Mobile Physician Services Blog
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With an aging Baby Boomer population in the United States. The concept of End of Life Planning has quickly become a necessary and important factor toward providing families peace at mind at the time of death for their loved ones. There are many steps a family can take with their loved one to prepare for their final goodbyes.
Choosing a Power of Attorney (POA) for your loved one is a necessary End of Life Planning step. A POA is a legally binding agreement that provides a person of your choosing legal authority to make estate and financial decisions on your behalf. Only a maximum of two people, 18 years or older, can be given POA status. They must be trusted to act in your best interest. To grant POA, the individual must be in a fully coherent state. POA is limited in its power. It only allows someone to handle financial and estate matters outlined by you, for example paying your bills or selling a piece of property. POA is only effective when you have the mental capacity to act. In the situation where you are incapacitated and unable to make decisions for yourself a POA is no longer effective. However, a Durable Power Attorney (DPOA) gives an individual the authority to make decisions on your behalf, in the situation where you are incapacitated. An individual can have both POA and DPOA status for their loved one.
There are two kinds of DPOA. Durable Power of Attorney for Finances, which allows an individual to make financial decisions if you become incapacitated and Durable Power of Attorney for Health Care, which authorizes an individual of your choosing to make health care decisions on your behalf if you become incapacitated. One important benefit of appointing both a POA and DPOA is that it allows you to choose who will make decisions for you if there is a situation where you are incapacitated and unable to make financial or estate decisions for yourself. Both a POA and DPOA play a necessary role towards providing not only financial and estate security but also healthcare security for our loved ones.
Along with appointing both a POA and DPOA for your loved one, drafting a living will is another important End of Life Planning step. A Living Will is a written and legally binding document that outlines all the medical treatments that you would like and not like to be done to keep you alive. It’s important discuss with your family, friends, and doctor about your end of life wishes and a Living Will is perfect way to document your end of life care. Five Wishes is the one of the most widely used Advanced Directive/ Living Will in the United States. This document allows individuals to choose: their health care power of attorney, the type of medical treatments the would like or not like, the level of comfort care they would like, how they would like to be treated when they are about to reach their end, and how their loved ones will remember them (funeral wise). Bound in a single document, Five Wishes provides families peace at mind and the assurance that your loved one’s final wishes are preserved.
Appointing both a POA and DPOA, and drafting a Living Will (Five Wishes) are important End of Life Planning steps to take to prepare for the inevitable death of any loved one. By planning ahead, you can get the medical care that you want, while avoiding any superfluous suffering. Planning ahead helps to relieve your loved ones with the burden of making tough decisions in moments of crisis or grief.
Alzheimer’s disease is the sixth leading cause of death in the United States. The month of September brings the world together to raise awareness for our patients and family members who have been diagnosed with Alzheimer’s disease. Alzheimer’s disease is a progressive disease that cannot be cured and destroys memories as well as important mental functions. It is known to be the most common cause of Dementia. Dementia is the complete loss of cognitive functioning and behavioral abilities.
Alzheimer’s disease was named after a doctor Alois Alzheimer, who discovered the disease while examining the brain tissues of a woman who had died of an unusual mental illness that showed all of the symptoms of what we now know as Alzheimer’s disease. He discovered many plaques and tangles spread throughout the brain, as well as many disconnected neurons thus discovering the progression of the disease.
Scientists to this day are still studying the brain changes during the progression of the disease and still do not fully understand what ultimately causes Alzheimer’s disease. Although studies have shown a shrinkage in brain tissues, plaques and tangles spread throughout the brain, loss of neuron connection, as well as the death of the neurons. It is also believed that early-onset Alzheimer’s disease may play a role in genetic components and that late-onset arises from a complexion of brain changes that occur overtime.
Early warning signs and symptoms for Alzheimer patients are the following: loss of memory that disrupts their everyday life, challenges in solving problems and planning, difficulty completing familiar tasks, confusion with place or time, trouble understanding spatial relationships and images, new problems with words in writing or speaking, misplacing items, losing their ability to retrace their steps, poor or decreased judgement, withdrawal from work and social activities, and changes in personality and moods. It is important to address any of these symptoms before the disease progresses further. Treating the disease with medications will only temporarily improves symptoms.
When caring for someone who has Alzheimer’s disease keep in mind of their symptoms and educate yourself briefly on the disease for a better understanding. Providing them with the proper support can have high emotional, physical and financial costs. Asking for help is the best thing to do and it isn’t taking the easy way out. It is showing that you care for them to have the absolute best care. Following their life long habits and avoiding new routines may make caring for an Alzheimer’s patient just a bit easier, while making them more comfortable with doing everyday things. Physical activity and playing the patients preferred music are great ways of showing support and can improve their behavior.
Safety is also important to remember when caring for an Alzheimer patient. A recommendation would be to have them wear an identification bracelet containing their name as well as their caregiver’s name and phone number.
Having the proper knowledge and understanding plays a major role in caring for an Alzheimer patient. Always keep in mind of how you would like to be treated if you were in the shoes of someone with Alzheimer’s disease.
Cholesterol is a natural wax like substance that is both beneficial and harmful to the body if too much or too little is produced. Cholesterol is used to build cells throughout the body and is produced by the liver. Cholesterol is also obtained through eating animal-base foods that are high in saturated and trans fat such as meat, poultry, and full-fat dairy products. Cholesterol is also obtained through plant-base oils such as palm, palm kernel, and coconut which are all used in everyday baking. These foods and oils work with the liver as a team to then produce more cholesterol.
When discussing cholesterol you will run into the terms LDL and HDL cholesterols. LDL cholesterol (low-density lipoproteins) is considered the bad cholesterol and HDL cholesterol (high-density cholesterol) would then be considered the good cholesterol however they both work together to keep the cholesterol levels balanced and too much or too little of either one can result in health problems. Hypercholesterolemia is the term that is used when the body has too much of the LDL cholesterol and Hypocholesterolemia is when the body doesn’t have enough of the LDL cholesterol, which isn’t as common. Then there is Hyperlipidemia which is when there is too many lipids, triglycerides and cholesterol in the blood stream.
When treating hypercholesterolemia on your own keep in mind that you may feel no symptoms and that the doctor’s recommendation is to get regularly blood tested every four to six years starting at the age of twenty. In order to treat or prevent high cholesterol it is recommended to maintain a heart-healthy diet by eating foods such as fruits, vegetables, whole grains, nuts and foods high in fiber. Having a high fiber diet can lower cholesterol levels by as much as ten percent. It is also advised to limit yourself to five or six percent of saturated fat in your daily calorie intake, which can really be beneficial to your health. Another recommendation is weight loss and proper exercising which also plays a big role when lowering cholesterol.
Hypocholesterolemia only affects about five percent of the general population and is usually inherited or obtained due to several secondary causes. Some of the causes of hypocholesterolemia could be an overactive thyroid gland, statin medications, liver disease, celiac disease, adrenal insufficiency, and malnutrition. Even smoking can play a major role when having hypocholesterolemia because it has been determined that smoking can lower your HDL cholesterol levels.
Without treating your cholesterol problem you may end up with a worse condition such as coronary artery disease or even have a heart attack or stroke. With the help of other bodily substances cholesterol can form a thick and hard deposits. This is called atherosclerosis, which narrows the arteries making them less flexible and more prone to blockage and clot formation which can then lead to a heart attack or stroke. Having high blood pressure or Diabetes can also increase those heart risks.
It is important to have your cholesterol levels checked regularly with your primary care physician to treat and prevent any further health complications. Make sure you are proactive for Cholesterol Awareness month.
Keeping ourselves hydrated is vital for our health, considering our bodies consist of 60%-80% water, give or take. Just by drinking around eight, eight ounce glasses of water a day, you can reduce and prevent negative health risks both internally and externally. In addition to, decreasing your risk for both colon and bladder cancer.
However, when not drinking enough water you may become dehydrated. When your body is 20% dehydrated you’re at increased risk of death due to dehydration. Becoming dehydrated can be caused by many things such as, illnesses, diarrhea, vomiting, sweating, frequent urination, Diabetes, and even burns. Dehydration can then trigger headaches, migraines, impaired mood, concentration and energy levels, as well as a possible reduction in memory and brain performance depending on the person.
Drinking more water is beneficial in many different ways. A few healthy benefits of drinking more water would be the treatment of dry skin, muscle cramps, treatment and reduction of kidney stones, regulating blood pressure, and weight loss. Water can play a huge role when trying to lose weight, considering it helps boosts your metabolic rate. It is recommended to drink cold water due to the fact that your body burns more calories while attempting to increase your body temperature. By drinking a glass of water a half hour before meals; you will feel more full and the water will suppress your appetite further helping in the weight loss process.
Behind the scenes, water does so much more than what we’ve already discussed. Further into the body, water is used to: transport nutrients and oxygen into cells, detoxify internal organs, help our organs to absorb nutrients better, protect and moisturize our joints, as well as keep our bodies at a regulated temperature.
All in all, consuming an adequate amount of water a day can substantially benefit your health and prevent and reduce many risks for chronic diseases. Just by starting the day with a glass of water will help further your health.
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By the decision of the 11th U.S. Circuit Court of Appeals, physicians in the state of Florida are once again allowed to question patients and their families about owning a firearm and record firearm information into their records.
The decision of the court, however, has left a provision intact that allows the patients and their families to refuse answering any questions pertaining to gun ownership. As well as, the patients and families being able to refuse any firearm discussion physicians cannot discriminate any patients solely based on a firearm status.
Before this change came into effect, in 2011 the Florida Firearm Owner’s Privacy Act was enacted. This law barred physicians from questioning their patients about firearms and from them recording any information about firearms into their records. The law was enacted after many complaints were made from patients that the physicians were inquiring about firearms and firearm safety and in some cases the physicians refused to provide a patient with care after their decline to answer.
Sometime after the law had passed a group of physicians and the ACP Florida Chapter sued the state while arguing that the law was violating physician’s free speech protections and that they are only trying to encourage firearm safety and make the patients and families aware of potential health and safety risks.
With that argument in the way the court ruled in favor of the plaintiffs stating that the right to own and bear arms does not preclude questions about, commentary on, or criticism for the exercise of that right. Which allows the physicians to ask patients and families about owning a firearm and giving them the choice to discuss or decline giving any information without the physician being able to refuse to give the patient healthcare depending on their choice.
The law was made to favor both the patients and the physicians but, the debate still stands for physicians concerned about the patients and their own safety and the risks of the patient having a firearm and the physician not being allowed to properly discuss the dangers and to maybe even prevent a future accident with a simple discussion.
All in all, a physician’s main concern is providing their patient with proper healthcare while maintaining a safe and secure environment for both them and the patient while respecting the patient’s rights.
Alcohol related risks usually don’t appear until later in life. People who drink alcohol excessively increase their risk of liver disease, heart disease, high blood pressure, stroke, pancreatitis, and even some forms of cancer. That being said the month of April is considered Alcohol Awareness Month and raises a specific awareness on the ninth with National Alcohol Screening Day. Screening your patients and informing them and their care givers about the risks and dangers of alcohol abuse is important and can be life-saving under many different circumstances.
Just by cutting down on how much alcohol you consume or even opting for low-calorie alternatives can help you maintain a healthier weight and appearance, considering alcohol has a high calorie content. Excessive alcohol consumption can also affect how well you sleep at night by possibly causing sleep disturbances as well as development of mental health difficulties, or even make existing problems worse.
If determined necessary by a Primary Care Provider, patients with Medicare can be provided with an annual alcohol screening under the “Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse” benefit. Typically, an alcohol screening is provided when a Primary Care Provider notices a patient’s need for help to reduce or abstain from the consumption of alcohol.
Medicare patients whom screen positive may be eligible for counseling. The Primary Care Provider then can perform the counseling for the patients that are competent and alert. Taking the steps to reduce and prevent alcohol abuse isn’t a difficult process when you seek the proper help and attention from your Primary Care Provider.
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