Advocate Trinity Hospital

Spring 2012Volume 3, Issue 1

Office for Mission & Spiritual Care773-967-5184TRIN-Mission-SpiritualCare

@advocatehealth.com

Advocate Trinity Hospital

President:Jon Bruss

VP of Mission & Spiritual Care:Reverend Brenda Jackson

Staff Chaplains:Reverend Gloria BrownReverend Alesia HillsmanReverend Laura Walker

Congregation Connections Program Coordinator:

Donna McGee

Administrative Assistant:Charlean Waller

Lay Ministers of Care:Rose Mary BelozElizabeth BohlingGail DewittLaJene DyerPamela IvoryOralia JacintoMaria Luisa MarquezMaria Del Rosario MarquezRosemary PetrichJohnnie ShaviersDorothy Spencer

Advocate Trinity Hospital2320 E. 93rd St.Chicago, IL 60617773-967-2000advocatehealth.com/trin

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Advocate Good Samaritan HospitalAdvocate Trinity Hospital

Office for Mission and Spiritual Care

to our faith communitiesConnections

Advocate Trinity Hospital – Community Event and Screening

Ladies’ Night Event – Go Red!

Tues., Feb. 28, 5:30 - 8 p.m.Compassion Baptist Church, 2650 E. 95th St., Chicago

Unwind with a relaxing chair massage, inspirational message, raffles, prizes and a delicious dinner. During the evening, you’ll learn about nutrition as well as heart disease and its prevention. There will be a gift bag for each registered guest. The event is free, but registration is required. Class 2W25.

Heart Risk Assessment

Available both Thurs., Feb. 23 and Tues., Feb. 28 at the following times:8:30 - 9 a.m., 9 - 9:30 a.m., 9:30 - 10 a.m. and 10:30 - 11 a.m.Advocate Trinity Hospital, 2320 E. 93rd St., Cardiac Rehab on the 5th floor

This screening evaluates your risk of developing heart disease and includes lipid profile (cholesterol), triglycerides, blood pressure, body fat analysis and blood oxygen saturation. A 12-hour fast is required before the appointment. This all is free, but registration is required. Upon arrival, let security at the front desk know you are here for the Heart Risk Assessment. Class 2C49.

Both events are free, but registration is required. Just phone 1.800.3ADVOCATE (1.800.323.8622) Monday - Friday, 8 a.m. - 6 p.m., or register on-line by clicking Register

On-line at advocatehealth.com and providing your information.

Our hearts beat as oneBecause heart health is critical, Advocate Trinity Hospital offers several opportunities each month to improve the health of your heart and to learn about taking care of it.

As I reviewed our classes, events and screenings for February, two happenings stood out – details are written below. I hope you will share this information with your congregants – and also consider writing these dates into your personal calendar. If you attend either event, you’ll be giving those you love a heart-healthy valentine.

This issue also offers extensive information about advance care planning – clearly and in a straightforward way. I hope this, too, will be of value to both you and your congregants.

Doesn’t it all tie together – encouraging those we love to take care of their hearts . . . taking care of our own hearts for ourselves and for those we love . . . lovingly planning ahead for our families?

Rev. Brenda Jackson, Vice-President Mission & Spiritual Care

Connections - Advocate Trinity Hospital Office for Mission and Spiritual Care Spring 2012 - Page 2

��������� � ������� ���������� �������������������� ��• Trinity Hospital offers a wide range of outpatient testing. • We pride ourselves on having outpatient programs which provide easy access for both physicians and patients. • Many of our programs, testing modalities and clinics offer same or next day appointments. • We even offer walk-in clinics on certain days. (For example, mammographies are available on a walk-in basis on

Thursdays.) All that is required when making an appointment is an order from your clinician and a pre-certification for certain tests or procedures. Valet parking is free for outpatient services.

Below are some of the outpatient programs as well as contact and scheduling information for them:

Outpatient Program,Department, Clinic

Program DescriptionContact and Scheduling

Information

Neurologial Services and Stroke Center Programs

EEGEMGStroke Rehab Program

773-967-1000773-967-5221773-967-5221

Cardiovascular Services

Catherization Lab Services: Emergent cardiac stenting for ST elevation heart attach (PCI), Pacemaker insertion, diagnostic angiogram, carotid angiograms, Pericardiocentesis, Cardioversions, Diagnostic Cardiac Catherization, Coronary StentsCardiac Testing: 64-slice Coronary CTA, Stress Testing, Holter Monitoring, Pharmacological Stress Testing, Bio-impedance Cardiography, Transesophageal Echocardiogram, Echocardiograms and Stress Echoes (Treadmill and Dobutamine), Cardiac Nuclear Medicine

773-967-1000773-967-5427

Peripheral Arterial Disease Services and Vascular Testing

Peripheral Stenting, Peripheral Vascular Testing, ABI, Vascular Doppler, Vascular Lab

773-967-1000773-967-5427

Cardiac RehabilitationPhase II and III outpatient program, Exercise with Your Phase II or III Spouse program

773-967-3991

Heart Risk Assessment Program

$20 Personalized Heart Risk Assessment conducted by licensed exercise physiologists and nurses includes cholesterol, LDL, HDL, triglycerides, glucose, blood pressure, body composition, weight, and lifestyle questionnaire. This assessment is free during the months of January and February.

1-800 3-ADVOCATE(1-800-323-8622)

Congestive Heart Failure ProgramsCHF Support GroupCHF Clinic

773-967-56881-877-4-AHCDOC(1-877-424-2362)

Women’s Health

Breast Imaging: Digital Screening and Diagnostic mammograms. CAD/Computer Aided Detection, a Computer over read of every screening mammogram. Ultrasound Breast exams, Stereotactic breast biopsies and vacuum assisted ultrasound breast biopsies. Needle localizations prior to surgery and sentinel node procedures.Breast Health SpecialistBreast Reconstruction

773-967-1000

773-967-5418773-967-5488

Pulmonary and Respiratory Services Pulmonary function testing 773-967-5260

Pain ClinicInterventional and pain management procedures, epidurals and kyphoplasty

773-731-0500

Advocate Health Center Southeast2301 E. 93rd StreetChicago, IL 60617

Diabetic education, primary care, pediatrics, dermatology, general surgery and obstetrics/gynecology

773-731-9898

Connections - Advocate Trinity Hospital Office for Mission and Spiritual Care Spring 2012 - Page 3

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 Trinity Hospital Office for Mission and Spiritual Care Spring 2012 - Page 4

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

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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!

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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

.