A Living Will, also known as a Healthcare Directive or Advanced Health Care Directive, is a legal document used to specify the healthcare or life support you would like to receive under certain conditions. If you are admitted to the hospital you will probably be asked if you have a living will. It is different from a Last Will and Testament, and does not take the place of one.

Because humans fear death, we try to prevent our own demise even when it is inevitableeven when it is in the soul’s best interest to leave this earth plane. With life saving equipment and mechanical life support, it is possible to thwart the natural process of death and suspend life. Few people realize that this process may actually tether a spirit to the body and keep the loved one’s soul from moving on to the next adventure in the Afterlife.

I completed my book about death and dying, and was going to print about the time the media began pumping out news regarding the passing of Pope John Paul II and Terri Schiavo’s suffering. The Pope requested to not be placed on life support, while Terri’s family refused to allow her to be taken off. Both their stories touched a place in my heart because I’ve experienced similar circumstances first-hand.

My grandfather refused life support or measures to resuscitate when he was dying of emphysema. While he struggled to breathe, we knew there was nothing his doctor could do to give him back his health. He felt his spirit was ready to depart, so my family honored his wishes and stood by him as he drew his last breath.

Like Terri, my uncle’s soul was a hospital hostagehis torture lasting for one year. While his body was on life support, his spirit came to me, asking for my assistance to help our family understand that he wanted to leave the earth plane. The healthcare directive he had in place allowed his wife and doctor to make medical decisions regarding resuscitation and life support, so there was legally nothing I could do. Besides, how could I tell my aunt that I had talked to my uncle’s spirit and that he wanted to leave? How could I tell her that he had changed his mind about his code status and wanted to be taken off life support? His final days were spent in coma and his spirit again came to methis time to ask me to sing and play a particular song for his funeral. I agreed and wished him well in the Afterlife. Fortunately, on the fifth day of his coma, my aunt finally allowed him to be unplugged from life support. I was not surprised when I got the call and was told that my aunt wanted me to provide music for the ceremony. I did not know my uncle well enough to know his tastes in music, so I was surprised when the song my aunt asked me to use was the same one my uncle had given me in my meditation.
I don’t blame my aunt for her decision; she was simply exercising her legal right provided by my uncle’s living will. She was not ready to let him go. I’m not sure if she could have pulled the plug before the fifth day or not, but this decision is something she should not have been burdened with. No one else wants to decide the fate of another human being, especially someone they love! My uncle’s preference not to be on life support for more than “X” number of days could have been clearly stated in his living will.

While life support is a wonderful tool for helping someone remain alive while the body heals enough to return to a meaningful life, the practice of keeping people artificially alive is overused and many doctors are afraid to tell the patient’s family that there is nothing more that medical science can do for their loved one. Many doctors are simply not trained to assist families with the emotional and legal issues about the dying process. Therefore, I encourage you to make a living will NOW and ask someone to facilitate who is able to carry out your desires even under emotional pressure. This will help you avoid being put through the misery (yes, it is painful to be on a ventilator!) of being on life support if your wishes are otherwise. It will also remove the burden of choice from family members who are grieving and possibly emotionally unable to make decisions.

It’s time to take responsibility for your end of life choices. On my website, there is a FREE pdf of a Healthcare Directive (living will) that may be printed, signed, witnessed, and used to legally establish your desires regarding life-sustaining procedures and end of life decisions.

Yvonne Perry is a metaphysical freelance writer, author and keynote speaker with a gift for assisting people who are afraid of dying or are grieving the death of a loved one. Get a complimentary copy of Yvonne’s E-book More Than Meets the Eye: True Stories about Death, Dying, and Afterlife, and download pdf of a legal healthcare directive at http://www.yvonneperry.net/books.htm.

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Quality Care Options is an established company advocating for the right of all seniors to receive excellent service and product. The organization recommends Certified Senior Approved Services to its elderly clientele.

Through its highly visible web sites and monthly ezines, Quality Care Options (QCO) attracts both the senior and the businesses that serve the senior population.

Barbara Mascio, Founder of QCO, has been inundated with requests from healthcare businesses for recommendations towards resources that would further promote an elder or healthcare related business.

These requests include; ‘Who should I call for the best liability insurance coverage?’ ‘Who do you recommend as a resource for market analysis?’ ‘How do I start an elder care business?’ and even ‘Who can handle our maintenance and lawn care?’

“Every business serving our senior population needs resources towards recruitment, security checks, lead generation and advice on marketing how-to’s and so we’ve provided a very affordable method for businesses offering these products, services and resources to reach our web site visitors”, states Barbara.

Not all advertising will be accepted. You must first submit your banner or text by following the guidelines found on http://www.qualityeldercare.com/advertising

Speakers and professional networking groups are offered special low rates of just $10 per month for an ad with a hyperlink to their web. Businesses to Business advertising can be purchased for as little as $20 a month. “We’re not trying to make a living from advertising revenue, that’s not what this is all about, states Barbara. We simply want to cover the administrative costs and provide our web visitors the resources they need to further grow their business.”

For businesses marketing directly to the senior citizen, please see http://www.qualityeldercare.com/providers to review how to apply for Senior Approved Certification as no advertising is accepted for this segment of our business.

Advertising on the Internet can be a crapshoot. You should do your homework before spending any amount of money. Does the web site have enough unique visitors each day interested in the service you offer? One site to check traffic stats on line is http://www.alexa.com Simply enter the url address of any web site to review certified traffic results. Obviously, you want a site to have higher web traffic than your own, or at the very least, equal to your traffic.

Barbara Mascio is the founder of http://www.qualityeldercare.com and of http://www.seniorsapprove.com

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Over the last couple years, we have been working with Healthcare organizations to adapt Lean to their complex processes in laboratory and hospital environments. Predictably, there was much skepticism from Clinicians and administrators alike - and rightly so. They were perfectly justified in asking - ‘how does a thinking that grew mainly out of the automotive industry apply to the healthcare environment?’

The answer is, ‘it applies perfectly’.

But giving an answer like that does not (and should not) convince all healthcare providers to blindly accept Lean and charge forward in the process transformation.

It took a few very courageous and visionary leaders to step forward and attempt applications within their environments - even if they were still a little (or a lot) skeptical.

Within a matter of a few weeks, the skepticism faded and the results began to appear. It works! And who would have believed that in a scientific profession there would be such a vast amount of opportunity to remove ‘non-value’ or waste.

The ‘non-value’ activities were not the people trying to do something wrong. In fact, the people were just working at trying to provide the best service, both in quality and turnaround time. The barrier was the existing ’system’. It forced them to do things, which actually hindered them from providing their clients with the best service.

Once we applied Lean, and removed the non-value added activities, they found they were able to respond and serve their clients faster and better. In fact, they could respond to more clients while using the same number of people and equipment. The result was higher satisfaction for the patients/clients and for the staff while lowering their costs to provide the service.

While none of these healthcare cases have achieved perfection - their staff have moved closer to it and they have discovered a structured and practical method for attaining the level of service they and their clients desire and expect.

Here are some recent examples of typical results:

MRI processing time
20% increase in patients per day

Elimination of entire processing areas
Processing done in one lab instead of two without any new equipment expenditures.

Waiting Times
Found that techs in x-ray areas were waiting for up to 30% of their time, now they can use their time more efficiently and service the patient faster.

Overtime
Eliminated overtime by reducing the batch sizes and creating flow.

Lead-Time
Reduced lead-time for test results from 8 hours to 2-3 hours by decreasing batches and eliminating waste.

Motion
Delivery personnel were spending most of their time walking (up to 50%) to deliver specimens. A new schedule significantly reduced motion waste.

Equipment Uptime
Improved equipment uptime - On average 3 pieces of equipment down per week. Now through the use of TPM, they haven’t had any down time in 8 weeks.

Space Savings
Using 5S, one lab freed up enough space to add three more needed stations without increasing existing floor space.

Processing Improvement
One area doubled their processing volume with marginal increase in staff and has sustained it for the last 6 months.

Rework Elimination
Originally 66% rework - now virtually none.

These results are proof that Lean works in Healthcare and are motivating Lean Advisors Inc. (LEAD)

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