Let's Plan in Place!
COVID-19 is re-shaping health care. Honoring Choices is helping adults to-
Stay Informed. Make a Plan. Help Your Community.
We have up to date information, easy to use tools, and resources from our Partners.
The Honoring Choices Partners come together around a shared goal of helping adults make a personal health care plan and connect to good care over their lifetime. The Partner's work has taken on a deeper, more urgent meaning due to COVID-19. Instead of hosting in-person events, our Partners are helping adults to "Plan in Place" and access needed care and support in their community. We also are working to minimize barriers to making a plan and getting timely, equitable high quality care.
Staying healthy is at the top of everyone’s list. Stay informed with the fast-changing, up to date information —
- MA Dept. of Public Health Coronavirus website. Link Here
- CDC- Center for Disease Control webpage. Link Here
- Healthcentric Advisors offers key information for Medicare beneficiaries. Link Here.
- COVID-19 Health Inequities Task Force. Link Here.
- Check with your town government for information and local resources
Great Tools & Information!
The Honoring Choices Partners share the latest COVID-19 related planning tools and information for care providers and consumers. Scroll down to learn what our Partners are doing to help adults & families in their communities!
Want to share your tools and resources? Just write a short description to post below. Email to Ellen, firstname.lastname@example.org
Get Started with a Health Care Proxy and Personal Directive
Every competent adult, 18yrs/older, can make a plan. You can do-it-yourself with the Getting Started Tool Kit.
Start by choosing a Health Care Agent. Your Agent has the power to make health care decisions for you if you are unable to make decisions yourself. Your Agent can get you the care you need, even for a short while you recover. Be sure to mail or fax a copy of your completed documents to your Agent and primary care physician.
The Getting Started Tool Kit makes planning as easy as 1-2-3:
- Who's Your Agent? Appoint a trusted person as your Health Care Agent in a MA Health Care Proxy. No Agent? No Problem- start with Step 2;
- What Matters Most? Write down your instructions for care in a MA Personal Directive (Living Will);
- Let's Talk About My Care. Talk with your clinicians, using the 5 Things to Talk About discussion guide, to get good care everyday.
Download a free The Getting Started Tool Kit
Health Care Proxy: What if I can't find 2 Witnesses?
Given the stay at home advisory order and the COVID-19 State Of Emergency, for many people it has become difficult, if not impossible, to have two witnesses physically present to sign Health Care Proxy. So what can you do? To start, remember that competent adults, 18 years old & older, have a civil right to direct their care decisions and to choose an Health Care Agent in a MA Health Care Proxy. If witnesses are not available during this State of Emergency, you can use the MA Health Care Proxy to create a personal document to choose a Health Care Agent. Although not a legal document, your personal document is evidence of who you want to be your trusted decision-maker and should be respected by your family and your physicians.
Here's how to create a personal document:
Download the MA Health Care Proxy. This document is recognized in MA as the means to communicate your choices;
Fill in information and sign the document;
In the Witnesses section, write in: "Witnesses not available during the COVID-19 State of Emergency";
You've now created a personal document, not a legal document. Give copies to your Agent, family, and physicians;
After the State of Emergency is lifted, you can update your Health Care Proxy and sign in front of two witnesses to create a legal document.
Complete your Personal Directive. Tell your Agent what you want for care.
If you are at high risk for COVID-19, you can call your primary care physician to talk about your medical condition and the benefits and risks of treatment decisions. Fill out your Personal Directive, and if you like, complete a MOLST form with your clinician.
¿Quién es su Apoderado? - Plan in Place with translated planning documents
Virtually reach to all adults and families in your community.
Our bi-lingual Partners offer culturally sensitive conversations by asking ¿Quién es su Apoderado? (Who's Your Agent?), and using our Spanish Health Care Proxy and Personal Directive to help adults make a plan.
Additionally, Honoring Choices has translated Health Care Proxy (9 languages), Personal Directive (Living Will) (3 languages), and wallet cards. Let us know how we can tailor and translate tools to empower adults to choose a Health Care Agent and give their Agent the power to advocate for quality care that aligns with an individual's culture, beliefs, goals and care choices. View the translated documents for free download here. Contact Ellen for more information, email@example.com
Family Caregivers: Take care of yourself and your family
It's a busy and stressful time for family caregivers, balancing work and caregiving responsibilities. Many caregivers are surprised to learn that in Massachusetts, a caregiver does not automatically have the legal power to make health care decisions for a competent adult family member unless appointed as a Health Care Agent in a MA Health Care Proxy.
It's never been more important to take care of yourself as you care for your family by making a health care plan. Every competent adult can complete a Health Care Proxy to choose a trusted person as a Health Care Agent, and give their Agent instructions for the kind of care they want in a Personal Directive (Living Will).
Do it for yourself. Help your family member make his/her own plan. Just download the Getting Started Tool Kit with free documents.
For more information and resources for family caregivers in the workplace , go to Massachusetts Caregivers Coalition.
AlzHereForYou and 24/7 Helpline - Great resources from the Alzheimer's Association
It's been a challenging time for individuals with Alzheimer's Disease and other dementias, and their family members and caregivers. Community health care professionals are working hard to help support all during the COVID-19 pandemic, made more difficult by the loss of access to resources and closure of day programs.
Have a question or need help finding a resource? Click on this link, AlzHereForYou to view a wide range of helpful resources. And be sure to call the 24/7 Helpline: 800.272.3900. Trained staff are there to help individuals, family members and caregivers, and also health care providers and community professionals find appropriate care and services.
24/7 Helpline: 800.272.3900
Find a Dementia Friends Information Session or Become a Champion!
Please contact Beth Soltzberg at firstname.lastname@example.org or 781-693-5628 if you’d like more information about attending an information session, or being trained as a Champion to lead information sessions.
Cake provides a Plan in Place option: Create & Store Documents On-Line!
- Go to the Honoring Choices-Cake portal
- Create your own free personal account
- View and download the Honoring Choices Health Care Proxy and Personal Directive and complete online, OR upload your completed documents to your personal account
- Access the Cake cards to create your own profile of end of life choices and preferences to store and share
JUST POSTED: "Racial Inequality in Advance Care and End-of-Life Planning Resources" . Read more here.
Be Prepared in the Time of Covid-19, from Ariadne Labs & The Conversation Project
Ariadne Labs and The Conversation Project offer a simple free guide to help adults be prepared during our pubic health crisis. The guide highlights three important things you can do right now:
- Pick a person to be your Health Care Agent;
- Talk about what matters most to you;
- Think about what you would want if you become serious ill with Covid-19.
Click here to download Be Prepared in the Time of Covid-19 guide
Serious Illness Care Program’s COVID-19 Response Toolkit, from Ariadne Labs
To support clinicians in having difficult conversations with patients at high risk for serious complications of COVID-19, Ariadne Labs has developed the Serious Illness Care Program’s COVID-19 Response Toolkit. The guide will help clinicians engage in compassionate conversations with high-risk patients about how they can best protect themselves and help them understand what matters most to each patient in the context of COVID-19.
The tools kit includes:
- COVID-19 Conversation Guide for Outpatient Care
- Telehealth Communication Tips
- Recommendation Aid
- Care Planning Resources
Click here to Download the COVID-19 Response Toolkit
Covid-19 and Advanced Care Planning, with the MA Coalition for Serious Illness Care
Communicating with the Public about COVID-19 and Advance Care Planning (ACP)
Massachusetts Coalition for Serious Illness Care (Coalition) is working with local and national partners to provide public messaging guidance to support appropriate advance care planning at this time and create a consistent set of language for organizations to draw from. They invite everyone to use the following messaging and social media posts in your work, adapt as needed and share with others in your network.
Here's the LINK to their tool kit
Engage High-Risk Adults in Proactive Planning Conversations with Respecting Choices Tools
Just in time! Respecting Choices® Offers Suite of Open-Source Care Planning Tools in Response to COVID-19
People who are considered high-risk for coronavirus-related complications are feeling especially vulnerable. Respecting Choices has developed a toolkit for clinicians to engage in proactive conversations about treatment preferences before a medical crisis. There are also tools for consumers and Health Care Agents. The Respecting Choices® COVID-19 tools and resources below will support these important conversations. They are currently free and open to all based on the Creative Common License.
- Proactive care planning conversation with high risk-individuals
- Proactive care planning conversation with HC Agents
- RECORDED WEBINAR: How to Have a Proactive care planning conversation in the context of COVID-19 – 30 minute pre-recorded Webinar
For Individuals and Health Care Agents
- Proactive Care Planning for COVID-19. A Guide for High Risk Adults
- Proactive Care Planning for COVID-19. A Guide for Healthcare Agents
Tools to support specific treatment decisions in high risk individuals
- Decision Aid: CPR
- Decision Aid: Help with Breathing
- User Guide for Decision Aids
- RECORDED WEBINAR: How to Use Decision Aids in conversation
Click here to see the full suite of tools, information and guides.
NEW: Health Care Proxy App for Beth Israel Lahey Health Patients
Beth Israel Lahey Health(BILH) has made it simpler than ever for their patients to choose a trusted person to ensure your wishes are respected when you are unable to speak for yourself. BILH patients can download the BIDMC Health Care Proxy app to complete a Health Care Proxy- it's quick and easy.
The BIDMC Health Care Proxy mobile app allows you to complete the Massachusetts Health Care Proxy form electronically and share it with your loved ones and healthcare team at BIDMC.
To get started:
- Search for BIDMC Health Care Proxy in the Apple App Store or Google Play Store
- Download the app on your tablet or smart phone
The Conversation Project: Start a conversation about what matters most.
The Conversation Project Tool Kits help adults talk about end of life care and what matters most. We combined our tools this year so adults can:
- Start a conversation with Conversation Starter Kits
- Use the Honoring Choices Getting Started Tool Kit to write down your care choices and what matters most
Learn more. Joint initiative with The Conversation Project.
Palliaitve Care COVID-19 Response Resources from CAPC
Center to Advance Palliative Care, CAPC, is providing a free tool kit and great resources in response to Covid-19, and has made online courses available to the public. CAPC is also collecting best practices and tools from palliative care team . Let them know how you are helping adults and families in your community.
The tools and resources include:
- Communication Tips
- Symptom Management Protocols
- Palliative Care Team Tools
- Using Telehealth
- Medicare and Medicaid COVID-19 Waivers + State Policy COVID Tracker
- Patient and Family Support Resources
- and much more!
Click here to read more.
Partners News & Resources
Our Partners share the latest information, resources and the important ways they are helping adults and families in their community. Tell us what you are doing and we'll post it below. Email Ellen, email@example.com
Medicare Reimburses More Clinicians to Start Proactive Conversations
Healthcentric Advisors, an Honoring Choices Partner, advised us in April that Medicare was reimbursing Physicians (MD), Nurse Practitioners (NP), and Physician's Assistants (PA) for proactive advance care planning conversations using audio- visual telehealth phone calls. As of May 1, 2020 the Centers for Medicare and Medicaid Services, CMS, announced new waivers that include:
Audio-Only (Phone) Telehealth.
CMS allows for audio-only calls (i.e. telephones), waiving the video requirement. Clinicians can be reimbursed for starting planning conversations using the Advance Care Planning (ACP) codes (CPT codes 99498 & 99498). It enables care providers to reach to a greater group of people using land lines and audio only.
Expanded Providers Can Start Conversations
CMS is expanding the types of clinical practitioners that can start planning conversations, waiving the requirement that reimbursable calls be limited to MDs, NPs, PAs. Now other practitioners are able to initiate planning calls including clinical social workers, registered nurses, certified hospital chaplains physical therapists, occupational therapists, and speech language pathologists.
Expanded Telehealth Benefits for Medicare Beneficiaries
The federal government announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of healthcare services from their doctors without having to travel to a healthcare facility. It includes clinician reimbursement for telehealth advance care planning conversations! Read the press release, frequently asked questions, and fact sheet. Thanks to Honoring Choices Alliance Partner Healthcentric Advisors for keeping Massachusetts and the New England states up to date on ever evolving critical information. Read more information here.
Patients "Extremely Grateful" for Proactive Planning Conversations
In the first few weeks of the epidemic, Baystate Health nurses called 5,000 patients at high risk for COVID-19 to start proactive conversations. The nurse and patient talked about how the patient was feeling in this stressful time, reviewed health concerns and access to medications, and helped schedule a telehealth visit if needed. The nurses also opened care planning conversations to help with a Health Care Proxy and/or MOLST form. Although some of the nurses were initially concerned about how patients might respond, they found the majority of patients "extremely grateful for the outreach call and the opportunities to talk about these issues."
Here's a note from a nurse to her colleagues and administrators:
"I reached out to a patient this morning as part of our Pandemic Outreach, and just want to let you know how appreciative she is that our office is doing this. We discussed that her Health Care Proxy was up to date. I noticed she did not have an active MOLST form in her chart. After explaining the MOLST, she decided she would LOVE a phone visit to discuss this with her doctor. She was a little concerned that she didn't know what questions where going to be asked, and after discussing them with me, we decided I would mail her out some information to review beforehand. The patient was extremely grateful and wanted everyone to know how AWESOME she thought the call was, and she really couldn't stress enough how appreciative she was for the reach out."
Taking Care of the Emotional Needs of Care Providers
The Peer Support Staff at the Betsy Lehman Center has complied a wonderful list of tools and resources for clinicians, staff, and managers to support your vital work and manage stress. This thoughtful, comprehensive list also includes additional resources on mindfulness and relaxation.
Tips for Dementia Caregivers from the Alzheimer's Association
"Most likely, dementia does not increase risk for COVID-19, the respiratory illness caused by the new coronavirus, just like dementia does not increase risk for flu. However, dementia-related behaviors, increased age and common health conditions that often accompany dementia may increase risk", says a great new posting from the Alzheimer's Association, and Honoring Choices Alliance Partner. Our Partners are reporting concerns with physical distancing while helping adults stay connected. Here are tools and resources on their new webpage:
- Tips for dementia caregivers at home
- Tips for staying healthy
- Tips for caregivers of individuals in assisted living
Adults, family and caregivers can call the 24/7 Helpline : 1 800 272-3900
Read the full webpage here.
24/7 Helpline. Let's talk about the challenges of dementia
The Alzheimer's Association's 24/7 Helpline is available at 1-800-272-3900 to anyone who needs to talk about the challenges of dementia during this time. Their Helpline staff are available around the clock for any questions or concerns you might have. They can help address feelings of isolation, and link to important resources that can help though this time.
Virtual ALZ Meetups Educational programs and Support Groups are now available on diverse topics. Click on the website for more information.
Adults, family and caregivers can call the 24/7 Helpline : 1 800 272-3900
Share A Meal: Donate to Community Food Banks
During this public health emergency, adults in your town, city or community may not have a reliable healthy food source. Consider making a food or financial donation to your local food pantry or food bank. Please call ahead to see if they are accepting food donations. Here are other resources to support with a financial contribution:
- State List of Local Food Banks. Link
- The Greater Boston Food Bank. Link
- Project Bread. Link
- Boston Medical Center Food Bank. Link
- The Greater Food Bank of Western MA. Link
- Worcester County Food Bank. Link
Thank you to Tufts Health Plan Foundation for supporting food banks and community services. See next section below.
Tufts Health Plan Foundation supports greater food access duirng Covid-19
Tufts Health Plan Foundation has identified the first 21 organizations to receive support from the $1 million it has committed to community efforts on behalf of older people affected by coronavirus in Massachusetts, Rhode Island, New Hampshire and Connecticut. Their first wave of funding directly helps address food insecurity in our communities.
Here are the Massachusetts organizations who received funding, and who are diligently working on the front lines to improve food access during the Covid-19 health crisis:
- The Boston Foundation, COVID-19 Response Fund
- The Food Bank of Western Massachusetts
- The Greater Boston Food Bank
- Union Capital Boston, COVID-19 Fund
- Watertown Community Foundation, Community Resilience Fund
- Watertown Food Pantry (via Watertown Council on Aging)
- Worcester County Food Bank
Read more here
Helping Adults Complete a Health Care Proxy and Durable Power of Attorney
Attorney Amy Hudspeth Cabell, Hudspeth Cabell Law, LLC, an Honoring Choices Partner, has been reminding adults about the importance of completing a Health Care Proxy. She has made the Honoring Choices Health Care Proxy link available to essential workers and those on the “front lines” such as supermarket workers, transit drivers, as well as health care providers. She is assisting in completing those forms and providing witnesses via social distancing procedures. She is offering a durable power of attorney document, at no charge, to those individuals. And for those who already have these documents in place, Amy offers a no charge review to make sure the documents are current and still meet their needs. Thank you Amy! Amy Hudspeth Cabell, Esq., Estate Planning & Elder Law Attorney, (781) 705-7300; Amy@HudspethCabellLaw.com
Meeting the Community Need at HESSCO
HESSCO, an Honoring Choices Community Partner, is an Aging Services Access Point (ASAP) and Area Agency on Aging (AAA) for South Norfolk County. They serve consumers in Canton, Dedham, Norwood, Foxboro, Westwoood, Medfield, Millis, Norfolk, Plainview, Sharon, Walpole, Wrentham.
HESSCO is continuing to provide essential programs since Governor Baker announced a Stay at Home Advisory for Massachusetts. They are helping ensure that our most vulnerable older adults receive vital care and services, such as:
- Meals on Wheels, which delivers hot meals Monday-Friday;
- In-Home Care Program, proving supports and services;
- Caregiver Specialist phone consultation, to support family caregivers.
GOOD NEWS: They can accommodate new referrals to Meals on Wheel and In-Home Care Program. Call 781-784-4944.
HESSCO is having an outpouring of support for volunteers at the ready to deliver meals or critical supplies. Consider volunteering or making a monetary donation to help them cope with this pandemic. Read more here
Telehealth and Proactive Care Planning
The Valley Medical Group, an Honoring Choices Partner, has come together to support each other and their patients during this pandemic. All four health centers in Amherst, Easthampton, Northhampton and Greenfield are open and provide patients with video and telephone visits, as well as in-house appointments when needed. Their ACP Committee has been communicating with staff and providers about continuing to help adults complete a Health Care Proxy and if needed a MOLST form. “We are appreciative of the role Honoring Choices has taken in advocating at the state level to waive consent requirements so we can help our most vulnerable patients be prepared during this health crisis", says Stephanie Pick, RN, BSN, MA, Special Projects Manager, Valley Medical Group. See the website for more innovative ways Valley Medical is serving adults and families.
Care Dimensions: Empowering adults & families
“Timing is Everything“ and “Living Forever- Not an Option”; Learning Institute's Free Resources.
Hosted by Care Dimensions
Care Dimensions will feature the Honoring Choices programs and tools on their cable show “Timing is Everything “ and their podcast “Living Forever- Not an Option” to empower adults to make a plan and reach out for good care. Care Dimensions just launched their Learning Institute to deliver education, workshops and resources on end-of-life topics such as hospice and palliative care, bereavement, advance care planning, and living with advanced illness. Whether you are a patient with a life-limiting illness, the loved one of a patient, a caregiver, a grieving family or a health care provider, you can learn more and view resources. Read more here.
Let's Grow An Herb Garden
Marlborough Council of Aging. In addition to gathering volunteers to grocery shop, pick up medications, and provide 85 seniors with hot meals weekly, the Marlborough COA offered a gardening curbside pickup to plant a herb pot garden. Seniors received an oval 12” container with soil and fresh herbs to plant and enjoy all season long! A fun project in a tough time to keep the community connected.
Palliaitve Care, By Your Side
Hebrew Senior Life, HSL,Metrowest-Boston. Beth, Palliative Care Nurse Practitioner, a member of the care team, has remained at the bedside providing essential care services throughout the pandemic at Hebrew Rehab Center, Roslindale. The care team of redeployed clinicians proactively contacted long term care patients in HSL facilities to discuss their wishes in the event of a COVID infection, and carefully recorded and updated patient care choices.
Caring During the Crisis
Jewish Family & Children's Services, JF&CS, Waltham, is hard at work helping the people they serve, and many others who have recently lost wages or feel lonely and isolated. They assist with emergency food, reassurance phone calls, virtual support groups, creative arts and activities programs for people with disabilities. "Your Elder Experts" helps with housing, writing and revising planning documents, and managing daily challenges.
LifeCare Advocates on the Frontline
LifeCare Advocates' care team has remained very close to their clients throughout the pandemic to support their immediate health needs, advocate for their care choices, and help families navigate the aging process in this time of uncertainty. They offer a "Brief Solution-Focused Virtual Consultation" to assist families during this challenging time.
Taking Care of Patients & Each Other
Norwell VNA & Hospice, NVNA, SouthShore, palliative care team's smiling faces can be seen under their PPE as they make essential in-person home health, palliative care and hospice visits. NVNA provides telehealth conversations to successfully use verbal consent to complete MOLST forms. They provide weekly support to staff to manage the emotional and physical impacts of stress during this challenging time.
Addressing the Increased Need in the Community
Minuteman Senior Services, Bedford, is busy meeting the increased demand for information on food, medicine, and essential transportation and resources. They continue to deliver hot lunches to home bound seniors through Meals on Wheels. The Home Care, Nursing, and Elder Protective Services staff are supporting seniors who are experiencing increased anxiety, loneliness, and vulnerability to abuse. They provide 1 to 1 support for Family Caregivers and connect to vital resources.
Virtual Bereavement Support
Hospice & Palliative Care Federation of MA, HPCFM. Grieving the loss of a loved one may be especially challenging during the COVID-19. Hospice and Palliative Care programs across the Commonwealth are providing virtual bereavement support and resources. HPCFM provides a list to contact organizations for more information and specifics about virtual bereavement support programs. HERE.
Virtual Caregiver & Grief Support Groups
HopeHealth, SouthShore is providing home care, palliative care and hospice care 24/7 and supporting the community with specialty virtual support groups, including a a grief support group, Dementia Caregiver and General Caregiver Virtual Support groups.
350 Councils on Aging #pulling together
Massachusetts Councils on Aging, MCOA. The Council on Aging doors may be closed, but services such as meals, transportation, grocery shopping, prescription delivery, online programming, senior serenades and much more are being provided. MCOA is #pulling together, supporting the 350 COAs with information, training, online programming and the re-opening process.
"Healthcare Planning Throughout Your Life" with Mass Health & Hospital Association
Patient Care Link provides a wealth of health care & safety information for hospitals & home care for patients, families and health care providers. Click here to learn how to:
- "Empower Patients to Make Health Care Choices";
- "Care for Patients with Alzheimer's Disease";
- "Start a Palliative Care Discussion";
- Explore topics and tools that advance healthcare quality and safety.
PatientCareLink is a joint venture of the Massachusetts Health & Hospital Association (MHA), Organization of Nurse Leaders of MA, RI, NH, CT, VT (ONL), Home Care Alliance of Massachusetts (HCA) and Hospital Association of Rhode Island (HARI).
Be healthy and live well in your community, with Age -and Dementia Friendly MA
Every town & city, business and employer can improve the way adults stay healthy and live well in their community. We've combined tools with our Age-and Dementia Friendly MA partners so you can:
- Learn how your community can meet the needs of adults as they age;
- View MA Age- and Dementia Friendly Integration Toolkit,
- View information & resources at MA Healthy Aging Collaborative
- Make a plan with the Getting Started Tool Kit;
- Use the translated documents for culturally sensitive conversations.
Learn More. Joint initiative with Age -and Dementia Friendly MA