Death and Dying, Death and Dying Education, Death in Mexico, Dying in Mexico, End-of-Life Education, End-of-Life Planning, Expats, Health & Wellness

The Death Positive Movement is Alive Amongst Retiree Ex-pats at Lake Chapala, Mexico

In the course of one week of August 2018 a fellowship, a Death Cafe, and a talk group at Lake Chapala, Mexico hosted events related to considerations for end-of-life.

These events, intentionally or not, are part of the growing Death Positive movement around the world – places to share, plan, or think about what we want; to consider how we foresee our own passing; and to learn from others who openly share their experiences.

Wikipedia’s explanation of Death Positive: 

“The death positive movement is a social and philosophical movement that encourages people to speak openly about death, dying, and corpses. The movement seeks to eliminate silence around death-related topics, decrease anxiety surrounding death, and encourages more diversity in end-of-life care options available to the public.”

See https://en.wikipedia.org/wiki/Death-positive_movement

Retiree ex-pats ages 50+ from Canada, Germany, the U.S., and the UK gathered at three different venues to hear or participate in interesting, lively, or poignant discussions about mortality.

The venues:

Lake Chapala Unitarian Universalist Fellowship

On a sunny lakeside morning, the fellowship hosted an inspirational, memorable service devoted to End-of-Life.

Sandy Wallin was the service leader. The sermon, “What I Learned from Charlie,” was delivered by Lew Crippen.  Hymns related to transitions – I’ll Fly Away ( performed on a recording by the Humbard family), plus One More Step, and Spirit of Life. The postlude was Handel’s The Trumpet Shall Sound.

Crippen’s sharing was an endearing, sometimes funny, but definitely moving tale about how witnessing the dying of his beloved rescue cat taught him more about love and life.

Lew Crippen, Unitarian Universalist, Lake Chapala, Mexico

Service poetry included Mending Walls by Robert Frost, and the surprisingly amusing Let Me Die a Young Man’s Death (Roger McGough), beautifully read by Wallin.

Note: The tenets of the Universalist Unitarians have much in common with palliative care and hospice – “to honor the inherent worth and dignity of every person,” plus “justice, equity, and compassion in human relations.”

See http://lakechapalauu.org/

Cafe Mortality Ajijic aka Death Cafe Ajijic

A group of American, Canadian, and German retirees and others recently gathered for the third Café Mortality Ajijic in Mexico August 2018. Thirty persons sat in an engaged way at  six round tables and one rectangle table (added at the last minute) at Min Wah Restaurant. Conversation was uncommonly lively. Participants included a hospice chaplain (a new café volunteer), a hospice nurse, a hospice volunteer (a new café volunteer), three psychologists, a psychiatrist, one professor, one journalist, and others.

Currently, there are three co-hosts sharing the duties – Debi Buckland, Wendy Jane Carrel, and Loretta Downs, each with 20+ years devoted to some or all aspects of end-of-life care, planning, and transitions. Each Cafe Mortality is introduced by one of the hosts. The August café was heralded by Loretta Downs who flew in from Chicago to lead.

Jade Young and Laura Petit, observers and volunteers at Cafe Mortality Ajijic, August 2018

In the last few minutes, a representative from each table stood up to share with attendees interests and concerns discussed – how to die peacefully at home in Mexico, how to take one’s life legally in Mexico, how to die on your own terms in Mexico (have your wishes honored), and what happens in the afterlife.

These all-volunteer social gatherings which discuss death and dying respectfully and informally (no agenda) are now held in 52 countries. See http://deathcafe.com/  

A review of the first Death Café Ajijic, held in February 2018, may be found at the following link:

https://wellnessshepherd.com/2018/02/25/death-cafe-ajijic-mexico-ex-pats-and-snowbirds-talk-gently-about-mortality/

The next Cafe Mortality is scheduled for October 9, 2018.  Please RSVP to wellnessshepherd@aol.com if you wish to attend. Note: the venue may change.

Open Circle Ajijic

David Acuff, PhD, talk show host, and author of 15 books, spoke to over 300 attendees at Open Circle Ajijic on Creation of the Afterlife: Perspectives of Different Cultures. He brought forth views from Native Americans, Australian aborigines, Judeo-Christians, Buddhists, and Hindus about what happens when we die. He interspersed his presentation with audience breaks asking those present to find a partner to ask questions with such as…Where are we going after our demise? As at Café Mortality, the audience was fully engaged with the subject, voices were animated and lively.

David Acuff, PhD speaks about the After Life at Open Circle Ajijic

In closing, Acuff offered a new view of afterlife suggested from findings at tombs of the Nazca mummies in Peru. Perhaps, he shared, there is evidence we are not alone in the world. According to DNA research in the spring of this year, mummies from 300 A.D. and 1400 A.D. had three fingers on each hand and were not homo sapiens.

Maybe we do go somewhere else, time travel, or reincarnate… all food for thought.

https://www.news.com.au/technology/science/archaeology/threefingered-mummies-found-in-peru-are-not-human-says-scientist-and-may-be-aliens/news-story/d27160119d077bf407b03c6562e15712

Open Circle’s mission is “to improve understanding of our community and our world.”  The web site is http://opencircleajijic.org/

 

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Hospice Physician Karen Wyatt
Death and Dying, Death and Dying Education, End-of-Life Care, End-of-Life Education, End-of-Life Planning, Health & Wellness, Hospice, Palliative Care

Death & Dying Education – A Chat with End-of-Life University’s Karen Wyatt, MD

Award-winning author, podcast host, and hospice physician Karen Wyatt connects healthcare professionals and the public with information about healing options for the dying through End of Life University, which she founded in 2013.

Backstory:

For three years+ I have been dedicated to a palliative care/hospice mission for Mexico. Even though I am back and forth to California, I am continually on the look-out for how care and support for patients and families is being provided on a national and global basis.

What interests me are differences place to place as they relate to education for providers, physicians, patients, and families – what’s missing, what’s working, what options and perceptions about dying are offered. 

This is where Colorado-based hospice physician and thought leader Karen Wyatt comes in. She brings my quest to my computer in an open and engaging way through her END OF LIFE UNIVERSITY web site podcasts. Colleagues share experiences, feelings, information and wisdom about how they are advancing best practices for end-of-life.

Dr. Wyatt’s approach to death and dying is holistic, with a special emphasis on sacred and spiritual aspects of our transitions. 

The goal of her effort is a national dialogue for “creative healing… opening the heart of Western medicine.”  The podcasts, connections, and resources are a welcome gift not only for healthcare professionals but the public as well.  See www.EOLUniversity.com.

In conjunction with the university, Dr. Wyatt launched an on-line book club in January 2018, The Year of Reading Dangerously, where she introduces one book per month about an aspect of end-of-life, and, interviews the book’s authors live on-line. Participants type in questions on-line or ask via the phone line they are listening on.

 

Hospice Physician Karen Wyatt
Karen Wyatt, MD, Founder of End-of-Life University

Interview with Dr. Wyatt

Please share with us about your personal history, and, what led to your work in end-of-life care.

I trained to be a family doctor. I had no knowledge of death and dying or hospice.

Three years after my residency, my father died by suicide. His sudden death upended my world. I felt guilty. I had training in psychiatry and couldn’t save my dad. I floundered for a long, long time trying to get through the grief. Three years after his death, I still felt very lost. I was wondering if I would ever smile or feel joy again. Suddenly a voice said, “call hospice.”  It was my voice, and I have no idea where the message came from.

I didn’t even know if there was a hospice in the Utah community I lived in. I searched “hospice” and found one. I called and asked if they needed a volunteer. When they discovered I am a doctor they enthusiastically exclaimed “oh my goodness!” The Hospice Director, stunned, continued to ask “what made you call us now?” I just had an inspiration, I replied. The Director continued, “Our medical director resigned 30 minutes ago and now you’ve called us.” Just like that I became a hospice medical director. I was guided to this place, and I knew it for sure when I met the team.

What inspired the creation of End-of-Life University?  What led you to gather fellow end-of-life colleagues to share what they know with each other and the public? 

Years in hospice have brought me profound spiritual experiences. I have learned many lessons about how to live my own life. Hospice has helped me live a life of appreciation and that brought me to the decision to write a book.  Many patients had asked if I could tell their stories one day. I made a promise to do so.

 

End-of-Life Book
by Karen M. Wyatt, MD

Writing a book was a long process and is what probably inspired the eventual creation of EOL University. I began the book in 1999 and finished in 2010. I felt I must live the lessons of the book in order for it to be complete. The book was published in 2012 and it was then I realized for the first time that the population, in general, was resistant to talking about death and dying. It seemed people were not ready or open; it was the last thing they wanted to talk about. It was then I knew I wished to do something to change this, something different needed to happen.

Brainstorming led to the question, what else may I be involved with other than a blog or writing? (At the time, Wyatt was posting occasional articles on Huffington Post and in local newspapers). The year was 2013 and I began listening to on-line interviews on other subjects and realized no one was doing this on-line for death and dying. I started the research to find people to interview. It was fun, I loved it (and still do). I was learning so much and wished to keep it going. That was five years ago. I am grateful to the Internet and social media as networks for good.

What response did you receive when you first began End-of-Life University?

End-of-Life University is always a work-in-progress, unfolding. In the beginning I felt no one was listening to the interviews, and that no one cared. The interest grew slowly over time. I learned consistency is important, showing up regularly.  I followed the top web sites in Google search. I recognized ranking makes a difference. Over the years EOL University has gone from 200 to 4,000 subscribers. There is a lot of patience on my part.

I knew I was in it for the long haul, and it was the right thing to do whether I received validation for it or not. In the last couple years, whenever I’ve been at a conference, I kept meeting people who have been listening to the podcasts.  Some would say, “every week, your interviews got me through two terrible years when my mother died, or “I’m interested in working in end of life because of your podcasts.”  One of most important things I learned is that your heart tells you to continue, even if there are signs showing otherwise.  You don’t know the impact you are making, but someday you may find out. Always trust your heart. 

How did the concept of creating the book club with its engaging title, the Year of Reading Dangerously, take hold?

 I felt it would be important. There are so many books, and books are another wonderful way people can learn about death and dying. The goal is to reach people.  The concept of reading and discussing a different book each month had been with me for a while. So late one night I posted the book club on Facebook to see if there might be any interest. I was imagining maybe 20 persons might respond, and if so, that would be great. Well 150 had signed up! Now over 1,000 have signed up.  It’s never too late to join. The response has been so positive I am thinking about continuing the book club in 2019.

What I like most about the club are diverse points of view, completely different voices with unique perspectives discussing end-of-life. I owned some of the books and hadn’t read them yet. Some of the authors I had invited to talk about their books suggested others. Katy Butler, author of Knocking on Heaven’s Door: The Path to a Better Way of Death, suggested Megory Anderson’s book Sacred Dying: Creating Rituals for Embracing the End of Life. Ken Wilbur is a friend and I felt his story Grace and Grit would be compelling.

I find a lot of our listeners are going through their own personal struggles related to death and dying. It seems energetically powerful and perhaps healing if people around the world are reading the same books. There is something enormously attractive about bringing people a shared body of useful knowledge.

See https://www.eoluniversity.com/yearofreading

Dr. Wyatt has retired from her medical practice. Her focus is end-of-life education. She enjoys speaking to audiences across the U.S. and has discovered that “threads” connecting those who do this work remain strong. “Death has called us in and somehow we end up sharing our experiences with others,” she says.

The “death positive” movement has taken off in recent years. Dr. Wyatt’s End-of-Life University and her podcasts seem to be at the right place at the right time.

It was almost 20 years ago when Bill Moyers’ PBS series ON OUR OWN TERMS showed that those of us who tend to the dying wish “to assure patients they can have a ‘good death’ one that fits them, their families, and their culture.”  This is Dr. Wyatt’s mission as well. More people are now receiving the message.

 

Thought: What do you wish for your end-of-life?

Links where you can learn more or support the non-profit, all volunteer End-of-Life University:

www.karenwyattmd.com

www.eolu.com

www.patreon.com/eolu    donations to non-profit End-of-Life University

https://www.amazon.com/What-Really-Matters-Lessons-Stories/dp/0982685548/  link to Dr. Wyatt’s award-winning book

Aging, Death and Dying, End-of-Life Care, End-of-Life Planning, Health & Wellness, Living Abroad, Mexico, Retirement

Death Café Ajijic, Mexico; Ex-Pats and Snowbirds Talk Gently about Mortality

A group of American, Canadian, and UK ex-pats and “snowbirds” recently gathered for the first Death Café Ajijic, Mexico. There were 18 persons present at Café El Grano including an anesthesiologist, a hospice nurse, a hospice social worker, a psychiatrist, teachers, and others. There were two facilitators who work with end-of-life planning and transitions.

If the term Death Café (excuse the brash wording, I prefer Sacred Conversation or The Conversation) is new to you, you may hear it more and more.  Death Cafes or Café Mortels began with Swiss sociologist Bernard Crettaz who held over 100 such meetings in his native country until recently. In 2011, Jon Underwood, inspired by Crettaz, created Death Cafes in England (see history at http://deathcafe.com/what/  ).

These all-volunteer social events to discuss death and dying respectfully and informally (no agenda) are now held in 52 countries including Australia, Europe, Canada, the U.S., and parts of Latin America where death has sometimes, but not always, been a foreboding and scary subject.  Buddhist, Hindu, or Muslim countries, and places with indigenous populations tend to consider death a natural part of life and honor it as such more easily. Most café organizers work with end-of-life, and tend to focus on alternative, kinder, spiritual ways of departing. Note: There is a Death Café in Singapore.

“At a Death Café… our aim is to increase awareness of death to help people make the most of their (finite) lives,” states the Café web site. Most of all, the Café encourages an exchange of stories and perspectives as a way to embrace death.

What prompted a Death Café in Ajijic?

First, a number of retired ex-pats and visitors die in Mexico unexpectedly, and, they die without a health care directive and/or an end-of-life plan. There is a need for continued conversation and education.

Second, Loretta Downs, MA, has been speaking to locals at a popular venue, Open Circle (as well as at In the Heart of Awareness, the Buddhist center), about end-of-life for several years.  She flies in from Chicago every January to deliver her talks. About 300 + persons show up to listen as she encourages her audiences to become friendly with the idea of mortality and to prepare for it – think about it, and express to others what you want.  See http://www.endoflifeinspirations.com.

DSCN2635
Wendy Jane Carrel and Loretta Downs, End-of-Life Guides, Planners, and Educators; Co-Hosts of Death Cafe Ajijic 2018

Third, yours truly, Wendy Jane Carrel, MA, has been speaking to ex-pats around Ecuador for three years and subsequently in Mexico with the same passionate message – make friends with your demise, please make a plan.

It seemed natural for Loretta and I to team up to host a Café for Lake Chapala.

My interests had been reinforced as a result of volunteering two years at Juntos Contra el Dolor, the only 24/7 palliative care hospital and hospice in the state of Jalisco, a model for Mexico. I was given the gift of observing how painful chronic and terminal illnesses are treated, the politics of medicine, the politics of opioids, cultural difficulties related to dying, family constellations, and the difficulties of running a non-profit in a rich country (yes, rich in many resources) with little tradition of philanthropy. Most of all, I learned the concept of a “good death” requires much education and outreach in Mexico as well as at home.

Loretta’s friend Nancy Gershman, who produces Death Café NYC, gave us welcome pointers before the Ajijic meeting. We followed Nancy’s advice – small tables of 3-4 for intimate conversation, one of us (Loretta) to circulate and ensure participant exchanges were flowing, see that anyone who was recently grieving the loss of a loved one was comfortable, followed-up by an evaluation to learn what we could do better the next time.  https://www.meetup.com/Death-Cafe-New-York-City/

Cafe El Grano, nice partitions for intimate conversation
Cafe El Grano, Ajijic, Mexico – nice partitions and small tables for intimate conversation – also a most accommodating owner 😉

Because Loretta and I travel often, she is based in Chicago, and I in LA, we may not be producing other cafes until January 2019 unless another healthcare worker can pick-up in our absence.

Note: If you have not heard of Ajijic, it’s a sleepy Lake Chapala village, with a population of around 10,000, an hour south of Guadalajara. It is a popular tourist destination. Lake Chapala is home to around 20,000 full-time retirees from north-of-the border.

The DeathCafe.com web site indicates there are 9 death cafes in Mexico. I could only find one. It is located in Mexico City. See http://deathcafe.com/deathcafe/1695/ .

I have so much more to learn. I am now eager to return home to attend hospice social worker and end-of-life guide Betsy Trapasso’s Death Café LA https://www.facebook.com/deathcafelosangeles/   or Maggie Yenoki’s gathering in Pasadena https://www.facebook.com/deathcafepasadena/

References

https://www.counterpunch.org/2018/01/12/what-happens-at-a-death-cafe/   excellent overview of a Death Café gathering in Sonoma, California by Shepherd Bliss

https://www.theguardian.com/healthcare-network/2017/mar/09/death-cafe-learn-talk-dying-patients

https://www.washingtonpost.com/news/acts-of-faith/wp/2017/07/10/the-founder-of-death-cafe-has-died-but-his-movement-to-accept-the-inevitable-end-of-life-will-live-on/

https://www.facebook.com/DEATH-Cafe-Singapore-402018853254286/  a unique look at what Death Café Singapore is paying attention to

https://www.prospectmagazine.co.uk/magazine/take-me-to-the-death-cafe

Aging, Alzheimer's, Assisted Living, Assisted Living Mexico, CCRC's in Mexico, Health & Wellness, Life Planning Communities Mexico, Living Abroad, Mexico, Mexico Senior Living, Senior Care Mexico

Guidelines for Choosing Assisted Living/Nursing Care in Mexico

Gardens at Casa de las Lunas in Puerto Vallarta with independent living, assisted living and respite care, private pay

According to realtors at Lake Chapala, Mexico, and the information desk at the Lake Chapala Society in Ajijic, the popular ex-pat retirement destination has received more than double the no. of potential renters, buyers, and information hungry folks from Canada and the U.S. than in years before. (Other popular retirement destinations are also seeing an increase in activity – see no. 3 below).

Among visitors intent on moving are travel aficionados looking for a unique cultural experience, the prospect of meeting stimulating people from all parts of the world, but more importantly, an opportunity to stretch their dollars.

And then there is senior living and healthcare, a subject of interest for most. For “sandwich-generation” boomers who lost savings and/or homes during the American recession of 2007-8, or spent savings for the education of millennial children or grandchildren, many are finding there may be little left for themselves or parents if assisted living or nursing care are ever required.

An added concern is that funding for Medicare and Medicaid in the U.S. are currently being challenged.

Alma, a non-profit home for 40 residents in San Miguel Allende

If the cost of assisted and continuing care in Canada (Canada takes care of its disabled, ill, and older adults through universal care programs but there is also private pay care) or the U.S. is not an option, there are more affordable options in other countries. The closest place to look is Mexico.

Here are guidelines for looking at assisted living and continuing care in Mexico, costing between $600 USD to $3500 USD/month, depending on the value of the American dollar and the Canadian dollar vs. the peso, the location, and the residence you choose:

  1. Take note – in Mexico the terms assisted living and “nursing home” are often one and the same, with exceptions. Care facilities are not known as they are north of the border – assisted living, rehabilitation, nursing home, and hospice. It is often an all-in-one approach. Also, with some exceptions, homes mix physically disabled residents with memory care residents.
  2. Select cities or areas you wish to be in for climate – coastal, desert, mountains. (Coastal tropical places cost a little more because A/C is expensive).
  3. If the future resident does not speak Spanish, seek places with ex-pat communities and English-speaking locals who are often a source of volunteers – Baja California Norte (Ensenada, Rosarito Beach, Tijuana), Cancun, Lake Chapala, Mazatlan, Mexico City, Puerto Vallarta. Or, choose smaller places such as Merida, and San Miguel Allende. Some care homes have all foreigners as residents, others locals and foreigners together. Usually one person on staff speaks English, sometimes more than one.
  4. Do the due diligence. Research places and determine costs. Most assisted living and “nursing homes” catering to foreigners have web sites in English easily found on Google Search.
  5. Consider private pay homes and non-profits, as well as residences run by nuns whether you are Catholic or not. Nuns often (but not always) provide quality care as most are nurses with a mission to serve, plus costs tend to be what Mexicans would pay if price is a consideration. Another level of care is found in government homes, some pleasant others not; some accept foreigners with residency cards. There are differences in every region of the country, and there are no rules.
  6. Note: no two places will be alike – financially, environmentally, socially, and in terms of care. Homes are not regulated with the strict standards one is accustomed to in Canada and the U.S.  However, there are places with quality care and high standards.
  7. Conduct site visits. Assess for yourself what might be an acceptable match in terms of environment and people. Would you or your loved one feel comfortable and safe? Do you like the space, the staff?  How are you welcomed? Do residents seem cared for or are they alone in “God’s waiting room” without attention and activities? Ask residents what they like best and what they don’t like. How clean is the home? Standards differ from place to place. Arrive at meal time… is there enough assistance for each resident? Is food fresh, nutritious, and nicely presented? Is it food you would or could eat? Does the home prepare meals compatible with health challenges? What about care plans and medication management? What about emergencies? How are these matters handled?
Patio at a private pay “nursing” home, Casa Nostra, at Lake Chapala

 

Casa de los Abuelos DIF (government) home for seniors, Morelia – these homes are intended for Mexican nationals but on occasion persons with residency visas who pay are accepted, depends on the place and availability

There are no simple answers for selection.

Ideally, we would all have perfect health to our last days and an abundance of funds which would allow us to receive the best possible care wherever we choose to live.

Note: CCRC’s (Continuing Care Retirement Communities, from independent living to demise), now referred to as Life Plan Communities, have not arrived in Mexico, with one exception. There are plans in the works for Life Plan Communities in Baja California, Cancun, and at Lake Chapala from American, Canadian, Mexican, and Spanish developers.

References:

https://www.youtube.com/watch?time_continue=2&v=6lYA7c1Pnuo   Ajijic, Mexico video 2017

http://www.pbs.org/newshour/bb/foreign-retirees-flocking-mexico/

https://www.seniorhousingforum.net/blog/2016/8/3/will-mexico-solve-senior-living-affordability-problem

Health & Wellness

International Coffee Day, September 30, 2017 – Is Coffee Good for Your Health?

I am neither a scientist, nor a physician. I am not a coffee expert.

What interests me (and probably you) is whether or not coffee is good for our health.

For a few years I stopped drinking coffee. I had read in a journal that coffee might create brittle bones. It may or may not be true. So for a while I drank alkalized water, and green tea, probably healthful alternatives.

But in recent years, traveling back and forth to Italy and around Latin America, I started drinking “macchiatos” or “cortados”. In San Francisco and Los Angeles I’ve been enticed by “Gibraltars”. Each of these treats are basically espressos with a little milk, miniature cappuccinos if you will. No sugar ever, no sweeteners of any kind. (Forgive me baristas, I do know there are subtle differences in the way you make each of the above coffees).

“Everything in moderation” was the mantra I kept in mind, and so I’ve continued.

On International Coffee Day I treated myself to an Illy Caffe from Italy – not organic, and not my favorite coffee. I still like Yemeni coffee best. But the Illy was wow!! The coffee cup and saucer in the photo below are part of a set gifted to me by sweet Norwegian neighbors, coffee lovers.

 

 

I did find an article about the possible carcinogenic effects of coffee roasting because of chemicals used. I’m assuming water processed coffee is still healthful. But I do not know. Nonetheless, there is legislation under consideration in the State of California to add warning labels to coffee bags and tins about possible carcinogenic effects from drinking coffee.

Here’s the article…

http://www.nydailynews.com/news/national/coffee-sold-california-carry-cancer-warning-labels-article-1.3520283

On the other hand, several articles speak to benefits – mainly increasing longevity, reducing the risk of stroke, reducing inflammation, boosting short term memory, helping headaches recede, and much more.

As I work in the areas of health and wellness with a focus on senior care, I’ve started to conclude that coffee, for those who enjoy it, and whose doctors have said it is okay to consume, might serve older adults well.

Articles about health benefits of coffee:

http://time.com/4962159/coffee-benefits-national-coffee-day/

https://www.caffeineinformer.com/7-good-reasons-to-drink-coffee

https://www.healthline.com/nutrition/top-13-evidence-based-health-benefits-of-coffee#section3

http://www.onemedical.com/blog/newsworthy/10-healthy-reasons-to-drink-coffee-2/

http://www.mercola.com/infographics/coffee-benefits.htm

http://time.com/4962159/coffee-benefits-national-coffee-day/

https://www.caffeineinformer.com/7-good-reasons-to-drink-coffee

https://www.healthline.com/nutrition/top-13-evidence-based-health-benefits-of-coffee#section3

http://www.onemedical.com/blog/newsworthy/10-healthy-reasons-to-drink-coffee-2/

http://www.mercola.com/infographics/coffee-benefits.htm 

http://www.cnn.com/2017/09/29/health/coffee-healthy-food-drayer/index.html

 

International Coffee Day web site is http://www.internationalcoffeeday.org

The International Coffee Organization is located in London, England and its web site is http://www.ico.org  .

 

Expats, Health & Wellness, Mexico

Alternative Healing Pop-Up Clinic at Lake Chapala Teams Americans, Canadians, and Mexicans

On Saturday, August 19, 2017, social worker/psychotherapist Toni Rahman, originally from Missouri, produced a Pop-Up Clinic to introduce alternative healing practitioners to each other at a Lake Chapala, Mexico refuge.

After a sage “cleansing” and blessing by Toltec shamanic student and host Craig Shanholtzer, nine persons introduced themselves and the work they do. An additional seven friends who support healing solutions came to learn and experience what the nine offer, and, to help get the word out to the community-at-large about resources at the lake.

It was a beautiful day spent on an inviting porch, in a splendid garden, or in quiet rooms either giving or receiving. “Magical”, “relaxing”, “wonderful” are the comments I heard.

 

Lake Chapala Pop-Up Clinic patio where participants were welcomed and got to know each other

 

Lake Chapala Pop-Up Clinic Healing Garden

 

Some healing arts folks who were present:

Toni Rahman, producer of the Lake Chapala Pop-Up Healing Clinic

Toni Rahman – psychotherapist, EMDR practitioner, angel card reader, and author of the newly released Being in My Body     http://www.ToniRahman.com

Kim Campbell – Canadian massage therapist with training in osteopathy

Doris Diaz, Kundalini yoga instructor

Doris Diaz – Kundalini yoga instructor, originally from Venezuela and Guadalajara, now a resident at the lake

Dara Eden, Reiki practitioner (far right)

Dara Eden – Usui Reiki Master Teacher/Intuitive Energy Healer, originally from California via one year in Vilcabamba, Ecuador    www.InnerChiMastery.com

Mahadevi – Thai massage therapist, ayurvedic consultations, from Colombia

Aracely Marquez – Mexican SCIO therapist (could not attend but will attend future Pop-Up Clinics)

Sophia Rose –  holistic therapist and coach, intuitive consultant, clinical hypnotherapist, and EFT practitioner from San Diego  www.catalystresource.com

Cynthia Rothchild – tantra teacher, watsu therapist, cosmic breathing teacher originally from Ohio  www.cincoelementosajijic.com

Earl Schenck, hands on healing and IET (Integrated Energy Therapy) practitioner for over 20 years

The next Lake Chapala Pop-Up Healing Clinic is scheduled for Saturday, September 23. The time and place will be announced on bulletin boards and in periodicals around Lake Chapala as well as on the sana-clinica.com web site sited below.

For more photos from the event click on this link:

http://sana-clinica.com/pop-up-clinic-ajijic-mexico/

Namaste mucho from Lake Chapala

Aging, Death and Dying, End-of-Life Care, Health & Wellness, Hospice, Palliative Care

Add Do Not Hospitalize to Your Advance Healthcare Directive or Five Wishes?

Can you have control over your end-of-life care? Is it possible to avoid aggressive medical treatment if you do not want it?

According to a Dartmouth Atlas study, 80% of terminally ill patients in the U.S. say they don’t want intensive treatments. 

My interpretation: Patients, whether terminally ill or not, are asking for comfort, quality of life for their last days, and relief from pain (palliative care).

The "End-of-Life Conveyor Belt": Dying patients are kept alive by machines, alone in a cold and sterile environment, their arms strapped down to the bed so that their catheters aren't dislodged. Photo: Getty Images, Jan Halaska / This content is subject to copyright.

Photo: Getty Images, Jan Halaska

“The ‘End-of-Life Conveyor Belt’ where dying patients are kept alive by machines, alone in a cold and sterile environment, their arms strapped down to the bed so that their catheters aren’t dislodged.”

The photo and statement above are from an article by Jessica Zitter, MD, for the Houston Chronicle.  She says, “my patients need to understand their options and make their own decisions.”

 

In order to make one’s own decisions in the U.S., such as avoiding hospitalization and invasive treatment, one must create an Advance Healthcare Directive or Five Wishes (an alternative advance directive recognized in 42 states and the District of Columbia). You must declare your specific medical wishes BEFORE such events might occur.

Your wishes must be notarized. Then they are legal. Be aware they may not always be honored by ambulance services or doctors in hospitals. Ideally, you will have an advocate who is your healthcare proxy or surrogate for healthcare decisions – usually a loved one with a copy of your wishes in hand.

It is also wise to prepare a POLST Physician’s Order for Life Sustaining Treatment (California) or MOLST Medical Order for Life Sustaining Treatment(New York). This way your wishes will be registered on an electronic record should you land in a hospital.

What is usually included in a healthcare directive?

It is common to include a DNR (Do Not Resuscitate), DNI (Do Not Intubate), or DND (Do Not Donate) organs or your body. These are personal choices – saving and prolonging life at all costs or not, tubes or not, donating or not. It is also common to designate a healthcare proxy or surrogate for healthcare decisions as mentioned above, someone you trust to make decisions in the event you cannot.

A recent article on Huffington Post reported on a request some folks are now including, a DNH (Do Not Hospitalize). See link below for entire article.

http://www.huffingtonpost.com.mx/entry/do-not-hospitalize-orders_us_59666c35e4b0a0c6f1e54ed9

I am currently in Mexico exploring senior care, palliative care, and end-of-life issues. The Do Not Hospitalize order got me thinking, even though I am in good health. So last week I updated my Mexican healthcare wishes because American and Canadian Advance Healthcare Directives are not recognized or honored if something happens in Mexico (or most of Latin America where Napoleonic code prevails, and not common law). I have a similar document for Ecuador. When anywhere outside the U.S. I carry a copy of my Five Wishes anyway.

Note: I am grateful to hospitals, one saved my life as I was not expected to survive my birth. In certain cases, such as extreme bleeding or falls, there may be no other option than a hospital. It would be wise to specify exceptions for hospitalization in your document if you decide to mention the preference. In my experience, most people in frail health want to be kept comfortable with palliative care at home, especially for their last days. In this circumstance, caregivers must know not to take you to a hospital.

Additional note: If you are traveling in Latin America, do not have health insurance with worldwide coverage, and are able to state your wishes cogently, and need hospital care, go to a public hospital. If you are accepted at a private hospital you will not be able to walk out the door unless every peso is paid.

An estimated 62% of Americans do not have an Advance Healthcare Directive.

I urge you to create your healthcare wishes if you haven’t already. I advise carrying a copy when traveling by air, train, or sea. Keep a copy handy in the glove compartment of your car … in case of emergency and for peace of mind.

References:

https://www.agingwithdignity.org/   where you can order a Five Wishes form in English or several other languages

http://capolst.org/   California Physician’s Order for Life Sustaining Treatment. You can download the pink form, fill it out, submit to your physician, who will in turn enter it into a statewide electronic system

http://www.dartmouthatlas.org/data/topic/topic.aspx?cat=18

http://www.houstonchronicle.com/local/gray-matters/article/What-Ted-Cruz-doesn-t-get-about-dying-with-dignity-10985879.php?cmpid=fb-premium

https://en.wikipedia.org/wiki/Advance_healthcare_directive

http://www.npr.org/2017/08/09/542390784/a-physician-explores-a-better-path-to-the-end-of-life   NPR/Terri Gross interview with Jessica Zitter, MD, a palliative care specialist

https://www.iadvanceseniorcare.com/article/memory-care/advance-directive-struggle-alzheimers-resident?utm_campaign=Vertical%20-%20Memory%20Care&utm_source=hs_email&utm_medium=email&utm_content=55520297&_hsenc=p2ANqtz-_ZuLjuUATBQhAi_dTeVehajW7RuvMRO7pZriRKLrolsP_2zJWe7N3QKGPp2sAzxtLBK5GEqz075MHAwzmHqrY33xvXzQ&_hsmi=55520297    an article which speaks to the complexity of advance healthcare directives