In Chicago, for example, those without health insurance go to the county hospital where they are treated without regard to whether they have health insurance. If the bill is passed, however, many of these county hospitals will either have to close their doors or deny treatment to those without health insurance.

Although the bill passed by the Senate has been depicted as using coercive means to require those currently uninsured to buy insurance they cannot afford, or as imposing additional new taxes on the American working man and family, that bill is based on a fundamental lack of understanding of how the health care needs of the nation’s poor are currently served.

The desperately poor, many of them unemployed, are not equipped to deal with complicated insurance programs, deductibles, co-pays and all the other accoutrements of the typical health care policy. They are poor, they are unemployed, they are sick, they need a place to go to be treated without red tape and procedural obstacles.

County hospitals across the country that have provided that place are now threatened with a cut-off of funding and in many cases with extinction by the current health care reform bill passed by the Senate.

A number of proposals for making health care affordable for all Americans have been put forward by those who have sought to be heard during the legislative process. All these proposals have been rejected by a Congress determined to impose government control of health care.

Among these rejected proposals is to allow people to buy health insurance they can afford. Currently, government mandates require a single man to buy maternity coverage he will never use, or to pay inflated premiums to insure against going insane. It would be similar to a government mandate requiring every person to buy a Rolls Royce instead of a Ford. And then when people can’t afford to buy the Rolls Royce, they’re without any car at all.

Another rejected proposal is to allow health insurance companies to compete across state lines, thus increasing the competitive pressure to provide affordable insurance. Proposals for modest curbs on the multimillion-dollar malpractice suits that divert billions of dollars away from health care and into the pockets of high-rolling trial attorneys have also been rejected.

Even proposals for limited but cost-effective catastrophic government insurance have been rejected by those determined to have government take over health care across the board.

Daily Care of Your Dog’s Teeth

Dogs should not be given highly alkaline or acidic food in order to prevent damage to their teeth.

The development of new teeth makes the animal bite anything that catches its fancy. If a dog does not get a bone or something resembling a bone to bite on early in its life, there is a higher risk of it developing dental disorders later in life. Therefore, dog owners should give their pets something to bite on during this crucial stage in their lives.

The teeth of hunting dogs need to be taken care of more than any other breed in order to avoid dental complications in furture. Get a good brush for your dog’s teeth. You need to, however, invest time, energy, and a lot of patience to use a brush on your dog.

Nip Dental Disorders in the Bud

Antibiotic treatment has to given right in the initial stages of a dental infection. Otherwise, it might lead to infection of specific areas. In worse conditions, the infection might spread to areas such as the pharyngeal region, the mucous membrane in the oral cavity and so on.

If the dog has bleeding in the oral region, it should be examined carefully for any dental disorders. Usually puppies, and at times, even adult dogs suffer from dental injuries. As a preventive measure, they should be immediately attended to. Otherwise, the animal might develop secondary bacterial infection.

In many countries, centers for disease control and prevention are now formulating guidelines to prevent dental disorders in dogs. Take you dog for regular oral examination. A little bit of care goes a long way in nipping any dental disorder in the bud.

So here’s what I’ll do for you. You can read this article, and get practical how-to advice about men skin care products and no one will know! It will be our little secret.

Close the Sale

Most men have this mistaken idea that men skin care products consist solely of soap, shaving cream, and some aftershave or cologne. The phrase “skincare” conjurs up images of women with cucumber eyes, trying to keep their skin feeling soft and pretty. But what man really cares about “soft and pretty” skin?

But I know a lot of men who care about first impressions. They care about being able to close a high-end sale, or confidently lead a group of associates, or give killer-presentations. They care about RESPECT. And respect is harder to attain when you look like your 14, but your really pushing 40. And those little red dots sprinkled on your face and neck certainly don’t help your case.

Believe it or not, but a good skin care regimen is actually more important for a man than it is a woman. Women don’t regularly take a sharp blade and scrape it across their cheeks, chin, and neck. That constant irritation can make skin itchy, red and irritated. Throwing on those alcohol-based aftershaves and colognes afterwards can make things even worse.

Talk about a solid return on investment! That 30 seconds you take in the morning and evening to properly care for your manly man skin will pay you dividends on your overall health, and your ability to “wow” at those first oh-so-important impressions.

A man with a healthy, young-looking complexion (but with an experienced face) is going to feel more confident about that getting promotion, or delivering that effective sales-speak to potential customers. Give yourself an emotional and physical edge on your competitors.

Go Below the Radar

Although they are an absolute necessity in order to nurse razor-burned and irritated skin back to health, high-quality men skin care products are very difficult to find. I say “high-quality” because most of the men skin care products being offered are not specifically designed for the unique needs that a man has.

You might as well be putting cucumbers on your eyes too…because your getting the woman’s formula in a new package. If there are any changes at all, it’s most likely just a new scent. At least they’re smart enough to figure out that YOU don’t want to smell like lavender.

If, by some miracle, the products were different, I would still not recommend that you use them. Why? Because they are full of chemicals and petroleum-by products that don’t help your skin, and are even worse for your total body’s health.

You need natural skin care for men. You need men skin care products that contain healthy ingredients to effectively soothe, and moisturize your skin, nullifying the effects of daily shaving.

What are the ingredients you should look for in your natural skin care for men products? Brazilian Babassu wax (as opposed to cancer-giving paraffin), and witch hazel. Both of these act to relieve both the razor burn that you have and the dryness and itching.

Natural skin care for men should always include these two ingredients, the witch hazel especially. Look for naturally processed witch hazel, not synthetically re-created.

You should also be on the lookout for Capuacu butter as an ingredient, because it is also especially good at treating dry, itchy, inflamed skin. It has even been proven powerful enough to be helpful in healing eczema.

As a rule, if the product you’re using isn’t produced by a company that includes all-natural ingredients as part of their mission statement, move on. Go below the radar, and use natural skin care for men products from companies who are smaller in scope.

In my experience, if the huge mega-skin care companies would spend just half of their marketing budget on research and development, their products would be infinitely higher-quality.

Your Bottom Line

In this economy, it’s important to make the best impressions on your customers, boss, and coworkers. Everyone’s skin (including mine) could use something. If you don’t eat healthy foods, your body will remain unhealthy. If you don’t use men skin care products that are healthy, your skin will remain blotchy, irritated, and wrinkled.

Taking 1 minute a day to attend to your skin’s needs is an incredibly simple way to boost your confidence, and maybe even your bottom line. To see the specific ingredients you should look for in your natural skin care for men products (including more details on the ones I’ve already mentioned), and where to find them, visit my website hyperlinked below.

If you are going for dental surgery then it is advisable to go to an expert dental care center. The reason behind it is that good dentist with hand on experience is more capable than ordinary doctors. People who understand the importance of living healthy always visit expert doctors. Cosmodentist provides expert guidance for the upkeep of your teeth at below affordable prices. Cosmodentist will provide faster and good results to your long dental problems. All of your dental problems will be wiped out within a few days that other dental clinics cannot wipe out within months. Cosmodentist is being run by expert team of dentists and has best equipment, tools of the world that no one can provide. You are advised to first visit this care centre and then make a comparison. Whosoever has compared the results has found something extra in our centre. Apart from this you should also visit dental care centre twice in a year. Yet brushing of teeth twice in a day is a best precaution that needs to be adopted.  The above all feature of our dental clinic is that we run new method of treatment and keep our staff update about the new innovations in dentistry and use leading instruments for treatment. In final we enumerate the importance of dental care centre run by expert dentist. For More http://www.cosmodentist.in/

‘Serious skin care’ is also about awareness. With the technological advancements and research, more and more facts are being brought to light everyday. Also, the composition and nature of skin care products seems to be changing with time. So trying out the new products is also a part of serious skin care. However, ‘serious skin care’ advises using a new product over a small patch of skin (not facial skin) first, just to see how your skin reacts to it.

‘Serious skin care’ also means knowing how to use your skin care products. Good practices include things like applying the moisturizers while the skin is damp, using upward strokes for better penetration of skin care products, removing the make up before going to bed, cleansing before moisturising or applying make up, using the correct amount of skin care products, etc. Thus, increasing the effectiveness of your skin care products is another focus area of serious skin care.

Some precautions, like avoiding contact with detergents, are also part of serious skin care. ‘Serious skin care’ means being gentle with your skin. Things like over-exfoliation, use of low quality products, and application of strong-chemical based products, are all harmful to your skin. Some people have a wrong notion about serious skin care. For them serious skin care is – using large quantities of products as often as possible. However, this really isn’t serious skin care (and that’s why awareness is so important).

‘Serious skin care’ is also about visiting your dermatologist for treatment of skin disorders. Ignoring the skin disorders can be fatal for your skin and might lead to permanent damage. So, if the things don’t improve with over the counter medication, you should immediately visit a dermatologist. Self-surgery e.g. squeezing of acne/pimples is a big no (it can lead to permanent damage of your skin).

So, seriously serious skin care is more about precautions and preventive measures (than treatment). Serious skin care is about being proactive as well as reactive. In fact, we can say that ‘serious skin care’ is about being proactive about the needs of your skin so that the need for being reactive is reduced to a minimum.

This Week in Health Care Reform

After months of public debate and private negotiations, health care reform discussions stalled following Tuesday’s Senate vote in Massachusetts. The Democratic Senate lost its 60th vote supermajority when Republican Scott Brown was elected to the United States Senate in the Massachusetts special election.

Health Care Reform Negotiations Post-Massachusetts Special Election

Massachusetts Election of Senate Republican Recasts Debate: Following the election of Republican Scott Brown to the Massachusetts Senate seat Tuesday night, Democratic leaders have been scrambling to revive what could now be a dying bill. The loss of the Democrat’s 60th vote in the Senate opens up the legislation to a Republican filibuster – something the Democrats have managed to avoid thus far in the debate.

House and Senate Democrats met this week to discuss how to move forward with the reform legislation in light of this election and promised Wednesday that they would push ahead. There are a number of options that Democrats are considering, but at this point they have not charted their course.

On Wednesday, Speaker of the House Nancy Pelosi (D-CA) attempted to rally House Democrats around a strategy to push the Senate bill through the House and onto President Barack Obama’s desk so as to avoid the need to again secure 60 Senate votes. However, the Speaker indicated on Thursday morning that she did not believe she has the needed 218 House votes necessary to move forward. This option would have allowed lawmakersto then propose additional modifications to the approved legislation through a process called “reconciliation,” which only requires 51 votes in the Senate.

Other remaining options:

1.
House and Senate Democrats could also quickly complete the merging of the two bills and vote on the combined package before Mr. Brown is sworn in.
2.
Democratic leaders could attempt to re-engage Sen. Olympia Snowe (R-ME), the only Republican who voted for the Senate Finance Committee’s bill passed in October. Democrats would need to allow her to amend the bill so that she could support its passage and give Democrats the needed 60th vote; or,
3. House and Senate Democrats could essentially start over in their respective chambers and propose scaled-back versions of the bill under “reconciliation” procedures or regular order. Reconciliation procedures would greatly limit the scope of the legislation to issues only related to raising or spending federal funds; therefore, many provisions, such as creating new insurance exchanges and an individual mandate, might be excluded.

President Obama seemed to indicate that he favors having House and Senate lawmakers start over again and produce a scaled-back bill. In addition, more moderate Senate Democrats – hesitant to push through such a huge partisan bill in light of the Massachusetts election – urged leaders to slow down.
Sen. Jim Webb (D-VA) has called on Senate leaders to suspend voting on health care reform until Mr. Brown is sworn into office. President Obama and Senate Majority Leader Harry Reid (D-NV) have iterated this same message. Further, Sen. Joe Lieberman (D-CT) called for a bipartisan effort as the best way to achieve health care reform legislation.

Health Care Reform Negotiations Prior to Massachusetts Special Election

Senators Urge Guarantee of Government Savings: In a letter sent last Thursday to Sen. Reid, five Democratic Senators asked for the inclusion of a “fail-safe mechanism” in the final bill. This mechanism would give Congress “the tools to keep costs under control should the current savings estimates fail to materialize.”

Both the Senate and House versions of the bill rely heavily on reductions in government spending, particularly around Medicare, to help pay for reform. Republicans and some nonpartisan analysts believe the government will not follow through on these spending reductions, which will lead to soaring costs.

President Obama Pushes for Less Protection for Biologic Drugs: Last Thursday President Obama pushed for a change in the health care reform legislation that would reduce the number of years that biologic drugs were patent protected from generic competition, previously set at 12 years. White House officials and Rep. Henry Waxman (D-CA) were negotiating for 10 years protection or less.

Members of the news media speculated that the move to reduce biologic drug protections could be a leverage point for President Obama to pressure the drug industry to increase contributions to pay for health care reform. In fact, the Wall Street Journal reported that Congressional Democrats had already asked drug companies to contribute an additional $10 billion or more, over and above the $80 billion which the industry agreed to early on in the reform negotiations.

President Obama Strikes Deal with Unions: Last week Democratic negotiators struck a deal with union officials and conceded to union demands to scale back a tax on high-end insurance plans. The deal would exempt union workers from having to pay the tax until 2018, five years after the tax would apply to other workers. While the deal would help gain union support for the bill, it would also reduce the amount of tax revenue generated by about 40 percent, to $90 billion. As such, Democratic leaders would need to find other sources of revenue to make up the difference.

Public Opinion

Exit Poll Indicates Health Care Reform as Hot Button Issue: As the ballot polls closed on Tuesday night’s Massachusetts Senate election, an exit poll conducted by Frabrizio, McLaughlin & Associates indicated that 52 percent of voters said that they oppose the federal health care reform measure and 42 percent said they cast their ballot to help stop President Obama from passing this legislation. In addition, 48 percent said that health care was the single issue driving their vote.

Polls Show Discontent: The latest Wall Street Journal/NBC News poll indicated that almost half of Americans believe the health care reform bill in Congress is a bad idea (46 percent). This figure is up dramatically from April when only 26 percent believed the plan was a bad idea. Further, just 33 percent say the plan is a good idea. Nearly half of those surveyed (48 percent) believe that passing the current legislation would be a “step backward.”

In addition, a new Quinnipiac University poll showed that public support for health care reform continues to decline. Thirty-four percent mostly approve, while 54 percent mostly disapprove. At the end of December, 53 percent of Americans mostly approved, while 36 mostly disapproved.

Looking Ahead

Currently, the path to health care reform is unclear. Democrats seek a way to secure the necessary votes to pass the legislation, and some now question the value of pushing such a large bill. President Obama had hoped to see a final bill prior to his State of the Union address, which has been scheduled for January 27; however, it appears this goal is likely out of reach.

It is extremely important that you understand the basics of children’s dental and oral care, because at this stage of dental care you are going to lay down a healthy and a strong dental care for the future. One best way which can help you to familiarize with the oral care needs of your child so that they have strong dental habits in the future is that you can educate yourself with the various fundamentals of children’s dentistry.

Oral Hygiene

It is important that the children’s brush your teeth twice and regular dental check ups are important in building good oral hygiene at an early age. It is important hat you brush your child’s teeth until they are big enough to do so. Brush your child’s teeth the right way. Select a small and a soft brush and pea size tooth paste is enough as it will not interfere in your brushing and it will not form much foam also.

Preventing Tooth decays by Cavities

Tooth cavities can be easily be prevented by good oral health, however some additional steps can be incurred to maintain your child’s tooth against the attack of cavities. You can use toothpaste which contains fluoride. As soon as your child’s permanent teeth have erupted it is important that you speak to the dentists about the application of sealants. Sealants are clear and a protective coating applied on the biting surfaces of the back teeth. The sealant protects against the cavity from shielding against the bacteria and plague. They are mostly placed on the back teeth, because these are the areas where there are more chances of being attacked by cavities.

Dental Habits

Although the children can develop good oral habits at an early age it is equally important that they break the bad habits like going to bed with a bottle, this is an extremely bad practice drinking any fluid which has sugar in it can cause the tooth decay very fast as the sugar substances react on the teeth throughout the night which in turn can cause the tooth decay as early as possible. Another habit which is considered as bad is the thumb sucking or the finger sucking habit. It is also a very bad practice to swallow the tooth paste.

Dental Problems

Incase your child does develop cavities in his baby teeth that it is important that you visit a dentist and get his cavities filled. Do not be in the assumption that there is no requirement of the cavities to be removed because the baby teeth would inevitably fall down, many kids do retain their baby kids for a long time and the cavities can be very painful at times.

So, it really comes to rephrasing the question to – ‘What is the best skin care product for me’. Yes, this is exactly the question that you should be asking, and unfortunately there is no easy answer for this. Arriving at the best skin care product for self will need some effort on your part.

First of all, you need to understand how the skin care products work. This is simple. You can consider all skin care products to be composed of 2 types of ingredients – Active and inactive. The active ingredients are the ones that actually work on your skin. The inactive ones just help in delivering these active ingredients to your skin. Both the ingredients need to work for your skin, in order for the product to be effective (and move on to become the best skin care product for you).

Besides the ingredients, the way you apply your skin care products is equally important. In fact, this is even more important. If you do not know how to apply skin care products, you might forever be hunting for the best skin care product for yourself, when that has already passed you. Moreover, it’s also important to decide on the frequency of application (of the skin care product). The environmental factors – temperature, humidity and pollution level, also affect the selection of best skin care product. Here are a few rules that you could use to ensure that your best skin care product is really the best for you:

* Cleanse your skin before applying that best skin care product.

* Use a makeup remover instead of plain water and remove your makeup before going to bed.

* The effectiveness of active ingredients is reduced when applied over another product e.g. over moisturiser. So apply that best skin care product first and then apply a bit of moisturizer if needed.

* Apply the products on moist and warm skin.

* You will have to experiment with a few products before you arrive at the one that is the best skin care product for you.

* Do not exfoliate too much or too hard.

* Vary your skin care routine as per the seasons (winter/summer etc), changes in environmental factors and changes in your skin type

Note that the best skin care product cannot be determined overnight. It’s only through experiment (and awareness) that you can find the ‘Best skin care product’ (for you).

Important Dental Care Tips

It is advisable to use the soft bristled brush with synthetic rounded bristles. When buying a brush, look for the seal of approval from American Dental Association. The toothbrush must be replaced every 2-3 months, or when the bristles are bent or worn. For good dental care, replace your toothbrush after you have suffered from cold.

Proper brushing technique is important for dental care, and brush outside, inside and inside surface of lower and upper jaws. Brush your tongue to freshen up your breath as bacteria and debris on the tongue cause bad breath.

The ideal dental care involves brushing the teeth at least once everyday, preferably at bed time. Brushing after the breakfast helps in thorough removal of plague daily. To clean each tooth properly, change the position of the brush after few strokes. Good dental care does not require too much of paste, and pea-sized fluoridated toothpaste is sufficient. It is essential to avoid brushing teeth too vigorously as it can wear down the tooth structure. It can also cause the gums to recede, exposing the root surface.

For good dental care, good flossing techniques must be used. But, many people do not enjoy flossing, as they are not aware of the proper technique, and hence hurt the soft tissues of the mouth during the attempt. A safe and effective alternative to flossing includes use of brush picks, floss picks, tooth picks and special plague removers.

Some dental specialists and dentists advise using the plague removers instead of regular flossing for dental care. The picks can reach the nooks of the mouth that are left unavailable for floss and toothbrush. Toothpicks are great for dental care, but they are not able to reach all the desired places such as behind the last wisdom tooth.

For good dental care, you can also make the toothpaste at home by mixing baking soda, salt, glycerin and peppermint. But, never swallow the toothpaste, as it may cause the fluoride toxicity. Brush mildly for 2-3 minutes as brushing vigorously for longer time does more harm than good.

Many studies have indicated a strong correlation between oral health and general health. Not paying attention to the dental care can lead to many health problems such as osteoporosis, heart disease, diabetes, respiratory disease and pregnancy problems. The bacteria causing the periodontal infection can enter the blood stream carrying the infection to many major body organs, leading to various health problems. Consider a periodontal evaluation if you have diabetes, osteoporosis, heart disease, respiratory disease or if planning to conceive a baby.

As a good dental care program, smoking must be avoided as it can cause tooth discoloration, bad breath, tooth decay and gum disease. Some of the other ill-effects of smoking include mouth bores, hairy tongue, shifting teeth, delayed wound healing, altered sense of smell and taste and jaw bone loss.

For good dental care, mouthwashes such as Chorohexidine or Listernine have effective antiseptic properties that kill the bacterial plague. It is also important to maintain a well-balanced diet, and minimize the consumption of sugary and starchy foods that are known to cause tooth decay. To maintain proper dental care, avoid eating between meals as it makes teeth more prone to decay.

It also helps to visit your dentist once in 3-4 months so that any oral concern can be diagnosed early. There are no symptoms associated with most of oral health problems till the disease has progressed to the advanced stage.

An advance health care directive lets caregivers and family and medical providers know a person’s healthcare wishes if he’s unable to speak for himself. The document can also appoint someone else to speak with legal authority for the person if he’s unable to do so for himself.
If someone plans to set up an advance health care directive, living will, or similar document, here’s what he needs to think about:
By the way, we hate spam as much as you do and will never sell your email address.

1. The person should consider how he wants to live during a terminal illness, and what his end-of-life preferences are when creating a health care directive or living will.

It’s not easy to bring up the subject of dying (especially if it’s your parent you’re caring for). But you, the individual, and the rest of his family will gain some peace of mind if you can get him to start thinking and talking about this subject, and eventually to execute documents that set down his wishes.

·One way many people get this discussion started is by showing the person the advance health care documents they’ve prepared for themselves. This both breaks the ice and gives the person a model on which to base his own documents.

·The job is to get him thinking about what will be important to him when he is incapacitated, and particularly when he’s dying, such as where he wants to be — at home if possible, or in a hospital — and what treatments (particularly life-prolonging ones) he wants and doesn’t want.

·He also needs to think about who he wants to make decisions for him if and when he’s unable to do so himself.

·The person should discuss these things with family, healthcare providers, and trusted advisors who will help him consider his wishes, options, and fears.

·But remember that a conversation doesn’t have the same legal force as an advance health care directive or similar written document, even if a doctor records it. In most states, only a written, signed, and witnessed advance health care directive legally must be followed by healthcare personnel and institutions.

2. The person should carefully consider whom he wants to serve as the agent to make decisions for him and support his choices when creating a health care directive or living will.

The agent the person in your care names in his advance health care directive should have several qualifications:

·The job can be emotionally difficult, so it should go to someone who cares deeply about his welfare.

·It should also be someone who is likely to be able to remain physically near him during a prolonged healthcare crisis.

·And it should be someone who has a strong enough personality to stand up to family members, doctors, and hospital personnel if necessary.

·Sometimes a trusted friend will make more objective decisions, or will follow the person’s wishes more carefully, than a family member.
Whomever he winds up choosing, he has to discuss the responsibility with that person and make sure she’s willing to accept it before naming her in the document.

3. Use sample forms for the advance health care directive or living will as planning tools.

Situations to address

Each individual’s advance health care directive should be personalized to reflect his particular wishes. An advance health care directive should address situations such as:

·When (if ever) the person in your care would want artificial life-sustaining treatment, such as during permanent unconsciousness or severe dementia

·Types of life-sustaining treatment he would and would not want, such as artificial nutrition and hydration, surgical procedures, and cardiopulmonary resuscitation (CPR) — and under what conditions

·Instructions about other medical procedures that may arise given the person’s medical history

·Organ donation instructions

·Pain control preferences

·Where he wants his care (at home or at a designated nursing facility, for example)

Documents available online

Generic advance health care document forms are available from many sources, but the forms are designed to be planning tools only. They don’t offer a final product — the forms are meant to trigger but not replace communication between the person in your care (the principal) and the designated decision maker (the agent).

Still, they are useful for getting started. Most state legislatures provide official forms for advance health care directives and living wills. These examples, among others, are available online:

·    New York
·    California
·    Delaware
·    Illinois
·    Oregon
·    Massachusetts

Similar forms are provided by such groups as state medical and bar associations. For example, sample forms can be found online through the California Medical Association, AARP, and the American Medical Association.

The importance of state forms

·Though there’s no single form that must be used for an advance health care directive, an individual should use his state’s standard form if it has one. He should also follow his state’s signature and witness requirements. For example, most states require two witnesses to the person’s signature; some states also require notarizing the document.

·In most states, witnesses cannot include relatives, heirs, medical providers or their employees, or anyone responsible for the patient’s healthcare costs. If the person in your care is in a nursing home, some states require a state nursing home ombudsman or patient advocate to witness the signing.

·Once the document is executed, the individual should give copies to his doctors and hospital, the person he designates as his healthcare agent, family members, and other advisors. He should keep a list of individuals and institutions that have a copy of the advance health care directive, in case he ever wants to revoke or change it.

4. Update the advance health care directive or living will based on changing end-of-life wishes.

·Encourage the person you’re caring for to revisit his advance health care directive periodically, as long as he’s able to do so. His feelings and choices may evolve as his situation changes — for example, after he’s diagnosed with a serious illness, or as he witnesses others going through the end of life.

·People commonly make changes right before a major surgery. He may also change his feelings about who should act as his healthcare agent, or his original choice might no longer be able to take on the job.

·He can terminate or change the advance health care directive as long as he has the mental capacity to do so. If he wants to make a change, he should prepare and sign a new document and have it properly witnessed again; just making handwritten changes on a previous document is not a good idea.

·If he does execute a new document, he should send a copy to every person and institution that has a copy of the previous one, explaining that the new one replaces the old. In most cases, completing a new advance health care directive automatically revokes all previous directives, but it’s always a good idea to let everyone know personally.