Are You Prepared? Advanced Care Planning 101

advanced care planning

This month, November, is Hospice and Palliative Care Month. In recognition, we strongly encourage all who haven’t initiated discussions about Advanced Care Planning to take advantage of November as a steppingstone. If you’ve already done your planning – congratulations on this important step – just be sure to review and update your directive to reflect any changes in your preferences or medical circumstances.

What is Advanced Care Planning?

Advanced care planning is a process that involves making decisions about your future healthcare preferences in advance, particularly if you become unable to make decisions for yourself due to illness or incapacity. The primary purpose of advanced care planning is to ensure that your medical care aligns with your values, beliefs, and personal preferences. It also helps reduce the emotional burden on your family and healthcare providers by providing clear guidance.

Key components of advanced care planning include:

  • Advanced Directive (also called Healthcare Directive or Living Will): This document allows you to specify your preferences for medical treatments, such as life-sustaining measures, resuscitation, and organ donation. It outlines the circumstances under which you want specific treatments or interventions and when you do not.
  • Appointment of a Healthcare Proxy or Agent: In some cases, you can designate a trusted individual to make medical decisions on your behalf if you’re unable to do so. This person is often referred to as a healthcare proxy or agent.
  • Discussion and Communication: The process involves open and honest discussions with your loved ones, healthcare providers, and, if you’ve appointed one, your healthcare proxy. These conversations are crucial to ensure that your wishes are known and understood.

Resources for Advanced Care Planning

Creating an advanced directive is an important step in ensuring that your healthcare preferences are documented and followed when you cannot make decisions for yourself. There are various resources available to help you create an advanced directive:

  • State-Specific Forms: Most U.S. states have specific forms or templates for advanced directives that are legally recognized. These forms are usually available through state government websites, local hospitals, or legal aid organizations. They are designed to meet the legal requirements of your particular jurisdiction. Connecticut’s starting point webpage for Advanced Directives can be found here.
  • Online Resources: Numerous websites and organizations offer advanced directive forms and guides. Some popular resources include:
    • CaringInfo: This is a program of the National Hospice and Palliative Care Organization (NHPCO) that provides free state-specific advanced directive forms and information.
    • Five Wishes: This is a user-friendly advanced directive document that is accepted in most U.S. states. It goes beyond medical decisions to address emotional and spiritual issues. You can purchase a copy online.
    • AARP: The American Association of Retired Persons (AARP) offers advanced directive forms and information that can be customized to your needs.
  • Consult an Attorney: If you have complex medical preferences or want legal advice, consider consulting an attorney who specializes in healthcare or estate planning. They can provide guidance, answer your questions, and ensure that your advanced directive complies with your state’s laws.
  • Hospitals and Healthcare Providers (including RVNAhealth!): Many hospitals and healthcare providers have resources available to help you create an advanced directive. They may offer informational brochures, access to standard forms, or guidance from social workers or ethics committees.

Remember that creating an advanced directive is an important legal and healthcare document, and it’s essential to follow your state’s specific guidelines to ensure its validity. Be sure to share a copy of your advanced directive with your healthcare provider, family members, and your chosen healthcare proxy or agent, if applicable.

Contact RVNAhealth for More Information

Begin the dialogue regarding Advanced Care Planning by reaching out to our team at RVNAhealth. We’re here to assist you in starting these conversations proactively, without the urgency of a crisis. We provide informative materials to assist you, and our team members are available for discussions. Planning ahead is a choice that no one has ever regretted. In fact, it’s a precious gift you can give both to yourself and your loved ones. To learn more, contact us at 203-438-5555, or visit our website.

Grief, Healing and the Holidays

Grief, healing and the holidays. Presentation at RVNAhealth

This holiday season might mark the initial one following the loss of a loved one. The holidays can become hard for many as grief tends to cling to us. It doesn’t just affect us personally; it also becomes intertwined with specific moments and locations.

“Instead of the usual holiday traditions evoking feelings of ‘comfort and joy’ in us, they tend to resurface memories and emotions that can also bring forth feelings of sorrow and heartache,” says Garrett Walkup, RVNAhealth Manager of Bereavement, Social Work, and Pastoral Care Services.

Special Presentation: Grief, Healing and the Holidays

To provide additional support during this time of year, RVNAhealth will host “Grief, Healing and the Holidays” on Tuesday, Nov. 14th from 1:00-2:30pm, at its 27 Governor Street, Ridgefield office. The lecture will include “how to cope with the emotions and feelings of the season, how to handle holiday traditions, and what to do differently – and the same,” says Walkup.

Walkup will cover a number of helpful suggestions to help you with coping and healing.  Strategies such as mindset, being kind to yourself, asking for support, creating boundaries, and more will be covered.  Following Walkup’s discussion, there will be an optional opportunity to stay and enjoy fellowship over coffee and cookies.

This program is open to all members of the community and is intended to offer support through the holiday season for those who have experienced a loss. As we will be serving refreshments, please register HERE to help us with planning. Please contact Garrett Walkup, at 475-529-6118, or if you have any questions.

Ongoing Monthly Grief/Bereavement Support Groups Available

RVNAhealth also offers monthly support groups at both its Ridgefield and New Milford offices. These are open to anyone needing a space for comfort, and guidance on grief and healing. Please see current dates available below. Check out the RVNAhealth calendar / support groups tab for the latest information and offerings.

Highlighting the Hospice Conversation

highlighting the hospice conversation

Jimmy Carter and his decision to enter hospice care has taken prominent placement in national news over the past six months. His decision to make public his election for hospice care has had a profound impact on how people perceive and discuss end-of-life care. Despite assumptions that hospice care is a short-term arrangement primarily for individuals at the brink of passing away, Carter’s case has demonstrated that hospice care can extend for a longer period and truly focuses on patient quality of life.

Current statistics show that only slightly more than half of those patients eligible for hospice care opt to receive it. At the age of 98, the former president’s choice to enter hospice care has led to a shift in public understanding. His family’s reports of him enjoying simple pleasures, such as ice cream and staying engaged with the activities of the Carter Center, highlight that hospice care can provide comfort and maintain a sense of normalcy for patients, rather than solely concentrating on medical interventions.

Carter’s openness about his journey has prompted conversations about hospice care’s benefits and debunked common misconceptions. Hospice care isn’t solely about imminent death; it centers on enhancing a patient’s well-being, managing pain, and emotional support for both patient and family. Carter’s situation underscores that hospice care can offer a higher quality of life for patients who opt to prioritize comfort and quality of life over aggressive medical treatments.

By openly sharing his care choice, Jimmy Carter has contributed to breaking down barriers surrounding discussions on death and end-of-life care. His example encourages a broader dialogue about the importance of making informed decisions regarding care options, advocating for individual preferences, and recognizing that hospice can offer solace, dignity, and a higher quality of life during one’s final stages.

For more information from RVNAhealth on myths and frequently asked questions about hospice care, visit our page.

RVNAhealth Hospice and Palliative Teams Win 2023 Florence Wald Award for Excellence in End-of-Life Care

2023 Florence Wald Award accepted by RVNAhealth Hospice and Palliative Care team

RVNAhealth’s Hospice and Palliative care teams won the 2023 Florence Wald Award for Excellence in End-of-Life Care.

Florence Wald Connecticut History

The Florence Wald Award for Excellence in End-of-Life Care was established to honor Florence Wald. Wald was a pioneer in improving the care of dying patients across the world. Her focus on an interdisciplinary approach to end-of-life care led her to open the first hospice in the United States (here in Connecticut) in 1971. A visionary leader with unwavering commitment to social justice and reverence for life, Wald valued patient, family, and team participation. She truly listened to their input which ultimately launched the hospice reform movement in this country. Thirty-seven years later at the time of her death in 2008, over 4,700 hospices had been instituted across the country.  And today, in 2023, there are over 8,000 hospice and palliative care institutions!

RVNAhealth Acceptance of Award

2023 Florence Wald Award given to RVNAhealth Hospice and Palliative Care Teams
2023 Florence Wald End-of-Life Care Award

The award was presented on May 11th at the annual Statewide Hospice & Palliative Care Summit, hosted by the Connecticut Association for Healthcare at Home. Theresa Santoro, President & CEO of RVNAhealth, and team members attended a ceremony to accept the award. “This award is a reflection not only of the incredible work of our Hospice and Palliative teams but of the work from everyone at RVNAhealth. It is performed naturally and with great compassion and has a tremendous impact on our patients,” said Santoro

Keri Linardi, RN, BSN, PHN, CHPCA, RVNAhealth Chief Clinical Officer, elaborated on how the RVNAhealth team exemplifies Wald’s commitment. “The key is meeting patients and families where they are in their illness trajectory. Our approach is quite different because we spend more time listening to what patients want.  We educate them on the best approach to meet those needs, and provide the right care at the right time which includes many ancillary services. We hold ourselves, and each other, to higher standards because every patient and their loved ones deserve the best experience during such a monumental time. This is what makes this team so special.”

For more information on RVNAhealth’s hospice and palliative care services, please call 203.438.5555 or visit our website.


Celebrating our Hospice Volunteers

Last week RVNAhealth celebrated Hospice Volunteer Appreciation Week. RVNAhealth, and all Medicare-certified hospice programs, are required by law to have 5% of service hours performed by volunteers. Why?  Because hospice care in the U.S. was founded by volunteers, and the commitment to the power, beauty, and altruism of volunteering remains. In the past 12 months our RVNAhealth team of 50 hospice volunteers have provided over 1,500 hours of help in in the office and in the field visiting patients and their family members. We are so fortunate to have these volunteers and Stephanie Peppe as our Hospice Volunteer Coordinator to manage all of the required training and visits. Thank you to all of our volunteers !

Hospice Volunteers Wanted! If you are interested in learning more about our hospice volunteer program – we’d love to hear from you.  As a hospice volunteer, you can feel good knowing you are doing meaningful work whether it be providing companionship to a patient, comfort to a family, or organization to the office. Learn more about hospice volunteering and watch our therapy dog, Sophia, in action! Email Stephanie Peppe, or call 203-438-5555 x1025 to get started today.

If you need a little more convincing, we are overjoyed to share a lovely poem written recently by Hospice Volunteer Pam Bruno about one of our patients. Pam has been visiting Dottie for over six months. They spend about five hours a week together and the two of them have built a wonderful bond. The poem is called, The Gift of Sitting with Dottie. We hope you enjoy it as much as we did.

Palliative Care versus Hospice Care…Alike and Different

Every year the Healthcare industry recognizes National Hospice and Palliative Care in the same month. The two practices are celebrated together, as they share a similar philosophy on person-centered care and an interdisciplinary team approach focused on quality of life. But they also share misunderstandings about what each practice offers.

Hospice care is elected when a patient and family wish to go from a curative plan of care to one of comfort and caring. Hospice addresses a patient’s pain and symptom management, and overall well-being from an interdisciplinary approach – including physical, mental, social, and spiritual. This care supports both the patient and their family, helping bring focus to quality of life and allowing a patient to realize their wishes for their final life chapter.

Palliative care helps individuals with a serious illness, at any age and any stage of their illness. Patients do not require a terminal diagnosis and often still receive curative treatment for their condition. Palliative care provides a specialized team, including clinical, social workers, and pastoral care, who work with patients to help them understand their treatment options and can act as a central coordinator of care – which can be extremely beneficial in the often overwhelming early days following the diagnosis of a serious illness. Care is intended to improve quality of life and give a patient more control by improving their ability to cope with their disease.

Common illnesses addressed by both palliative and hospice care include cardiac and respiratory illnesses, cancer, Alzheimer’s, AIDS, kidney disease, and more. Both practices address symptoms for comfort, including pain, shortness of breath, depression, nausea, and difficulty sleeping, to name a few.  The largest difference is in the individual decision to continue treatment for disease, which palliative care addresses, or cease treatment and focus on quality of life and final wishes with hospice. With both practices, early intervention is most beneficial to the patient.

RVNAhealth offers both hospice and palliative care in the home or at a patient’s facility. If you have questions or would like to discuss a potential palliative or hospice care need, please contact us at 203.438.5555.

A Month of Thankfulness but an Honor Year-Round

Community Dementia Presentation on June 16th 2023

As November brings a celebration of thankfulness with the Thanksgiving holiday, at RVNAhealth another type of thankfulness is celebrated throughout the month. November is recognized as National Hospice & Palliative Care month. It is a time we show our appreciation for the nurses, aides, social workers, and others, who pour their heart and soul into the compassionate care of our hospice patients and their families.

”When asking any member of our team why they chose to work in the hospice field, you often hear the phrase ‘it’s an honor’ mentioned,” says Hospice Clinical Director, Jessica Velasco, RN, CDP. “They are honored to be a part of a patient’s end-story…honored to have families welcome them into their homes to care for their loved one…honored to share in a family’s personal stories, thoughts, and emotions. RVNAhealth’s Hospice team works around the clock daily to deliver a remarkable standard of care and support to our patients and their loved ones. During this month as we celebrate and recognize the hospice profession, please join me as we ‘turn the table’ and express what an honor it is to work alongside this amazing team!”

We send our tremendous gratitude and appreciation to the following Hospice teams:

Thank you to our Medical Directors who oversee the care and management of our patients. Our Medical Directors provide round the clock expertise, patient team coordination, and support to our Nursing and extended interdisciplinary teams, helping to ensure comfort through each patient’s individual hospice journey.

Thank you to our Nursing Team — those in the field and in the office, those who work weekdays, weekends, and night shifts. Our Nursing staff do everything from creating and overseeing patient care plans, to answering family calls and questions, to reviewing charts and ongoing adjusting of comfort measures, to teaching and helping loved ones to best support their family member. Our Nursing Team members work 24-7 to ensure patients and family members are supported through easily accessible communication and compassionate expert care.

Thank you to our CNAs (Certified Nursing Assistants), a team that comprises a core function of everything we do in Hospice.  These talented hands-on health care professionals spend the most time with our patients, following plans of care, aiding with activities of daily living, and dynamically supporting their changing needs.

Thank you to our Social Workers who provide emotional and informational support and education to patients and their families, helping them navigate and understand the hospice care journey. They are also trained to comfort and guide families with grief both during and after a loved one’s passing.

Thank you to our Pastoral Care Team who provide non-denominational spiritual care that is personalized to each patient’s beliefs and wishes. Trained to help individuals explore and navigate feelings, understandings, and hopes, this team also provides bereavement support for our patients, loved ones, and the community.

Thank you to our Music Therapists who use their restorative talents to support comfort, fond memories, and the release of emotions throughout care. Whether as a quiet listening experience or as an active entertainment with dialogue or song, our music team strives to meet what a patient needs the most on any day.

Thank you to our Hospice Volunteer Team who have donated over 2,000 hours of their time in the last year alone providing visits to our patients and their families, as well as assisting in our offices. From chatting, to playing games, to walks, and supportive listening, our volunteers add meaningful moments to our hospice team every day.

Thank you to our Therapy Dog, Sophia who works tirelessly to provide joyful, tail-wagging visits and cuddles.

Thank you to all other RVNAhealth interdisciplinary teams who work to ensure our hospice program delivers best in class service to families when they need it most!

For more information on RVNAhealth Hospice services, please visit our website or call us at 203.438.5555.

Celebrating Life…RVNAhealth’s Annual Hospice Memorial Service

On Tuesday, June 21st, RVNAhealth’s ComfortWELL team hosted its second annual RVNAhealth Hospice Memorial Service in the Ridgefield office for the families and loved ones of our hospice patients who have passed away. The memorial service is an opportunity for all to honor their loved ones who have passed away and pay tribute to the lives they led. It was a beautiful evening, made particularly special by the bonds and love shared by families, friends, and staff. We are grateful to the families who came and to all the families who entrusted us with the care of their loved one in their final stage of life.


This time helps family heal, connect with the team who cared for their loved ones, and express one more time their experience. It not only helps families but also staff. Our hospice staff spend significant time with patients and their families. Special bonds are created, so we grieve for patients as well. As Hospice Nurse, Lauren Messina, MA, BSN, RN put it “seeing the names of my patients at the memorial service gave me a sense of closure.”


One of the family members in attendance expressed her immense gratitude for our continuum of care. Her husband had been under our home health services for rehabilitation therapy but, after recognizing a decline in his health, he was referred to our ComfortWell hospice services. She expressed how easy and smooth the transition had been. From home health to hospice, she was in awe of the high caliber of RVNAhealth staff who visited her husband.

A second RVNAhealth Hospice Memorial will be held this coming fall in New Milford for families and friends of our ComfortWELL patients in the northern territory.


For more information on RVNAhealth’s ComfortWELL hospice services, please visit our website, or call 203.438.5555.

In the Words of our Patients and Loved Ones…

“In February, 2021, my close friend Lewis Little died at his Redding home. In his final days, Lewis and I and his family received amazing care and support from your Hospice staff.  I continue to receive outreach from your Bereavement team, which I find very comforting. I sing with the Ridgefield Chorale.  Our Spring concert this May will include a video presentation of singers’ expression of thanks to people and organizations that supported them during the difficulties of the COVID-19 pandemic.  My intention is to include a photograph of myself holding a sign thanking RVNAhealth Hospice Services.”

– Margaret Sheahan

For more information about RVNAhealth Hospice services, please call 203.438.5555 or visit our website.


RVNAhealth Hospice Program Earns CHAP Re-Accreditation

During the week of September 27th, a CHAP (Community Health Accreditation Partner) surveyor was on-site in Ridgefield, conducting an audit of our Hospice program for re-accreditation; and reviewing our Palliative Care program for first-time accreditation.  It could not have gone better.Continue reading