Daily Preparedness

Though this is the season of giving, one gift we would all like to avoid is all too common this time of year–upper respiratory infections due to ‘colds’, flus and other ailments quickly passed from one to another. This year, it seems that the varieties of germs floating around has the propensity for quickly accelerating into bronchitis and/or pneumonia. These unwelcome holiday guests can put a serious damper on your ability to deck the halls with another other than kleenex, vaporizers and prescription medication. However, like most unwanted guests, there is much you can do to prevent acquiring or passing on these little critters of misery!

First and foremost, if you are playing host to a germfest, STAY HOME as much as possible. Miss church meetings, call in sick to work and isolate yourself. If everyone would do this, the chances of an epidemic are reduced to nil. At the least, follow common sense and keep your germs to yourself.

What can you do to reduce your risk of infection or of spreading infection? Read on!

1. WASH YOUR HANDS. Soap, water and a little bit of friction are the best ways to combat the spread of germs. Use warm water, soap and scrub for at least 15 seconds. Wash often and thoroughly, but always before preparing or eating food, after using the restroom and any time you have contact with an infected person.
2. USE A TISSUE INSTEAD OF A HANDKERCHIEF. Handkerchiefs are pocket petri dishes for bacteria and virus’. Keep them for ceremonial uses and use disposable tissues for the serious work. Throw away your soiled tissues immediately.
3. KEEP YOUR HANDS OFF YOUR FACE. When you touch your eyes, nose or mouth you are passing all of those germs you collected as you went about your daily life right into the areas where they like to grow.
4. COUGH AND SNEEZE AWAY FROM OTHERS. Cough into your sleeve, a tissue or turn around for pity’s sake! Did you know that the average speed of your sneeze is 100mph! Just think of a sneeze as a rocket propelled germ rocket–a biological weapon if there ever was one, so keep it to yourself.
5. MOUTHS ARE NOT FOR MISCELLANEOUS OBJECTS. If you have the bad, bad habit of sticking pens, pencils and similar objects into your mouth–STOP IT RIGHT NOW! Also avoid licking your fingers in order to turn pages. Let’s not even discuss the germ count on money!
6. IN THE OFFICE. Clean your work area, keyboard and phone often. Keyboards and phones are great homes for all sorts of nasty stuff. Individually wrapped alcohol wipes are great cleaning devices and are safe on nearly all keyboards, remotes and phones. Don’t forget to wash your hands after using the bathroom, copy/fax machine, touching items in the lunchroom or anything frequently touched by others.
7. GERMS CAN SET UP HOUSE NEARLY ANYWHERE. Clean doorknobs, light switches, refrigerator doors, bathrooms, kitchen counters, telephones and remotes at home. A spray disinfectant is a good item to add to the cleaning basket.
8. CARRY HAND SANITIZER. This quick, easy to use solution to hand washing is affordable and easy to use. Just remember that it relies on friction to work so don’t skimp in the hand rubbing portion of the routine. Be certain to get between your fingers.
9. TEACH THE CHILDREN WELL. Children are germ machines on two legs. Those in school are exposed daily to a wide variety of germies and they bring them home with them! Insist that your school follow a strict ‘You are sick, you are going home’ policy. Teach them to wash their hands frequently, saying the ABC’s as they scrub. Stick a small bottle of hand sanitizer in their backpack. Insist that your child stay home when they are sick! Keep their backpacks off of kitchen counters and eating surfaces.
10. DON’T SHARE CUPS, CHAPSTICK, MAKE-UP. Use paper cups in the bathroom and teach your children to NOT share their chapstick or other personal care items. No drinking after others. For older children and teens, warn them about drinking out of cups prepared by others at a party. Insist that they drink only from a container that they open and that they keep in their possession–this one isn’t so much about germs as it is about what others might put in their drink. The consequences can be much worse than pneumonia.
11. DON’T SHARE FOOD OR UNTENSILS. This includes at home as it limits the passing of nasties from one child to another. A good dishwasher and powerful soap will also help stop the spread of germs.
12. USE DISPOSABLE PRODUCTS. This is particularly important when a bug hits your house. Use paper towels, paper plates and cups. If you use hand towels in the bathroom or kitchen, replace them frequently. Have a separate towel for the sick person to use. Replace kitchen sponges daily. Sanitize them by boiling or running through the dishwasher on hot water (the dishwasher is still not likely to sanitize it).
13. PLAN AHEAD. Have soup, cough drops, tissue, paper products and lots of fluids stored in case someone does get sick.
14. VENTILATE. Weather permitting, open windows even briefly to allow fresh air to circulate through your house.
15. MOISTURIZE. Add humidifiers to the bedrooms if dry air is a problem. Consider using a netti pot or nasal saline spray daily if you must be in contact with those who are likely to be sick.
16. PRACTICE GOOD HOUSEKEEPING. Keep kitchens and bathrooms clean at all times. Don’t just straighten these rooms, sanitize them! Replace towels and bedding frequently. Clean toys regularly in hot soapy water.
17. EAT HEALTHY. It is often difficult during the holidays, but remember that your body needs good nutrition to fight off germs. Avoid too many sweets, drink plenty of healthy fluids such as water and take your vitamins.
18. GET ENOUGH REST. Another tricky one during busy seasons, but try to get adequate sleep every night. If you do come down with a cold, allow yourself extra sleeping time to fend off the invasion before it escalates to something worse.
19. EXERCISE. Getting 30 minutes of exercise three or more times a week builds your immune system. Park further away from your office door, take the stairs, ride the exercise bike while watching a holiday special or just walk around your house briskly as you dust and sanitize.
20. RELAX! Take time to unwind. A body under stress is more likely to get sick than someone who is well rested and relaxed. Don’t attempt to be Martha Stewart this holiday season–remember she has a full time staff and orders carry out.

Stay healthy!

Preparedness and provident living extend well beyond the edible goodies in your pantry and the water safely stored!  The well-prepared home is one in which a family can shelter for at least two weeks without having to depend on outside support.  Even better, is a home that would allow you to stay in place for months if need by!  This level of preparation is not intended to fulfill some doomsday scenario, but to allow you to weather the storms of life–illness, weather events, unemployment, unexpected expenses, inflation and a wide range of small to large disasters.  A prepared and provident home takes advantage of sale prices to stock up and then uses up their ‘bargains’ until the next sale rolls around.

Hygiene: feminine products, hand sanitizer, baby or other disposable wipes (if you don’t have water, this would be your primary source of hygiene for the whole family), toothpaste, mouthwash (even if you don’t use regularly, it will keep mouth healthy & can disinfect other items), diapers, toilet paper, facial tissue, bleach, dishwashing soap (not dishwasher soap), dishwasher soap, laundry detergent, spray disinfectant, paper towels, garbage bags, basic household cleaners, disposable abrasive pads, ‘comet’ or similar powdered cleanser.

Health: vitamins, pain relievers, thermometer, cold medication, prescription medication, rubbing alcohol, cough drops, anti-diarrhea medication, laxative, a well stocked first aid kit, hydrogen peroxide, disposable latex gloves (if anyone is allergic to latex, order non-latex gloves), N-90 facial masks, antacid, & any other over the counter meds your family uses regularly.

Safety/comfort: candles (the best are those encased in glass container), matches, fire extinguisher, flashlights, batteries, battery operated radio, heat source (firewood, portable heater, etc—NEVER use a BBQ inside and NEVER store an extra propane tank inside your home or garage), smoke detectors that run on batteries, extra warm clothing, fans, sufficient blankets and/or sleeping bags, hats, mittens, rain gear

Tools: basic tool box to include a screwdriver, hammer, nails, pliers, screws, etc, tool to turn off gas line (can only be re-opened by professional), bung wrench if you store food in plastic buckets, plastic sheeting, duct tape, painter’s tape (these items can help seal up windows, etc. to keep home warmer as well as patch holes in the roof & package excess trash), snow shovel, regular shovel, paper, pencils.

Eating: disposable plates, cups, pans, & flatware, paper napkins, aluminum foil, BBQ (only outside), & camp stove.  Don’t forget extra fuel!

Car: keep at least ¼ to ½ tank of gas at all times. Have your car emergency kit packed and updated. And keep your car well maintained!

Pets: Remember to think of your pet needs as well.

Cash:  Every home needs a reasonable amount of cash in small bills (NO larger than $20) stored.  In many natural or man-made disasters, access to checking accounts, debit cards and credit cards is cut off.   All transactions are made with cash, and change is often not available.

Entertainment: Have you considered how you would keep yourself and your children busy if you don’t have electricity or cannot go out to your local ‘amusements’?  Be certain that you have books, games, hobbies and an idea of how to entertain yourself and your family at home.  Practice once in awhile–it’ll be good for your relationships and your wallet.

Information: Do you have a ‘hard copy’ of quick recipes, phone numbers, important addresses, etc?  Be wary of keeping all of your vital information electronically.  Technology is wonderful and we all rely on it, but keep at least a minimum of information in a format that is easy to access regardless of whether you have power or internet access.

Think through the specific needs of you and your family. Adapt these suggestions to meet those needs and then evaluate what you have on hand. Many of these items, such as paper towels, need only be stored in a larger than normal quantity.

The concept of being prepared daily is to prepare today for not matter what tomorrow brings. This process of living often includes the concept of visualizing “What-If this..or that…happens?” We can never visualize all possibilities, but being prepared will allow us to face challenges and overcome them! Although it is important to prepare with commodities such as food, water, sanitary needs, etc, it is also critical that we become ‘paper prepared.’ Everyone has accounts, statements, certificates and other items that we may need to refer to at a moment’s notice. This may be nothing more serious than needing to call the cable company because our TV isn’t receiving a signal. Or it may be as serious as a mandatory evacuation or the death of a loved one.

No matter the scenario, having our ‘paper’ world organized is critical to achieving a state of daily preparedness. The first, and probably one of the most vital, steps in becoming ‘paper prepared’ is to organize and maintain a ‘What-If’ Notebook.

A ‘What-If’ Notebook houses copies of all of the information you need to have at your finger tips. And completing it is really easy! Just follow this simple ‘recipe’:

Ingredients:

A 3-ring notebook marked on binding with the words “What IF?”

Some page protectors

Access to a photocopy machine

Blank pieces of paper

Pen

Gather the following documents and place in notebook with page protectors, which will protect the pages and make them easier to access and allow you to quickly add items as you receive them. Your notebook should contain these documents:

1. Important ‘certificates’—birth, death, marriage, diploma, divorce papers, titles, Social Security statements, disability, custody agreements

2. Insurance policies—at least front page of each. You can also simply add a bill for the insurance, so long as the statement includes policy number, contact information for the insurance company and type of insurance.

3. Location of will or trust papers. Contact information for trustee or attorney.

4. As bills come in, simply photocopy each of the following and place in notebook (or place an original bill): insurance, utilities, phone, credit cards, mortgage, loans, cable, ‘easy pass’, anything you or someone else might have to shut off, change or refer to.

5. Driver’s license and other important IDs, including passport. Photocopy in B&W at a different size than normal.

6. Names (and relationship), addresses, phone numbers, email addresses of close friends and relatives. . (a friend told me that after they went through a hurricane, she couldn’t remember her own mother’s phone number!)

7. Letter authorizing a trusted relative to discuss your medical care with a healthcare professional.

8. Advanced directive for medical care. Have this notarized!

9. Names & contact information for doctors.

10. Prescription drugs, including dosage, pharmacy & physician. You can ask your pharmacist to print this information out for you. Slip a small photocopy of this into your wallet!

11. Important medical history and allergy information.

12. Who should be contacted in case of an emergency13. Name, phone, address, and email of out-of-state contact persons.

14. Inventory of household goods, especially valuables.

15. Blank paper & pencil

16. Anything else you think you might need to refer to if your entire home were lost, you had to evacuate or face a life-altering change.

As you work on this notebook, keep it in one location. Near where you pay your bills is a great location as you can easily slip in statements and bills as they arrive. Make a note of the location of your notebook and attach the note to your 72-hour kit. That way, you will know where it is and grab it should you have to evacuate. Also let your grown children or other trusted family member know where you keep the notebook.

Your ‘What-If’ Notebook is a recipe for paper preparedness that will make your everyday ‘normal’ life easier, less stressful and more organized!

In the musical “Annie”, there is that classic song with the lyrics, “Tomorrow, tomorrow, there’s always tomorrow, you’re only a day away..” The younger we are, the more we believe that our tomorrows are endless and probably merely improvements on today. As we contemplate our future, we are full of hope, enthusiasm and great plans for all that life has in store for us. Often in this type of contemplation, we don’t want to think about the realities of life, the nitty-gritty ‘what ifs’ about living; illness, dying, aging, handicaps, health issues, caring for elderly parents and hardships. But, life can deal any or all of these to without warning. Being prepared is our only true defense! Here, then, are a dozen things we all should do to prepare for anything that ‘tomorrow’ might bring, for we all know that ‘tomorrow is only a day away…’!

1. Have you granted trusted relatives the right to discuss your medical care with your physician or other medical personnel? Federal and state laws make it illegal for medical personnel to discuss your care with anyone unless you have given permission for them to do so. This is good, but could be a problem should, say your loving daughter believes you are exhibiting the signs of a stroke. If daughter calls your doctor, the doctor, legally shouldn’t discuss her with you. My Mother & I discovered this when she passed out and then was less-than-fully-functioning for a while. Her doctor had her write a letter listing those she authorized to talk to him and their contact information. The letter also gives the doctor the right to call one of us if he believes there is something we need to be aware of. This also applies to your children over the age of 18 (16 for some matters), so have them execute such an authorization before going off to college. You might want to consider granting someone a medical power of attorney. This is often part of a living trust and some wills. This gives an individual the right to make medical decisions for you in case you are incapable of doing so for yourself.

2. Have you recently checked your will or trust? A living trust greatly can reduce the process should you become incapacitated or pass away. Consider changing from a will to a trust. The trust can divide your assets as you see fit and protect you in case you are incapacitated. Periodically review the terms and see if they fit your current circumstances and wishes.

3. Do you have an Advanced Directive? This document details your wishes should you be terminally ill or if you need to be resuscitated. Your doctor, hospital or attorney can provide you with the simple form.

4. Consult an estate attorney before you add anyone’s name to any your real or personal property. Some families attempt to circumvent probate this way, but it can leave all parties open to all sorts of liability and tax issues. It may be better to form a ‘Limited Liability Corporation” if non-spousal relatives wish to own property jointly. Each state’s laws differ so be certain to contact an attorney.

5. Do you have someone you can trust to help you review your financial situation? Who will take care of your finances if you are incapacitated? Again, a trust with two executors can be a great thing.

6. Do you have your financial and insurance information in one place that someone knows about? A simple three ring binder can work. As you pay bills for insurance, etc. or receive statements, simply put one copy of each form in your notebook. You might want to add any charge accounts you have, especially those that have credit life. You don’t have to replace the copies as you receive your statements–just add any new ones you open. Photocopy the deed to your house, your car registration and any other document and put those copies in your notebook. Now, add contact information for those you would need to contact in an emergency. It wouldn’t hurt to give a copy of this to your executor. It is a great back up in case you have an emergency or lose your home.

7. Put passwords on all of your accounts—bank, credit union, credit cards, etc. Don’t open an account where they won’t let you use a password. The password will protect you from someone else changing the information on your account. This is a simple and yet effective way to prevent someone stealing your credit! If you think you won’t remember the password, chose a word and write a sentence about it in your address book. For instance, if your password were “Mercedes”, write down, “My first car was a Mercedes”. That will help you remember.

8. Do you have copies of your birth certificate, marriage license, service records, car registration, divorce decree, passport–all those pesky life documents we need? Put them with your account notebook or notate in the book where you keep them.

9. Write down your wishes for your “Final Farewell”. If we don’t speak our minds, those we love won’t know what we want and may spend more time or money than we would have wanted “Paying tribute to us.” Family feuds are often started over, “What Mother would have wanted.” For instance, I would rather my children go on a lovely cruise than spend $25,000 on a casket for me. (Did you know you could order discounted caskets online now??? Not legal in all states, but in many. For instance, you can order a traditional, tasteful, handmade casket produced by monks for as low as $695.) Shopping ahead of time is much, much better than buying prepaid funeral plans. Research burial options and decide ahead of time.

10. Be very, very, very, very cautious of anyone offering to sell you insurance, prepaid funeral plans, financial management, etc, etc. Have a trusted friend or relative who will talk through the many offers you might receive before you make a decision. Never enter into a long-term contract without taking at least 72 hours to think about it. The same is true of investments and other major purchases. Trusted, reputable institutions will never pressure you or use scare tactics.

11. If you are married, are you a full partner in knowing everything there is to know about your financial situation, the insurance you have, liabilities, etc.? If you aren’t, you should be!

12. Is your home safe for you? Before you fall, have grab bars installed in your bathroom. If you need them other places, have them installed now. Check for tripping hazards. Have a phone that does not rely on electricity. If you think you might require assisted living, start shopping early. Choose one that will accept Medicare in case you outlast your resources.

And one bonus:

13. Decide at the beginning of each year which charities you wish to support. Decide how much you can reasonably afford and then donate it. Throw ALL OTHER letters from charities into the trash BEFORE you open them. You can also decide every quarter or twice a year.

We have all heard the horror stories of thieves stealing an individual’s credit identity to rack up bills that result in a host of nightmares for the victim. But, have you considered the possibility that the same sort of criminal may be targeting your medical identification?

Alarmingly, there has been an increase of cases involving criminals who use the ‘medical identity’ of another to receive medical care in someone else’s name. The victim of the fraud ends up with bills for medical care they did not receive and, in some instances, diagnosis and treatments listed in databases that do not belong to them. The financial cost can be overwhelming and the possibility of malpractice frightening.

What can you do to safeguard your medical identity? Here are a few suggestions:

1. Treat your medical insurance card like you would a credit card. If lost, report it immediately to your insurance company. Don’t show your insurance card to or loan it to anyone other than trusted healthcare providers. At the medical facility, do not stand at the counter and rattle off insurance information that includes the numbers, social security number or birth date.

2. Read those EOBs! Insurance companies issue Explanation of Benefits when a provider is paid in your name. Look over those EOBs and quickly report mistakes to your insurance company. Shred EOBs if they include policy number, etc. Check that procedures billed to insurance company are accurate. Fraud schemes include providers billing for more expensive procedures, procedures not performed, charges for a specialist that wasn’t seen, ‘nurse’ visits when a trip to the lab would do, equipment not used and ‘splitting’ one procedure into multiple procedures in order to bill at a higher rate.

3. Check out benefits paid every year. Do a yearly check up on claims paid on your behalf. Quickly report any that you do not recognize. Make sure that your address or other contact information is accurate.

4. Watch out for scams! Clinics and physicians have been prosecuted for filing false bills covering tests and procedures that have never been performed. To avoid being a victim, avoid clinics that waive co-pays, offer ‘free’ tests, exams, transportation, etc. Again, check those EOBs for errors! I recently found an $11,000 error.

5. Check your credit rating. If someone has run up medical bills in your name, especially with false address, etc. you may likely find claims from credit agencies on your credit rating.

6. Ask for an accounting of disclosures. You have the right under HIPAA to get this document from every health care provider you visit. This document will let you know to whom information was released, when it was released and what information the provider received. As some medical databases are not interconnected, this is another way to track errors in your medical history.

7. If you find errors, what should you do? First, contact the provider and your insurance company. It may simply be a ‘coding’ error or honest mistake on the provider’s part. If it is not an error or you suspect fraud, contact your insurance, and keep records of who you speak to. Most insurance companies will aggressively pursue cases of suspected fraud. Report the fraud to your police department and receive a copy of the report. Other agencies will also investigate medical fraud. These include:

· City, County, State and Federal Law Enforcement Agencies
· Justice Department through the Assistant
· U.S. Attorney General’s Office
· Federal Bureau of Investigation (FBI)
· Postal Inspectors
· Department of Health and Human Services (HHS)
· Food and Drug Administration (FDA)
· Offices of Inspectors General (OIG)
· U.S. Department of Labor

For more information, check out these websites:

www.WorldPrivacyForum.org
www.BCBS.com/AntiFraud/
www.Consumer.gov/IDTheft/

(This information comes primarily from the Joint Commission on Accreditation of Healthcare Organizations, which inspects and issues accreditation to hospitals and other organizations that deliver medical care.)

The Speak Up program urges patients to get involved in their care. Research has shown that medical errors are a serious problem in the health care system. Informed, involved patients have the lowest occurrence of life-threatening errors. Remember, you are an important part of your healthcare team! By following the guidelines below, you can be your own best defense.

Speak up if you have questions or concerns. If you do not understand the answer, ask again. It’s your body and you have a right to know what is happening. Your health is too important to be embarrassed by asking for clarification. Speak up if you think you are receiving the wrong medication, test, or procedure. Ask your doctor to mark the part of your body that will be operated on. Don’t hesitate to tell the health care provider if you think they have you mixed up with another patient.

Pay attention to the care you are receiving. Don’t assume anything! Expect healthcare providers to introduce themselves, have a visible ID batch and double check your identity before proceeding. Notice whether caregivers wash their hands before tending to you and gently remind them if they fail to do so. Hand washing is the single most effective deterrent to infection. If something doesn’t seem right, STOP and ask the person to clarify. If you are not comfortable with the answer, ask for a supervisor. If you are not comfortable with the process used in a procedure, demand that the healthcare provider stop.

Educate yourself about your diagnosis, medical care and treatment plan. Ask the doctors you visit what training, certification and experience they have in treating your condition. Know what it means for a doctor to be ‘board certified’. Use legitimate websites to check your doctor’s qualifications. Gather information from your doctor, pharmacist, insurer, the library and respected websites about your condition. Thoroughly read all forms before you sign them. Make certain you understand any equipment or medications you are prescribed. Know how to use (or take) them and what side effects to watch for.

Ask a trusted family member or friend to be your advocate. This is vitally important if you must be hospitalized for out-patient or in-patient treatment. Your advocate can help you keep track of information provided to you, ask questions you may not think of, write notes of what is said and Speak Up for you if you can’t. Make certain your advocate knows your wishes regarding your care, life support and resuscitation. Ask your advocate to review consents or other forms you are asked to sign. If necessary, put in writing that your advocate can discuss your care with your providers. Your advocate should thoroughly understand the care you require when you are released.

Know what medications you take and WHY you take them. Medication errors are the most common health care mistake. Ask about the purpose of any medication you are prescribed, its benefits, side effects and potential hazards. Make certain that all prescribing doctors know ALL medications, vitamins and supplements that you take. This MUST include all herbal remedies, naturopathic medications or other things you ingest. If you do not recognize a medication (the shape, color, etc) changes or seems unfamiliar, double check that it is for you and the correct medication! Before swallowing any pill, make certain that you, your advocate and the person dispensing the pill know what you are taking. Read the contents of IV bags and know how long they should run. If you are not well enough to do this, ask your advocate to do it for you. Alter the nursing staff if the IV becomes painful, stops flowing or begins to flow more rapidly. Watch IV lines for excess air bubbles. Be certain that your physician, nurses and pharmacist know about any reactions that you have had to medications in the past. Use the same pharmacist for all prescriptions—this will help rule out adverse medication interactions. Make sure you can read the prescription handed to you. If you can’t, the pharmacist may not be able to either.

Use an ambulatory care center, surgery center, primary care or other type of healthcare organization that has been inspected and certified by a nationally recognized accreditation board such as JCAHO. Ask about the centers experience in caring for your condition. How frequently do they perform the procedure you need? If you have a choice between facilities, ask your doctor which one offers the best care for your condition. Ask them why they make that recommendation. Be certain that you understand about follow-up care and what to watch for before you leave the center. Be certain that you have numbers to call in case you have questions. Check www.jcaho.org to find out if the care center is accredited.

Participate in all decisions about your treatment! You are the center of the health care team. You and your doctor should agree on exactly what will be done during each step of your care. If you are an inpatient, be certain that nurses are following doctors’ orders. Understand why more tests or medications are being ordered. More is not always better. Keep copies of your medical records and share them with your health care team. Don’t be afraid to get a second or third or fourth opinion. Do not be afraid to change doctors if yours doesn’t want you to be actively involved in your care. Seek out others who have undergone the same procedure you are considering. Look for support groups, online message boards and reputable websites. Sharing information with others who have gone through what you are facing can be most helpful in facing what lies ahead. They can often help you prepare strategies that will ensure the best outcome possible.