OK, you’ve made the mid-April tax deadline. Congrats. Now what?

Here’s a thought: Get something arguably as important – or even more so – in order next.

We’re talking about critical health care decisions in the event you’re not able to communicate decisions yourself – decisions you can define in an “advance directive.”

That’s the aim of National Healthcare Decisions Day on April 16 every year, which is typically the day after taxes are due.

Unlike taxes, advance directives aren’t something you’re obligated to execute, but experts agree you’ll feel immense relief should you take on the task. You’ll then have legal documents in place to safeguard the ways in which you want important decisions made about your health care if you are unable to communicate them yourself due to an accident, illness or other factors.

“Having a conversation is a good place to start, after you’ve gone through the contemplative part of it,” says Sara Lowe, executive director of Emmanuel Hospice in Grand Rapids.

Lowe, and scores of her employees, have witnessed firsthand the friction that can ensue when advance directives aren’t in place, and loved ones start arguing about what dad or mom would want when they can no longer decide on their own.

“What we’ve seen is how there is so much more peace in the family when those documents are in place,” says Lowe, noting that setting up advance directives “can serve as a final gift of clarity for your loved ones.”

Conversations should eventually include the person or persons you’re confident about choosing to serve as your durable power of attorney for health care decisions revolving around the types of medical interventions you do and do not want dependent upon the situation.

“Those conversations help determine who the right person for that is,” says Lowe, emphasizing that you shouldn’t automatically choose your spouse or firstborn, but instead that person you can best trust to carry out your wishes.

Advance directives remain in effect until you change it, so it’s a good idea to review your advance directives on an annual basis, especially if your life has been affected by divorce, separation or other family crises that might affect your initial choice.

“You never know when something unforeseen is going to happen,” she says.

Lowe understands that some people find it a daunting task to discuss death and dying. Her suggestion?

“You don’t have to do it all at once. Take your time,” she says. “Think about it, then have those conversations. Break it up into smaller pieces, but then act.”

And she offers this to consider, “It’s always better to have advance directives in place and not need them, than it is to need them and not have them.”

A lawyer is not needed to fill out an advance directive, but witnesses are required for the document to become legally valid. For more information about advance directives, consider visiting websites like CaringInfo.org, where you can navigate to the state you live in for specific guidelines, and download forms. You can also learn more via the National Hospice and Palliative Care Organization at nhpco.org.

Once your advance directive is complete, be sure your doctors have a copy, as well as everyone who might be involved with your health care decisions. Store the original document in a safe but easy to find place. Avoid locking the document away, so it can still be accessed by loved ones if you’re unexpectedly hospitalized.

For more information about Emmanuel Hospice, call 616.719.0919 or visit EmmanuelHospice.org.

 

You might say that for hospice music therapists like Roger Scott, they perform their work in the key of C, where the “C” translates to care, compassion and comfort.

Along with colleague Miranda Eden, Scott is one of two board-certified music therapists employed by Emmanuel Hospice. He considers the complementary therapy the twosome provides arguably as vital as traditional physical care administered by medical staff. And it’s a popular choice among patients and their loved ones. In 2023, Scott and Eden made more than 1,770 patient visits.

“It’s a very intense, rewarding experience,” says Scott, who hails from California but settled in Michigan after earning a degree in music therapy at Western Michigan University.

He traces his interest in music therapy back to the year 2000, when he started serving as a member of the U.S. Army Europe Band and Chorus, primarily as a vocalist.

“When we’d perform for soldiers, it really seemed to make a difference to them,” he says, noting that after his discharge, he went to a conference for music therapists and “fell in love with it.”

At Emmanuel Hospice, music therapy is offered as one of many ways to enhance a patient’s life, engage the senses and create joyful memories. During the last two years working with Emmanuel, Scott has discovered that every day – and every patient – is different.

During a session, he’ll often sing and strum the guitar, inviting patients and their caregivers to sing or hum along. He’ll even record a patient’s heartbeat and then marry it to music, so it can be enjoyed time and time again.

Heartbeat recordings are an opportunity for patients to create a legacy gift for their loved ones. The accompanying music often speaks to a review of their life and serves as a keepsake for caregivers to cherish after the patient has passed.

What patients might need in the way of music therapy is largely tied to how they express themselves to any one of their care team members. Communication is key among Emmanuel colleagues in order to provide holistic care that supports the patient’s mind, body and spirit.

The end result often manifests itself in a reduction of the patient’s pain, a chance to work through emotions and as a special way to recount memories as they embark on an otherwise difficult journey. Music therapy can be employed at a hospital, home or other living center – wherever the patient is receiving care.

Scott has played everything from rock to pop to Gregorian chants for his patients, and says it’s surprising how many requests he fields for arias from operas, such as “Nessun Dorma,” which debuts during the final act of the Puccini opera “Turandot.”

Whatever the music, Scott says it’s common for the patient to choose something near and dear – hymns or folk tunes or something from their heyday – that reminds them of significant people and events from throughout their lives.

“Often times, people will light up when they hear something that was popular when they were younger,” he says. “It meets their needs, and can help them work through a tough time.”

Music therapy can bring up a range of emotions while helping manage anticipatory grief, pain and anxiety. It can provide great comfort, as well as sensory stimulation and self-expression.

“It’s always hard not to smile when they’re smiling,” Scott says, “and it’s hard not to cry when they’re crying. You do the best you can for them, and in doing so, seek those moments when you can bring patients and their family members to a place of peace.”

Music therapy is one of several complementary therapies and services Emmanuel Hospice offers. To learn more, visit EmmanuelHospice.org/holistic-care or call 616.719.0919.

Two sobering facts to consider: One, that heart-related disease is the leading cause of death among U.S. adults. And two, that hospice care is vastly underutilized by that very population.

“There’s a big gap,” says Melissa Page, director of clinical services at Emmanuel Hospice. That’s why she and her colleagues have been aggressively advocating for more education and awareness revolving around Emmanuel’s Heart & Soul Advanced Cardiac Program.

It’s a toolkit of sorts, linked in with a program developed by the National Partnership for Healthcare and Hospice Innovation in collaboration with the American Heart Association. The goal is to ensure patients with heart disease and their loved ones are well informed so symptoms can be managed safely at home, reducing trips to the ER or hospital.

A mainstay of the collaboration is a 32-page Advanced Cardiac Care Guide, which includes valuable information on everything from recognizing symptoms to dietary recommendations. Many patients living with end-stage heart disease are burdened by visits to the doctor’s office, emergency room and hospital due to breathing difficulties, edema, fatigue and other worsening symptoms.

Such exacerbations can often be prevented or managed by hospice and palliative care, says Julie Chambers, a nurse case manager for Emmanuel.

“With hospice care, it’s more about providing comfort,” Chambers says. “And that can mean fewer visits to offices and more time with family enjoying a higher quality of life while still collaborating with a cardiac team to treat anything from breathing issues to swollen limbs to fluctuations in weight and appetite.”

“We’re seeking ways to include people already involved with the patient’s care, while also folding in all the services our organization provides,” Page adds.

To that end, Chambers and Page and other team members at Emmanuel Hospice are constantly looking for ways to help make cardiologists and other professionals aware of the benefits hospice can provide.

“When hospice care is part of the formula, we see lower anxiety levels, less fear of the unknown and fewer feelings of helplessness,” Chambers says. “It’s all part of putting the patient at ease, a different culture of care.”

Support might include regular visits from Emmanuel Hospice experts, and can extend beyond traditional care to complementary therapies and services involving everything from massage to music to essential oils.

Chambers and Page emphasize that people affected by cardiac disease either personally or through a loved one can reach out with questions at any time, even if they’re not experiencing end-stage symptoms.

“Death doesn’t need to be imminent,” Page says. “It’s OK to simply call and say, ‘I’d like to know more about this.’”

“It’s also important for people to know that they’re not ‘giving up’ when they reach out to us,” adds Chambers. “We’re fighting against that stigma, that ‘If I’m going on hospice, I’m giving up.’ No. You’re choosing what you want, and we’re here to honor that choice.”

For more information about Heart & Soul, visit EmmanuelHospice.org/cardiac-care.

 

 

How to help combat tension? Maybe lavender.

Wish you could feel a bit more energized? Try lemon.

As for improving congestion and mental focus? Peppermint, perhaps.

In hospice care, these and other essential oils are finding their way into the mainstream as ways to minimize adverse reactions and maximize therapeutic benefits, often in conjunction with other methods of treatment.

At Emmanuel Hospice, essential oils have been part of the care team’s toolkit for upwards of five years now, relying on 100% natural extracts from plants which support the holistic wellbeing of mind, body and spirit.

“We currently utilize four essential oils,” explains Jenny Kellogg, Emmanuel’s support programs manager. “There’s lavender, a light and floral scent, which can ease feelings of tension, and sometimes reduce a person’s anxiety and even help calm them and promote restful sleep.

“Then there’s lemon, a bright and citrusy scent, which can be used for odor control and for uplifting moods, sort of like the opposite of lavender.

“The third is frankincense, an earthy scent with a Biblical tie-in, which can help with emotional balance and spiritual awareness. A patient might be struggling with their diagnosis, and frankincense can offer some respite from those feelings.

“The fourth is peppermint, a cool and refreshing scent, which can help with multiple things. It can clear congestion, improve mental focus and help with nausea and headaches.”

Kellogg stresses that Emmanuel only uses essential oils procured from a reputable supplier, rather than diluted oils you might purchase in some retail stores. In any case, Emmanuel limits their use to only a few drops at a time that are diffused into the air, sprayed onto linens or applied sparingly to a piece of felt that can be pinned to clothing.

The reaction patients have to the oils can vary.

“Like with most things, reactions are different,” Kellogg says. “All oils are unique in their scent and utilization. It offers a person-centered approach to symptom management based on each patient’s preferences and needs.

“A lot of times, people will gravitate toward lavender oil because it helps them sleep, or puts them at ease. And others like lemon oil because it can improve energy and promote an invigorating environment.”

Since essential oils are so potent, they’re used with extreme care. Emmanuel uses protocols about how much to use in a diffuser or the correct amount to spray into the air or introduce to clothing or bedding. It takes 60 pounds of lavender to produce just one ounce of its essential oil. For the same amount of essential lemon oil, 90 lemons are required.

Though there are studies demonstrating health benefits from essential oils, Kellogg says “some patients connect with and believe in oils more than others.”

“This is just another way we offer patient’s choice in their plan of care and ways to improve their quality of life,” she adds.

Overall, they serve as a valid alternative to some medications, and represent “an important tool for us, especially for patients who hesitate to add more medications to their list.”

Essential oils are one of many complementary therapies and services Emmanuel Hospice offers that can be used alongside pharmaceutical approaches or as an alternative to enhance each patient’s life. Others include massage therapy, music therapy, pet visitors and virtual reality, to name a few.

“It’s all about how best to treat the patient and the patient’s family,” Kellogg says. “If essential oils can help, we’ll make them part of the journey.”

For more information about holistic end-of-life care, visit EmmanuelHospice.org or call 616.719.0919.