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Posted by Positive Aging SourceBook on 01/17/2023

GOALS OF CARE - Discussion with Brittany A. Lamb, MD


Knowing our value of quality of life vs length of life & what quality of life means to us will inform our GOALS OF CARE Brittany A. Lamb, MD will share her unique perspective and  share important steps we can take to improve healthcare outcomes for ourselves or our loved ones.

Questions Asked

  • How does the social worker play a role in the Goals of Care discussion with the provider? Often they are overwhelmed and overworked.
  • Do you find people are focusing on quanity of life based on fear? I have experienced enough to have had discussions with Doctors that are amazed that I recognize my timeline is short. I am OK with that.
  • How do we prevent medical professionals from withholding options based on our care goals or what medical professionals perceive that our care goals should be?
  • How can we know what  medical procedures might be proposed when we are still totally health?
  • Do you think Goals of Care conversations happen at research hospitals...ie. Hopkins Cancer centers or Dementia trials?

Chat Transcript

12:04:14     From  Courtney Nalty : Good morning! Very excited about this presentation.- Courtney Nalty with Generational Support

12:05:57     From  Alicia Heeter : Good Morning- Alicia Resident Service Coordinator

12:06:00     From  Diane Watson : Diane Watson-Spring Hill Community Village in Lorton, VA- Good Morning All

12:06:58     From  sandra lawrence : Good morning all.....Sandy Lawrence from ICAP, INC the facilitators of the HELLO Game workshops.  icapinc53@gmail.com

12:08:25     From  Melissa Bressler : Looking forward to this discussion! Melissa Bressler, Outreach Manager at HandyPro and Occupational Therapist / Melissa@handypro.com / 301-960-1060 / HandyPro is a multi-service company providing home modification services and accessibility equipment for improved safety and fall prevention at home.

12:10:00     From  Ashley Johnson : Ashley Johnson. Deputy Division Chief & Long Term Care Coordinator for Division of Aging and Adult Services for City of Alexandria, VA. Would love to connect with each of you! Ashley.johnson@alexandriava.gov or 703-489-3000

12:11:02     From  Andy Riley : Good afternoon! Andy Riley from Comfort Keepers, Home Care Specialist. 703-591-7117 andrewriley@comfortkeepers.com

12:15:16     From  Carla Andersen : Carla Hope Andersen RN of Happy Hearts Home Care. Thank you Dr. Lamb. I've been wondering why these issues have often  been swept under the rug throughout my 40 year career. It seems most nurses see this as problematic and unnecessary. Keep it coming

12:20:45     From  Curtis Gregor : Sorry I have to leave for a job interview. I believe this is going very well.

12:21:21     From  Roslyn Schmidt   to   Hosts and panelists : Some serious illnesses clear in time. Some help may be necessary. Communication can be creative as one gets through the illness. Thank Deciding to end life may be premature. Irreversible Vegetative state is more clearly final.

12:21:27     From  Kris Geerken   to   Hosts and panelists : So helpful to hear the example about your grandmother’s views on QOL.

12:21:51     From  Steve Gurney - ProAging Community : Helping people share their wishes for care through the end of life. https://theconversationproject.org/

12:24:25     From  Kim Flash : Maybe the hospital SWer can also help the patient/family brainstorm the questions they want to ask the doctor, when they do get to see the doctor.

12:24:30     From  Ashley Johnson : Thanks Steve, that's exactly what I was alluding to.

12:25:27     From  Kris Geerken   to   Hosts and panelists : What you’re sharing today is incredibly helpful - I have to leave for another meeting.  I look forward to seeing the recording. Thank you!

12:25:45     From  Alicia Heeter : At times I find myself having these conversations and educating residents on ways to put it in writing, wills POA of health care with specific instructions, DNR's, make a list of questions for providers.

12:27:09     From  Courtney Nalty : I wrote a book, The Hospital Discharge Handbook that provides questions to ask doctors, nurses, and social workers to assist you.

12:27:32     From  Alicia Heeter : I try to empower the older adults I work with to make these decisions while they can still advocate for themselves while they can to ensure their choices will determine their treatment. then I support and continue to encourage

12:28:04     From  Karen Dotson : POLST is a portable medical order that captures your goals of care decisions.  The form is appropriate for those in their last 1-2 years of life.  Goals of Care discussion training to become a certified facilitator is available with CE for nurses, SWs, chaplains and other counselors.  Visit www.virginiapolst.org and look under Professionals -> Upcoming Training.  The curriculum can also be found directly from Respecting Choices - Advanced Steps ACP Facilitator Certification.https://respectingchoices.org/types-of-curriculum-and-certification/facilitator-certification/

12:29:50     From  Kathleen Steed   to   Hosts and panelists : As I am listening to this, I hear frequent mentions of “family.”  What about those of us who are solo agers?

12:30:29     From  Richard Hilburn : GOALSofCARE(sm),PLLC   Dr. Ric Hilburn, MD, FACP  571-524-5663 ;  goalsofcare@outlook.com; goalsofcareMD@gmail.com; 492 Elden St, Herndon, VA 20170;GoalsofCareMD.com(new site pending)

12:30:59     From  Steve Gurney - ProAging Community : Here is the discussion with Courtney Nalty Understanding Hospital Discharge https://www.retirementlivingsourcebook.com/videos/understanding-hospital-discharge

12:33:11     From  lisa cusumano   to   Hosts and panelists : So this is advance care planning.

12:34:08     From  lisa cusumano   to   Hosts and panelists : Manny times I will ask for a Palliative care consult is the hospital for my client and its very difficult to get one.

12:38:00     From  Ashley Johnson : Great questions! It's very underused.

12:38:11     From  lisa cusumano   to   Hosts and panelists : I work as a care manager in NY and FL

12:38:44     From  lisa cusumano   to   Hosts and panelists : And the dr. Is correct, people do not know what it is.

12:39:32     From  Dixcy Bosley   to   Hosts and panelists : As a nurse care manager, I have to be assertive and fearless when requesting hospice referrals from doctors. It is important for folks to know they can request a referral and hospice will assess you and their  doctor will determine if you qualify …If you are not eligible, you will not be enrolled ..No loss. Hospice care sooner than later is always better and extends life. And QUALITY.  Less is more

12:41:29     From  Karen Dotson : Capital Caring Health provides hospice and palliative care at home in DC, Northern VA and PG and Montgomery Counties in MD.  https://www.capitalcaring.org/hospice-care-palliative-care-at-home/

12:41:31     From  Courtney Nalty : Great answer!

12:42:29     From  Roslyn Schmidt   to   Hosts and panelists : Lifelong consequences can often be tolerated creatively. Some doctors give rash choices, without offering options. Other doctors view situation differently. Quality survival is often more possible than initially discussed.

12:43:44     From  Jennifer Brown : I understand this is a highly complicated legal, political and personal issue, but where do you stand on the right  to die as a part of a individual care plan

12:44:50     From  Deborah Dougherty : DC uses the MOST form.

12:46:25     From  Margi Helsel-Arnold : I am amazed how many doctors do not discuss the MD MOLST forms with their patients—I am often introducing the topic with my clients—I give them a form to bring to their doctor for next appt—it is ridiculous when most of our clients are in their 80’s and 90’s—Margi Aging Life Care Manager, gercare.com

12:47:23     From  Karen Dotson : Dr. Lamb, please also send your VA POST training to the Virginia POST Collaborative - you may call us at 888-VAPOLST (827-6578)

12:49:21     From  Richard Hilburn : Absolutely SUPERB presentation!  Thank you!

12:49:44     From  Deborah Smith : Thank you !!!

12:49:50     From  Alicia Heeter : Very informative! Thank you!!

12:50:49     From  Steve Gurney - ProAging Community : https://blambmd.com/

12:50:52     From  Richard Hilburn : By the way, the Veterans Administration form - VA 10-0137 is an excellent ADV DIR form that anyone may download and use--legal in all 50 states.   Does not require a lawyer.

12:50:52     From  Steve Gurney - ProAging Community : blambmd@gmail.com

12:51:18     From  Lena Carosa : Thank you, very helpful

12:51:42     From  Carla Andersen : happyhearts-homecare.com is not an agency but the name of my very unique, short-term live-in care service for elders nearing end-of-life. Loved today's discussion. Thank you all for sharing your wisdom and for your commitment to caring.

12:51:50     From  Karen Dotson : Excellent resource:  https://polst.org/

12:52:48     From  sandra lawrence : Much needed conversations about your wishes.  We do such workshops in the faith and organizational community in Philly and SJ area.  Special focus in Black & brown cultures.  It is needed to make faith leaders informed as well.

12:52:58     From  Ashley Johnson : @Carla  can you please send your contact information?

12:53:38     From  Elisabeth Green : tbi

12:54:13     From  sandra lawrence : Sandy Lawrence, ICAP Inc email icapinc53@gmail.com or 215-221-4249 we include the Hello Game.

12:54:30     From  Ashley Johnson : I agree. Language matters.

12:54:38     From  lisa cusumano   to   Hosts and panelists : https://www.barloweandassoc.com/.         We offer quality of life care planning and advance care planning. I love what you are doing and I wish more people in the medical profession would assist in these conversations.

12:56:02     From  Dixcy Bosley   to   Hosts and panelists : Compassion and Choices has a wonderful Adv Care Planning  Tool kit .  Contact Wendy Minor at. Wminor@compassionandchoices.org .  She will send you a free copy

12:56:03     From  sandra lawrence : Goals of Care is far more useable than just advance directives.  Make it plain and clear. thank you I have learned so much

12:56:10     From  lisa cusumano   to   Hosts and panelists : And having the conversations with your family or health care providers

12:57:35     From  Janet Nelson : Building a care network to support your Goals of Care is also important.

13:00:14     From  sandra lawrence : Are there PA area counter associates teaching what you are teaching?

13:03:22     From  Dixcy Bosley   to   Hosts and panelists : We need more doctors as prescribers for Medical Aide in Dying..    Compassion and Choices needs you to support their work.  We need to get the law passed in VA and all the remaining states

13:03:41     From  Carla Andersen : Carla Hope Andersen, RN 757-818-3679 smoothmovesbodywork@yahoo.com.   Thank you.

13:04:26     From  Kathleen Steed   to   Hosts and panelists : Traffic program as always!

13:04:32     From  Courtney Nalty : This has been an excellent presentation. Thank you so very much Dr. Lamb and Steve!

13:04:33     From  Ashley Johnson : Thanks Dr. Lamb!!!!

13:04:34     From  Karen Sorensen : Excellent discussion, Steve and Dr. Lamb. Thank you!

13:05:00     From  Ashley Johnson : and thank you Steve for bringing this awesome topic!

13:05:20     From  Theresa Rankin   to   Hosts and panelists : Thank you Steve + Dr. Lamb❣️

13:05:53     From  Sherry Martin : very helpful discussion.  thank you!

13:05:58     From  Clareen Heikal : Thank You!  I wish more lay people would also tune in to lectures like this.  Clareen Heikal, Cheverly Village, Maryland

13:06:12     From  lisa cusumano   to   Hosts and panelists : thank you!!

13:06:18     From  Elicia Johnson : Thank You!

13:06:20     From  Dixcy Bosley   to   Hosts and panelists : Steve …you are the best

13:06:21     From  Carla Andersen : Great Presentation! Very helpful!


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