In an online posting today by CBC News in Canada, Jim Brophy, the director of the Canadian Auto Workers Union's (CAW) Occupational Health and Safety Clinics for Ontario Workers, stated that the Union fields calls daily regarding asbestos-related health problems and that the number of calls has increased steadily in each of the last three years. According to Brophy, the number of asbestos-related worker deaths is expected to peak in the next decade.

However, states Brophy, Canada is "probably alone among the industrialized countries in not documenting the extent of the disease and its impact on our society." Canada began mining asbestos in 1879 and continues to do so in Quebec, from where it is exported to many developing countries for use in cement pipes and roofing tiles. According to the article, Ottawa and Quebec City spend millions of dollars each year on trade promotion through Canada's Chrysotile Institute. Concerned with the rising number of worker deaths, the CAW has been, and will continue to, campaign the Canadian government for a country-wide ban on asbestos use and production.

Just last week, the U.S. Senate took the first step toward banning asbestos when it unanimously voted to pass the Ban Asbestos in America Act. If it becomes law, the Act would ban the importation, manufacture, processing and distribution of asbestos-containing products in the United States. For more information on the Ban Asbestos in America Act, see Bill to Ban Asbestos Passes Senate, posted October 5th.

The Seattle Post-Intelligencer reported Thursday on a report due to be released at the end of this month by the Government Accountability Office (GAO) which conducted an investigation into the EPA's examination and cleanup of hundreds of former vermiculite processing plants. For several decades, millions of pounds of asbestos-contaminated vermiculite ore was shipped from mines in Libby, Montana to processing plants throughout the U.S. and Canada, where the finished product was used to make many consumer and construction products, including home insulation. The ore and the finished products were sold by W.R. Grace & Co. under the brand name Zonolite. According to the article, government reports show heavy concentrations of residential Zonolite sales throughout Washington, Oregon, Idaho, Montana, Wyoming, California, and Canada. Although the exact number of U.S. homes that contain vermiculite insulation is unknown, it is estimated that up to 300,000 homes in Washington state alone could have been affected.

According to the GAO's report, in its examination of sites in over 250 communities that processed vermiculite ore from Libby, the EPA utilized outdated criteria and inconsistent survey methods causing it to underestimate or miss entirely the danger to people who lived and worked near those processing plants. This is extremely disconcerting in light of the number of documented deaths from mesothelioma and other asbestos-related diseases of people who lived and worked near the Grace vermiculite mines in Libby, Montana.

Equally disconcerting is what's not contained in the report--the magnitude of the EPA's failure and/or refusal to warn the millions of homeowners that they may be exposed to cancer-causing asbestos in their home insulation. According to the article, in 2002 the EPA stated its intention to issue a Public Health Emergency regarding the danger of asbestos-contaminated Zonolite home insulation. Such a declaration would have authorized monies to be used for further research, clean-up efforts, and public awareness and education campaigns. In 2003 the EPA promised a national consumer awareness campaign to provide homeowners with information about vermiculite insulation. Neither of those efforts ever materialized and millions of American homeowners, residents, families and workers continue to be exposed to asbestos-containing vermiculite insulation.

According to scientists, the slightest disruption of Zonolite insulation could release millions of asbestos fibers into the air. Public health officials interviewed for the article called the EPA's failure to inform the public of the danger of asbestos-contaminated vermiculite insulation "unconscionable."

To learn more.

The U.S. Senate voted unanimously Thursday to pass S. 742, the Ban Asbestos in America Act of 2007. The bill, championed by Senator Patty Murray (D-WA), would ban the importation, manufacture, processing and distribution of asbestos-containing products, and direct the EPA to ensure that all asbestos products are off the shelves within two years of the bill's enactment. According to Senator Murray, currently 2,500 metric tons of asbestos are imported into the U.S. every year in hair dryers, ceiling ties, brake pads and other products.

Senator Murray and her staff have worked tirelessly for the past six years to shine a light on the dangers of asbestos and garner support for a bill to ban the deadly, cancer-causing material, meeting with labor leaders, lobbyists, lawyers, doctors, as well as with victims of mesothelioma and other asbestos-related diseases and their families. Murray faced a lot of opposition in her fight to get this bill passed. According to the Seattle Post-Intelligencer, Murray stated that "when you go after an issue like this, you're fighting a lot of big-time money. Lobbyists for manufacturers, the sand and gravel folks, people with commercial interest and a lot of clout fought this. I wasn't surprised that many other (lawmakers) didn't want to get involved because they thought it was impossible." The bill, re-introduced in March, gained bi-partisan support with the help of Senator Johnny Isakson (R-GA) and was unanimously approved by the Senate Committee on Environment and Public Works (chaired by Senator Barbara Boxer (D-CA)) in August. (See Senator Murray's Bill to Ban Asbestos Moves Forward, posted August 1st).

If approved by the House and not vetoed by President Bush, with the passage of this bill the U.S. would join over 40 other countries who have banned asbestos. Senator Murray has stated that she is sure the bill will become law. In addition to banning asbestos, if passed, the bill would create a $50 million "Asbestos-Related Disease Research and Treatment Network" consisting of 10 new research and treatment centers around the country, and would create a new National Asbestos-Related Disease Registry to facilitate more comprehensive research.

The issue now shifts to the House where a companion bill, the Bruce Vento Ban Asbestos and Prevent Mesothelioma Act of 2007 (H.R. 3339) has been introduced by Congresswoman Betty McCollum (D-MN). Passage of the bill, named after Congressman Bruce Vento, who died from mesothelioma in 2000, is expected to be imminent.

For more information on Senator Murray's Bill to Ban Asbestos, click here.

Caring for a loved one who has been diagnosed with Mesothelioma or another serious medical condition can be emotionally and physically exhausting. As caregivers we sometimes forget the importance of taking care of ourselves. I have worked with caregivers who have become overwhelmed, fatigued, and suffered from “caregiver burnout”. At times caregivers feel guilty if they take care of their own needs. It is important to remember that if we don’t take care of ourselves during this challenging time, then we may become unable to provide proper care to our loved ones.

Below is a list of tips on how to take care of yourself while providing the best possible care to your loved one:

1. Take time for yourself (schedule breaks into your day, get a good nights rest, practice self care and stress management strategies, and pamper yourself whenever you can)

2. Practice good nutrition (eat balanced meals and drink plenty of water – your health and nutrition are just as important as your loved one’s)

3. Exercise (a short walk a few times a week is a good start – exercising is a good way to take a break, decrease stress, and increase your energy)

4. Prioritize your tasks (make a list of tasks that need to be completed, do only what is most important, and delegate tasks to other friends and family members)

5. Be realistic (set boundaries, keep daily “to do” list reasonable, don’t feel you need to do everything yourself, and keep realistic expectations of yourself and others)

6. Continue activities that are meaningful to you (listen to music, work in the garden, continue your hobbies, and schedule time away from home or with friends/family)

7. Keep your sense of humor (try to find humor in everyday and remember “laughter is the best medicine”)

8. Consider getting outside support (attend a support group, gain strength from your faith or religious affiliation, access local community resources, and/or internet support options – these options provide us not only with a place to get assistance, but also an opportunity to help others)

9. Seek professional help (you may find yourself feeling lonely, anxious, guilty, angry, scared, frustrated, confused, lost, or tired – you may feel any or all of these – and if you feel overwhelmed by these feelings contact your doctor, social worker, hospice staff, or another community resource for help)

Most of us will play a role in the caregiving process at some point in our lifetime; as a caregiver, a recipient of care, or possibly both. Your role as a caregiver makes a tremendous difference to your loved one. It demonstrates kindness, love, and loyalty. Be gentle on yourself and remember that you are doing the best you can.

In a past blog, I talked about planning for the future needs of a person suffering from a major medical illness such as Mesothelioma or other asbestos related illness. I touched on the general issues that may need to be addressed. In this blog, I will focus more specifically on the options for assuming control of financial and medical matters. At some point, a family member or other concerned individual may need to assume responsibility for decision making and will need the authority to do so. How and when these actions take place, depend on a variety of issues. Understanding the different options will help you and your family make the right decisions for your circumstances.

Below are explanations of some of the options used to manage your loved one’s affairs:

• Restricted Bank Accounts: Co-signatory accounts require two signatures for withdrawal (unless one owner becomes incompetent and unable to sign). Accounts with permanent withdrawal orders (where the bank issues a monthly allowance to holder) and deposit orders (such as direct deposit of benefits checks) are also options.
• Representative Payee for Social Security: The Social Security Administration can appoint a person or an organization as a “payee” to receive and cash the monthly public assistance checks (Social Security, Social Security Income/SSI, Veteran’s Benefits) for a recipient deemed incapable of managing his/her own funds.
• Power of Attorney: A document which authorizes another person to act on behalf of the individual granting the “Power of Attorney”. The person giving the power is called the “Grantor” and the person granted the power is called the “Attorney-in-Fact”. The authority given can range from general powers, allowing the Attorney-in-Fact to handle all financial transactions and affairs, to limited powers such as handling the check book only. The principle must be competent when appointment is made. The Power of Attorney remains in effect until revoked by the grantor or upon the incompetence of the principle. To continue a Power of Attorney beyond incompetence, the document must be a Durable Power of Attorney.
• Conservatorship: A legal process where the court appoints a person to handle just the real estate/property and financial matters of the ward who is unable to do so. A petition for conservatorship must be filed in Probate Court. This may be used when a person is no longer capable of acting in a responsible manner regarding financial decisions, but is still capable of making appropriate decisions regarding their personal care.
• Guardianship: A “guardian” is appointed by the court to make personal, health care, and financial decisions for a person who, due to either mental or physical disability, is incapacitated. The incapacitated person is referred to as the “ward”. The guardian assumes the responsibility to make all decisions regarding personal affairs, health care, and financial matters. (Note: Properly executed Advance Directives – Durable Power of Attorney and Health Care Proxy – go a long way in making certain that the person’s wishes regarding both personal and financial decisions will be met if the patient is no longer capable of doing so. However, if the patient has not given anyone legal authority to act in their place and they are no longer capable of making these decisions, the courts can be asked to appoint someone to take on this responsibility.) A petition for Guardianship is a detailed process that requires filing of necessary papers in the appropriate court.
• Advance Directives: An advance directive is a document you prepare to inform others of your wishes should you become medically incompetent to make your own health care decisions. Medical personnel must abide by the decisions of your agent as if you were making the decisions yourself. Although the form is a legal document, you do not need an attorney to complete one. Each state has its own guidelines and requirements for advance directives.
• Trust: A trust is an arrangement in which a person (trustee) holds property, real or personal, for the benefit of another (beneficiary). The court is not involved in a trust. The trustee’s authority is confined to what is outlined in the trust arrangement. There are many types of trusts and professional advice should be sought.
• Living Will: A Living Will is a set of written instructions that outline the patient’s health care wishes at the end of life. If a person completes a Health Care Proxy form and also has a Living Will, the Living Will provides instruction for the proxy. This document differs per state - find out how a Living Will is handled in your state.
• Health Care Proxy: The Health Care Proxy is a simple legal document that allows you to name someone to make health care decisions for you (if for any reasons and at anytime you become unable to make or communicate those decisions). Some states only recognize a Health Care Proxy, some use Advance Directives, and some may have a combination. (Note: Choose your proxy wisely. Be sure you know and trust this person. Also, be sure to educate this person regarding your beliefs/wishes and confirm they can fulfill these personal decisions.)

Researching your options is the first step. Deciding what will work for you and your family is the second. As always having these discussions is difficult, but helpful (especially when having the conversations before you are in crisis and having them again over time). Medical and financial providers will be able to provide additional guidance and assistance. Social workers, case managers, attorneys, and financial planners will be able to look at the specific circumstances to help you navigate these crucial decisions.

You may also be interested in getting more information at the following sites:

http://www.caringinfo.org – Caring Connections
http://www.putitinwriting.org – American Hospital Association
http://www.agingwithdignity.org - Aging with Dignity
http://www.naela.com - The National Academy of Elder Law Attorneys