--what's not to resolve?

Happy New Year!

December 21, 2016

Looking to spread some holiday cheer?

Are you lucky enough to have a veterans' hospital near you? Check their web site and you'll find any needs for volunteering and donations. Money is always nice, but there may also be a plea for in-kind gifts of specific items for veterans and their family members.

I know this: Our service men and women are on duty 24/7, 365 days a year, even on Christmas. Please remember them in your prayers and on your gift-giving lists.

And Merry Christmas to everyone!

November 23, 2016

Pass the turkey--and let's talk about the future

One of the many things I will be especially grateful for tomorrow is being invited to be a guest essayist for the web site LifeZette.  Click here:  www.LifeZette.com

I wrote about the importance of sharing your wishes for care with loved ones, just in case there is ever a medical crisis in the future when you are too ill to think or speak for yourself. Not saying you should bring this up between the first seating and dessert, but maybe over turkey sandwiches?

I wish everyone a blessed time with family and friends, safe travels and don't forget to take along containers for leftovers!

November 12, 2016

National Hospice and Palliative Care Month

I guess it should come as no surprise that the month of official thanksgiving is also a month to think about the organizations that involve caregiving--folks that top our list of things to be thankful for.

Hospice has a very special place in my journey and in my heart. On his birthday, November 22, 1998, my younger brother, Wesley J. Kline, lost his courageous battle with leukemia. At the time, I didn't know one thing about what to expect as his life came to an end and, sadly, his medical professionals weren't much help. But soon after that very frustrating and confusing experience came the opportunity to serve as a hospice volunteer. One thing led to another, and it turns out that being witness to Wesley's passing was the life-changing moment that led me to my passion for educating others about medical decision making and the meaning of legacy.

It takes very special staff and volunteers to provide quality hospice care. If your community is not as blessed as we in the Des Moines area, I hope you will consider what you can do to address that. Every person--every single one of us--deserves a final chapter that focuses on patient rights, patient values and patient autonomy. God bless our hospice workers.

And Happy Birthday to my brother Wes. He was "one of the good guys."

November 1, 2016

National Family Caregivers Month

November is National Family Caregivers Month.  Did you know that in the 1950s, only nine percent of American adults lived alone?  Today that number is closer to 29 percent--that translates to a lot fewer live-in caregivers. In fact, in the next 14 years, there will be a 79 percent increase in the number of Americans aged 80 and older who will need assistance.  The projected growth in the number of potential caregivers to serve those needs?  One percent.  One.

Think about the caregiving needs you and your loved ones may have in the coming years.  Give it some thought and then make a plan. And if you know someone who is already providing care for a family member, give them a hug.

September 20, 2016

A short documentary worthy of your time

If you have Netflix, please invest 24 minutes viewing the just-released documentary Extremis. It is an intimate and educational look at end-of-life decision making through the eyes of the physician as well as the patient and loved ones. In 24 short minutes, the makers of this film manage to touch on the process of shared decision making, the crucial role of personal values in that process and the nearly overwhelming challenges that patients, physicians and proxies face every day.

This film should be mandatory for every professional involved in the health care system and for every patient and family member facing the possibility of medical decision making now or in the future.  Oh yeah, that's all of us.