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TRANSCRIPT
The heart of the matterThis Connections issue discusses several important concerns for the ministry we share:
The article entitled Big Boomin’ Heart Fair addresses the physical heart, whereas our features on medical ethics, hospice and advance care planning focus on deeper matters of the heart.
Faith, values and beliefs determine how we live our lives, engage in relationships and even discern how we might finish this life. Ministries of care understand the profoundly deep and sacred pathways that encompass the whole person – body, mind and spirit. Everyone involved with fostering healing strives to know what is in one’s heart in order to honor that which is most true and blessed for each and every person.
Even if we don’t give out heart-shaped valentines every day, we can share a ministry of healing that demonstrates God’s love for all those in need, those whose hearts we are privileged to know and touch.
Rev. Jim ChristianVice President, Mission & Spiritual Care
Advocate Good Samaritan Hospital
Spring 2012Volume 3, Issue 1
Office for Mission & Spiritual CareAdvocate Good Samaritan Hospital630.275.1185GSAM-SpiritualCare
@Advocatehealth.com
Faith leaders and caregivers are long on helping others and notoriously short on self-care. But we at Advocate Good Samaritan Hospital have set up a time and place for you to care for your heart – easily!
On Saturday, Feb. 25 from 8 to 11 a.m., we are holding our Big Boomin’ Heart Fair in the main hospital on the lower level atrium. There is no charge for any of the screenings.
Screenings provided at the Heart Fair include blood pressure, asthma and pulmonary functions.
This year we have added the more accurate, two-step screenings for cholesterol and diabetes. Register for these screenings at 1-800-3ADVOCATE (1-800-323-8622). Step 1: You fast for 12 hours
(at your convenience) and then go to an ACL lab (there are several in the area including one at our hospital) for a blood test. Step 2: A cardiac nurse reviews your test results with you at the Heart Fair.
“The two-step test has advantages over the finger-stick test,” said Colleen Kordish, R.N. “If the finger stick revealed an abnormal result, the doctor would never prescribe from it and would schedule another lab test. That meant more time, fasting and money. But if this two-step test is abnormal, you don’t have to start over. Your doctor can look up your lab results directly and go forward from that.”
Our hours: The Office for Mission and Spiritual Care provides spiritual care for patients and their families 24 hours a day every day of the year. The office is open from 8:30 am to 5 pm Monday through Friday. During those times, you may contact us at 630.275.1185. Evenings and weekends, call 630.275.5900, and ask the operator to page the on-call chaplain.
. . . for your congregants and for you!
Advocate Good Samaritan HospitalOffice for Mission and Spiritual Care
to our faith communitiesConnections
Big Boomin’
Heart Fair
Connections - Advocate Good Samaritan Hospital Office for Mission and Spiritual Care Spring 2012 - Page 2
Ethics questions can arise at any time, especially at the beginning of life if there is a critically ill newborn and at the end of life. Today’s health care decisions can be very complex in the context of our highly technical world, and decisions regarding treatment options are sometimes difficult to make.
“In general, I assume that we are all motivated by our beliefs of what doing the right thing means,” said Ed DuBose, Director of Clinical Ethics for Advocate Health Care. “But different points of view exist – for patient, family members, health care professional. Each is sincerely trying to figure out the right way to go, and from time to time, values conflict.”
One of the most common conflicts DuBose sees is between the patient’s right to make decisions and the family’s thoughts on what is best for that patient. Without an advance care plan in place, uncertainties can abound. When conflict arises, DuBose works as a mediator to be sure each person has a chance to have his thoughts heard. He listens and asks questions, and most times things can be resolved.
Another difficult decision is turning the corner from
aggressive treatment to hospice. Physicians often delay recommending hospice, and
families in emotional pain may delay making such a decision. While hospice admission is given consideration at six months, the national average for hospice is only two months.
“I think this disparity is because we have such high expectations of medical professionals. We’re a youth-oriented society and don’t want to recognize that each one of us is going to die,” said Joal Hill, Director of
Research Ethics at Advocate Health Care. “But choosing hospice in time gives a family weeks or even months of peace without excessive medical interventions and with time to say good-by in the richest way.”
At Advocate Good Samaritan Hospital, our chaplains and our ethicists are ready to help patients and families sort through difficult medical decisions.
If you feel that health care wishes are not understood or if there is disagreement about decisions, you may want to ask for an ethics consultation. Anyone – medical or nursing staff, patient, family member, patient representative – can access the ethics committee at Advocate Good Samaritan Hospital and request a consultation. The committee provides numerous ethics consultations every year. To contact them, please ask a nurse or chaplain, or contact the hospital operator to page the on-call chaplain.
AutonomyRespect a patient’s right to make
decisions.
Beneficence
Do what is in the patient’s best interest.
Non-maleficence
Do no harm to the patient.
JusticeServe all fairly.
Medicalethics
Ed DuBoseDirector of Clinical EthicsAdvocate Health Care
Joal HillDirector of Research EthicsAdvocate Health Care
“We’re a youth-oriented society and don’t want to recognize that each one of us is going to die.”
Connections - Advocate Good Samaritan Hospital Office for Mission and Spiritual Care Spring 2012 - Page 3
Advocate Good Samaritan Hospital3518 Highland AvenueDowners Grove, IL 60515630.275.5900www.advocatehealth.com/gsam
Good Samaritan Health and Wellness Center3551 Highland Ave., Downers Grove, IL
630.275.2879
Advocate Good Samaritan Outpatient Facilities:6840 S. Main St., Downers Grove, IL, 630.275.684015900 W. 127th St., Lemont, IL, 630.243.7100
Office for Mission & Spiritual [email protected]
Vice President:Rev. Jim Christian
Chaplains:Jill Bates Barbara BurkhardtDonald Frye Johnny GillespieKathy Gingrich Anna Lee Hisey PiersonClaire Marich Kim Neace Cathy Stewart Laura WilliamsLinnea Winquist Adrienne Zervos
Chaplain Educators:Amy Snedeker Jeni Porche
Department Secretary:Julie LaFayette
To continue receiving Connections, your email address must be current. Please inform us of any changes in your email address or other contact information: Call 630.275.1185 or email to [email protected].
Daybreak Bereavement ProgramsAdvocate Hospice
1441 Branding Lane #220 • Downers Grove, IL 60515
Widow to Widow Ongoing support groupMeets 3rd Saturday of each month, 10 a.m. to 12 noonSupport and guidance is offered to and by women who have lost their partners. There is no charge, but registration is required. Call Penelope Gabriele at 630.829.1753 to register.
Second Year of Grief Workshop – Guest speaker: Coach Enge Wed., Feb. 29, 6:30 to 8:30 p.m.For those with one year or more since the death of their loved one. Most people expect it will be easier after the first year. In some ways, the second or third year can be better, but they can be difficult in other ways. While the emotional pain of the primary loss may subside, the resulting secondary losses are becoming more obvious. Explore the various ways of managing grief. Call Penelope Gabriele at 630.829.1753 to register.
Service of Remembrance
Advocate Good Samaritan Hospital Chapel
Special Memorial Service for Recently BereavedSun., Mar. 18, 4 p.m.Good Samaritan Mission & Spiritual Care and Advocate Hospice join together in leading this service as a comfort for families they serve who have recently lost a loved one. For more information, call 630.829.1753 or email [email protected].
(The next service will be June 10.)
Hospice Corner
Preparing for emergenciesCardiac health and careIn upcoming issues
A Blessing for HealingIn our anxiety, In our pain,In our hopes,
In those who will treat us,We turn to you, O loving God.
For our healing, For our peace of mind,
For our recovery, For our families,
We turn to you, O God, Only you, always you, faithfully you.
For there is no otherIn whom we can so confidently trust.
Amen
Connections - Advocate Good Samaritan Hospital Office for Mission and Spiritual Care Spring 2012 - Page 4
Advance care planning (ACP) begins with exploring and understanding your personal goals and core values so that future health care decisions – should you become unable to make those decisions yourself – align with your beliefs.
At its best, ACP includes a discussion of those goals with the person who represents your preferences for you (your surrogate or agent) and a written plan that clearly and accurately represents them (advance directive).
Choose your surrogate thoughtfully. He/she can be your spouse, an adult child (not necessarily your eldest), a sibling or a close friend. Choose someone you trust with your health care decisions who will respect your wishes and put them into action regardless of his/her own attitudes. Your surrogate needs be prepared to make these
decisions and act during a stressful, difficult time. He/she deserves to know this up front. Not everyone wants this responsibility.
Discuss your wishes in detail until your surrogate fully understands them. The conversation may cover types of medications and treatments you desire, the care you do and don’t want if you are seriously ill or injured and your concerns about end-of-life issues. You may also want to talk about funeral plans. Share with your family who your surrogate is, and explain to them that he/she does not have any power unless you are unable to make health care decisions for yourself.
Begin before ACP is needed. Don't wait for a medical crisis to make decisions about advance care planning. Make decisions while you are able to process information easily and are not under pressure to make hard choices right away.
Many people are unaware of their end-of-life preferences regarding medical treatment simply because they haven’t taken the time to consider them, but once they do, their personal values and spiritual beliefs often lead them smoothly through the process. (Clergy can clarify ethical decisions for people of faith.)
Continued on next page.
Advance care planning (ACP) glossaryAdvance care planning – All communication – both oral and written – that contributes to building a personal plan of your wishes for your future medical care.
Advance directive – A written statement telling how you want your medical decisions to be made in the future if you are unable to make them for yourself. ADs may include:
• Power of attorney for health care – You name someone (a surrogate or agent) to make health care decisions for you if you are unable to make them yourself. (Power of attorney, different from power of attorney for health care, deals with financial decisions and is not empowered to make health care decisions on your behalf.)
• Living will – Directs your physician and indicates your wishes about death-delaying procedures. Not a Last Will and Testament. It applies only when you have a terminal illness from which your doctor thinks you cannot recover and you are unable to make decisions for yourself.
• Do not resuscitate order (DNR) – A medical treatment order saying that cardiopulmonary resuscitation (CPR) will not be used if your heart and/or breathing stops. This form also requires a physician’s signature.
A brief history of advance directives (ADs)1967 – Chicago attorney Luis Kutner suggested the first living will to facilitate the rights of dying people to control decisions about their own medical care.
1968 – Living will legislation presented to a state legislature. The Florida bill failed to pass in 1968 and again in 1973.
1976 – The Karen Quinlan Case raised awareness of right to privacy and appointment of surrogates as end-of-life decision-makers. The concept of an ethics committee was introduced.
1976 – California established rights of patients and surrogates to forego life-sustaining treatments through a written document.
1977 – Forty-three states considered living will legislation; seven states passed bills.
1980s – Legal rulings applied right to forgo treatment to more routine treatments, based on benefits and burdens to individual.
1990 – U.S. Supreme Court’s Nancy Cruzan decision supported an individual’s right to refuse treatment, even life-sustaining.
1991 – The House of Representatives passed the Patient Self-Determination Act (PSDA) that requires hospitals ask patients being admitted if they have or wish to have ADs.
1992 – All states passed legislation legalizing some form of ADs.
Understanding advance care planning
April 16th
National Healthcare Decision Day
Connections - Advocate Good Samaritan Hospital Office for Mission and Spiritual Care Spring 2012 - Page 5
Advocate Health CareAdvocate Health Care Facilities:
Advocate BroMenn Medical Center, Normal Advocate Christ Medical Center, Oak LawnAdvocate Condell Medical Center, LibertyvilleAdvocate Eureka Hospital, EurekaAdvocate Good Samaritan Hospital, Downers GroveAdvocate Good Shepherd Hospital, BarringtonAdvocate Illinois Masonic Medical Center, ChicagoAdvocate Lutheran General Hospital, Park RidgeAdvocate South Suburban Hospital, Hazel CrestAdvocate Trinity Hospital, Chicago
Children’s hospitals:Advocate Hope Children’s Hospital, Oak LawnAdvocate Lutheran General Children’s Hospital, Park Ridge
Share the news! This publication may be copied for use by others if printed acknowledgment of source is included.
Looking for a previous issue? To read back issues of Connections, please go to: advocatehealth.com/newsletters
Forms can lead into conversations. Basic forms are readily available to complete the living will and health care power of attorney, two frequently used documents. The forms themselves can serve as excellent starting points for conversation. But there is so much more to ACP than simply filling out forms! After all, these are very important decisions, so both knowing your own mind and expressing your specific preferences are critical.
Sometimes these conversations are uncomfortable. Discussing your beliefs and values is personal, and strong emotions often
erupt, touching on deep feelings and exposing fears you may want to avoid. But taking the necessary time, working through complex
issues and talking with loved ones about your true wishes is, in fact, an essential part of good care. Not only does it leave your family feeling relieved because they are following your wishes, ACP also ensures respect for your well-being and your right to self-determination.
Preparation is comforting. A family is comforted when they have direction. For some families, forgoing treatment becomes an act of caring. For other families, continuing treatment (perhaps based on cultural or religious beliefs) comforts them because they know it is consistent with their loved one’s wishes.
Guessing a person’s preferences without knowing them can be torture to a family. Families face difficult decisions when ill loved ones become unable to communicate their preferences regarding medical procedures. Dedicated children and siblings can become distraught trying to guess what a loved one might want, and well-meaning relatives seeking to do what’s right may disagree because of lack of concrete direction.
If you become critically ill, are unable to speak for yourself and have not named an agent, Illinois provides guidance for physicians to determine a surrogate for you. This person may or may not be the one you would choose and is less empowered to make decisions than one you have chosen yourself.
Statutory short formIllinois has revised its form for power of attorney for health care. It is a little longer than the previous form, has a few organizational changes and includes more legal jargon.
One of the significant changes is the inclusion of the phrase, “in accordance with reasonable medical standards” as relates to
life-sustaining/death delaying options. With this phrase, the agent who has power of attorney for health care can reflect on what would be beneficial to the patient. If a procedure or treatment does not seem reasonable, the agent can, in good conscience, elect not to use it.
How ACP happens. After considering your wishes, you can complete the AD forms on your own (forms are readily available on line; see Resources above) or with guidance from your faith leader, doctor or trusted advisor. This can be done without a lawyer, but the forms do need to be signed by witnesses. GIve copies to your loved ones and physician.
At Advocate hospitals, each patient is asked at admission if he/she has an AD or wishes information about one. Our chaplains are trained to discuss these decisions compassionately with patients.
Faith leaders themselves sometimes lead a general information session about ACP for their congregants and introduce them to the AD forms. They follow that up with individual conversations and further guidance for those who so wish. This personal touch often removes the barriers to completing advance directives.
Our chaplains can also give congregations presentations on ACP. (For information, call 630.990.5650.)
Continued from previous page.
Resources for ACP• Fivewishes.org (Aging with Dignity – Five Wishes)
• Abanet.org/aging/toolkit (ABA tool kit for ACP)
• www.Idph.state.il.us/public/books/advin.htm
• Isms.org (Illinois State Medical Society)
• aarp.org/families/end_life (AARP - Information on caregiving, long-term care, wills, end-of-life, grief support)
• Cecc.info (Chicago End-of-Life Care Coalition)
• ACP International Conference, Donald E. Stephens Convention Centre, Rosemont, IL, May 31 – June 2.
• Respectingchoices.org (How to develop an ACP program)
• Advocatehealth.com
There is so much more to ACP than simply
filling out forms!
Prac
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bene
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He/
she
has
a ba
selin
e of
kno
wle
dge
that
is b
oth
obje
ctiv
e an
d su
bjec
tive.
Tha
t doc
tor
know
s w
hat i
s no
rmal
for
you
and
wha
t is
abno
rmal
for
you,
how
muc
h st
ress
you
exp
erie
nce
in
your
wor
k, th
e dy
nam
ics
of y
our
fam
ily a
nd h
ow to
bes
t wor
k w
ith y
ou to
impr
ove
your
wel
l-be
ing.
Hav
ing
a re
gula
r ph
ysic
ian
has
a be
nefic
ial e
ffect
on
man
y he
alth
car
e se
rvic
es, i
nclu
ding
pre
vent
ive
serv
ices
for
child
ren
and
redu
ctio
ns in
hos
pita
l use
am
ong
patie
nts
with
chr
onic
pr
oble
ms.
Dia
betic
s w
ho h
ad s
tand
ing
rela
tions
hips
with
thei
r do
ctor
s w
ere
mor
e lik
ely
to fo
llow
a d
iabe
tic d
iet,
mon
itor
thei
r su
gars
and
rec
eive
rec
omm
ende
d pr
even
tive
exam
s.
Ove
r tim
e, d
eep
trus
t dev
elop
s be
twee
n do
ctor
and
pat
ient
. H
ones
t ans
wer
s –
even
to h
ard
ques
tions
– b
ecom
e ea
sier
to
spea
k. C
omm
unic
atin
g ab
out p
ain
and
need
s be
com
es le
ss
awkw
ard.
Sha
me
disa
ppea
rs.
A d
octo
r w
ho k
now
s th
e pa
tient
wel
l ser
ves
the
patie
nt b
est.
Sim
ply
havi
ng a
n on
goin
g re
latio
nshi
p w
ith a
phy
sici
an c
an
mea
n gr
eate
r w
elln
ess
for
you
and
your
love
d on
es.
Res
ourc
es:
1-80
0-3-
AD
VO
CAT
E or
Adv
ocat
ehea
lth.c
om •
find
ahea
lthce
nter
.hrs
a.go
v
Com
ing
in M
arch
: H
ow to
sel
ect a
prim
ary
care
phy
sici
an
Wom
en a
nd h
eart
att
acks
We’
ve k
now
n fo
r a
whi
le th
at m
en a
re fr
om M
ars
and
wom
en
are
from
Ven
us, b
ut w
e ar
e ju
st n
ow le
arni
ng th
at th
e se
xes
are
diffe
rent
in a
noth
er r
espe
ct: h
ow th
ey e
xper
ienc
e he
art a
ttack
s.
A w
oman
’s sy
mpt
oms
of h
eart
atta
ck c
an b
e dr
amat
ical
ly
diffe
rent
from
a m
an’s
and,
in fa
ct, l
ess
dram
atic
. Per
haps
this
is
the
reas
on w
omen
hav
e m
ore
unre
cogn
ized
hea
rt a
ttack
s th
an
men
and
are
mor
e of
ten
mis
diag
nose
d in
ED
s an
d se
nt h
ome!
Bot
h se
xes
ofte
n ex
peri
ence
thes
e sy
mpt
oms
of h
eart
atta
ck:
✦Pr
essu
re o
r a
sque
ezin
g pa
in in
the
cent
er o
f the
che
st w
hich
m
ay s
prea
d to
the
neck
, sho
ulde
r or
jaw
✦Li
ght-
head
edne
ss, f
aint
ing,
sw
eatin
g, n
ause
a or
sho
rtne
ss o
f bre
ath
Man
y w
omen
– 4
3% o
f the
m, i
n fa
ct –
nev
er
expe
rien
ce a
cute
che
st p
ain
duri
ng a
hea
rt
atta
ck. M
any
do h
ave
shor
tnes
s of
bre
ath,
but
they
m
ay a
lso
expe
rien
ce u
nexp
lain
ed fa
tigue
or
pres
sure
in
the
low
er c
hest
whi
ch c
an b
e m
ista
ken
as a
sto
mac
h pr
oble
m.
Unu
sual
fatig
ue, n
ause
a, d
izzi
ness
, dis
com
fort
that
feel
s lik
e in
dige
stio
n, b
ack
pain
– th
ese
sym
ptom
s ar
e no
t unc
omm
on fo
r a
wom
an h
avin
g a
hear
t atta
ck. I
t’s a
lso
wor
th n
otin
g th
at s
ome
wom
en –
abo
ut s
ix w
eeks
bef
ore
the
actu
al h
eart
atta
ck –
hav
e sh
ortn
ess
of b
reat
h, u
nexp
lain
ed fa
tigue
or
stom
ach
pain
as
an
earl
y w
arni
ng s
ign
that
they
mig
ht h
ave
a bl
ocke
d ar
tery
.
If yo
u be
lieve
you
're
havi
ng a
hea
rt a
ttack
sym
ptom
, dia
l 911
im
med
iate
ly fo
r an
am
bula
nce
to ta
ke y
ou to
the
ED.
2-12
Febr
uary
–
Am
eric
an
Hea
rt M
onth
Res
ourc
es: A
dvoc
ateh
ealth
.com
• W
omen
hear
t.org
• w
ww
.nhl
bi.n
ih.g
ov/h
ealth
/pu
blic
/hea
rt/o
ther
/hhw
/hdb
k_w
mn.
pdf (
The
Hea
lthy
Hea
rt H
andb
ook
for W
omen
) •
heal
thie
rchi
cago
.org
(Liv
eWel
l Nat
iona
l Con
fere
nce,
hos
ted
by B
uild
ing
a H
ealth
ier
Chi
cago
, Hya
tt R
egen
cy C
hica
go, J
une
6 -
7) •
kno
wyo
urnu
mbe
rs.c
om/h
eart
/ad
voca
te.h
tml
Pray
er:
Dea
r Lo
rd, w
e w
ear
red
this
mon
th to
hon
or th
e he
arts
of
the
wom
en in
our
live
s: m
othe
rs, g
rand
mot
hers
, sis
ters
, dau
ghte
rs, c
o-w
orke
rs a
nd fr
iend
s. B
e w
ith th
em e
ach
and
ever
y da
y. A
men
.
Date Site Name Site Address City First Appt. Time
3/5/12 Lisle Township Office 4721 Indiana Ave. Lisle 9:00 a.m.
3/6/12 Holiday Inn Chicago – Carol Stream 150 S. Gary Ave. Carol Stream 9:00 a.m.
3/8/12 St. Thomas United Methodist Church 2S 511 IL Route 53 Glen Ellyn 9:00 a.m.
3/9/12 St. Francis of Assisi Parish 1501 W. Boughton Rd. Bolingbrook 9:00 a.m.
3/10/12 Lemont VFW Post #5819 15780 New Avenue Lemont 9:00 a.m.
3/24/12 St. Mary of Gostyn Church 444 Wilson St. Downers Grove 9:00 a.m.
3/28/12 First Congregational Church of La Grange 100 6th Ave. La Grange 9:00 a.m.
3/29/12 Christ Lutheran Church 60 55th St. Clarendon Hills 9:00 a.m.
4/4/12 Oak Brook Public Library 600 Oak Brook Rd. Oakbrook 9:30 a.m.
4/10/12 Divine Providence – Mayfair Room 2500 Mayfair Ave. Westchester 9:00 a.m.
Preventive Health Event Advocate Good Samaritan Hospital is pleased to sponsor a preventive health event. Life Line Screening, the nation’s leading provider of community-based preventive health screenings, will host their affordable, non-invasive, painless health screenings this spring at the locations below. Screenings will be offered that scan for potential health problems related to: ✦ Blocked arteries, which is a leading cause of stroke✦ Abdominal aortic aneurysms, which can lead to a ruptured aorta✦ Hardening of the arteries in the legs, which is a strong predictor of heart disease✦ Atrial fibrillation or irregular heartbeat, which is closely tied to stroke risk
Register for the Stroke, Vascular Disease and Heart Rhythm Package for $139.00 (the cost for all the screenings). All four screenings take 60-90 minutes to complete. Your health is in your hands, so call Life Line Screening today, 1.888.653.6441, or visit lifelinescreening.com for more information or to pre-register.
Hospital Contact:Patient Advocacy & Community HealthAdvocate Good Samaritan Hospital3815 Highland Ave.Downers Grove, IL 60515630.275.1149