It’s Common Sense to Come Together for Our Kids

(The Huffington Post, October 2, 2013)

By Sen. Chris Dodd and Sen. Bill Frist, M.D.

When we served together in the Senate, we found ourselves on different sides of a variety of issues. But when it came to common-sense measures that benefitted our country and our citizens, we pulled together.

We were proud to cosponsor the Organ Donation and Recovery Improvement Act because we knew its reforms would help save thousands of lives in America. Today, we’re pulling together to support another common sense measure — early education for all children in America.

There is little debate that education is key to a child’s future success, or that it is key to our global competitiveness as a nation. But one of the most overlooked ways to improving educational opportunities in America is reaching kids early enough.

Two out five children in America have had no preschool or kindergarten education by age 5. When these children do enter school, many are already behind their peers.

As science has clearly shown in recent years, most brain development is complete well before a child enters kindergarten. Without early learning opportunities, many children are entering school without the tools they need to stay on track and succeed.

Unfortunately, poor children in America are most likely to lose these critical opportunities. As a result, children from low-income families can easily fall 18 months developmentally behind children from middle-class families by the time they’re just 4 years old.

Let us share one anecdote from our friends at Save the Children, to show just what a difference early learning can make. The non-profit organization recently received a letter from the superintendent of an isolated, rural school district in Alpaugh, California.

Poverty, language and cultural barriers, and lack of parental engagement in the education system have long meant that children in the district enter school ill-prepared to succeed, he said.

But this year, he reported, the first group of children who had been through Save the Children’s early learning program entered the first grade. Every one of them is reading at grade level, he said, “something unheard of in past classes.”

This success is particularly significant because research is clear about the importance of reading at grade level by the time a student enters the 3rd grade.

Helping all families have access to children’s books and information on how they can support their child’s development goes a very long way. And giving more children the chance to attend high-quality preschool is the smart thing to do.

One study found that every public dollar spent on preschool returns $7 through increased productivity and savings on government assistance programs and criminal justice costs.

We all have a role to play in helping more children succeed. That can be through volunteering in our own communities, contributing to programs that make a difference, or voicing support for proposals to expand high-quality early education in America.

There is critical work taking place in our country to improve K-12 public education. However, there is more to do to ensure millions of children do not fall behind before they even reach school. Common sense tells us, investing in our children early is the right thing to do.

This blog post is part of a series produced by The Huffington Post and Save the Children, as part of the latter’s drive for universal early education, which is the focus of their gala on October 1 in New York. For more information about Save the Children, click here.

 

This article was originally featured in The Huffington Post http://www.huffingtonpost.com/chris-dodd/its-common-sense-to-come-_b_4031431.html

It’s never too early to discuss your final wishes

(The Tennessean, September 22, 2013)

By Manoj Jain, M.D. and Sen. Bill Frist, M.D.

A week before my (Dr. Jain) elderly parents came for a long visit, I asked them if they would be willing to have a conversation about end-of-life planning. But it wasn’t until the day before they left that we sat at the dining table with documents I had printed from the Tennessee Health Department website.

Too often among family, such end-of-life conversations do not occur. Studies show that 60 percent of people say they do not want to burden their families with difficult end-of-life decisions. More than 80 percent of people agree that it is important to have end-of-life instructions in writing. Yet less than 25 percent of people have followed through with written directions to ease the burden on their family members.

Why do we not have this crucial conversation? Talking about end of life is certainly uncomfortable. Yet, there may be an even greater fear. Talking about death may be akin to opening Pandora’s box, or being perceived as someone who is encouraging or wishing for our loved one to die.

But by having a conversation about death, we are not inviting or encouraging death for our loved ones, we are profoundly affecting how the end of life will be experienced by everyone involved — both the individual whose wishes are to be respected, and all of the family members who carry their memory forever.

I (Jain) feared that my parents might misunderstand my intentions. As we sat at the dining table, I broke the ice by talking about the death of my grandfather at 93, and how he was clear in his wishes not to go to die in a hospital. My father then told me how he spent the final day and hours with his father, sitting with him. As our conversation went on, I realized that my parents, too, had desired to have an end-of-life conversation.

Whether you are concerned about an elder family member, or preparing to share your own end-of-life wishes, there are resources and tips to make the conversation easier.

Starting the conversation

Approach the topic directly and gently. Start the conversation with plenty of time, on common ground, perhaps by discussing a shared experience. Confirm your desire for a family member’s wishes to be honored, for their dignity to be preserved.

The Tennessee Department of Health provides further guidance for this conversation in its “Five Wishes” resource. More than 18 million “Five Wishes” packets have been distributed.

A structured document called an advance-care plan, or living will, can help guide the conversation. While it is a legal document reflecting our wishes, an attorney is not required to draft it or sign it. In Tennessee, advance-care plans are available online: http://health.state.tn.us/advancedirectives/.

An advance-care plan requires three major decisions. First, an individual must name an agent. A health care agent is a person who will make health care decisions for you. You can make this effective at any time. An agent is usually a trusted friend or relative who you feel will make the best decisions on your behalf.

Next, an individual must determine how he or she defines quality of life in the final days. You decide which conditions are acceptable to you: permanent unconsciousness, such as in a coma; permanent confusion, like end-stage dementia; or dependency for activities of daily living. These are not easy decisions, and over time your opinions may change. Having a frank and thoughtful conversation about your wishes will empower your family if any of those situations arise.

Treatments and Interventions

Finally, individuals must decide which treatments and interventions they would like to take advantage of. At the end of your life, do you wish to receive CPR? Life support? Surgery? Tube feedings? Advance-care plans offer explanations and definitions of each option. If you have questions, your local doctor or nurse can help.

The final product — a two-page document — will be notarized or signed by two witnesses. Then copies should be shared with your physician, your health care agent and close relatives.

Culturally, it is hard for us to talk about and prepare for death, but taking the time to prepare now will be invaluable for you and your family later. Conversations about end of life do not need to be single, marathon affairs. Express your wishes, do your research, discuss again as circumstances change. It is never too early to agree together to a plan, but it could be too late.

 

Dr. Manoj Jain is a Tennessee doctor who writes for The Washington Post. Dr. Bill Frist is a heart transplant surgeon and former U.S. Senate majority leader.

This article was originally featured in The Tennessean http://www.tennessean.com/apps/pbcs.dll/article?AID=2013309220100