End of Life Care

SEPTEMBER 2019 | FUTUREOFPERSONALHEALTH.COM

An Independent Supplement by Mediaplanet to USA Today

END OF LIFE CARE

Maria Shriver The acclaimed author wants to change how we talk about grief

Everything you need to know about life insurance

Why it’s important for caregivers to get time off

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Why You Shouldn’t Wait

to Talk About Hospice

The time to learn about hospice is before you’ll ever need it. Learn about what this option can provide for you and your loved one. t’s an all too common situation: A family is at the bedside of a loved one in the hospital who is seriously ill and nearing the end of their life.

Each member of the family has a different idea of what should be done and what the patient would have wanted.

Have a plan Far too many people wait until they are in the midst of a medical crisis before thinking about what options are available or what care they or their loved ones would have wanted. Hospice profession-

als deal with these challenging situations every day — that’s what they are trained to do. But they also encourage people to learn about options of care early in the course of an illness.

When a family is coping with a serious illness and a cure is no longer possible, hospice provides the type of care most people say they want at the end of life: comfort and dignity.

What patients get Considered to be the model for high-quality, compassionate care for people with a life-limit-

ing illness, hospice care includes expert medical care, pain management, and emotional and spiritual support. Care is provided by an interdisciplinary team of professionals and trained volunteers. The wishes of the patient and family are always at the center of care.

Most hospice care is provided in the home — where the majority of Americans have said they would want to be at this time.

Care is also provided in nursing homes, assisted-living facilities, and hospice centers. Care is paid for by Medicare, Medicaid, and

most private insurance plans and HMOs. The National Hospice and Palliative Care Organization reports that over 1.5 million people with a life-limiting illness received care from our nation’s hospices last year.

Hospice providers can help with information about care options and choices, and ensure your wishes are a priority. They will make sure your loved ones receive support as well. n Jon Radulovich, M.A.,Vice President, Communications, National Hospice and Palliative Care Organization

Publisher Mikayla Varunok Business Developer Victoria Borkowski Managing Director Luciana Olson Lead Designer Tiffany Pryor Designer Lee Miller Lead Editor Mina Fanous Copy Editor Dustin Brennan Director of Sales Shannon Ruggiero Director of Business Development Jourdan Snyder Director of Product Faye Godfrey Content Strategist Vanessa Rodriguez Cover Photo Kwaku Alston All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

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PLEASE RECYCLE

Possibilities, made possible by Coventry.

A life insurance policy is a financial asset—one that can be sold to help pay for seemingly impossible healthcare expenses.

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All regulated life settlement activities are performed by Coventry First LLC.

Why Selling Your Life Insurance Could Be a Worthwhile Consideration for Funding Care We asked life insurance experts about the details of this asset, and how pursuing it could be a beneficial decision when faced with the cost of hospice or palliative care.

Jack Elder, J.D. Vice President, Coventry

Peter Hershon CLU® & ChFU®, Senior Vice President, Coventry

What is a life settlement and what do you wish more people knew about it?

What factors should policyowners consider when searching for a life settlement provider?

Jack Elder: Life insurance is a valuable asset. Most Americans have spent several decades investing in their life insurance policies in order to ease a potential hardship on their beneficiaries. But, over time, many people find their life insurance no longer fits the situation they’d planned for all those years ago.

Selling that life insurance policy to help fund things they need today — costly and unexpected healthcare expenses, for instance — turns it from a financial burden into a helpful asset. What’s more, policyowners often realize there’s more value in that than either surrendering it to their insurance company, which often nets out a value less than the policy’s worth, or simply letting it lapse. That difference in total return amount can mean a lot in the difficult decision-making process of sending a loved one to costly end-of-life care.

Remember that life settlements aren’t one-size-fits-all. Most types of life insurance qualify for life settlements, including universal life, whole life, variable life, survivorship, group life, and even term life. And when it comes to settling these policies, there are two options. People who still need insurance can retain a portion of their coverage and eliminate their ongoing premium payments, which is called a Retained Death Benefit. Others can settle the entire policy for one cash payout.

In the end, consider that policy owners have choices. The good news is that the market for unneeded life insurance policies is robust, mature, and highly regulated, which means more competitive offers for consumers. This gives policyowners the choice to sell their unneeded life insurance to a number of potential buyers. Partnering with one that meets their needs requires research to find the right fit.

Peter Hershon: Like any financial decision, choosing to sell your insurance policy requires you to weigh all of your life settlement options in order to understand when selling makes sense. However, because nearly 85 percent of people are unaware that it’s possible, this choice isn’t always a simple one.

While researching different life settlement providers, making a decision on who to partner with comes down to a few key considerations: Know how your estimates are being provided. You’ll come across two standard options in your search: instant-value calculators and direct communication via phone or email. The first option can offer policyowners a speedy estimate based on their answers to a few simple questions. Speaking with someone directly can take more time but allows the provider to evaluate your exact circumstances with more detail. Addressing the specifics of your health — like the need for hospice or palliative care — could make a difference in the range of options you’re being offered.

You’ll also want to consider their reputation. It’s worth looking into how long a life settlement provider has been in business, how much they’ve delivered to policyowners, and if they have any rankings or accolades to report. Sometimes the numbers speak for themselves, but long-standing experience in the industry says something, too: that a company has learned to adapt with every market shift and consumer interaction they have.

After taking all of these important factors into consideration and deciding what will best serve your healthcare needs, the last question you need to ask yourself is: Is this a company you trust? n

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How Death Doulas Are Changing End-of-Life Care for the Better While facing death is challenging and often emotionally painful, it doesn’t have to be.

According to the U.S. Census Bureau, 10,000 Baby Boomers will reach age 65 each day over the next 15 years. Each of them will have to face the death of someone they love: a parent, sibling, partner, or friend. Of course, many of them will also have to face their own death.

Our healthcare system already struggles to care for the dying in the ways they deserve. There are gaps in service throughout the journey from diagnosis to death, particularly when it comes to dealing with the emotional and psychological aspects of facing death. And those gaps are going to grow over the next couple of decades.

A support pro To fill those gaps, a whole new category of caregiver has emerged: end-oflife doulas. Based on the approach of birth doulas,

this relatively new form of caregiving focuses on quality of life. Also referred to as death doulas or death coaches, these caregivers support a dying person and their loved ones emotionally, psychologically, and spiritually through the dying process.

The traditional approaches to a terminal illness focus on medical intervention and treatment. While that makes sense at the beginning of an illness, it can cause unnecessary suffering when those treatments are continued when they are futile — as is too often the case. In the end, that approach robs people of their quality of life in the time they have left.

Our medical system just has difficulty turning off the spigot of treatment.

When it finally does, its idea of comfort care is mostly about the management of the physical symptoms of dying. As a result, too many people live in emotional pain and fear as they approach their death.

Dying with dignity End-of-life doulas change the traditional narrative of dying by offering the dying person an opportunity to review their life story, focus on its meaning, and address the unfinished business they would regret leaving behind when they die.

These doulas support a dying person’s wishes for the atmosphere around them and the involvement of loved ones.

Doulas use music, touch, guided imagery, and even ritual to bring deeper meaning and greater ease to the dying process. They also help families with basic care, and offer them compassion and guidance in the midst of emotional turmoil.

In the end, doulas transform the dying experience into one that contains tenderness and beauty, alongside the inevitable pain and suffering. n Henry Fersko-Weiss, Executive Director, International End of Life Doula Association

Caring for More Than Health in Patients With Life-Limiting Illnesses Consumers expect a level of quality when seeking care for their diabetes, heart disease, and other illnesses. They should expect that same quality from their palliative care as well.

Many people living with a serious illness, whether it’s heart failure, lung disease, cancer, or another, don’t have access to palliative care, which can make all the difference in how they feel physically, emotionally, and spiritually.

New U.S. national palliative care guidelines aim to improve access to this care, which provides relief from the symptoms and stress of serious illness, improves quality of life for both the patient and the patient’s family, and can be delivered concurrently with disease-focused treatments.

The guidelines include tools, resources and practice examples to help with implementation. They expand on the eight domains of palliative care: physical aspects; psychological and psychiatric; social; spiritual, religious, existential; and cultural aspects of care, as well as the general structure and process for care, and best practices for caring for a patient at the end of their life.

The purpose of the guidelines is to improve access to quality palliative care by fostering consistent standards and continuity of care across settings. This will allow people living with serious illness and their families to receive the best care possible. Learn more at www.nationalcoalitionhpc.org/ncp.

Betty Ferrell, Ph.D., M.A., FAAN, FPCN, Steering Committee Co-Chair, National Consensus Project for Quality Palliative Care

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Author Maria Shriver Wants to Change How We Think About Grief Maria Shriver has made it her mission to normalize grief, and to understand why, when everyone experiences it, it can feel so isolating.

PHOTO: KWAKU ALSTON

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ne of the most difficult experiences in life is losing a loved one and it is also one of the most difficult experiences to talk about.

Not only can loss feel disorienting and hard to put into words, but grief can be a taboo subject.

Maria Shriver, the writer and former first lady of California, has made it her mission to normalize the difficult process and to shed light on the many forms grief can take.

“We’re always going through some sort of grief process,” Shriver said. “I don’t think it’s necessarily ‘Oh, I had this grief process and now that’s over.’

I think any time you’re letting go of something — whether it’s an animal, a job, a parent, a person, a marriage, a relationship — all of these things involve grief.”

Many forms Grief can manifest in different ways and Shriver encourages people not to minimize their

grief because they’re afraid it will seem trivial to others.

“Some people grieve more over the death of an animal or a pet than perhaps a sibling or a parent,” she said. “But their relationship with that animal might be more intense than their relationship with a person.”

We often only associate grief with death, but Shriver hopes to broaden the conversation to include all kinds of loss, listing “the death of belief, the death of an identity, the death of a marriage.” Allowing yourself to grieve also opens up the possibility for joy.

“You can also celebrate and learn that after dying, there is life,” Shriver said. “After grief, there is hope.”

Writing about death Shriver published her first book — a picture book titled “What’s Heaven?” — in 1999. The story of a young girl who lost her great grandmother has helped thou-

sands of parents discuss death and grief with their children.

“People told me ‘Oh, that’s not going to be successful,’ because people don’t want to talk about death, grief, heaven,” Shriver said. “It went on to be a phenomenon.”

“What’s Heaven?” also helped adults tap into their own past experiences of grief.

“What people told me when they were reading ‘What’s Heaven?’ is that it brought stuff up for them as children, and that they could then talk to their kids,” Shriver said. “All of these things are parts of our life, and just because we’re grownups doesn’t mean that they don’t still linger or still have an impact.”

Shriver has since published several other books, many of them bestsellers. She also uses her platform to recognize people who work in hospice care.

Looking inward When considering her own death, Shriver is practical.

“I’ve written letters to my children to read upon my death about what they meant to me,” she said. “I do make sure that I’m keeping myself organized so they don’t inherit a mess.”

Shriver recently wrote the introduction for the 15th anniversary of Elisabeth KüblerRoss’s book “On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss.” In it, Shriver writes, “there is a fear that if you start crying you are never going to be able to stop.” That fear is what keeps many from reckoning with their grief.

“Everybody’s scared to die,” Shriver said, “and we’re all going to do it.”

Yet Shriver believes that facing such inevitability, difficult as it may be, can enrich one’s life.

“I think how we live, and how we die, and how we let go, and what we believe, it’s all part of the same cycle.” n Ross Elliott

Ross Elliott MEDIAPLANET • 7

To learn more about hospice and palliative care, read more at futureofpersonalhealth.com