So you’ve been to your primary care provider and they’ve told you it’s time to see a specialist. Or maybe they’re changing practices or retiring! Or maybe you’re looking at our list of recommended doctors appointments and realizing you need to make some new appointments as you get older. Whatever the case, now you’re tasked with finding a new doctor – and it might feel daunting. We’ve got some tried and true recommendations to make this task just a little easier for you.
Don’t be afraid to ask for a recommendation!
Start with the doctor you trust – who do they recommend you visit? Maybe that’s a specialist within a greater healthcare system (Vanderbilt, St. Thomas, etc.) or maybe it’s someone who has expertise in your specific diagnosis. But don’t stop there! Next, if you’re comfortable, reach out to your family and friends to see if they have a provider whom they really like. Why do they like their doctor? If you trust their opinions, this might be a good resource for you.
If you’re able, consider the possibility of driving to get a good doctor. Sure, they’re on the other side of town, but if they come highly recommended and you’re only going 1-2 times a year, it might be worth the traffic!
Lastly, be sure to consider any deal breakers. This looks different for everyone, but it could include transportation factors, a specific focus in their practice, or you’re looking for a doctor of a specific gender (like a female OB/GYN). Take my example – my husband and I are child-free, so I was very pleased to find a gynecologist who doesn’t also help with childbirth. It means she is able to focus on what matters to me and isn’t away delivering a baby when my appointment time comes around.
Check out their internet presence.
Most offices these days have a website, listing their hours, providers, and even patient ratings of the physicians. Do you like what you read there? Or is there something that makes you think twice? If there are comments, take the time to read those, as they may give you a deeper understanding of the provider’s demeanor and care (rather than just a 5 star rating).
Additionally, use this website to confirm the doctor’s licensure. You can also view any disciplinary matters on your particular doctor in their Practitioner Profile on this website.
Contact the provider’s office.
The last thing you want is to show up and find they only accept a certain type of insurance coverage! Call the office and ask if they take your insurance; you can find your information on your insurance card. Keep in mind that the staff may need to look up the information, but “I don’t know” is not an acceptable answer here. If the person who answers isn’t sure, ask to speak to someone in the billing department to verify your coverage.
Don’t forget to also ask if you will need a referral to their office from your primary care provider. Some specialists will accept self-referrals, but your insurance company might think otherwise!
What about a copay?
Oftentimes, your insurance card will list a copay amount for various types of providers. If not, be sure to log in to your insurance company’s website and verify the copay, or call the number on your card to speak with a representative. Specialist visits typically have a higher copay amount than a regular PCP appointment; you will want to be prepared.
Remember: just because you see a doctor once doesn’t mean you have to continue seeing them. Just like any professional, you should find someone that you are comfortable with – which isn’t a reflection on the doctor or their skills, sometimes it’s something that you just have a gut feeling about and want to find a better fit. Feel free to tell the doctor this. If you can articulate what you want, tell them and ask if they have a recommendation. They probably know other doctors in their area!
You and your provider are a team, and by working together, you should be able to ensure you are taken care of for years to come! You have the ability to direct your healthcare and make decisions for your future; hooray for being proactive!
As a child, our parents are responsible for making sure we get our regular check ups and vaccinations, but as an adult- throw in figuring out health insurance- things get so much more complicated!
Scheduling doctor appointments is a necessary task that can come with a lot of headache and uncertainty. How often should we go? Where do you find a primary care physician????
Just like you get your car a check up before you go on a long trip, it’s important to regularly check in with appropriate medical professionals in order to prevent a bigger health crisis down the road. Which screenings do we need throughout our life and at what intervals? Let us help you relieve some of that stress by following these scheduling and screening tips!
Read on for a list of appointments you should make this year, and remember to ask if your insurance is in-network when you schedule! We’ve got a handy tool at the end of this article to help you keep track of your appointments.
Appointments for All Adults 18+
Primary care physician (PCP)
When: Annually
Who: Everyone. Seeing a PCP on a regular basis is the best way to monitor your wellness. Your PCP will be able to help you make an informed decision on what appointments you should add to your annual list.
Dentist
When: Every 6 months
Who: Everyone
Gynecologist
When: Annually or if pregnant/trying to conceive
Who: People with female reproductive systems. It is recommended that you begin annual gynecologist visits as a teenager or after you become sexually active. Regardless of sexual activity, it is recommended that your first visit be by age 21 at the latest. If you have a new sexual partner, an STI test is recommended. If you regularly have more than one sexual partner, it might be wise to have a STI and Pap test every 6 months.
Eye doctor
When: If you have healthy vision, schedule a visit once in your 20s, twice in your 30s, and once at age 40. Those with existing vision needs should follow their eye doctor’s recommendations on frequency of visits. If you develop any vision difficulty or eye problems, a check up is recommended.
Who: Everyone
Dermatologist
When: Annually
Who: Everyone, especially if you spend a lot of time in the sun, are fair-skinned, or have family history of skin cancer.
Vaccinations
When: As recommended. Your PCP should be able to help you decide when to get vaccinations or boosters. Vaccine recommendations frequently include:
Annual flu vaccine comes out around September
HPV vaccine and meningitis for young adults
Shingles
Covid 19 vaccine and appropriate boosters
Who: Everyone
It’s important to get regular appointments with your doctors so they will have a baseline for your health conditions in case things change.
Appointments for Adults ages 40 +
Gynecologist – Mammogram
When: Annually
Who: People with breasts
PCP – Rectal Exam/PSA blood test
When: Annually
Who: People with prostates
Gastroenterologist – Colonoscopy
When: Regular screenings are recommended for those between the ages of 45 and 75. If your colonoscopy shows no signs of cancer, you can typically wait 10 years before scheduling another one.
Who: Everyone
If you’re 50+, add this l screening to your list:
Lung Screening
When: Annually
Who: Adults who have smoked 1 pack of cigarettes per day for 20 years or 2 packs per day for 10 years and currently smoke, or adults who have quit smoking within the last 15 years.
If you’re 60+, add this screening to your list:
Osteoporosis Screening
When: Age 65 and up
Who: Cisgender women and People assigned female at birth
If you have a family history or risk factors of any particular diseases, talk with your PCP to decide if you need earlier, more regular, or other specific screenings. Remember, prevention is better (and cheaper) than the cure!
Extra tips:
Need a New Year’s Resolution? Schedule all of your doctor appointments before the end of January so that you can cross that task off your to-do list and feel good about prioritizing your wellness
The ACA covers 100% of preventative health care. Visit Healthcare.gov for more information.
Add travel time to your appointments in your calendar
Remember to wear short sleeves to doctors appointments so they can easily take your blood pressure
We know keeping up with all of these appointments and screenings can be overwhelming. If you’re a visual organizer like us, please use our fillable guide to make sure all of your appointments are scheduled. Hang the guide on your fridge or in your office so that you’ll never miss an appointment!
Cheers to taking care of ourselves and advocating for our health in 2023!
Assistants are nothing new. Siri, the first voice-activated assistant of its kind, was introduced in 2011. Can you believe it was that long ago? We can’t! But even before that, there were other tools, including dictation, readers, and audio books. As time has progressed, they’ve gotten more advanced, becoming even more helpful than before.
Here’s why you should consider using voice-activated assistants.
1. We’re Not Getting Any Younger
Baby boomers are moving into their 70s, 80s, and 90s. Even Gen Xers – once considered the younger generation to avoid at all costs – are now approaching their 50s and 60s. In fact, between 2015-2050, the older population is supposed to double, reaching 2.1 billion. Baby boomers and Gen Xers are facing challenges that can be handled using devices that weren’t available to them (or, at the very least, weren’t in widespread use) when they were younger. Fun fact: April, a young Gen Xer/elder millennial, didn’t get her first cell phone until she went off to college at 18 years old!
2. You Want to Stay in Your Home
You’re already living successfully in your own home. You have independence. And Alexa (or Siri, or the bot of your choosing) can help it stay that way.
If you’re concerned that your kids will want to put you in an assisted living facility, a great way to keep the ball in your court is to invest in smart devices. Why? Because you can say, “If I need anything, I can ask Alexa.” With the help of a smart device (or multiple smart devices), you can age gracefully in your own home without ever truly being “alone.”
3. Help with Your Daily Tasks
Your day-to-day routine can even be improved with the help of AI. There’s a huge cognitive burden on adults – no matter their age – that can be lifted by using these tools to help remember things. You can:
Set reminders for medication
Get reminders for doctor’s appointments
Enjoy weather and news updates
Let Siri provide activity suggestions
4. Safety for Those with Mobility Issues
Younger people with mobility issues, vision challenges, etc. can be helped by voice-activated devices as well. Since all you need is your voice and a minimal investment on the device itself, you can easily access the help you need, whether it’s to call a family member when you fall down or simply want an audible answer to a question so you don’t have to squint to read the answer!
5. It Can Help You Feel Less Alone
Need someone to talk to? Alexa’s got jokes. (April says they’re terrible, but if you love to hear corny jokes, it might be right up your alley.)
A feature that April doeslove is that her Echo Show enables her to send pictures of her dogs to her parents. It cycles through the most recently liked photos and sends them along to her family!
6. It’s Fun and Convenient to Use
Are you tired of looking for your remote? Then use Alexa! Want to listen to your favorite obscure musician from the 1920’s? Your grandkids may roll their eyes, but Alexa will be happy to put those tunes on repeat for you. Though you’ll probably start out with a voice-activated assistant for safety reasons, you’ll probably begin using it for fun after a while!
7. Protect Your Home Even if You’re Not In It
Last month, we enjoyed the time of the year when we celebrate a spunky towheaded kid who single-handedly protects his home after being left behind while his family went on Christmas vacation.
The whole disaster could have been avoided if we had voice-activated assistants in the 90s. Even if his parents didn’t use Alexa to communicate with their son, the kid would have had a much easier time tricking the would-be robbers, using Alexa to turn on the lights, turn on the music, and more from the safety of a neighbor’s house.
(Though a movie about that probably would have been less fun to watch.)
8. Worried About Privacy? Consider This
Privacy concerns are one of the top reasons people don’t implement helpful devices like Google Assistant, Cortana, or Siri. But did you know that there are some workarounds that can help with this concern?
AI assistants like Alexa, Siri, Cortana, and Google are simply tools in our toolbox. Want to hear more about the tools we use in our lives as we get older? Sign up for our newsletter for more!
As we enter into the holiday season, I’ve invited my dear friend, Gabby Daikon, to share her experience with grief after losing her mother as a young adult. I met Gabby about a year ago through her grief journals and later joined her for virtual Yoga Nidra and “bad bitch” meditations. In a year that has been unpredictable, these practices have brought me comfort, and I hope her words will be a comfort to you.
Grief is all-consuming and yet different for every individual.
For me it felt like a fog, a fog that I knew was there but I couldn’t get to the other side of it. I hear that is what Seattle is like, I guess grief is like Seattle. I have never been but I hear it is beautiful but always cloudy. I think grief is similar in that it feels constantly dreary but also has a weird comfort and connection to the true essence of life. I am sorry if you live in Seattle and that offended you. I truthfully have no idea what Seattle is like.
Grief is a journey
My grief journey has been a bumpy ride, to say the least. I have struggled tremendously, found support, struggled again, learned to surrender and the ride keeps on going. I found that my biggest mistake was pretending to be OK. I held all of the burdens of my losses inside of myself and made myself sick. Truly sick.
Ride the waves
We run and hide from any negative emotions, but the more we tense and grip, the harder they hit. Instead, float on the tides. Let your emotions move you around without crashing over you; brutally. Wade into the fears, float with them, don’t judge yourself, and usually, you can come out without drowning.
Grief-positivity
My true healing began when I learned how to surrender to the pain, the grief, and all of the parts that make this life. It is so sad that grief is such a large part of life and yet rarely spoken about. I believe that when we begin to speak about it we can all heal and find the beauty in our journey.
Yoga Nidra provides a moment of reprieve
I found Yoga Nidra at a time when I truly needed it. I felt this constant pain of anxiety because I had this undercurrent of grief that I just could not truly access. Yoga Nidra was the first time I felt at peace for 45 minutes. I am not saying it healed me completely but it gave me a moment of reprieve and sometimes when we are deep in the grief journey that is all we can ask for. A moment of reprieve.
Yoga Nidra is a guided meditation
Yoga Nidra gives us the opportunity to float with the currents. During Yoga Nidra there are no moving postures, simply lie wherever you feel comfortable and allow yourself to feel supported. It is a guided meditation – you are not left alone with your thoughts, you are supported by the meditation. During this time you may be having trouble feeling rested, Yoga Nidra is equivalent to 3 ½ hours of deep REM sleep to the body. It also helps move energy through the subconscious mind and welcome what the mind needs to welcome without the tension and anxiety attached to it.
Yoga Nidra makes you an observer of the mind, an observer of grief, being able to welcome it without having it drown you. I invite you to just take a few deep breaths, allow what comes to come, and know that you can handle it.
Grief is personal
There are scientific benefits that I can list but the truth is that grief is not some scientific formula, we just have to do what we can to get through and for me, that was writing to my Mom and other loved ones when I truly needed her and Yoga Nidra. With the loss of a key family member there is so much more loss that people don’t speak about- like; the family dynamics, your personality, a self-identity, and so much more. So if you are deep in your grief all I can offer is my truest empathy and compassion because there are no magic words, it is just hard, and sometimes we just need people to understand how hard it is.
Use the promo code GALS to get a discount on one of Gabby’s services
Looking to reduce stress and anxiety? Improve your mental clarity? If so, consider adding Yoga Nidra to your wellness routine. Use the promo code “GALS” and you can get a discount on Gabby’s services.
Ten Holiday Traditions to Consider when a loved one dies
When your family adds members, like a new baby or newlywed couple, the holidays can be more joyous than ever. Of course, the flip side of that is that when your family loses someone, the holiday season can become a painful reminder of their absence.
I am very fortunate to still have both of my parents around, and until recently, my husband did too. Doing the work that I do, I’m always cognizant that our loved ones won’t always be around. However, when my mother-in-law passed unexpectedly this year, it threw a lot of our plans into chaos.
We had holiday traditions that will be difficult to carry on, and so I’m thinking about how we can continue existing traditions while acknowledging our loss, or create new traditions that honor the time we enjoyed with her.
Here are a few options that I’ve come up with to explore this year, and as the years go on.
Go to their favorite places.
My mother-in-law, Lynn, had very eclectic tastes. She loved art museums, coffee shops, bookstores, and any place that had locally made crafts. She is the one who created my candle obsession through various gifts over the years. This year a couple of new places have opened in our neighborhood that I know she would have loved, as well as places that she and I went together that I will probably visit again.
Wear their favorite colors/styles.
Normally when we think of attending a funeral, we think of people wearing black. I’ll never forget reading Their Eyes Were Watching God by Zora Neale Hurston in high school, where the main character wears her husband’s favorite color when he dies. Although I had no clue the toll death can take at that time of my life, thought it was a lovely way to honor him and their relationship.
If you were fortunate to inherit some clothes from your loved one, the holidays may be a good time to take them out. Smell them. Do they still smell like your loved one who has died? Isn’t that wonderful to be able to smell them again?
My grandfather died while I was in law school. One of my favorite things that we did together was take walks. He took a walk every day and had a coat rack full of sweaters, coats, and flannel shirts for anyone who wanted to walk with him if the weather was cool. When he passed away, I was able to get a few of the cardigans from his hall tree. They no longer smell like him, but I can’t wear them without remembering all the walks we went on and the ways that those walks helped shape our family.
Make their favorite recipes or eat at their favorite restaurant.
My mother in law loved Chef’s Market in Goodlettsville. It’s where she chose for our rehearsal dinner, and where we got take out from almost every Christmas Eve. While we may skip Chef’s Market for the holidays this year, I’m going to suggest we start going there on her birthday each year.
Share stories about them. What was their favorite thing about the holidays?
Did they love going to the movies after opening presents? Were they a wonderful or horrible gift giver? The holidays are a wonderful opportunity to share memories that were made over the years.
Donate to their favorite nonprofit or help someone they loved.
Helping others is always a great way to think outside of yourself for a while. Maybe you set up a re-curring donation to a cause they cared about or find a few days to volunteer for an organization stuffing envelopes or making calls.
Even if you don’t have a lot of time or money, you can find a way to be helpful. If you use Amazon, you can make your purchases through their Amazon Smile website instead and they will donate a portion of your purchase to the charity of your choice. Kroger has a similar program that is tied to your Kroger Plus account.
Visit their grave, memorial, or a place they love. Don’t be afraid to talk to them. Give them an update on what has happened through the year.
I know this may seem silly to some people. But in all likelhood there were some things you shared with your deceased loved one that might not be as appreciated by anyone else. Maybe you heard a joke that you know would crack them up, or want to make sure they are caught up on the family goings-on. You can say things out loud, or just think them (like a prayer) but having a way to continue the relationship that was so important while they were living is so comforting.
Save a place for them at the table. Consider putting their picture at their place instead of a place setting.
Just because someone isn’t with us physically at the holidays, chances are that they had an impact on how you celebrate. Find physical space for your loved on in your holiday celebrations.
Read their favorite book out loud.
In Iceland there is a tradition of getting books as gifts on Christmas Eve. Then the family cozies up with their book and hot chocolate for an evening of reading. I think it’s a lovely tradition. Since Christmas Eve was the part of the holiday that we spent with my in-laws, I might suggest that we adjust this tradition to read her favorite book and drink tea instead. It’s Tolkien, so we won’t finish, but maybe we’ll put it back on the shelf until next year.
Look through photos of them and favorite memories.
Even though your loved one is no longer with you, hopefully they weren’t camera shy. Many families now create photo slide shows for memorial services, and the holidays might be a good time to pull that back up on your computer, go through the photos one by one, and talk about the events happening when the picture was taken. I bet you’ll learn a few things about your loved one, and get to share some things too!
10. Make a toast to their influence on your life, using their favorite drink.
Whether your loved one preferred champagne, eggnog, or Coca-Cola, the holidays seem like the perfect time to raise a glass in their honor. Toast to the immaterial things they left you. Did your son inherit their sense of humor? Your granddaughter has their love of science? They are a piece of you, so now is a great time to honor them.
The people we love don’t leave us when they pass away, and there’s no reason we should try to leave them behind during the most cherished parts of our lives.
For the month of November, we want to focus on caregivers. While family caregiving can be rewarding, it also takes a toll. Most family caregivers hope to add a professional service to their loved one’s support system, but figuring out how to do that is just one more thing to add to your already-full plate.
What types of care are there? Who provides these services? How much do they cost? What limits are there? How do I pick the right service for my family?
You’ve got the right questions, and Google is overwhelming. So we called in an expert. Our friend Perry Brown, President of our local Right at Home care team, was kind enough to provide us information about the types of care options available and the most common questions you may have. If you’d like to know more about Right at Home, we encourage you to check out their website here and sign up for their newsletter. If you are ready to talk to someone about in-home care, Perry and his team would be happy to help. You can reach them by phone at (615) 360-0006 or by email at info@rahnashville.net.
Let’s Look at Types of Care You May Want to Consider
When an older loved one or adult with a disability needs caring support at home, it can feel daunting to know which professional care services are best. Who can help with bathing and meals? Is a registered nurse needed for wound care? Can hospice care happen at home?
The Global Coalition on Aging and the Home Care Association of America state that almost 70% of Americans who turn age 65 will need assistance at some point to care for themselves. These senior care industry leaders also report that “already 40% of adults aged 65+ need assistance with daily living activities.” The fast-growing care needs of the country’s increasingly older population can leave care recipients and their families confused over in-home care options. The complexity of nonmedical and medical services available also may jeopardize a loved one from getting the timely and attentive care they need.
To help simplify the professional in-home care choices, Lorraine Grote Johnson, Director of Care Quality at Right at Home, a leading in-home care agency, notes that it is important to understand the differences between home care and home healthcare. Grote Johnson, a registered nurse for more than 35 years in both hospital and home settings, gives the following overview of common care services available in the home.
Home Care
In-home caregivers are the extra hand to provide personalized support to a loved one in their own familiar home surroundings. Home care can be part time, full time or live-in assistance ranging from light housekeeping and meal preparation to personal grooming and toileting. At-home caregivers can provide care services such as being a companion who helps write the grandchildren to driving the care client to medical appointments and to complete errands. Home care allows a loved one to stay safe and independent at home as long as possible. Grote Johnson points out that home care staff members are not legally allowed to take on skilled medical care such as dispensing medications and working with tube feedings. Most at-home caregiving services are covered through private pay.
Home Healthcare
Home healthcare is skilled nursing care that is prescribed and directed by a physician and supervised by a registered nurse. Home healthcare is suited for complex health issues that require a higher level of medical assistance, or when a loved one is recovering from an injury or recent illness. A professional skilled nursing team can accommodate a client’s numerous medical care situations such as monitoring vital signs, medication setup and management, dressing changes, and continence care.
“Generally, home healthcare is delivered by Medicare-certified companies and may include physical therapy, occupational therapy and speech therapy,” Grote Johnson said. “A registered nurse makes a care plan and supervises a home health aide who helps a client with activities of daily living such as bathing and dressing. The RN does supervisory visits in the home at least once every two weeks.”
Medicare and other health service providers that pay for home healthcare determine the number and length of nurse visits to the home. Private pay skilled nursing care has no limit on in-home service hours. Specialized palliative care and hospice care also fit within the realm of home healthcare.
Palliative Care
Palliative care is specialized support for people living with a serious illness or transitioning toward death. Palliative care focuses on pain relief, comfort and reduced stress for an ill loved one and balanced overall health for the patient and family members. Palliative care serves not only the dying but also those with chronic diseases such as cancer, congestive heart failure, kidney disease and Alzheimer’s. A specially trained palliative care team includes doctors, nurses, professional caregivers and other specialists who work together to improve the quality of life for the care client.
Hospice Care
Originating in Europe during the Middle Ages, hospice, which is derived from the Latin word for “hospitality,” is care that aids the critically ill and dying with medical, emotional and spiritual support. Hospice or end-of-life care is a type of palliative care, but the ailing person is no longer seeking curative treatment. The aim of hospice care is to extend comfort, peace and dignity to individuals in the dying process. Hospice programs also support a patient’s family with counseling and bereavement care. Hospice teams of doctors, nurses, social workers, chaplains and other caregivers provide care in patients’ homes or at a hospice center, hospital or in-patient care facility.
“Hospice typically serves a terminally ill person with a life expectancy of six months or less,” Grote Johnson explains. “In some cases, a hospice patient’s health improves to the point where the individual no longer needs the specialized care. Also, if a person starts to feel better, they may want to negate hospice and start receiving curative medical treatment again. At any point, a hospice client can change their mind about their care.”
Tips for Choosing At-Home Care
Because of the quickly expanding number of at-home services on the market today, Perry Brown, President Right at Home Nashville advises those in need of care and their families to consider the following tips for choosing at-home care:
Select services only from a professional, licensed agency. Make sure you see actual proof of certification and licensing for the agency.
Be certain that the caregiver who works with your loved one is insured and bonded.
Get a detailed care plan or treatment plan upfront. Ask about goals of the suggested services.
Review the caregiver’s qualifications, experience and amount of supervision on the job.
Discuss all financial costs and evaluate options for saving money on home care, including long-term care insurance, a reverse mortgage, Veterans Aid and Attendance benefits, etc. Reference Right at Home’s information on how to pay for home care.
For securing skilled nursing care and home healthcare, Grote Johnson offers additional suggestions. “Choose a company that knows and maintains federal and state regulations,” Grote Johnson advises. “Make sure the company does criminal background checks on their nurses and caregivers and verifies their licenses. Ask whether the nursing staff has gone through a thorough orientation and if they know infection control practices and what to do in emergencies. Also, make sure skilled nursing staff members have critical thinking skills and completed competency testing, and that home health nurses have the proper qualifications, because they are taking your loved one’s life into their hands in what could be life-or-death situations.”
Availability of qualified at-home services varies by locales across the country, so Brown recommends reviewing at-home agencies online, then visiting with the agencies in person. “Be sure to check references of the in-home agency candidates and their specific caregivers,” Brown explained. “Talk to others in the community who are familiar with the agencies and their reputations. In getting the best care possible for your loved one, every question and concern matters.” For additional information about choosing home care, home healthcare, palliative care or hospice care in your area, talk with local medical professionals for referrals, or contact the National Association for Home Care & Hospice, or use the U.S. Administration on Aging’s Eldercare Locator.
As we approach Halloween and Día de los Muertos, it seemed appropriate to get a little more matter-of-fact about deathcare resources. One end-of-life resource that we want to highlight is the option of engaging a “death doula” for those who are facing the end of their lives.
Our guest blogger this week is Ellen Abbott. We met Ellen in her role as Care Manager for Visionary Care Consultants but soon learned that we shared an interest in helping people through some of the most difficult transitions of life. Ellen completed her certification as a death doula in 2019, so we asked her to tell us more about what a death doula is and how they serve those at the end of their lives.
You may have heard recently about a “death doula” or an “end of life doula” and wondered who they are and what do they do? As a death doula myself, I’m happy to tell you!
What is a death doula?. We use midwives to educate and assist families to help bring babies into the world, why not have the same for those who are towards the end of their journey here?
There is a growing movement among end-of-life professionals in the United States to bring back the role of a non-medical person who stands in the gap between doctors, hospice, and the family of a dying loved one. This person guides the family and the client around the maze of the healthcare system, educates on hospice, offers practical information about death and provides emotional support around the entire process.
Who do death doulas serve?
A death doula serves the dying person as well as their loved ones. The goal of a death doula is to make sure that their client’s final wishes and needs are carried out before, during and after their death. This creates a healing and easier transition for the client and family.
When should a death doula be called?
You don’t have to have a terminal diagnosis to hire a death doula. There are some doulas who focus on helping their clients plan so that they know what they want at the end of life, and instructions on what the family needs to know to carry out those wishes. This is extremely helpful to the family and client since the topic of death and final wishes are not popular conversations in today’s world.
How do death doulas charge for their services?
Every death doula is different. Most offer free consultations and then an hourly rate of anywhere from $30-$100 an hour. Some offer packages for legacy planning along with being present for the client at the time of death. In middle Tennessee there is a Death Doula alliance, made up of local doulas that have been trained specifically for this role. They come from all backgrounds but usually from nursing, social work, counseling or clergy.
Over the last century, death has been viewed as a medical failure even though we all know one day we will die. A death doula helps to normalize these conversations and talk about these topics that no one wants to bring up. The death doula starts with the end in mind, to ease client’s fears, knowing they have a plan and someone at their side when the time comes.
After the US Supreme Court issued its decision in Dobbs on June 24, 2022, women’s equality and reproductive freedom were completely diminished by the state of Tennessee. How does the Dobbs decision impact estate planning? Here are some questions to consider:
Question: Will children born outside of my marriage have a claim to my estate?
Our opinion: Yes. Tennessee law dictates that Minors inherit from their parent’s estate.
How would a forced pregnancy affect a man who did not intend to become a parent?
We are not family law attorneys, and if you become aware of a pregnancy by a previous sexual partner, we encourage you to speak to an experienced family law attorney to discuss your options. Please keep in mind that many issues related to child support, pregnancy, and parental rights will be subject to new interpretations of the law under Dobbs.
However, there are laws in Tennessee that protect minor children from being disinherited by their parents.
For example, if a man dies, all of his minor children are able to inherit from him. While he can disinherit unknown, nonmarital adult children through his will, he cannot disinherit minors, even if he has a Will.
So let’s say a man lives in Tennessee and gets a sexual partner pregnant. If he dies while the child is a minor, the mother can petition (on behalf of the child) for a share of the estate. She will have to prove paternity but the child can be acknowledged in multiple ways. This includes communications with the father or testing the paternity via the DNA of the father or his other children.
Yes, you can be proven a father even after you are dead. It doesn’t matter if this child is born before or after the children of your current marriage or relationship- if they are under 18 when you die, they can ask the Court for a share of whatever you left behind.
Question: What is the impact of Dobbs on Estate Planning for those who expect to need fertility treatments?
Our opinion: We don’t know yet.
This is a really tricky area. My best guess is that matters related to artificial reproductive technologies (ART) will be legislated faster than before. We will know more about the impacts on individuals and families as matters work their way through the courts.
As your Estate Planning Attorney I will recommend that we plan for everything, including unborn children
If you’ve ever made an estate plan with an experienced estate planning attorney, you’ll know that we ask some pretty personal questions about your family planning.
That’s because we usually try to make our plans flexible enough so that future children can be included without needing to pay an attorney to update your Will or Trust. However, we will probably need to update documents more frequently given recent changes to the law.
Additionally, we will want to make sure that we try to be specific enough in our drafting to disinherit unplanned offspring from outside of relationships. The same goes for any previously frozen biological material that could potentially grow into a fetus. Yet another impact of Dobbs on estate planning to consider!
As fetal cells attain more rights, estate administration may become more difficult
As cells are legislated to have rights of their own, it will become more difficult to administer estates. For example, let’s say that a man dies after having frozen embryos with his ex-wife. By many state laws, those are now “children” under the legal definition. It would not be unfair for the ex-wife to say she is the mother of children who outlive him and should inherit his estate. If at some point those children were implanted-whether in the ex-wife or someone else- they would have needs as they grew older and the father’s assets could pass to them. However, it’s more likely that these cells would never be implanted or may be implanted but not be carried to term, at which point, who inherits from the embryo?
Question: What else should we be thinking about?
Our opinion: A lot of things will need to go through the Courts before we have final answers. In the meantime, here are some things I expect:
Higher insurance premiums
Higher medical bills
Fewer OB/GYNs
Fewer fertility clinics
More single fathers.
Push to create a biological/DNA database to track parents/putative parents.
Doctors will be unwilling or unable to provide appropriate medical treatment for women undergoing miscarriages. This will make undergoing fertility treatments especially dangerous if you have had problems carrying a pregnancy to term.
By effectively creating a system where there are two patients in one body, the law in many states now creates a conflict in the standard of care. The doctor will not be able to take direction from the pregnant person. This will cause more lawsuits against fertility specialists and other OB/GYNs. More lawsuits mean higher malpractice rates, which mean even higher costs for patients.
Many surrogates will no longer be willing to help couples create families.
Frozen embryos will no longer be intentionally destroyed.
Fertility clinics may become unwilling to create embryos for future use if they will be unable to destroy the biological material.
Many more babies will be available for adoption. So will older children.
Fewer women will consider using ART, because the inherent risks of pregnancy will no longer be treatable.
There will be fewer medical advances for difficult pregnancies due to women choosing not to have children.
Young adults will begin long-term contraception at earlier ages.
These are just some things I’m considering as we enter this new legal landscape.
In conclusion
The implications of the Dobbs decision is completely unknown. However, we do know that it will have a huge impact on Estate Planning. If you’re looking for an attorney in Nashville who can create a thorough will, look no further. Attorney April Harris Jackson will consider everything, including the implications of Dobss on family planning.
April Harris Jackson is an Elder Law attorney based out of Nashville, TN. She is also a Chairperson of the NBA Estate Planning and Probate Committee.
You don’t have to be wealthy to benefit from creating a trust fund! Create a revocable trust with our Nashville attorney as a part of a well-thought-out estate plan. All it takes is proper planning and administration. Come learn the basics with us!
What is a Revocable Living Trust?
A revocable living trust (also known as a living trust or revocable trust) can be a great way to help your loved ones protect their wealth and pass it down to future generations. It does this by creating a legal arrangement in which assets are placed within a “trust” and managed by a trustee(s). In most cases, when you set up a revocable living trust, you are also the trustee.
Why would I want to set up a revocable living trust?
There are many benefits to setting up a revocable trust to pass on your assets. One of the main reasons someone sets up a revocable living trust is because they want 100% control over how and when the assets will be used. This provides protection for your assets and prevents mismanagement. Many people prefer to set up a trust over a will because it provides a private, and hassle-free transition of assets to the family. You can set up a trust to fund many of your family’s future financial needs. For example:
Use a trust to pay for college
Parents often wonder if they should fund their children’s college education through loans, a 529, an IRA, or a trust. There are pros and cons to each option, and it ultimately comes down to what the parents feel is best for their family. A trust can be a little more flexible and offer a way to provide a continuous flow of benefits. This is perfect for a parent that wants peace of mind when it comes to their child’s future.
Provide financial support for a person with a disability
Estate planning for someone with special needs requires a lot of consideration. A trust is a powerful tool that you can use to provide financial support. While Special Needs Trusts are unique and irrevocable, an attorney can create provisions for a revocable trust to become irrevocable after your death. Special Needs Trusts provide stability and predictability in a person’s life, allowing them to maintain financial stability after you are gone. It can also help an individual with special needs remain eligible to receive Medicaid benefits. If you are worried about supporting a person with a disability, reach out to us! Our team is here to help.
Use a trust to donate to a charity
A trust is a great way to simplify the process of donating to a charity. Using a trust to fund a charity is private and much easier to create than a foundation.
Pass down your large assets with a trust
A trust can be a great way to pass down large assets, such as a house, to loved ones without having to go through probate or other legal hassles. This is because a trust agreement creates a legal document that outlines who will own the property and how it will be managed. Certain types of trusts can also protect your assets from being taken away by creditors or the government.
Determining Whether a Trust is Needed
When creating an estate plan, one of the decisions you will have to make is whether a revocable trust is needed. If you want to do something more complicated than an outright transfer of assets at death, a revocable trust is probably right for you.
Advantages of a revocable trust
Here are some of the advantages of a revocable living trust in Nashville, TN
Avoid probate – If you’re like most people, you want to avoid your family being exposed to the lengthy process of probate court. A well-managed trust negates the need for this.
Privacy – Privacy is a cherished commodity and many of us would like to have some degree of privacy when it comes to our finances. A revocable trust can provide a way for people to have privacy while still maintaining control of their assets, even after death.
Provide for future generations- A revocable trust can distribute outright at a certain time or may provide for generations past the creator’s own children. If you have concerns about how your children or their spouses may spend their inheritance, a trust can be a way to make sure that assets are used in a prudent way and preserved for future generations.
Disadvantages of a trust
Hiring an attorney – The upfront fee of hiring an attorney can intimidate people and can be seen as a disadvantage to setting up a trust. However, the cost should not be a determining factor. An estate planning attorney will understand the legal system and its implications on your estate.
Asset accessibility – A family trust may be less accessible to beneficiaries than other types of estate plans.
Difficult to change – It can be more difficult to change or revoke a trust than a will.
Revocable living trust vs a Will – What’s the difference?
The difference between a living trust and a will is mostly timing and control.
A revocable living trust allows you to change the terms or revoke the trust. It “lives” and operates alongside you while you are alive. This is important because it gives you the ability to control your assets and make decisions about how your money is used. You can also change your mind about how your money is used or who gets access to it after you die.
A Will, on the other hand, only goes into effect after you die. It specifies to the probate court how you wish for your assets to be transferred.
A revocable living trust is designed to become irrevocable after a certain event occurs- often the death of the first spouse in a long-term marriage.
Step-By-Step Guide: How to set up a revocable living trust
Step 1: Hire an Estate Planning Attorney near you
Regardless of the size of your estate, you must get counseling from a qualified estate planning attorney in your state. While every law firm is different, most follow a process that is similar to this:
How to hire an estate planning attorney
Reach out to a law firm
At Graceful Legal Services, PLLC, we offer you the chance to see if we are the right fit for each other first. The first step is to schedule your free 15-minute call. During this call, you will discuss your needs and your situation. Our intake coordinator will let you know if we can help you and give you an estimate of the attorney’s fees. If we are a good fit, and you decide to move forward with our services, you will be invited to schedule an hour-long Strategy Session with our attorney.
Do a paid consultation with an attorney
At GALS, we offer an hour-long Strategy Session. At your Strategy Session, you get to discuss your situation with our attorney, ask questions, and share concerns. After our attorney gets all of the details, they will provide a recommendation to fit your needs. They may recommend a specific kind of trust or discourage you from making one altogether. Our firm will also provide a step-by-step plan of action that you can use to achieve your goal. In other words, get a consultation with an estate planning attorney to help you decide what is best for you based on your assets, your family situation, and your goals.
Hire an attorney to carry out your plan
After your consultation, you will know if you need to hire an attorney. Let’s assume that you do at this point. It will be up to the firm to send you their contract for legal representation. We call this a “Representation Agreement”. Once you sign the Representation Agreement and pay the retainer fee, you become a client.
A word of caution:
Please do not set up a revocable trust online or by yourself. While we would love to send people to a less expensive option, the truth is that things get so messed up when you’re dealing with trusts. Our firm has tested many of the will and trust drafting software (curiosity killed the cat, right?) and there’s a lot of room for error. You cannot imagine how messed up a trust like this could be.
The key point is this: If you are going to set up a trust, hire an estate planning attorney to discuss your options. There are rules that need to be followed in order for a trust to operate correctly.
Step 2 – Gather Information Needed to Create a Trust Document
A trust document is an important legal document that sets forth the terms and conditions of your trust. Your estate planning attorney will be responsible for the meat and potatoes of the trust document. However, you will be responsible for knowing who the players will be. You will also be responsible for outlining the assets and property you would like to place within your trust.
At GALS, we use decision-making software that makes everything easier. If you would like to get a glimpse of the software, consider taking our Virtual Estate Plan Challenge. With this 7-email series, you will be guided through thought exercises to prepare you for creating your estate plan. At the end of the challenge, you will be invited to try out the software. It costs nothing and it’s easy!
In order to understand the trust document, you need to be familiar with these legal terms:
Legal Terms in a Trust Document
Grantor
Grantors are the individuals or entities who transfer assets and property to the revocable trust. A grantor is a person who signs the trust document as the initial settlor.
Initial Settlor
The person who sets up the trust. Same as the Grantor.
Trustee/Executor
The person or entity who administers the trust. You can have more than one trustee but it’s not common. Sign up to watch this Webinar: It Takes Two, or Does it? if you would like to learn more about having multiple trustees or executors. The trustee you choose must be completely trustworthy. Choose your trustee wisely. If you are unsure about trusting someone you know, hire an attorney or a Trust Company to act as the administrator of the trust.
Successor Trustee/Executor
The trust document lists who will be the successor trustee in the event of incapacitation or death of the first trustee.
Beneficiary(s)
A beneficiary in a revocable trust is someone who receives benefits from the trust, such as income or property. The beneficiary can be an individual, business, charitable organization, or any other legal entity. A trust can have one or more beneficiaries. The beneficiaries may receive the trust property either immediately or at some later time. A trustee must distribute the trust’s assets to the beneficiary whenever the trustee determines that the beneficiary is entitled to those benefits. The beneficiary’s name(s) must appear on the trust document.
In addition to naming beneficiaries and how you will fund the trust, you will also need to outline how the trust assets will be managed and distributed. What are your terms? Do you want your children to inherit from the trust at a certain milestone or date? Do you have stipulations you would like followed? Your attorney will make suggestions of what to do.
Step 3 – Sign and notarize the trust agreement
The state of Tennessee requires that the trust agreement must be signed and notarized in person. The process of notarizing your revocable trust provides a layer of security and helps to prevent fraud. It also helps to confirm validity after the grantor dies.
Step 4 – Transfer assets into the trust
Every asset that you want in the trust needs to be transferred. This means that all titles (house, bank accounts, etc). need to be transferred and renamed to that of the trust’s name.
In conclusion
Setting up a family trust in Nashville is a relatively simple process that can provide a great deal of financial security for you and your loved ones. By following the steps outlined in this article, you can rest assured that your assets are well-protected.
If you are considering hiring a lawyer to set up a trust in Tennessee but are unsure if it is the right option for you, don’t hesitate to schedule your initial call with us. We can help you determine if trusts are right for you and if we can help create one that meets your specific needs. Our free 15-minute call can provide you with the information you need to make an informed decision.
Absentee Ballot Information Tennessee Election 2022
We want to remind you that it is time to request your Davidson County Tennessee Election Absentee Ballot for the election on August 4th, 2022. Your Absentee Ballot can be requested now! We recommend that the ballot be sent in the mail no later than July 28th.
If you meet the following requirements you are likely eligible for an Absentee Ballot:
The voter is sixty (60) years of age or older;
The voter has a physical disability and an inaccessible polling place;
The voter is hospitalized, ill, or physically disabled and because of such condition, cannot vote in person. A doctor’s statement is NOT required!
The voter is a caretaker of a person who is hospitalized, ill, or disabled. A doctor’s statement is not required!
The voter is unable to vote because of jury duty.
The voter will be outside Davidson County during the Election period.
The voter is in the military or a citizen living overseas.
The voter is observing a religious holiday that prevents them from going to a polling place on Election Day.
You can find more information on eligibility requirements and request your Absentee Ballot for the upcoming election here.
Select your county on the map to get the mailing address for your election commission.
How to return your Absentee Ballot for Tennessee Election 2022:
You must return your ballot by mail (USPS, FedEx, UPS, etc.). Hand delivery or handing it to a poll worker during early voting or on Election Day is not permitted.
Pick up voter registration applications in person at the following locations:
County Election Commission Offices
County Clerk’s Offices
Public Libraries
Register of Deeds Offices
Register during a transaction with one of the following agencies:
Department of Health (WIC program)
Department of Human Services
Department of Intellectual and Developmental Disabilities
Department of Mental Health
Department of Safety (motor vehicles division)
Department of Veteran’s Affairs
Voter Registration Deadline
Postmarked: July 5, 2022
In-person request by: July 5, 2022
Online request by: July 5, 2022
If you are eligible, request your absentee ballot and VOTE today!
Not registered to vote? Your voice matters! Register to vote TODAY!
Early Voting Dates for Tennesee Election 2022: July 15 – July 30, 2022 (Varies by county)
Other Helpful Resources for Tennesseeans
Other helpful resources for the State of Tennessee can be found on our “Resources” page. Here you will find:
Community Resources such as the Tennessee Vulnerable Adult Coalition which raise awareness of the various forms of abuse committed against vulnerable and older adults.
