With more than 350 factory-trained professionals on staff, Hofmann says it provides leading training and sales support for its customers. The recently renovated Hofmann training and manufacturing facility in Conway, Arkansas, provides state-of-the-art instructional classes to help shop owners and professional service technicians improve performance, productivity and most importantly, the bottom line.

Our center in Conway offers Hofmann customers a wide variety of training options to help them maximize the efficiencies of their equipment and valuable strategies to help them grow their businesses, said Ronald Racine, North American training manager. At Hofmann, we stay connected to our customers after they invest in our equipment to ensure they receive all the support and service they need to succeed in the marketplace.

As part of its long-standing commitment to the U.S. market, the Jack D. Michaels Training center in Conway, named after the former Snap-on CEO and president, provides Hofmann customers with training on automotive service equipment, customer service and vehicle repair strategies. Classes are available to direct sales agents and distributors, as well as end-users of Hofmann products. The contemporary facility includes modern classrooms, fully-equipped training garages and an engineering lab.

The Conway facility also houses all facets of equipment production, including product design, manufacturing, sales and distribution. The company has more than 200 employees in the Conway area.

Customers can learn more about Hofmann wheel service products by calling 800-251-4500 or visiting us.hofmann-equipment.com/en/.

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Renovated Hofmann Training Facility Provides State-Of-The-Art Learning Opportunities - AftermarketNews.com (AMN)

Imagine that youre sitting across the desk from a CEO of a Fortune 500 company. You are interviewing for a position to run all of marketing in a new division. And he asks you why they should hire you. What would you say?

Yep, that happened to me once. Heres what I said: I know how to sell. By the end of the conversation I had an offer.

All of us need to know how to sell in our careers and in our lives. This is true whether you are selling yourself, or pitching an idea or product. Buyers can be your soon-to-be boss, a colleague, the marketing team, a venture capitalist, or your kids.

This means you should hire marketers who can sell. Yet, its much more than that. Every employee within an organization has a responsibility to sell the companys products and services, its brand, and ideas too. This is true no matter the size of the company or the position of a given team member.

But, not everyone knows how to sell or likes to sell. Most people enjoy focusing most on what they love and do best and avoid tasks they dislike or do not have skills in -- like selling. Heres how to take the mystery out of selling.

Get non-salespeople who know the nuts and bolts involved. Whether its the founder, engineers, or marketers theres a really good chance they understand the significant stuff about why your products or services are necessary. Make sure that knowledge gets in front of your future customers! Force technicians* (maybe yourself) out of their comfort zone and get them use to selling their passion and skill for your company and its products.(*A "technician" is a person with tangible, hands-on skills, as named by Michael Gerber in his book, Why Most Businesses Dont Work and What to Do About It.)

Help non-salespeople learn to sell. Selling isnt only about getting a buyer to sign on the dotted line. Give your non-salespeople both the skills and appreciation for selling with training created just for them. Bring in someone who will teach basic sales principles and how to talk with a buyer when the situation calls for it. No dry and boring sales training allowed! Itll give an unexpectedly wonderful return on the training dollars you spend.

Instill a consultative selling and customer success mindset. This may be the easiest part of getting non-salespeople to sell. Technicians by nature like to explain their products and service; because they deeply understand these and also because theyre proud of how your offering helps buyers. But often, an excessive amount of nitty-gritty details are over-shared. All you have to do is channel that enthusiasm into a bit of a structured process. The key to this is helping your team understand exactly what your business sells and the outcome what the buyers can expect in terms of benefits and value. Then, on top of that, teach your team to think about customer success -- because one of the major result every customer wants is to attain something positive, maybe even his or her dream. Let your team know that ultimately their job is to help people get what they need and want. Thats how your staff will earn a buyers attention.

Baby steps are good with a heavy dose of mentoring. Have them jump on a few sales calls or do demos all day long at a tradeshow. Also, ask people in your organization to represent your business at networking events, including giving the dreaded 7-second elevator pitch. And without a lot of notice, tell them that youd like them to meet with the CEO or investors to explain a new project. Watch and listen and give positive feedback -- theyll get comfortable and start to have fun!

It's good for everyone in all areas of your business to know some sales techniques and understand the selling process. They will be more in-tune with what goes on during the sales cycle, plus be ready to jump in and help.

One persons actions can make a big impact.

Ron Stein is founder of More Customers Academy, helping business leaders build strategic messaging and positioning that cuts through the competitive noise to grow revenue. Ron has developed his own highly successful 5-step Stand Out & Sell More approach to winning new customers as a result of his twenty-five years of business development, marketing, and selling experiences. He works with a range of businesses, from startups to large corporations across industries including technology and healthcare, manufacturing, and financial services and banking. Ron conducts workshops, leads company meetings, offers keynote talks, and consults. He can be reached at 727-398-1855 or by email.

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Take the mystery out of selling - Florida Trend

Welcome to the Mata Shakti Ashram!

The mission of Mata Shakti Ashram is to promote the teachings of Kundalini Yoga and Meditation as taught by Yogi Bhajan, to provide education and practice of Sikh Dharma, and to be a place where co-creative gardening is manifested.

What does Mata Shakti Ashram mean?*The word Mata means mother in India. In Portuguese and Spanish, the word Mata means wood or forest, and Mata Shakti Ashram is located in a quiet wooded setting.*The word shakti means empowerment and primordial cosmic energy. Shakti represents the dynamic forces of feminine divine energy that move through the entire universe.*The word ashram means the locus of activity for spiritual practices. We seek to be a spiritual center in Chapel Hill, but need your assistance to manifest this vision.

ClassesCurrently the services offered at Mata Shakti Ashram include Mondaylunchtime and Thursday evening Kundalini Yoga and Meditation classes, monthly workshops, early morning sadhanas (spiritual practice) & Gurdwaras (worship services) at appointed times. Yearly 200 hour level Kundalini Yoga teacher trainings are offered, & 500 hour level trainings will be offered beginning in 2017. See Class Schedule.

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Mata Shakti Ashram

The fate of Dera Sacha Sauda ashram in Gurgaon is in the balance after the Punjab and Haryana high court sought details of all Dera assets from the Gurgaon administration and also other districts in the state.

Following large-scale violence by Dera followers after the conviction of Ram Rahim Singh in a 15-year-old rape case by a special CBI court on August 25 in Panchkula, in which public property was damaged and more than 30 were killed, the high court directed the state government to evaluate Deras assets to compensate the damages.

The ashram, Naam Charcha Ghar in South City-2 in Sector 50 is wearing a deserted look for the last four days. The facility, spread over 1,155 sq yards, was alloted to Dera by the Haryana Urban Development Authority (Huda) in June 2006.

Huda also gave possession of the plot to Dera Sacha Sauda in 2008 and submitted the land details, with current market value, to Gurgaon district administration.

An official told Hindustan Times that the property is currently valued from Rs4 crore to Rs5 crore, roughly.

We cannot reveal the exact calculation done by the competent officials but roughly, as per current collector rate, it will definitely not cost less than Rs4.5 crore as a well-furnished three-storey building has also come up on the land. Since the high court is monitoring the issue, we cannot reveal details of the matter to the media, the official said.

A contingent of the Gurgaon police continues to monitor the area and the ashram, the main gate of which continues to remain locked.

The outer wall of the ashram still has a large hoarding of Ram Rahim Singhs latest movie Jattu Engineer, also produced and directed by him. The police have evacuated the ashram and have strictly prohibited the entry of public.

Residents of the area said that the hoarding has turned into a joke among the locals. Baba Ram Rahim looks so funny on the Enfield Bullet. He used to come here in luxury car with his cavalcade. The entire area used to turn high-profile with his presence but now, all is gone and the police have taken custody of the ashram, said Diler Singh of Jharsa.

Vinay Pratap Singh, deputy commissioner (DC) of Gurgaon, said, We have assessed Deras assets and sent the details to the Haryana government. We will not reveal any particulars in this regard.

Our duty magistrates and police have done a tremendous job in ensuring peace across the city, said Singh.

The CBI court on Monday sentenced Gurmeet Ram Rahim Singh to 20 years imprisonment.

Excerpt from:

Ram Rahim conviction: Fate of Dera ashram in Sector 50 uncertain, court to decide - Hindustan Times

Dera Sacha Saudas (DSS) Ghaziabad ashram in Karhera wore a deserted look as followers of Gurmeet Ram Rahim Singh stayed away from the facility following his conviction on Friday.

The ashram came up around two years ago on the banks of river Hindon. Ram Rahim had also held an event to promote his movie Messenger of God at the Karhera ashram.

As per an estimate, there were nearly 40,000 followers of Singh in Ghaziabad district till the afternoon of August 25, prior to the CBI court holding him guilty in the rape case.

A Hindustan Times team visited the ashram on Monday afternoon when the CBI court sentenced Ram Rahim Singh to 20 years of imprisonment for raping two women 15 years ago. Besides the PCR vans, only a single caretaker was present at the ashram, which is spread over nearly five bighas. Apart from organising satsangs, the caretakers also grow vegetables in the remaining area.

None of the followers or the coordinators have come to the ashram since August 25. We generally hold Ram Charcha (a form of satsang) here and hundreds of people attend but the last assembly took place on August 19 and I dont know when it will be held again, said Bhoora, the caretaker, who is from Aligarh and earns Rs6,000 as monthly salary.

The Karhera ashram is under the scanner since the court held the self-styled godman guilty and large-scale violence broke out in Haryana and parts of NCR. In Loni, a UP Roadways bus was torched by unidentified men and two DTC buses were also set afire.

We found dozens of spades and grass cutters at the ashram. As a precautionary measure, the equipment was seized. Who knows if these could have been used as weapons, a police personnel deployed at the facility said.

The ashram has come up on the floodplains but has temporary structures, apart from the small, permanent structures of toilets.

During assemblies, DSS books and food items are sold to people. Followers who come to attend satsang purchase these items, which are costlier than the items available in the market. But our followers like to purchase these items, Bhoora said.

The ashram area was peaceful as police camped on the Karhera road and inside the facility since Monday morning. There has been a regular deployment of police since the violence on August 25. DSS coordinator for Ghaziabad, Jitendra Kasana, was not reachable as his mobile phone remained switched off.

The situation on Monday remained peaceful but we are taking extra precautions for the night. It is because of vandals who could use items such as petrol bombs to flare up violence. Petrol pump owners have been strictly told not to sell petrol in bottles or cans. A majority of DSS members or followers have been put under surveillance and they have been strictly told to abstain from any act that could escalate law and order in the district, said Akash Tomar, superintendent of police (city).

The Ghaziabad police have deployed all PCR vans for crucial night duty and have assigned areas to circle officers, who will be accompanied by provincial armed constabulary personnel.

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Dera Sacha Sauda ashram in Ghaziabad ashram wears deserted look - Hindustan Times

Shares ofAshram Onlinecom Ltd. (ASHRAM.BO) are on watch as the Tenkan Line has moved belowthe Kijun line, indicating negative momentum for the equity. Ashram Onlinecom Ltd. moved0.00 in the most recent session and touched1.10 on a recent tick.

The Tenkan Line or Tenkan Sen (Sen means line in Japanese) is known as the conversion line or turning line is similar to a 9SMA but actually is quite different. Remember a SMA (simple moving average) will smooth out all the data and make it equal but the Tenkan Line will take the highest high and lowest low over the last 9 periods. The explanation for this is Hosada felt price action and its extremes were more important than smoothing any data because price action represented where buyers/sellers entered and directed the market, thus being more important than averaging or smoothing the data out. As you can see by the chart below, the Tenkan Line is quite different than a 9SMA. Because the TL (Tenkan Line) uses price instead of an averaging or the closing prices, it mirrors price better and is more representative of it. You can see this when the TL flattens in small portions to move with price and its moments of ranging.

Akin to all moving averages, the angle of the Tenkan line is very important as the sharper the angle, the stronger the trend while the flatter the Tenkan, the flatter or lesser the momentum of the move is. However, it is important to not use the Tenkan line as a gauge of the trend but more so the momentum of the move. However, it can act as the first line of defense in a trend and a breaking of it in the opposite direction of the move can often be a sign of the defenses weakening.

Turning to addtiional indicators, Ashram Onlinecom Ltd. (ASHRAM.BO) currently has a 14-day Commodity Channel Index (CCI) of -106.70. Dedicated investors may choose to use this technical indicator as a stock evaluation tool. Used as a coincident indicator, the CCI reading above +100 would reflect strong price action which may signal an uptrend. On the flip side, a reading below -100 may signal a downtrend reflecting weak price action. Using the CCI as a leading indicator, technical analysts may use a +100 reading as an overbought signal and a -100 reading as an oversold indicator, suggesting a trend reversal.

Investors may be trying to define which trends will prevail in the second half of the year. As the markets continue to chug along, investors may be trying to maximize gains and become better positioned for success. Technical analysts may be studying different historical price and volume data in order to help uncover where the momentum is headed. Coming up with a solid strategy may take some time, but it might be well worth it in the long run. As we move deeper into the year, investors will be closely tracking the next few earnings periods. They may be trying to project which companies will post positive surprises.

We can also do some further technical analysis on the stock. At the time of writing, the 14-day ADX for Ashram Onlinecom Ltd. (ASHRAM.BO) is 30.78. Many technical chart analysts believe that an ADX value over 25 would suggest a strong trend. A reading under 20 would indicate no trend, and a reading from 20-25 would suggest that there is no clear trend signal. The ADX is typically plotted along with two other directional movement indicator lines, the Plus Directional Indicator (+DI) and Minus Directional Indicator (-DI). Some analysts believe that the ADX is one of the best trend strength indicators available.

Interested investors may be watching the Williams Percent Range or Williams %R. Williams %R is a popular technical indicator created by Larry Williams to help identify overbought and oversold situations. Investors will commonly use Williams %R in conjunction with other trend indicators to help spot possible stock turning points. Ashram Onlinecom Ltd. (ASHRAM.BO)s Williams Percent Range or 14 day Williams %R currently sits at -100.00. In general, if the indicator goes above -20, the stock may be considered overbought. Alternately, if the indicator goes below -80, this may point to the stock being oversold.

Tracking other technical indicators, the 14-day RSI is presently standing at 32.60, the 7-day sits at 28.34, and the 3-day is resting at 15.91 for Ashram Onlinecom Ltd. (ASHRAM.BO). The Relative Strength Index (RSI) is an often employed momentum oscillator that is used to measure the speed and change of stock price movements. When charted, the RSI can serve as a visual means to monitor historical and current strength or weakness in a certain market. This measurement is based on closing prices over a specific period of time. As a momentum oscillator, the RSI operates in a set range. This range falls on a scale between 0 and 100. If the RSI is closer to 100, this may indicate a period of stronger momentum. On the flip side, an RSI near 0 may signal weaker momentum. The RSI was originally created by J. Welles Wilder which was introduced in his 1978 book New Concepts in Technical Trading Systems.

For further review, we can take a look at another popular technical indicator. In terms of moving averages, the 200-day is currently at 1.58, the 50-day is 1.36, and the 7-day is resting at 1.13. Moving averages are a popular trading tool among investors. Moving averages can be used to help filter out the day to day noise created by other factors. MAs may be used to identify uptrends or downtrends, and they can be a prominent indicator for detecting a shift in momentum for a particular stock. Many traders will use moving averages for different periods of time in conjunction with other indicators to help gauge future stock price action.

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Peeling Back the Layers on Shares of Ashram Onlinecom Ltd. (ASHRAM.BO) - Morgan Research

Dear Doctor: Ever since the news about lead in the drinking water in Flint, Michigan, I've wondered about the water in my own home. I live in Oklahoma, and our house was built in 1988. Should I be worried?

Dear Reader: You've asked a timely question that, unfortunately, has a complex answer. Let's start with why the presence of lead in our environment whether in the water, air or soil, or in the products we use or come into contact with is of grave concern.

Lead is a highly toxic metal that has a detrimental effect on virtually every system in the human body. Children, with their developing brains and nervous systems, are particularly vulnerable to the effects of lead. The amount of lead that an adult can tolerate with minimum ill effect can cause significant damage to a child. The challenge is that until it becomes acute, lead poisoning virtually has no symptoms.

Lead causes anemia, hypertension and damages the kidneys and the reproductive system. Even low blood levels of lead affect the development of the brain and nervous system. In children it can result in lower IQ, hearing problems and behavioral changes like reduced attention span. The neurological damage caused by lead is believed to be irreversible.

Exposure to lead is bio-accumulative. That means the lead you ingest stays in the body and, as exposure continues, blood levels increase. And although the health crisis in Flint has put the spotlight on lead in water, the presence of lead-based paint in older homes poses the most common risk. It's a topic we've addressed in a previous column.

As for your situation, there is some good news. In 1986, two years before your home was built, the Safe Drinking Water Act significantly reduced the amount of lead permitted for use in plumbing fixtures, including pipes and solder. However, it wasn't until 2014 that the most stringent regulations regarding the use of lead in water delivery systems went into effect.

You will also want to find out whether your water supplier is in compliance with federal lead contamination regulations. Federal law requires regular testing for contaminants. The results are published in a document called the Consumer Confidence Report. Ask for a copy. Should you wish to test your own water, the Environmental Protection Agency has a list of certified labs on its website. Most home improvement stores also sell water-testing kits.

If you believe your water supply is contaminated with lead, the EPA suggests the following:

Flush your pipes for 30 seconds to two minutes before using water for drinking or cooking.

Use only cold water for drinking or cooking. Hot water may contain higher levels of lead.

According to the EPA, it is safe to bathe or shower in water that contains lead, as it is not absorbed through the skin.

Consider installing a water filtration device that is certified to remove lead.

We recommend a visit to http://www.epa.gov, where you'll find a wealth of information and resources.

Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.

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Flint crisis has homeowner worried about water supply | Health and ... - Hanford Sentinel

Fitness trackers and smartwatches have been around for years now. And although they've definitely helped get more people moving (shout out to everyone who's done laps around the dining room table before bed just to hit 10,000 steps), there isn't a whole lot these wrist pieces can do to help you reach your personal goals.

But Fitbit is about to change that with the launch of its new Ionic smartwatchthe companys first true smartwatch. Here's everything you need to know. Image: Fitbit 1. It was designed as a health and fitness watch first. The company prioritized the health and fitness features and functionality, which sets it apart from some of the competition. That said, it also works with Android, iPhone, and Windows smartphones, so you can still stay connected with notifications at your wrist.

2. The features are next level. The Ionic has all the features you expect: steps and activity tracking, GPS, continuous heart rate, and water resistance up to 50 meters. Like the Blaze, it offers on-screen workouts, but instead of a small stick figure, you can see an actual model on the full-color displaycrucial for good form. It also has algorithms for specific sport modes such as running, cycling, swimming, yoga, and even high-intensity interval training. And the automatic exercise detection makes accurate tracking of stop-and-go activities like running (hello, stoplights!) completely effortless.

3. It runs on a new operating system, Fitbit OS.This means the watch can support your favorite third-party apps, so you have access to information like weather or news updates and can use your favorites like Strava or Starbucks. Plus, it allows developers to easily create new apps and custom faces specifically for this watch and its multiple sensors.

Image: Fitbit 4. You'll be able to personalize training and nutrition programs that work for you and your goals. The brand is also launching a new app called Fitbit Coach (a rebranded version of the current Fitstar personal trainer app). This new version features personalized training and evolving plans that adapt based on your feedback (think: too easy, too hard, just right). With Ionic, you'll also be able to access audio-only coaching paired with your favorite music, so you can head out for a run and have a virtual coach in your ear all the way.

5. The battery lasts longer than the competition. You'll get four-plus days of battery life (or up to 10 hours with GPS use), so you don't have to take it off every night to charge it. By sleeping with the watch, you can benefit from the sleep stages and insights feature, which tracks light, deep, and REM sleep (a future application might be something like detecting sleep apnea in users).

6. It holds all your favorite music. Sure, there are other watches that store music (this one will hold around 300 songs with 2.5 GB of storage), but Fitbit partnered with Pandora to let you load your three favorite radio stations straight onto the watch. You'll have access to about two hours of preloaded content per station, so you can take Pandora offline and go phone-free during your workouts. To listen, you'll need wireless headphones (there's no headphone jack on the watch), which is why Fitbit is also launching new Flyer wireless headphones ($129.99, fitbit.com), with fully customizable parts (tips, wings, and fins in multiple sizes) that let you go for a run without them falling outa miracle! The Flyer has noticeably crisp sound quality and two settings: Signature and Power Boost, so you can get extra pumped during workouts.

7. It doubles as a wallet. You'll no longer have to awkwardly find a pocket for that single credit card on your next run. Fitbit Pay allows you to make payments via Visa, Mastercard, and American Express (bank partnerships may come in the future) with a quick scan of the watch.

8. It'll be available October 2017. But you can preorder it now it at fitbit.com for $299.95. Image: Fitbit 9. There are even more exciting things to come in 2018. Next year Fitbit is adding subscription-based guided health programs to Fitbit Coach, such as a four-week guide to reducing sugar and a six-week program for running beginners. And Ionic will be updated with new training plans thanks to a multiyear partnership with adidas.

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Fitbit Unveils a New Smartwatch, and It Could Actually Help You Reach Your Health and Fitness Goals - Greatist

Steve Russell believes he has found one of the best volunteer positions he could have for his skills.

He was an engineer at the U.S. Army Corps of Engineers, Rock Island District. For the past four years, the retiree has used his analytical skills and his eye for detail to help clients navigate the always changing Medicare plans.

You cant golf all the time, Russell said. Being a (Senior Health Insurance Information Program) counselor gives me something very complicated and challenging to help people with.

The program, known as SHIIP, provides free counseling to Medicare beneficiaries.

Enrollment for Medicare benefits is open all year as individuals turn 65 years old and become eligible, but there also is a special enrollment period from Oct. 15 to Dec. 7 for reviewing drug plans and Medicare Advantage plans.

Russell and other SHIIP counselors are available for appointments during the upcoming open enrollment period to help consumers review plans.

People with Medicare Part D coverage should check every year to make sure their plan fits their needs, Russell said. The providers can change premiums, co-pays, deductibles and the formulary every year and all of those can have an impact on your individual benefits.

The formulary is the list of medications covered by a specific Medicare Part D provider. For example, the provider may cover a medication one year, but not cover it the next year. If that drug is something you use, it could result in increased costs if you remain with the same insurer.

One medication may cost you $200 a month or may not cost anything depending on your plan, Russell said. If you have Medicare Part D, you should sit down with a SHIIP counselor with your list of medications and look at what the providers of Part D coverage have on their formulary.

We do everything we can to help people get the plan that best fits their needs.

SHIIP volunteers are not representatives of the insurance providers and are not involved in sales. Their role is to provide objective information and assistance to their clients.

To qualify as an advisor, SHIIP counselors attend three updates each year and take a certification test they must pass in order to be counselors.

Russell said it is important to make an appointment with a volunteer during the fall Medicare Part D enrollment period.

During the year I might have 10 to 12 appointments in a month. During the Part D enrollment period, I might have that many appointments in a single day so it is important to set up an appointment in advance, he said.

Russell and the other Genesis SHIIP volunteers who each year assist hundreds of clients will be honored on Wednesday in Cedar Rapids as recipients of the Iowa Governors Volunteer Award.

The Governors Volunteer Award program honors dedicated people across the state who volunteer their time and talent to help an agency or organization.

Genesis SHIIP volunteers served 708 clients in 2016 and spent more than 700 hours counseling clients. They also saved clients $364,383 by finding a Medicare plan meeting their needs.

The Genesis volunteers serving the region are Russell, Bob Lavender, Garry Rudish, Lynn Sours and Jerry Stanger. Another volunteer will join the group for the fall open enrollment period.

Were very proud of this group and the complex, important work they do throughout the open enrollment period, but also all year long as clients call with questions about their plan, said Allyson Miller, volunteer services coordinator, Genesis Medical Center, Davenport. This group is very deserving of recognition.

To set up an appointment with the Genesis SHIIP volunteers, call (563) 421-1096.

See more here:
SHIIP counselors help clients during Medicare enrollment period - Quad City Times

Chances are every one of us know someone who is living with a chronic, life-limiting illness that cannot be cured. According to the Center to Advance Palliative Care, approximately 90 million Americans are living with progressive illnesses. Heart disease, cancer, stroke, diabetes and Alzheimers disease are the most common.

Even though there may not be a cure for many of these chronic illnesses, there are numerous treatment options to help each person to live their best life possible. During this stage of life care not cure the focus is placed on quality of life, symptom management and pain control, rather than continued medical tests and treatments that aim to cure the illness. This type of supportive care is called palliative care.

Understanding and meeting the physical, emotional and spiritual needs of those living with chronic and life-limiting conditions is the focus of palliative care. Palliative (which means to relieve or soothe) care is specialized care for those living with a serious issue. Palliative care improves the quality of life for both the patient and their loved ones.

Palliative care concentrates on reducing the severity of chronic or progressive disease symptoms rather than striving to halt or reverse the disease when curing the illness is not an option. The palliative care team, which includes physicians, nurse practitioners, nurses, social workers, dietitians, pharmacists and spiritual leaders), educates patients and families about treatment plans and goals while addressing and supporting their physical, emotional and spiritual wishes. This helps patients maintain a good quality of life and can improve a patients ability to tolerate ongoing medical treatments.

Palliative care is not hospice or end-of-life care but can include aspects of hospice care, such as decisions regarding long-term pain control, death and dying, and other end-of-life related issues and assists in the transition to hospice, when appropriate.

Emmalee Kennedy, M.D., is the medical director of Northern Arizona Healthcares (NAH) Palliative Care Program. She is part of a team of compassionate medical providers at NAH, Northern Arizona University (NAU and other regional health care organizations who are working to educate health care providers, caregivers and the community about the benefits of palliative care.

As physicians and healthcare providers, our goal is to cure sometimes, to relieve often and to comfort always, Dr. Kennedy said. When a cure is not possible, palliative care is there to provide support and care for the patient and their loved ones. It is important for people to know they dont have to suffer just because they have a chronic condition or life-limiting illness. Palliative care provides a team of caring experts who can help each person live life to their fullest potential each day.

New national and state palliative care protocols mean better patient-centered care

One of the newest developments in palliative care is on the administrative side rather than the treatment side.

To bring clarity about the patients wishes and ensure consistency of treatment, a medical form is being implemented nationwide: Provider Orders for Life-Sustaining Treatment or POLST. In Arizona, the form and new protocols are termed AzMOST or Arizona Medical Orders for Scope of Treatment.

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Dawn Rivas, M.S., R.N., is a doctoral student and the interim assistant director and assistant clinical professor at NAUs School of Nursing. She and Dr. Kennedy are currently members of the AzMOST task force and are working in conjunction with other state leaders to develop and implement a POLST/AzMOST program in Arizona. At present, Flagstaff Medical Center has a POLST pilot program, which is the only such program in the state; other communities are currently looking to start POLST pilot projects of their own.

POLST and AzMOST provide continuity of care across settings of care with a goal of increasing patient quality of life and improving patient satisfaction, Rivas explained.

POLST/AzMOST improves the quality of care and quality of life for chronically ill patients by creating a process that asks about, documents and honors a patients wishes for medical treatment. The patients medical orders and desires are known and carried out without requiring a new set of orders every time the patient needs medical care. All healthcare professionals must adhere to the physician-signed medical order regardless of where the patient is receiving care or who is providing the care.

The new forms and protocols centralize information on these issues, improves record keeping and transfers appropriate information between healthcare professionals and between care settings. Information includes the patients diagnosis, prognosis and desires regarding medical and life-sustaining treatments and interventions, as well as general orders about what level of invasive treatments (such as a feeding tube) a patient would consider if their condition worsened. Depending on the patients preferences, the form may also include orders for do not resuscitate, do not intubate and other life-sustaining treatments.

The forms should be printed on bright pink paper so care providers can identify them in the case of an emergency. (Do Not Resuscitate or Pre-Hospital Medical Care Directive forms are printed on orange paper.) At home, these forms should be kept where easily seen, such as on the refrigerator, or with other quickly accessible medical and legal forms.

Is there a health topic you would like to know more about? Contact Starla S. Collins, health writer, life coach and PR expert, via email at StarlaSCollins@gmail.com.

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Palliative Care: When cure is not an option - Arizona Daily Sun