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Health Q&A

Posted August 22, 2012 in Advice Column

Q: What’s an advance directive?

A: There are two types of advance directives: living will and durable power of attorney for healthcare. Both kinds of advance directives can help free your family from the stress of making difficult decisions for you.

Living wills, also known as “medical directives” or “healthcare declarations,” are written instructions that explain your wishes for healthcare in the event you can’t communicate as a result of a terminal condition or irreversible coma.

Durable power of attorney for healthcare, also known as “healthcare proxy” or “appointment of a healthcare agent,” lets you name a person to make medical decisions for you if you become unable to do so.

    Truths about advance directives:
Power of attorney for financial matters does not, by default, provide power of attorney for healthcare. These are typically separate legal documents.

Discuss advance care planning when you’re well — don’t wait until you become ill. Advance directives do not say, “don’t treat me.” They say, “treat me the way I want to be treated.” Advance directives only go into effect if you are otherwise unable to make decisions and communicate your healthcare wishes. A lawyer may be helpful, but is not required to complete an advance directive. Each state has its own requirements regarding number of witnesses or the need for notary seals.

Call HCI Hospice Care Services, (641) 856-1102, to request a free advance directive packet.

Information provided by Terry Terrones, RN, MSN, CHPN, HCI Care Services of South-Central Iowa, 103 East Van Buren St., Centerville, (641) 856-5502,

Q: I injured my shoulder and may have a tear in my rotator cuff. What’s involved with surgical repair?

A: An injury to your rotator cuff can be a very debilitating injury. The rotator cuff is a group of four small muscles that position the ball in the shoulder socket during movement. The muscles insert on the top of the large arm bone, the humerus. When the cuff tendons are torn, the normal mechanics of the joint are disrupted.

Unfortunately, rotator cuff tears generally do not heal on their own, and surgery may be necessary for normal functioning. Choose your surgeon wisely, and closely follow his or her post-operative instructions. The rehab process is very slow due to the slow healing rate of the tendon repair. Most surgeons recommend keeping your arm in a sling for four weeks with no movement except for passive movement done by your physical therapist. Your physical therapist will slowly progress you through the rotator cuff repair rehab protocol. The healing process and rehab process may take six months or longer. Patience and protection are keys for success. Call your physical therapist for more information.

Information provided by Ray Tresemer, P.T., Tresemer Physical Therapy Inc., 612 E. Franklin St., Centerville, 641-856-2515.

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