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october

Breast Cancer Awareness Month

It’s time to speak up about breast cancer, and the month of October is dedicated to doing just that. As the most common form of cancer, it’s likely that someone in your life whom you care for deeply has been diagnosed with breast cancer. Given how prevalent breast cancer is and the repercussions it has on individuals and families affected, this month is a time to rally together and raise awareness about it.

october breast cancer

Breast Cancer Statistics

In the United States, more women die from breast cancer every year than any other form of cancer. It’s currently estimated that 1 in 8 women in their lifetime will be diagnosed with an invasive form of breast cancer. Two of the greatest risk factors of getting breast cancer are female gender and older age, though men and younger women can get it as well. The statistics are alarming, and a diagnosis can feel daunting and isolating, whether it’s yourself or a loved one or family member who is receiving it. Fortunately, breast cancer research continues to thrive, which has led to improvements in screening processes and treatment success. These improvements have been given some of the credit for the slightly decreased death rate from breast cancer over the past several years. In order to take further advantage of the strides we’ve made in battling breast cancer, we must continue to educate our communities about the screenings and treatments available.

breast cancer stats

Self-Monitoring for Changes

While there is no way to guarantee prevention of breast cancer, it is recommended that all adult women perform a breast self-exam monthly. This is a great way to self-monitor for any changes or abnormalities that may occur in the breast tissue. As you age, this becomes an even more important habit as age is one of the main risk factors. It is important to note that not every growth or lump felt in the breast tissue is a cancerous mass. Some non-cancerous masses are abnormal but do not grow outside of the breast tissue. While these lumps do not innately pose a risk, some of these growths can increase a women’s risk of getting breast cancer down the road. Any abnormality or change in your breast tissue that you notice or feel should be examined by a health professional immediately. Just under half of women diagnosed with breast cancer were diagnosed after noticing a lump during a self-exam, so the importance of this routine cannot be overlooked. In addition to regular self-exams, maintaining a healthy weight through exercise and a nutritious diet is another important way to reduce your risk of breast and other cancers.

Receiving a Breast Cancer Diagnosis

Should you receive a diagnosis of breast cancer, take the time to find a team of doctors whom you are comfortable with and trust with your care. This team can include an oncologist, or cancer doctor, a surgical oncologist, a radiologist, a case worker, a registered dietician who specializes in cancer nutrition and possibly several other specialty providers. These individuals will be with you, alongside your personal support system, to make sure you receive the best care available from diagnosis on. Treatments and interventions will differ depending on the type of breast cancer you are diagnosed with and your doctors will help you navigate all of the options and should use their expertise to recommend the best course of action. Make sure you feel comfortable asking questions and engaging in your treatment plan. Your providers have the knowledge and the skill sets to provide excellent care, but it is just as important that you feel included in the decisions being made and prepared for the treatment road ahead.

breast cancer ribbon

Raising Awareness

Whether you are young, old, male, female, part of a high-risk category or not, it is our shared efforts in spreading awareness this month of October and all months following that will successfully raise awareness, education, and resources about breast cancer to every individual diagnosed and every family and friend supporting them. As a society working together, it is within our reach to decrease breast cancer diagnoses within our communities and to improve the outcomes and survival rates of those diagnosed.

Sources

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American Cancer Society

BreastCancer.org

National Breast Cancer Foundation, INC.

Breast Cancer Survivors – A Cut Above the [Breast]

As a survivor of breast cancer, few will understand the struggle you endured, but many acknowledge and honor the strength it took to carry on.

breast cancer ribbon

Alongside the relief and celebration that comes with completing treatment and hearing the long-awaited word “remission” may come a host of other emotions. Some of them may not be as positive. You may feel fear of the cancer coming back or anxiety about not seeing your treatment team as often. Surgeries and treatments can alter the way you feel about your body. These emotions are natural after what you’ve been through, and it’s important to know that you’re not alone and that you have resources at your disposal to live your life as fully as possible following recovery.

Listen to Your Doctor

After completing treatment and entering into recovery, it is important to abide by your doctor’s recommended follow up care. This care often includes checkups every few months for the first several years after treatment. As your cancer-free time increases, the frequency of appointments can begin to decrease. If you had breast-conserving surgery to include a lumpectomy or a partial mastectomy, it is recommended that you get a mammogram 6-12 months after surgery and radiation and continue to get them annually for monitoring. Pelvic exams may also be included in your follow up care as some of the hormone drugs can increase your risk of endometrial or uterine cancer. Another test that may be done, especially if you have gone through menopause, is a bone density scan. Monitoring your bone health will be a priority for your doctor especially if your cancer treatment included drugs that can reduce bone density.

women in pink

Focus on Your Mental Health, Too

Battling cancer and enduring the challenges that come with treatment can leave you feeling exhausted. It can be challenging to find the energy to keep up with follow up care, knowing that it will be a crucial part of your life as a survivor. Express any concerns or anxiety or overwhelm you are feeling about your continued treatment and monitoring with your doctor. Collaborate with them and let them help you feel more in control when it comes to your checkups. Equally important as your medical team is your support system. Continue to lean on the individuals who supported you through treatment, whether it be family, friends, a loved one, a support group or a therapist. Support systems can often help to shoulder some of the burden when it comes to remembering appointments, driving to procedures, and encouraging you to continue doing the things you love outside of your healthcare.

breast cancer ribbon tree

Everyone’s Experience is Unique

Every single individual’s experience with surviving breast cancer is unique and special. You will have your own thoughts, feelings, challenges and success that you overcame and that you will continue to experience as you embrace a heightened awareness of your health for the rest of your life. Beyond this, you are an example of hope and strength for others who are fighting their own battle against breast cancer. Continue to spread awareness this month and every other so that we can continue to win more of these battles.

Sources

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American Cancer Society

Cancer.net

Person’s meditating hands in a grassy field

Importance of Self-Care In Grief

We all grieve differently, but one thing remains true for everyone: the importance of taking care of yourself. Whether you’ve found yourself in a state of just going through the motions or you’ve put all your focus on taking care of your loved ones, it can be easy to put your own needs on the back burner when facing the loss of a loved one.

However, it’s absolutely imperative that you take time to focus on yourself, too. In honor of Mental Health Awareness Month, we are discussing the importance of self-care throughout the grieving process.

Mental Health Awareness Month

Mental Health Awareness Month dates all the way back to 1949 when the National Association for Mental Health (now known as Mental Health America) first organized the observance in the month of May to help raise awareness and lessen the stigma attached to mental illness.

For a long time, society looked at mental illness as being just one thing. There was always a negative stigma attached to the term, and people often thought of those living with a mental illness as having ‘gone mad’. However, that is simply not true. Over time, we’ve learned more about the many layers and types of mental illness.

Mental illness is the term used to describe mental health conditions that impact a person’s mood, thinking, and behavior. Common mental illnesses include:

How Grief Impacts Mental Health

Losing a loved one can be a traumatic experience. You may feel as though you lost a part of yourself and that your life will never be the same. While there is some truth to this, it’s important to remember that you are still here and must go on living your life.

“We don’t move on from grief. We move forward with it.

–          Nora McInerny

Feelings of sadness, anger, loneliness, and hopelessness are all common throughout the grieving process. However, these feelings can sometimes develop into chronic grief which can in turn become a mental illness. In some cases, grief can lead to depression.

Symptoms of chronic grief can include:

How Self-Care Improves Mental Health

Self-care used to be thought of as bubble baths and pampering yourself, but there is much more to self-care. Just like the grieving process, self-care can look different for everyone. But the overall concept is to take care of yourself physically, mentally, and emotionally.

To take care of yourself physically is pretty simple: eat a well-balanced diet, drink plenty of water, exercise regularly, and practice healthy hygiene habits. However, taking care of yourself mentally is a little less cut and dry. This is where it really differs from person to person. To take care of yourself mentally and emotionally, you need to take time to do the things that make you feel good and happy. Hobbies are a good place to start when focusing on taking care of yourself mentally. Maybe you enjoy sitting outside and reading a good book, maybe you are an artist, maybe you enjoy taking long walks with your dog. Whatever it is that leaves you feeling happy and fulfilled, do it!

Research shows the more you practice self-care, the more confident, creative, and productive you are. This also leads to experiencing more joy, making better decisions, building stronger relationships, and communicating more effectively. Overall, you will be in a better frame of mind, making you a better version of yourself. This is not only good for you, but it’s also good for those who depend on you.

When you take time to take care of your whole self (physically, mentally, and emotionally), it will help you to process your feelings of grief in a healthier way.

How Hospice Can Help You in Your Grief Journey

Always remember that you do not have to face the journey of grief alone. Lean on friends and family to help you through. Don’t be afraid to talk about your feelings. Sometimes we feel the need to be strong for those around us. If this is the case and you would feel more comfortable talking to someone outside the family, lean on the support of your hospice bereavement team. Our kind, compassionate bereavement coordinators are always available to talk or just listen. Never hesitate to reach out.

If you or someone you love is struggling with their feelings of grief and would like to talk to one of our bereavement coordinators, please contact us at 1-800-695-7074.

Collage of people

Asian American and Pacific Islander Heritage Month

By: Anonymous

May is Asian American and Pacific Islander (AAPI) Month, a time to learn about and celebrate the rich histories and cultures of Americans from the Asian continent and the Pacific Islands. The AAPI population is remarkably diverse, with 24 million people tracing their roots to over 30 countries. Many different cultures mean many different beliefs and traditions regarding the passage from life to death.

Demographic research reveals that AAPI Americans are less likely to access hospice and palliative care than other groups. Asian Americans, for example, have been shown to use fewer end-of-life services. Studies attribute this to cultural beliefs, language barriers, attitudes about death, and family-centered decision-making. But good hospice and home care can meet these challenges.

Respecting Differences

We recognize that the AAPI community has diverse attitudes and practices surrounding illness, hospice, and death.

Although some AAPI practices are widely shared, such as respecting elders, using white and yellow colors, and burning incense, some practices vary. Chinese and Korean values can require the family to keep vigil by a dying loved one. The Chinese tradition, however, may maintain a hierarchy within the family structure, while the Korean tradition might maintain the division of genders. In other AAPI traditions, individuals, like expectant mothers, are discouraged from visiting someone at their end-stage of life for their own protection. In addition, some cultures place great value on a loved one being cared for in their own home at the end of their life.

Embrace Hospice understands that these spiritual practices can, and should be, honored. We’re here to accommodate by providing professional, competent, caring, in-home service that maintains sensitivity to these values. 

Personalized Care Informed by Cultural Respect

Care goes beyond medical support. We are prepared to and can help you and your family with the hospice and bereavement journey with sensitivity toward AAPI’s religious, spiritual, cultural, and personal beliefs. This respect extends beyond rites and rituals and into practical care. The Native Hawaiian belief that spiritual essence (mana) is in all parts of the body can, for example, influence feelings about organ donation or cremation. But awareness of this belief informs our good care for a Native Hawaiian in the end stage of life.

The AAPI population is growing. By 2050, AAPI will become nearly 10% of the total United States population. It’s important that they can get the end-of-life care they need. Our staff ensures that everyone in our care, their family, and their loved ones are treated with respect. 

Some Eastern philosophies view death as part of a cycle in which a loved one’s passage serves as a reminder to celebrate the miracle of life. Our team celebrates the lives of the people we care for, and what makes each of them unique. We’re proud to join this month’s celebration of Asian and Pacific Islander American Heritage Month. We invite interested AAPI Americans to learn about our hospice and in-home services, confident their culture and traditions will be honored.

Close up of hospital sign

On National Hospital Week and Every Week, We Thank You!

By: Anonymous

We invite all community members to join us to recognize National Hospital Week, May 8 to May 14, 2022. Here’s more about this yearly observance and how we honor it at Embrace Hospice.

What Is National Hospital Week?

National Hospital Week is observed every year during the week that includes May 12, Florence Nightingale’s birthday. Florence Nightingale is best known for founding modern professional nursing and demonstrating the importance of nurses and their roles in the healthcare community.

Established in 1953 by the American Hospital Association, National Hospital Week highlights and recognizes hospitals and healthcare workers and the many innovative ways they support their communities.

Thank You For All You Do

Our team understands how challenging and demanding the hospital setting can be. We want to thank physicians, nurses, social workers, discharge planners, aides, and all other clinical staff members who have supported and cared for our patients and communities over the past year, especially given the unique ongoing challenges presented by the COVID-19 pandemic. Your hard work, long hours, and dedication to your communities have helped improve the quality of care for thousands of people in need.

Partnering With Hospice Care

As a leading hospice treatment provider, Embrace Hospice extends extra thanks to hospitals that partner with hospice providers. Your care and services have dramatically improved the quality of life for terminally ill patients and their families. In addition, you have given our team the opportunity to help these families save on hospital-related costs and deliver highly personalized care that helps them fulfill their loved ones’ final wishes.

We look forward to continuing our relationships with hospitals that partner with hospice treatment providers and are confident that together we can handle any unforeseen challenges that may come our way. In honor of National Hospital Week, thank you.

Elderly stroke patient and their caregiver

Hospice Eligibility for Stroke Patients

Some of the most common misconceptions about hospice care involve when it’s appropriate for a patient to elect hospice services and what diagnoses qualify a patient for hospice. People often assume hospice is only for cancer patients, but that is simply not true. You may be surprised to learn that stroke patients also qualify for hospice services.

What is a Stroke?

Strokes are the number five cause of death and a leading cause if disability in the United States. A stroke is defined as a disease that impacts the arteries leading to and within the brain. It occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or ruptures. When this happens, part of the brain cannot get the blood and oxygen it needs, causing it and brain cells to die.

Stroke Warning Signs

The American Stroke Association uses F.A.S.T to help us identify warning signs of a stroke.

F = Face Drooping

If one side of the face is drooping or numb, this can be a common sign of a stroke. One way to help to determine this is by asking the person to smile. If their smile is uneven, that is an indication of face drooping caused by a stroke.

A = Arm Weakness

Another sign can be if one arm feels weak or numb. Ask the person to raise both their arms. If one arm drifts downward, it could be a sign of a stroke.

S = Speech Difficulty

Slurred speech is a third sign of a stroke.

T = Time to Call 911

If someone is showing these three warning signs of a stroke, call 911 immediately.

Other Signs and Symptoms

Other signs and symptoms of a stroke can include:

Stroke Risk Factors

Given the danger of strokes, it’s important to understand the different risk factors, including both those within and out of your control.

Risk Factors You Can Control

Some risk factors of stroke are within your control. These can include:

Risk Factors Beyond Your Control

As with anything else, some stroke risk factors are beyond your control. These can include:

Hospice Qualifiers

Hospice can benefit patients who are in the terminal stages of a stroke. The following criteria could be indicators that it may be a good time to consider the additional support of hospice.

If you are still unsure if your loved one qualifies for hospice, or if you have any questions about hospice for stroke patients, please don’t hesitate to contact us.

National Volunteer Month

Volunteers are an essential part of the hospice care team. The difference they make for our patients and their families is immeasurable. Whether it’s through direct care or administrative work behind the scenes, there are countless ways a hospice volunteer can help.

We are beyond grateful for the incredible people who volunteer their time and talents to make a positive difference in our patients’ lives. In honor of National Volunteer Month, we’d like to recognize just a few of them. We asked our volunteers to share what made them decide to be a hospice volunteer and what they find most rewarding about their experience.

Dennis

Hospice of the Midwest Volunteer – We Honor Veterans Program

Dennis

“On September 10, 2018, Mr. Kelly Gafkjen, Chaplain, Hospice of the Midwest, was a guest speaker at our Urbandale-Johnston Veterans of Foreign Wars monthly meeting. Kelly was on a mission seeking veterans to talk to veterans in local hospice care in their homes or hospice facilities.  Many veterans in hospice would like to share their life and military experiences, but feel only a fellow veteran can associate with their feelings. At the conclusion of his presentation, Kelly asked that we consider volunteering, receive some minimal training, and agree to talk to veterans who are seeking fellow veterans to talk to.  After our meeting concluded, a number of us discussed the information presented by Kelly, and three of us thought this was right in line with our VFW mission of “Veterans helping Veterans”.  Contact was made with Kelley and the three of us started our training at the Fall Training Session September 27, 2018 , conducted by Kelley and Taylor Schneider.  By the end of October we had finished our training and were waiting for our first assigned veteran. Under the guidance of Taylor I was introduced to my first veteran during a pinning ceremony on November, 30, 2018.  Since then I have had the privilege of meeting and sharing both civilian  and military experiences with 9 veterans of WW II, Korea, Vietnam and the Cold War eras.  Every veteran, whether Army, Air Force, Navy or Marine, were all comrades and had their own unique and fascinating stories to tell. Some sad, some humorous, but all seemed willing to share with enthusiasm. I so much enjoyed visiting with these men, and I only hope they felt the  same comradery that I felt while in their presence.  I will miss these veterans but look forward to meeting my next comrade.”

Kendall and Ashley

Premier Hospice Volunteers

Kendall and Ashley

“Kendall and I (Ashley) love volunteering for Premier Hospice! We started in 2019 and volunteer weekly. Kendall states that he enjoys working in an office setting and learning new skills. I have been working with Kendall through the Medicaid Waiver program for almost 5 years. Seeing Kendall get to experience a work-type setting and learn new skills has been very rewarding. Nikki is a lot of fun to work with and always makes us feel appreciated!”

Arav and Anishka

Grane Hospice Volunteers

Arav and Anishka

“We started volunteering for a local hospice during the pandemic (2020). We stumbled upon the opportunity from an email our mom received asking for donations of homemade casseroles and cards for hospice patients and their families. At first, it started by making occasional cards and casseroles, and then it turned into a routine every other week activity. This evolved into helping other hospices including including Grane Hospice. We have made homemade cards and even have given a virtual concert for the patients at Grane Hospice. We feel grateful to be able to give back to others in need even during a worldwide pandemic. It shows no matter what the circumstances, we can help others in our community. All this volunteer work has inspired us to create our own non-profit group called Rays of Sunshine, benefiting local hospices. We hope to expand and help even more local hospices in the future.”

Daniel

CompassionCare Hospice Volunteer

Daniel

“Coming from a family where both parents were in the medical field, I have had an interest in medicine ever since I can remember. In the pursuit of getting involved with medical volunteering opportunities, I wanted to commit to something that would provide meaningful experiences in vulnerable people’s lives, as well as my own. Although my patients’ physical bodies are failing them, they still have great wisdom to impart when given the chance to share and be heard. Many times, I leave the local assisted living facility with an enlightened perspective that I believe will serve me well in the career I am aspiring to have. From hearing first-person stories of World War II experiences to celebrating 96 years of living, there is always a window for valuable learning opportunities when I have the chance to spend time with these folks whom I now consider my friends.”

Joan

AT Home Care and Hospice Volunteer

Joan

“I Prayed about being a Hospice Volunteer and this is how the Lord is using My ability as a Hairdresser, to bring Comfort and Joy to the Patients. The most rewarding aspect is seeing the Happiness in the Faces of the Patients and their Families. Working with Them is a Blessing to Me.”

Virginia and Flynn

Grane Hospice Volunteers

“Being a hospice volunteer is about having a passion and love for helping others. No, I don’t physically help them but the most rewarding part about volunteering with my dog, Flynn, is seeing the joy it brings to residents. Residents look forward to our visits and remember us from week to week, allowing special connections to be made. I’m thankful for the opportunity Flynn and I have to give our time and make people smile.”

Kennedi and Ernest

Hospice of North Alabama Volunteers

Kennedi and Ernest

Kennedi and Ernest – graduate level social work students with Alabama A&M University and the University of Alabama – are student volunteers with Hospice of North Alabama in Huntsville. They sit with patients to provide caregiver respite. Hospice volunteer work allows students to garner a strong understanding of how social workers broker services within a healthcare agency as well as how to coordinate with various other healthcare and social service agencies.

Ernest states “I have learned that the process of dying and bereavement is as diverse as the families we serve. The first step of serving this population is engaging the patient and/or caregivers on what they want this time in their lives to be like—no two answers are the same.”

Along with the home environment, they also work with residential care communities to provide comfort and support. This gives them experience working with diverse community types and medical care needs.

Kennedi states “The things I’ve learned while interning at Hospice of North Alabama have prepared me to be a more caring and competent social worker. The compassion and kindness that HNA shows to the patients has been extended to me from the very beginning, and I’m so grateful. This has been the greatest experience of service I have committed myself to.” Ernest agrees, adding: “Knowing that you have provided support to a patient and/or their family in this transition period is rewarding. Establishing the trust that fosters comfort and emotional resiliency is an experience that will give volunteers a unique understanding of how health care best serves patients in all life stages.”

Choi-ha

Premier Hospice Volunteer

“My internship and volunteering experience with Premier Hospice was meaningful and fulfilled my longstanding desire of working with end-of-life services to clients and their families. 

I enjoyed working with a well-resourced team that included a chaplain, bereavement coordinator, social workers, liaisons, nurses, a doctor, and a volunteer coordinator. Each of them brought to bear their own particular skillset, and we all collaborated to make our clients’ end of life as comfortable and dignified as possible. 

Besides teamwork, I enjoyed, I enjoyed visiting with my client once a week. My primary role was to support and strengthen the care providers so that they might function better.

I also enjoyed supporting other team members by making caring calls to clients or their families. It was amazing how much comfort and reassurance I could bring to them through the calling service. My participation in the online bereavement group was my gain in the understanding and knowledge of the process in group work, particularly for grieving families. 

Through my time with Premier Hospice, I have grown to better appreciate the important role of leadership in the hospice setting. The internship was profitable to my professional growth and development.”

Katie

Premier Hospice Volunteer

Katie

“I volunteer with hospice to facilitate new transitions. In January 2020, I completed the training to become an End-of-Life Doula in New York City. In my move to Indianapolis, it was important for me to find a strong hospice program where I could be actively involved in the moments of life and death with others.

I volunteer because dying is an important cycle in every community. It is never easy to participate in the dying process, it pulls at every piece of your being. But there is nothing more rewarding than helping a patient or caregiver smile again while recalling a significant life moment. There is nothing more rewarding when the world feels burdensome, to help others find peace even for a single second.”

Thank You, Volunteers!

Thank you to these incredible individuals – and to all the volunteers on our team – for all you do for our patients and their families. You are amazing!

Interested in learning more about volunteer opportunities at Embrace Hospice? We’d love to have you on our team! Learn more and apply here.

Senior woman drinking water with shaking hands

Parkinson’s Awareness

By: Dr. Laura Mantine

Parkinson’s disease (PD) is caused by the loss of dopamine-producing nerve cells within the brain. The loss of dopamine causes symptoms like stiffness, slow movements, balance problems, and depression. There are certain specific motor symptoms that accompany Parkinson’s disease. A resting tremor happens when a body part, usually a hand or foot, shakes slightly when a person is not using it. Bradykinesia is when movements are extremely slow, and patients may have freezing episodes which are temporary, involuntary periods where a person is unable to move. A PD patient may also experience changes in speech, smaller handwriting due to difficulties performing repetitive motions, and a “masked” face due to a loss of facial expression. Patients are also at an increased risk of falls from a combination of poor balance and severe stiffness. A PD patient may develop difficulty swallowing which can lead to weight loss, malnutrition, dehydration, and pneumonia.

There are also non-motor symptoms that are present in Parkinson’s disease. Parkinson’s dementia is a significant, permanent decline in attention, memory, and problem-solving that impairs daily life. A patient may develop hallucinations or delusions throughout their disease course which can lead to increased caregiver stress. Patients may also suffer from severe constipation, urinary problems, and sleep disorders that affect their quality of life.

A Progressive Disease

As a progressive disease, Parkinson’s disease symptoms will slowly worsen over time. While PD affects people in unique ways, there are typical patterns of progression, defined by five stages. In stage 1 and stage 2 of Parkinson’s, patients may experience mild shaking and stiffness. As the disease advances into stages 3 and 4, loss of balance and slowness of movement begin to impair daily functioning. Stage 5 is the final, most debilitating stage of PD. In this stage, patients are wheelchair- or bedbound and require 24-hour nursing care. Patients are said to have end-stage Parkinson’s disease at stages 4 and 5 of the disease. In end-stage Parkinson’s disease, symptoms are so severe that medication stops working well, and patients require full-time caregiver assistance. Eventually, end-stage PD patients become candidates for hospice care, a service that focuses on easing symptoms and improving comfort at the end of life.

Hospice Eligibility

There are no formal PD eligibility guidelines for determining when a hospice referral should be made, and there is no definite timeline when it comes to the final stages of Parkinson’s disease. However, hospice care is available to patients who are expected to live six months or less. Doctors and hospice agencies will consider factors relevant to PD like a patient’s history of falls, hospitalizations, withdrawal from activities, inability to perform self-care, and lack of benefit from medication. There are very general hospice guidelines intended to cover a broad-spectrum of neurological disorders. The guidelines for neurological illnesses state that patients must meet one of the following to be eligible for hospice: critically impaired breathing or rapid disease progression in the past year.

Critically impaired breathing is unlikely to be applicable in Parkinson’s disease. Primary respiratory problems are not typical in advanced PD. The second criterion, evidence of rapid disease progression in the prior year, tends to be more useful for patients with end-stage PD. A rapid disease progression means that patients are bedridden, have unintelligible speech, require a modified diet, and need major assistance with activities of daily living. Nutritional impairment is common in end-stage PD. Patients are unable to maintain sufficient oral intake and experience weight loss and dehydration. Life-threatening complications that may occur in end-stage PD include recurrent aspiration pneumonia and pressure ulcers of the skin.

Hospice for Parkinson’s Patients

Hospice care is an extra layer of support to help care for loved ones with end-stage Parkinson’s disease. The goal of hospice care is to optimize comfort and ease physical, emotional, and mental suffering during the dying process. Members of a hospice care team include a doctor, nurse, social worker, and home health aide. Most patients with PD die from the same diseases such as heart disease, stroke, and cancer, that others do. As such, hospice care may be considered even before a patient with PD reaches the end stages of their disease. Deciding when it is time to enter hospice care can be a difficult decision for a person and their loved ones. However, being admitted to hospice can ensure a person and their caregivers have access to a variety of services that are needed.

References:

“Eligibility for End-Stage Parkinson’s Disease Hospice Care.” By Colleen Doherty, MD. Published on October 24, 2021. Medically reviewed by Isaac O. Opole, MD, PhD. https://www.verywellhealth.com.

“The Role of Hospice in Parkinson’s.” Parkinson’s Foundation. 2018. https://www.parkinson.org.

Young woman consoling elderly loved one

April Is Bereaved Spouses Awareness Month

By Jacquelyn Buffo, MS, LPC, CAADC

Losing a loved one to a terminal illness is one of the most painful experiences you can go through. The loss of a spouse or partner is traumatic for many people, and the grief journey can feel overwhelming, confusing, and painful. However, each person grieves and works through the grieving process at their own pace and in their own way. If you are grieving the loss of a partner or spouse, you are not alone. The month of April is Bereaved Spouses Awareness Month, observed since 2008. Bereaved Spouses Awareness Month provides support and resources for bereaved spouses.

The difficulty of losing a spouse is followed by a grieving process that can be challenging for many people. Grief is a process and includes many different types of symptoms, some more severe than others. Feelings such as shock, sadness, numbness, and even guilt can occur after losing a spouse. Your experiences of grief may be different than others, and it is dependent upon factors specific to you. Grief can present as intense emotions and can also present in behaviors.

For example, bereaved spouses may experience:

How Hospice Care Can Help 

There is no right or wrong way to grieve, and support and help are available to you. An available resource along your journey of bereavement is hospice care. Hospice can help spouses prepare for the impending loss of a loved one. The hospice’s bereavement team can also help spouses after a patient passes. The mission of hospice care is to deliver compassionate, quality care to individuals with terminal illnesses and support the families through the caregiving phase and bereavement process.

Many spouses spend a significant amount of time and energy caring for and tending to their ill partners. But unfortunately, they may overlook their own needs and feelings during this time. Utilizing the hospice team as a source of support can help spouses tend to their emotions and needs when it is difficult.

If you are struggling with the loss of a loved one, it is vital to get the help and support you need. First, talk to a trusted family member or friend about what you’re going through. Loved ones can be strong sources of validation, support, and compassion. You can also talk to your doctor if you notice a change in behavior and mood or if you are having difficulty performing the normal activities of daily living, such as showering regularly and eating. Your doctor may be able to provide you with medication and can also provide you with referrals to a grief counselor or support group near you.

Sources:

  1. Mourning the Death of a Spouse | National Institute on Aging (nih.gov)
  2. Missed Opportunity: Hospice Care and the Family – PMC (nih.gov)
Quote about love with flowers and company logo

February is Full of Heart

By: Dr. Laura Mantine

Love is all around this month, especially on Valentine’s Day, when we take time to turn to those closest to us and say those three magical words. However, if you have a loved one who suffers from advanced cardiac disease, one of the best ways to show how much you care may not come in a sentimental card or a box filled with chocolates. Instead, it may come from calling hospice. Oftentimes, people don’t realize that hospice care is an option for people who suffer from advanced cardiac disease. Instead, these patients often spend their final days and months in and out of the hospital, receiving treatments that do little to improve the course of the disease. Hospice offers a supportive program of holistic care designed to help patients manage symptoms, forego emergency room visits and receive convenient, compassionate care right in their places of residence.

Heart Disease

The estimated annual cost of heart disease is about $200 billion each year. Heart disease is the leading cause of death in the United States across all demographics. Heart disease accounts for 17.8% of hospice deaths, second only to cancer (30.1%). During hospice care, cardiac patients are monitored by a team of physicians and nurses, who administer medications and treatments to keep them as comfortable as possible. Social workers can access valuable community resources. Chaplains and counselors provide emotional and spiritual care for the patient and family. Volunteers can sit with patients, read to them or help them with light household chores, and allow caregivers to get some much-needed respite.

Hospice Eligibility for Heart Disease Patients

End-stage heart failure is often marked by an abrupt, dramatic decline, followed by recurring recovery and stability until sudden death. Patients are ideal candidates for goals-of-care conversations when they have severe refractory heart failure or extensive symptoms of cardiac insufficiency, have tried or cannot tolerate maximum medical management and are not candidates for curative therapies or surgical interventions. Hospice care addresses a wide range of symptoms, including shortness of breath, chest pain, weakness and functional decline. Eligibility for hospice may require documentation of progressive loss of functional capacity over years, progressive failure to respond to therapies and a desire to discontinue curative treatment. Patients should check with their physician to see whether they are eligible for hospice based on their history of congestive heart failure, arrhythmias or heart attacks. The physician may also consider any coexisting diseases like HIV, diabetes, respiratory illness or kidney disease when transitioning a patient to hospice care.

How Hospice Can Help Heart Disease Patients

In addition to increasing a cardiac patient’s quality of life, hospice often increases the cardiac patient’s quantity of life as well. In a study reported in the March 2007 Journal of Pain and Symptom Management, congestive heart failure patients who chose hospice survived 81 days longer than those who did not. Even when modern-day technology or surgery can no longer offer hope, patients with late-stage cardiac disease need to know that help is always available. Hospice allows these patients to experience as much joy as possible in their remaining days while minimizing their discomfort and pain.

References:

Centers for Disease Control and Prevention, National Center for Health Statistics. (2016). Multiple Cause of Death 1999-2015 on CDC WONDER Online Database. Data are from the Multiple Cause of Death Files, 1999-2015, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. 

Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association. Circulation. 2017;135:e1–e458. DOI: 10.1161/CIR.0000000000000485.

National Hospice and Palliative Care Organization. (2018). NHPCO Facts and Figures 2018 edition. 

Ziaeian, B., & Fonarow, G. C. (2016). The Prevention of Hospital Readmissions in Heart Failure. Progress in cardiovascular diseases, 58(4), 379–385. doi:10.1016/j.pcad.2015.09.004

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