For people curious about living wills or transitioning into a nursing home, two educational programs are now being held each month in Butler.

The sessions are hosted jointly by the Visiting Nurses Association and Sunnyview Home.

As part of the Caregiver Advocacy, Rights and Education, or CARE, program, the two sessions are designed to answer questions and to provide a forum for senior citizens and their families.

The first session, on dealing with advanced care directives, or living wills, is held from 6 to 7:30 p.m. on the first Wednesday of each month in the first-floor conference room at Sunnyview.

The second session, No Easy Answers, is designed to aid caregivers during their loved ones' transition to a skilled nursing facility.

That program is offered from 1 to 2:30 p.m. on the third Wednesday of the month at Sunnyview.

The CARE program will last in its present form through October, said Jolene Formaini of VNA, one of the program coordinators. CARE will then be evaluated to determine its future course.

Since the program began in May, Formaini said the topic of living wills has been on peoples' minds, probably because of publicity relating to Terri Schiavo, the Florida woman whose feeding tube was removed in March after 15 years.

Formaini said in the case of Schiavo, whose condition was diagnosed as a persistent vegetative state, no living will existed. The lack of a will led to a legal battle because Schiavo's preferred course of action was not known and because no one had been named beforehand as a decision-maker.

"We didn't know who she wanted to make decisions for her," Formaini said.

Naming

a power of attorney for health care is the most important thing a person can do, he said.

The other is creating a checklist that identifies what action a person would prefer in any given situation.

"It's important to think, 'What if I was in the situation that Terri Schiavo was in? What would I want?'

"Get it written down, approach that person," she advised. "If I'm ever in a state I cannot recover from, this is what I want you to do. I do or don't want CPR. I do or don't want a feeding tube.

"Once you do a living will, it only ever takes effect if you are in that state," she said. "It doesn't take effect unless you become incompetent."

Formaini also said family members and physicians are not legally bound by the living will, so choosing a decision-maker and being explicit in one's wishes are especially important.

Formaini said the living wills do not require the use of an attorney, but require the signature of two unbiased witnesses.

"Make several copies," she advised. A person's physician and family members should fully understand the document in advance, she said.

In addition to living wills, Formaini said common concerns and topics in the session have included deciding when loved ones are ready for hospice, dealing with guilt if issues like removing feeding tubes arise, and coping with issues of day-to-day care.

During the No Easy Answers sessions, topics often relate to the experiences of both patient and family during a transition to nursing home care.

"It helps the families deal with some of the feelings that they feel when they are placing a loved one in a nursing home," said Melissa Mitchell, admissions and social services director at Sunnyview and one of the CARE coordinators.

"Both sessions have a video. We have questions (and answers) and also a support session," said Mitchell, explaining the program seems to be benefiting Sunnyview residents as well as caregivers in the community.

"There is always a representative from Sunnyview and the VNA at each session.

"It's a good program. We're hoping to continue it definitely throughout the year and at that point reevaluate and look at offering different educational sessions on what is the hot topic at that point and what individuals are interested in."

The sessions are free, but registration in advance when possible is preferred. To register, call 724-282-1800.