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National Healthcare Decision Day is forthcoming. Here’s an easy and free way to commemorate the occasion: openly discussing how we want to be cared for at the end of our lives. Join Renown Health’s experts at a workshop about making decisions about an advance directive. Among the random national holidays, this one has significance: April 16 is National Healthcare Decision Day. And experts agree that the best time to discuss your views about end-of-life care and to learn what choices are available is before a life-limiting illness or crisis occurs. By preparing in advance, you can help reduce the doubt and anxiety related to decision making for your family if you cannot speak for yourself. “Completing your advance directive is a gift you give your family,” says Mary-Ann Brown, RN, MSN, director of Palliative Care. “The stress associated with these difficult decisions is decreased if everyone knows what is important to you and what you want the end of life.” What Are Advance Directives? An advance directive is a document that states your choices about medical treatment and names another person to make medical decisions on your behalf if you are unable to. This document allows you to make legally valid decisions about future medical care. Find more information about advance directives and the form online. The Conversation The first step in completing an Advance Directive is to think about what’s important to you and talk to your loved ones. The Conversation Project provides helpful tools to guide you and your family through this challenging topic. Getting this information together will help you fill out and complete your advance directives. Some things to consider and discuss with your family include: When you think about the last phase of your life, what’s most important to you? Who do you want involved in your care? Who should make decisions on your behalf if you’re not able to? Where do you want or not want to receive care? Are there specific treatments you would or would not want? Complete Your Advance Directive Planning In order to complete an advance directive, you will need either two witnesses or a notary to sign the form. Be sure to note restrictions on the witness process. When an advance directive is complete, you should keep the original. Copies should be given to your agent named in the form, your family, your doctor(s) and the location that you receive care. Renown Health offers four advance directive workshops every month to cover the details of filling out this document. A healthcare team is available to answer questions and work through the process with you. A notary is also present to finalize the process, which means you can complete your advanced directives during this workshop. Find the workshop by calling 775-982-RSVP for more information. Advance Care Planning Workshop April 17, 1-2:30 p.m. | Free Join Renown Health’s experts for a workshop about making decisions regarding end-of-life care. You will learn how to fill out an advance directive, receive one-on-one assistance and have your documents signed by a notary. Workshops are typically held several times each month. To RSVP, call 775-982-7787

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Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!

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August is National Make-a-Will month. We talked to Renown Health Foundation Planned Giving Officer, Abbey Stephenson, to learn more about wills, trusts, and estate plans and why you should feel motivated this month to get started. Did you know that 2/3 of Americans don't have a will or trust? If this is you, don’t worry, you’re not alone. Although there are laws in place to determine who inherits your assets if you die without a will or trust, having a will or trust ensures your assets go where you want them to go after you are gone. They can also help minimize disputes between family members and heirs about who gets what. In Nevada, the laws that govern who gets what if you die without a will or trust can be found in Chapter 134 of the Nevada Revised Statutes. There are other documents that people often prepare at the same time as their will or trust – like an advance health care directive and durable power of attorney for assets. These documents all together are called an estate plan. Although they have other purposes too (like nominating a guardian for a child, planning for disability or avoiding probate, which is a court process), wills and trusts are documents that say who will receive your assets after you are gone. The most common type of trust is often called a revocable living trust or a family trust. People who have a trust usually still have a will, although it is a shorter form of will called a pour-over will. It’s a good idea to talk to an estate planning attorney about whether or not a trust makes sense for your family or circumstances.  Now that you’re ready to get started, here are some mistakes to avoid: 1. Failing to plan Not setting aside the time to plan may be the biggest mistake. Failing to prioritize preparing or updating your estate plan means your last wishes and desires may not be fulfilled. The right documents memorialize what you would like to happen upon your disability and death so that other people can know and follow your wishes with respect to your care and your assets.  2. Failing to coordinate beneficiary designations Certain types of assets like life insurance and retirement accounts are not covered by your will or trust and need to be addressed separately. These types of assets are referred to as non-probate assets because they transfer under contract principles and don’t require court supervision or probate to be distributed to the named beneficiaries. By completing beneficiary designation forms provided by the retirement account custodian, insurance company or financial institution, you can direct your assets to one or more beneficiaries. 3. Failing to title your assets properly Asset titling refers to how you own your asset – such as in your individual name, jointly with someone else, or in a trust or entity. For example, assets titled for two people with a “right of survivorship” will automatically go to the surviving owner. Review your asset titling and make changes, if needed, to ensure your property and assets are passed down the way you intend. 4. Failing to include charities meaningful to you In addition to providing for family members and other important people in your life, you many also choose to give to charities meaningful to you in your estate plan. When you include a charity in your estate plan, that gift is called a planned gift and many charitable organizations, including Renown, recognize such donations through their legacy giving societies. As you prepare to make your own will or a more comprehensive estate plan, we recommend you consult with a lawyer. Here are some free resources that may be helpful too:  Renown Health Foundation is proud to sponsor the Family Estate Planning Series put on by PBS Reno and the Community Foundation of Northern Nevada. The free, 8-week course of 90-minute, in-depth workshops is a great place to learn much more and to help you get started in the planning process. The next course begins on September 7, 2022. More information can be found here. Renown Health offers periodic advance health care directive workshops where attendees can learn about, complete, and sign their directive. The next workshop is scheduled for September 14th. More information can be found here. The American College of Trust and Estate Counsel provides information on a number of commonly asked estate planning questions here. If you are interested in including a charitable gift to Renown in your estate plan, we would be happy to talk to you about how your gift will make a difference for our mission. Please contact Abbey Stephenson at abbey.stephenson@renown.org or visit renown.org/LegacyGiving to learn about Renown Health Foundation’s Legacy Giving Society and ways to give.

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Did you know certain medications can interact with everyday food and drink? We asked VP of Pharmacy Services Adam Porath how to take these important medications safely. One in five Americans between the ages of 40 and 75 are currently taking a statin drug to reduce their cholesterol level or to prevent atherosclerosis (hardening of the arteries). Many others also take anticoagulants (blood thinners) to prevent blood clots from forming, which can increase the risk of stroke. Adam Porath, VP of Pharmacy Services at Renown Health, explains how to safely take these medications. What is a statin? A statin is a drug that can lower cholesterol by helping your body absorb cholesterol or by blocking a substance your body needs to make it. The American Heart Association cites a global study reporting the benefit of statins to help reduce heart attacks and strokes. Common statins include atorvastatin (Lipitor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor). Which foods or drinks should be avoided while taking statin drugs? Grapefruit juice is the only food or drink that has a direct interaction with statins. Statins do not directly interact with any food but people taking statins should moderate their intake of saturated fats to help lower their LDL cholesterol and overall risk of cardiovascular disease. What is a blood thinning drug? Blood thinning drugs, such as warfarin, rivaroxaban (Xarelto), apixiban (Eliquis), dabigatran (Pradaxa) and edoxaban (Savaysa), are used to prevent stroke. Which foods or drugs should be avoided while taking blood thinning drugs? If taking warfarin, alcohol and cranberries (including juice) should be avoided. Patients taking warfarin should be aware of foods that contain Vitamin K (green leafy vegetables) and try to maintain a consistent diet of these foods. Warfarin interacts with many over the counter and prescription medications. Patients should consult a pharmacist when starting, stopping, or changing doses of any medication when taking warfarin. Also, patients taking any blood thinning medication should avoid over-the-counter pain relievers (i.e. aspirin, ibuprofen, etc.) How do I know whether to take my medication with food or not? Consulting with a pharmacist is the best resource to determine if a medication should be taken with or without food. In general, all statins and blood thinners can be taken with or without food. The only exception is Xarelto (rivaroxaban), which should be taken with the largest meal of the day If you are a Renown patient you can also review your prescriptions online, request a refill or ask a question via MyChart. With MyChart, you can access all your healthcare information securely 24/7.

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We plan for the birth of a child, weddings and retirement, but rarely do we discuss how we want to be cared for at the end of our lives. Getting through this challenging conversation and completing an Advance Directive can give you peace of mind that your loved ones will not have to make difficult choices on your behalf. The best time to complete an Advance Directive is now – don’t wait until a life-limiting illness or crisis occurs to discuss your views about end-of-life care and to learn what choices are available. By preparing in advance, you can help reduce the doubt and anxiety related to decision-making for your family if you cannot speak for yourself. What are Advance Directives? An Advance Directive is a document that states your choices about medical treatment and names another person to make medical decisions on your behalf if you are unable to. This document allows you to make legally valid decisions about future medical care.  “Completing your Advance Directive is a gift you give your family,” says Director of Palliative Care, Mary-Ann Brown RN, MSN. “The stress associated with these difficult decisions is decreased if everyone knows what is important to you and what you want at the end of life.”

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August is National Make-a-Will Month. We talked to Abbey Stephenson, Planned Giving Officer at Renown Health Foundation, to learn more about wills, trusts and estate plans and why you should feel motivated this month to get started. Why Make a Will There are so many reasons why it is difficult to make a will or put an estate plan in place. These include: Lack of time or money to prepare a plan The misperception that “only rich people need an ‘estate plan’” How intimidating legal documents can be General discomfort with planning for the future Given the barriers to making a plan, it’s not surprising that only 32% of Americans have a will or trust in place. But having a will or trust matters because these are the documents where you can say who will inherit your assets, who will manage your assets and estate, and who should be guardian of a minor or a child with a disability. Where to Begin If you have been thinking about putting together a will and don’t know where to begin, here are some next steps you can take. 1.  Learn the terms. If you have never created a will, trust, or an estate plan, the language can be hard to get used to. A few important terms to know include: Last will and testament (also known as a will): a legal document that describes how you would like your property and other assets to be distributed after your death. This is also the document where you can nominate a guardian for a minor or disabled child. Personal representative (also known as an executor): a person named in a will responsible for collecting your assets, paying your debts and final taxes, and distributing the remaining assets to those stated in your will. Personal representatives must be formally appointed by a judge and report certain information to the judge for review and approval. Living trust (also known as a revocable or family trust): a legal arrangement set up through a document called a trust instrument or a declaration of trust that gives someone called the trustee power to make decisions about the trust creator’s money or property held in the trust. Estate plan: a collection of documents that help organize what happens to you and your assets upon your disability and death. Your estate plan is comprised of documents such as a will, trust, and advance health care directive. If you want to learn more about these terms and estate planning in general, you are invited to attend a free one-hour estate planning education session on Aug. 22, 2024, at 10 a.m. or Oct. 21, 2024, at 11 a.m., hosted by Renown Health Foundation. Click here for more information and to register. 2.  Create a list of assets. Start by creating a list of your assets including real estate, investments, bank accounts, retirement accounts, business ownership interests, vehicles, life insurance, valuable personal property like jewelry or artwork, and any other significant assets. Click here and read our free estate planning guide. 3.  Put together a list of 2-3 people you trust. When you create your will, you need to name a personal representative who will collect all your assets, pay your debts, and work with the probate court to distribute the balance to the people and charities you name in your will. If you create a trust, you need to name a trustee to manage the trust assets under the terms of the trust document. It is a good idea to include at least two people who can take on these roles in case the first person becomes unavailable. If you do not have anyone you would trust as a personal representative or trustee, there are trust companies, banks, and other professionals and institutions who may be able to assist you. If you are the parent of a child who is under 18 or has a disability, you will also nominate a guardian in your will to care for that child if you and the other parent are gone.  4.  Start a list of who you would like to inherit your assets. Which people and organizations would you like to inherit the assets you own at the time of your passing? And which assets or how much would you like them to receive? You might want to consider who relies on you for support such as family members or charities, individuals and organizations that have made a difference in your life, or those you have a special fondness for. It is important to use the legal names of individuals you include as beneficiaries and the Tax ID number for any charity you include.  If you decide to make a gift to Renown as part of your will or estate plan and notify us, you will be included in the Renown Legacy Society. Legacy Society members enjoy invitations to exclusive events, special acknowledgments, and other unique benefits. Click here to learn more about the Renown Legacy Society. 5.  Put together a list of your professional advisors and enlist their help. Write down the names and contact details for any professional advisors you work with such as your accountant, financial advisor, investment manager, attorney, insurance agent, and planned giving officer.  You may want to seek their advice on how best to proceed and which assets are best gifted to which individuals and organizations from a tax standpoint. Collaboration among the professionals with whom you work can help your plan to run more smoothly when it is needed. Depending on your circumstances, it may make sense for you to introduce your trusted individuals to these professionals. 6.  Start drafting. Once you have these items in place, you will be in a good position to begin the drafting process. There are many capable estate planning attorneys in our community who can help you with drafting. There are other drafting resources available as well, but only a licensed attorney can provide you with legal advice. Click here to attend the free Family Estate Planning Series sponsored by Renown and presented by PBS Reno and the Community Foundation of Northern Nevada.

Read More About How to Get Started and Make Updates to Your Will