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Who Will Speak for You? Advanced Health Care Planning

Life changes in an instant. We never know when we may be involved in a serious car accident, suffer a stroke or be admitted to the hospital unexpectedly. If you are unable to speak for yourself, do your family members and health care providers know how to proceed with your care? Do your loved ones know which treatment options you would pursue? Or, would they feel overwhelmed and unprepared to make difficult decisions?

We’ve written about the importance of advanced health care planning in previous blog posts (The Need for Advanced Care Planning, The Blue Folder: Making Final Wishes Known, and Make Your Wishes Known–Plan your future!), and shared the peace-of-mind advanced planning can provide when difficult decisions must be made. Advanced care planning is simply smart life planning—and can be one of the greatest gifts a person can ever give to loved ones.

Think about what is important to you and document your wishes in an advanced health care directive; if not for yourself, then for your loved ones. Be sure to name someone to speak for you when you can no longer speak for yourself, and talk to this person and your doctor about your wishes. You can download your state’s advance directive form, and begin the process today.

To learn more about advanced health care planning, we encourage you to attend our upcoming webinar Advanced Health Care Planning on May 14, presented by Susan Johnson-Drenth, JD, of JD Legal Planning. In this webinar, Susan will share the precautions and actions needed to ensure your wishes are carried out if you are unable to speak for yourself.

Conversations about living well and then dying well aren’t necessarily easy to have, but they are critical to the well-being of those we love. Finding a way to have this talk may bring great comfort and a special grace to those left behind. No one should be left wondering, did we do the right thing?

*NOTE: If you do not have access to an Internet connection, the Advanced Health Care Planning webinar will be broadcast in Hospice’s Fargo office, located at 1701 38th St. S., on May 14 at 7 p.m. If you would like to attend this broadcast at the Fargo office, please RSVP to Bonnie at (701) 356-1524 or bonnie.oelschlager@hrrv.org. For more information about this webinar or others, visit our website.

Common Sense and a Little Grace to HELP Hospice

Susan Fuglie, Executive Director Hospice of the Red River ValleyBy Susan Fuglie

Does one voice on Capitol Hill matter?

When you are a North Dakota delegation of one, stepping off a loaded bus amidst a parking lot filled with loaded buses, you have to wonder. This was me, in late March, merging with my hospice colleagues into the steady stream of dark business suits, brief cases, rapid paces and protesters headed toward the Supreme Court on the sidewalks of The Hill.

Armed with pertinent information from the National Hospice and Palliative Care Organization, I entered the offices of Congressman Rick Berg and Senators John Hoeven and Kent Conrad to plead our hospice case.

In spite of all the political and health care-specific turmoil, I was not surprised to be well-received. The hospice mission, after all, touches so many lives. I had the privilege of meeting with the remarkably bright and informed staff people who carry health care portfolios for their respective congressmen. These people are a vital link between us and the congressmen, who—being human—must rely on at least some help to keep pertinent issues in front of them. The time, attentiveness, substantive dialogue and, in one instance, tears from these individuals assured me that hospice matters to them and to our congressmen.

This is no time to ask Congress for more money. Wisely, this was not the purpose behind hospice representatives storming The Hill in late March. Rather, we were collectively asking for some grace and common sense in how the future of hospice is approached in health care reform, as inevitable change occurs. This is a message congressmen can get behind—and I believe they will.

Still, I was a voice of one. So, rather than telling you about some particularly unusual protests occurring on the Capitol lawn, describing the exquisite tulip beds on the grounds, or even getting into the details of our hospice “asks,” I am inviting you to raise YOUR voice on behalf of hospice care in America. Your voice, you see, is not only added to mine, it is more important than mine. Certainly, people on The Hill expect to hear from me; it is part of my job. But, YOU? You truly are the constituents from whom our congressmen want to hear. Do YOU value hospice care? Has it touched YOU or people for whom YOU care? Is the service important enough to protect into the future? Are rural residents as deserving of hospice care as those in our larger communities? If so, SPEAK UP!

Your voice has probably never mattered more to the hospice movement as it does right now. Changes in health care have to be made. Certainly, all of us as consumers realize this. Hospice of the Red River has been proactively making organizational changes for years, recognizing the inevitable. But unreasonable, unfunded mandates and disproportionate rate cuts will bring us to our knees. All we ask is for common sense and grace. And then, our collective passion for the hospice mission will survive the present turmoil. Just some common sense and a little grace.

I invite you to learn more about the HELP Hospice Act. Or, to learn more about what you can do to help, visit the Hospice Action Network. For more information about Hospice of the Red River Valley, visit our website or call 1-800-237-4629.

Please, raise your voice in support of hospice care. You WILL be heard—your voice matters!

Susan Fuglie is the executive director of Hospice of the Red River Valley.

Join Us! End-of-Life Care Informational Series

Confidence in Care Webinar SeriesWhen a family hears the words “hospice care” for the first time, it can be scary. It’s impossible to fully prepare yourself when faced with making end-of-life care decisions, especially when it involves someone you love.

We know how challenging it can be to determine if someone is appropriate for hospice care–especially if your loved one has Alzheimer’s or other forms of dementia. We can help walk you through the process of identifying who meets the medical guidelines for hospice care, and help you understand what’s included in care for this type of condition. Likely, you have many other questions about advanced health care planning, including advanced directives, and how hospice care is paid for.

We are pleased to share this information with you in our upcoming Confidence in Care webinar series. We are partnering with the Alzheimer’s Association of Minnesota/North Dakota and JD Legal Planning to bring you information you need to make informed end-of-life care decisions. We hope you’ll join us for this informational webinar series:

Memory Loss and End-of-Life Care
May 7 from 7-8 p.m.
Learn the difference between Alzheimer’s and other forms of dementia, the unique challenges of caregiving and the benefits of hospice care for those individuals in the advanced stages.

Advanced Health Care Planning
May 14 from 7-8 p.m.
Learn the precautions and actions needed to ensure that your wishes are carried out if you are unable to speak for yourself.

The Medicare Hospice Benefit
May 21 from 7-8 p.m.
Learn about cost coverage for end-of-life care you are entitled to through Medicare.

To register, visit our website. For more information, call 1-800-237-4629.

If you do not have access to an Internet connection, the webinars will be broadcast in Hospice’s Fargo office, located at 1701 38th St. S., at the dates and times listed above. If you would like to attend a broadcast of a webinar at the Fargo office, please RSVP to Bonnie at (701) 356-1524 or bonnie.oelschlager@hrrv.org one week prior to the webinar.

* Note: This series is intended for the public; certificates of attendance for health care professionals will not be provided. These webinars are not eligible for CEUs.

My Wish to Give + My Chosen Cause = A Winning Plan for the Future

By Joy Crouch

Most of us go into each day with a plan. If we are going to the grocery store, we take a list. If we are packing for a trip, we think through what we’re going to need. With gas prices at all-time highs, we map out the most efficient routes for our errands.

We plan all life long for those things that are important to us. We may be looking at purchasing a different car, or taking a vacation or redoing our kitchen. Maybe we’re thinking a little longer-term toward college or retirement.

Our planning can reach beyond the now and extend far into the future. It is refreshing to know we can plan to protect ourselves and our loved ones financially while at the same time providing support for a charity.

People of all walks of life and all income levels
can consider ways of giving that go beyond
the traditional reach into the wallet for cash.

Planned gifts are not checks we write today…these are thoughtful investments into the future. Warren Buffett said it best: “Someone is sitting in the shade today because someone else planted a tree a long time ago.”

I have the joy of visiting each week with people who have experienced, first-hand, the incredible care and support of Hospice. I often hear, “I wish I could do more for Hospice or other causes I care about.” I’m always glad to tell people they can. And that it’s easy to do. Planned giving doesn’t have to be complex or complicated. It truly is just an extension of what we already do.

Planned giving can even provide answers to some of our common dilemmas:

  1. My CD rates have plummeted to less than 2%. Is there a way to earn more?
    Yes! A Charitable Gift Annuity (CGA) with rates based on your age is an option. For example, a 75-year-old entering into a $5,000 CGA agreement would receive a 6.4% interest fixed payout annually, plus additional income tax deductions. (An 85-year-old would receive 8.1% interest).
  2. My mandatory IRA distributions each year trigger more taxes. Can I avoid this?
    Yes! Contact your IRA holder before your distribution is made and direct that charitable contributions be sent directly to them from the IRA. You are only taxed for monies that come into your hands. If you already make these contributions, or want to increase your giving, this is a great way to both support the charity and avoid extra taxes.
  3. I want to be sure that the important work of my chosen charity will continue long into the future, but I just don’t have the income or means to give now. Is there anything I can do?
    Yes! Many people make provisions in their wills for direct gifts to charities. However, other methods exist. For example, any charity can easily be added to the beneficiary list for your life insurance policy or retirement account. There are ways to include a charity for stocks, properties, mineral rights or other holdings. If your desire is to make this kind of gift, I, or someone at your favorite non-profit organization, can help with your situation.

Won’t you consider planning ahead for a gift? I would welcome the opportunity to help you accomplish your goals!

If you’d like, visit our website for more information on planned giving. For other helpful tips, read our blog archives for the three basic estate documents you can get in place now to prepare for the future.

Joy Crouch is a development officer for Hospice of the Red River Valley, specializing in planned giving. She is always happy to visit with people about their wishes for supporting Hospice and other organizations.

What are the Basic Elements of an Estate Plan—at Any Age?

Guest Blogger:  Mona Tedford, CFP®, CTFA
Vice President, Bremer Trust in Fargo

No matter what your age, it’s important for each of us to consider getting basic estate planning documents in place. Doing so can spare your loved ones undue stress in the event of your incapacity or death. The following three documents form the core of a good, basic estate plan. Below is a description of each document and some common misconceptions:

1) Last Will & Testament

  • Your Will governs the distribution of assets which are solely in your name, through the legal process known as probate. Having a Will does not avoid the probate process—but it ensures that your wishes are carried out (without a Will, state law determines which relatives will inherit your solely-owned assets).
  • If assets are titled with another person or entity (for example, as joint tenants with right of survivorship, transfer on death, in trust or with a designated beneficiary) they will pass per their titling, regardless of what your Will states.
  • In your Will, you not only indicate to whom your assets will pass, but you also name a guardian for any minor children and you nominate a personal representative (sometimes called Executor) to administer your Will. That person’s duties include:
    • Gathering assets
    • Paying final bills
    • Arranging for filing and payment of income and estate tax
    • Filing an inventory and accountings with the court
    • Communicating with the heirs
    • Distributing assets
  • Your Will, and the decisions you make within it, do not take effect until you die. People sometimes believe that the person they have named as personal representative in the Will could act on their behalf during life in event of incapacity (to pay their bills, etc), but this is not the case. This is why the Durable Power of Attorney is a crucial planning document.

2)   Durable Power of Attorney

  • A Durable (meaning it remains in effect in event of incapacity) Power of Attorney is a written document which you can use to empower another person (the agent or attorney-in-fact) to make decisions for you. This authority ends upon your death. It is wise to name contingent agents (e.g. name the spouse as agent; if he/she cannot serve, then Child A; if he/she cannot then Child B, etc).
  • A power can be a “general” power, giving the agent all powers held by you, or a “limited” power, which restricts the agent to performing only those actions specifically listed.
  • A Durable Power of Attorney may help avoid the more costly alternative of a conservatorship in the event of incapacity. A conservatorship, however, has the potential benefit of court supervision. It is best to seek legal advice for the drafting of the Will and Power of Attorney documents.

3)         Advance Health Care Directive

  • The term “Advance Health Care Directive” is commonly used to describe two key documents (sometimes combined into one) designed to address end-of-life decisions: the Living Will and the Durable Power of Attorney for Health Care.
    • The Living Will is a written statement of one’s wishes if he or she might become terminally ill, and may include directions as to when to provide or withhold artificial nutrition, hydration and other life support. People sometimes confuse the Living Will with the term Living Trust—the latter is a legal arrangement for the titling and management of assets.
    • In a Durable Power of Attorney for Health Care, you (the principal) appoint another person (the agent) to make health care decisions if you are incapable of doing so (it may or may not be related to a terminal illness situation).

It’s never too early to make sure you have your estate planning documents in place. Most importantly, be certain that your loved ones, and the other individuals involved, know where to locate your estate planning documents.

Mona Tedford has been working in the field of wealth management for more than 20 years. She is Vice President for Bremer Investment Management and Trust in Fargo, and holds the Certified Financial Planner ® and Certified Trust and Financial Advisor designations.

Thank You, Veterans

Gen. Dwight D. Eisenhower visits paratroopers, including Bill Hayes, at center behind Ike's right hand, in England on June 5, 1944, moments before the troops boarded transport planes bound for Normandy and the June 6 D-Day invasion. Bill Hayes is one of many veterans Hospice of the Red River Valley has been privileged to serve.

In honor of Veterans Day, all of us at Hospice of the Red River Valley would like to extend our heartfelt gratitude to each of our nation’s veterans.

We also want to extend our thanks to the many veterans and their families who have allowed us to give back by serving those who have served for us. In 2009 alone, we provided hospice services to 192 veterans in our service area. It is truly an honor and a privilege to provide care for these American heroes.

Our veterans are deserving of the highest-quality end-of-life care available. We’re honored to partner with several organizations to help ensure hospice services are available to veterans in our region. Through our partnerships with the Veterans Administration Medical Center, the North Dakota Veterans Home, and various fraternal veterans’ organizations, we continually look for ways to grow and improve our outreach to veterans and their families.

Please take a few moments today to join us in thanking all veterans for their service to our country.

Welcome to the Hospice of the Red River Valley Blog!

The launch of our blog has been a long process, built from conversations with co-workers about the types of questions caregivers—and the general public—often have about care giving, and ultimately about hospice care. We wanted to explore these issues and questions in a way that effectively reaches as many people as possible, in a comfortable environment. We hope this blog will be a tool to do just that.

The goal of our blog is twofold; first, to provide resources and information for care givers, healthcare professionals and the general public. Second, by giving a “sneak peek” into what goes on behind the scenes at a hospice organization, we hope readers will come to a better understanding of what hospice care is really about. It is our goal to open lines of communication, encourage dialogue, answer questions and break down the walls of fear and uncertainty that often surround the decision to begin hospice care.

The greatest advantage of a blog is the ability to interact and connect with readers. We encourage you to post your comments, questions and thoughts with us. What topics would you like us to address? Do you have a personal experience to share? We’d love to hear from you.