April 16th was the third annual National Healthcare Decisions Day, the day to encourage family conversations leading to completing an advance directive. Aging with Dignity Board of Directors member Leslie Piet, a nurse who created the Omega Life Program at Johns Hopkins Healthcare, was featured in a WBFF-TV Baltimore, Maryland story about Five Wishes. Other TV stories in Pensacola, Florida; Greensboro, North Carolina; Philadelphia, Pennsylvania; Orlando, Florida; and Boston, Massachusetts featured physicians affiliated with UnitedHealth Group, a Five Wishes partner organization.
Many of our other Five Wishes partner organizations did their part too. NHDD/Five Wishes presentations were made in Clearfield, Pennsylvania; Lake City, Florida; Traverse City, Michigan; Chesterfield, Virginia; Rockingham, North Carolina; New York, New York; Waldorf, Maryland; Charlevoix, Michigan; Greely, Colorado; St. Augustine, Florida; Orange Park, Florida; Miami, Florida; Wadesboro, North Carolina; Marshalltown, Iowa; and Chicago, Illinois, among others.
I was tremendously impressed with how Haven Hospice in Florida incorporated Five Wishes into its excellent community outreach effort before and during National Healthcare Decisions Day. Partnering with a local bank, Haven Hospice sponsored specially-printed bank desktop displays, Five Wishes pocket cards, imprinted deposit slips and stickers.
We saw a 90% increase in traffic to the Aging with Dignity website during the entire week of National Healthcare Decisions Day. On April 16th itself, visits were up 232% over our normal traffic.
Save the date: Mark your calendars for April 16, 2011, the fourth annual National Healthcare Decisions Day.
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On April 15th, the eve of National Healthcare Decisions Day, President Barack Obama issued a Presidential Memorandum directing all hospitals that receive Medicare and Medicaid funding to allow bedside access to the patient's legally designated health care agent, if they are not already doing so. As we pointed out, his action represents an enormous victory for patient rights.
The German, Hebrew and Italian versions of Five Wishes are now available. As with the other translated Five Wishes, the bilingual format allows English-only medical personnel to easily see what the non-English speaker wants or doesn't want. This brings to a total of 26 languages in which Five Wishes is available.
 On the road: Aging with Dignity and Five Wishes were prominently featured during the American Academy of Hospice and Palliative Medicine's annual conference in Boston in early March. I also was in Washington, D.C. in late April for the National Hospice and Palliative Care Organization's annual conference. NHPCO President/CEO J. Donald Schumacher urged attendees to set aside what competitive differences may divide them and instead to remain united in their mission. On April 7th, I participated in the unique "Can We Talk?" all-day conference on advance care planning in Denver, Colorado. Wherever Aging with Dignity goes, I'm always amazed at how many people come up to our exhibit table to tell us their own stories of how Five Wishes helped them or their patients.
The next week I was in West Palm Beach to be the keynote speaker for an evening event honoring the area's social workers and sponsored by VITAS Innovative Hospice Care. Incidentally, now social workers can earn continuing education credits with Five Wishes. We know of many training programs that successfully use Five Wishes presentation resources, such as our instructional DVD (also available in Spanish) and Presenter's Guide. There are also many health care providers who use the instructional DVD as a self-contained in-service training program on advance directives.
Most recently, I just returned from a swing through southern California that included stops in Riverside and Long Beach. In Riverside, I spoke at an event hosted by Village Health that also featured a presentation by VITAS.
In Long Beach, I discussed Five Wishes and how it differs from Physician Orders for Life Sustaining Treatment (POLST) forms. Short version: Advance directives are appropriate for any adult age 18 and older, whereas POLST is appropriate only for those patients who are likely in the last year of life. Federal law requires health care facilities to offer an advance directive to those they admit. POLST is not an advance directive, but information from an advance directive can be imported into a POLST.
To help clear up confusion, we've posted a portion of my PowerPoint advance directives-POLST presentation, which you may find helpful in understanding some of the key areas of difference. This is one of many free, helpful presentation items available via our website.
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Aging with Dignity founder Jim Towey was the keynote speaker in Las Vegas for a Nathan Adelson Hospice-sponsored National Healthcare Decisions Day event. Jim talked about his years as Mother Teresa's lawyer and how her life and work inspired the creation of Five Wishes. Nevada Governor Jim Gibbons issued a gubernatorial proclamation praising Five Wishes. We are also grateful to Sen. Harry Reid for sending a representative from his office and for being a positive force in promoting advance care planning in Nevada.
Jim Towey was also the keynote speaker for the United Partners for Human Services annual conference here in Tallahassee, Florida. Jim encouraged attendees to remain steadfast despite uncertain economic times and to focus on the joy of serving others and their communities.
March 30th marked the fifth anniversary of the death of Terri Schiavo. An Associated Press report, "5 years after Terri Schiavo case, few in U.S. heed lesson and make end-of-life wishes known," quoted me noting that part of the problem is that many advance directives are needlessly complicated and often don't address the things most people care most about.
Five Wishes has been the subject of several scholarly studies, the latest of which attests to its readability compared with other state-supplied advance directive forms. That study shows wide variation among the states; for example, 39 states' forms require a tenth grade education or better to complete them (Utah's is 19th grade - the equivalent of a master's degree). Five Wishes is written in everyday language, so it is easy for all to understand and use. Another study among 147 Latinos age 60+ shows the majority preferred less-aggressive, comfort-focused end-of-life care, yet few had documented or communicated this preference.
We continue to get great feedback from colleges and universities that use Five Wishes in their medical, nursing, gerontology and social work programs. We got a note from Dr. Lynn Allchin, Assistant Professor in Residence at the University of Connecticut School of Nursing. She told us they distribute and discuss Five Wishes with their freshman nursing students, as well as with both their accelerated and generic pre-licensure nursing students.
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Attorneys, estate and financial planners are also among the 23,000 partner organizations that use Five Wishes.
Austin, Texas psychologist Albert Cantara's great April 14th guest editorial published in the Austin American-Statesman asked the same simple question we have been asking for some time - why must Texans use government forms and language to express their own personal wishes? "No doubt the Texas law was well-intended, but it clearly isn't working," Mr. Cantara noted, recommending Five Wishes.
Oil spill relief: Hope Today is our ongoing pilot project in nearby Franklin and Wakulla counties in Florida, both of which are already economically depressed and will be severely impacted by the oil spill in the Gulf of Mexico. The fishing and oystering businesses are almost certain to be negatively affected, as will the multiple generations of people who earn and once earned their living in those waters. We are gearing up for what we expect will be a longterm response and pledge that 100 percent of donations received marked "Hope Today" will go directly to those in this region.
The January 12th earthquake in Haiti was a major disaster for the island nation, and recovery remains slow. To aid in the medical treatment of those injured, we donated copies of Five Wishes in Haitian Creole and partnered with the American Hospital Association and its Florida chapter to help spread the word.
Many of the Area Agencies on Aging report that making Five Wishes presentations in the community is a great way to familiarize seniors with the many other services the AAAs provide. Some use local community access TV, picnic-in-the park events or "senior seminars" to help spread the word.
My Wishes (and Spanish language Mis Deseos) is the pediatric version of Five Wishes. Although it is not a legal document, it does help a child express how he wants to be cared for if he became seriously ill. Janet Ruth of Caregiving in America magazine recently talked about My Wishes during an interview on KARE-TV in Minneapolis.
Thank you once again, Jane Dinnen of Munson Medical Center in Traverse City, Michigan. Jane was featured in a WWTV/WWUP-TV news report on Five Wishes, showing her making a Five Wishes presentation to a group of Zonta International women. Jane has been a great friend to us and was in 2006, an Aging with Dignity National Innovator Award honoree.
Aging with Dignity's new headquarters office in Tallahassee, Florida is a third larger than our old downtown location. The expanded area will help us better serve our 23,000 partner organizations as well as the millions of individuals who use Five Wishes. Our mailing address remains P.O. Box 1661, Tallahassee, FL 32302.
Yes, that was us: AARP has a great five-minute video on its website that talks about end-of-life care and the importance of advance care planning. At the 4:15 mark, students at Georgetown University are seen distributing copies of Five Wishes and Cinco Deseos during National Healthcare Decisions Day.
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