AUSTIN, Texas -- COVID-19 has forced many families to make end-of-life decisions without clear direction from their loved ones, which is why Texans are being encouraged to set aside time for such discussions over the holidays.

Maria Otero, national Latino outreach manager for Compassion & Choices, said it's an especially important conversation for Hispanic and Latino families, because of their higher risk of dying from the virus.

Compassion & Choices has created a free, online and bilingual end-of-life toolkit that Otero said can help families communicate about what often is a difficult subject.

"This toolkit walks you through each of the steps of planning the process from understanding your options to reducing your risk using telehealth," Otero explained.

Otero added Spanish-speaking communities often prefer to receive health-care information in their own language, and the toolkit has been designed to accommodate that.

In addition to language barriers, she said cultural traditions in some Latino families can inhibit end-of-life planning.

Cecilia Vasquez Vigil had not prepared end-of-life instructions when she was hospitalized for 34 days with COVID-19 in March.

She said her extended family faced more tough conversations when their 88-year-old mother contracted the virus and later died.

Since then, Vigil has been using the toolkit's step-by-step planning instructions. She said the conversations have not been easy for her children, but have helped reduce anxiety in such an uncertain time.

"I've definitely learned that, having those tough conversations with them, that the toolkit has been very rewarding in that I know my kids are going to be OK," Vigil commented. "I know my husband's going to know what to do."

Compassion & Choices is urging Texans to fill out and share their advance-care directive with their family and health-care providers.

The document spells out the kind of care you want or don't want, and designates a proxy to make medical decisions for you in case you can't speak for yourself.

Mother's Day is fast approaching and an Arizona mom wants women of all ages to make sure they are prioritizing their heart health.

Nearly 45% of women age 20 and older are living with some form of heart disease and do not know it.

Sharla Fisher was in her late 30s when she received her first pacemaker. She said she always lived an active and healthy lifestyle but would experience occasional blackouts. It was not until she sought medical attention experts determined she had an abnormally low heart rate and blood pressure and was later diagnosed with neurocardiogenic syncope, also known as vasovagal syncope.

"It is not a fatal condition by any means," Fisher explained. "But what becomes fatal is this happened to me while I was driving with my children on the freeway. This has happened to me when I'm flying cross-country, in a cab in the middle of a city I don't know at one o'clock in the morning."

Fisher added in talking with her doctor, they determined a pacemaker would help regulate her cardiovascular system. Fisher shares her story to inspire other women to take heart health seriously. This year's American Heart Association Go Red for Women Luncheon will celebrate women like Fisher and share vital information to keep women healthy. The event will be on May 8 at the Westin Kierland Resort and Spa in Scottsdale.

Fisher pointed out after receiving her pacemaker, things still did not feel right. She wound up in the emergency room while traveling and was diagnosed with cardiac tamponade, which is when there is excess fluid in the sac surrounding the heart. Doctors informed her she would need open-heart surgery, prompting Fisher to call her children and say goodbye.

"Because I didn't know how we would make it out of this procedure, and, like I said, my organs had already started shutting down," Fisher recounted. "Obviously I am here, so there is a good story that comes out of all of this, but it was then that it really opened my eyes to women and heart disease."

Megan Stuff is this year's Phoenix Go Red for Women chair and said she has been having discussions about heart health with her young daughters who are 8 and 12 years old.

"We have to start these discussions so that we really can break some of those statistics," Stuff stressed. "That is my goal for the luncheon is to just bring awareness and advocacy for cardiovascular disease in women and just start the conversation as early as possible."

Many residents of West Virginia are at risk of losing health care under a federal proposal to cut Medicaid funding by $880 billion.

Sen. Jim Justice, R-W.Va., and Sen. Shelley Moore Capito, R-W.Va., voted for the cuts.

Ellen Allen, executive director of West Virginians for Affordable Healthcare, said more than 500,000 Mountain State residents rely on Medicaid for health coverage.

"We've seen no interest in our legislators trying to make up the difference so they can keep health care intact for over a half a million West Virginians," Allen pointed out.

Allen added other states are also preparing for potential cuts and looking for solutions to fill in the gaps. More than 200,000 West Virginians lost Medicaid coverage after the end of pandemic era continuous coverage rules.

Allen explained 72,000 residents in skilled nursing facilities need Medicaid to pay for housing and care. She believes some facilities will shut down when faced with budget cuts.

"These are people who couldn't afford long-term care and policies," Allen explained. "Their families don't have the resources to support them. So what are you going to do with 72,000 people in skilled nursing facilities when Medicaid is not there to support it?"

State-supported home care for people with disabilities could also be at risk. According to the National Rural Health Association, slightly under half of the nation's rural hospitals are operating at a loss. Cuts to Medicaid would likely mean more rural hospital closures statewide.

The Alaska branch of the American Heart Association is helping save lives by teaching the use of cardiopulmonary resuscitation and automated external defibrillators in rural communities.

In a medical emergency, such as a heart attack, time and distance can be a formidable obstacle in rural Alaska for getting a patient to a hospital. The association said only about 10% of people who suffer a cardiac arrest outside a hospital will survive but access to CPR or a defibrillator can triple those odds.

Kristin George, executive director of the American Heart Association of Alaska, said it is all about keeping the blood flowing.

"The benefit of having CPR and AED education is restarting the heart," George explained. "If we can keep the blood flowing to the heart, then we're not losing any of the parts we need. The reason we do the education is to continue to keep that heart beating."

George noted by 2030, the association plans to visit more than 220 rural Alaskan villages. Each visit will include a hands-only CPR and AED skills session led by a LifeMed Alaska expert. Each town will get a CPR Anytime Training Kit, so residents can practice their skills and teach others.

George pointed out the goal is to increase the number of residents in Alaska's rural communities trained to provide chest compressions or apply an external defibrillator to restart a heart. She emphasized many remote villages in Alaska are detached from the state's road system, meaning it can take a long time for medical help to arrive.

"Any village that's out on the coast or anything like that is going to be pretty much unable to get there without a plane," George observed. "Or if you wanted to take the longest trek of your life and do it sled dog or by snow machine."

George added the Association has set a goal of doubling the survival rate from cardiac arrests in Alaska by 2030. The Foss Family Foundation and LifeMed Alaska are sponsoring the rural Alaska effort.