End-of-Life Care – Start the Conversation Today

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Oct 09, 2018

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The final chapter of our lives can be filled with difficult and emotional decisions. A rapid decline in health or an emergency can prompt family members and health care professionals to have to make critical end-of-life care choices. Our personal intentions can get lost during these often-hurried situations.
According to a survey conducted by The Conversation Project, 90 percent of Americans believe talking about end-of-life care with loved ones is important, yet 27 percent of individuals have actually done so.

Starting a conversation about end-of-life care in advance can help ensure that your intentions are respected and carried out, says Barbara Goll, B.S., Community Education Liaison at Homeland at Home. Beginning the conversation may not be easy, but it can bring you and your family peace of mind.

When you are ready to start the conversation, consider these ten tips:

1. Plan a good time to speak with your family. Potential opportunities include:

o A family gathering like a holiday.
o Before you or your family members take a trip or will be separated for a period of time.
o Prior to a serious medical procedure.

2. Decide who you want to be part of the conversation. This might include close friends, a spiritual leader and/or health care professionals, including hospice support.

3. Choose a setting that ensures you and your family members are comfortable.

4. Think about ice breakers or ways to start the conversation, such as:

o My health is good right now, but I want to be prepared for whatever may happen in the future.
o Ive been thinking about how _______ died and it has me thinking about what I want.

5. Start the conversation slowly and allow time for feedback from your family. You dont need to cover every detail at one time.

6. None of your decisions are final at this stage. The start of the conversation is a springboard for future communication.

7. Discuss hospice services to support you and your loved ones with difficult decisions, challenges and frustrations that may arise.

8. Set a date in the future to revisit this conversation as your life circumstances may change.

9. Encourage your loved ones to document their end-of-life wishes.

10. Dont get frustrated if some family members arent receptive. Keep up the effort until you feel your personal intensions will be met.

Think of hospice as a resource for you and your family, Goll says. At Homeland Hospice, we work to bring you peace of mind for your end-of-life journey.
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Editors Note: This article was contributed by Wendy Shumaker, Asst. Director of Marketing for Homeland Hospice, HomeHealth and HomeCare. Content for this article was sourced from The Conversation Project National Survey 2013.

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However, providing consistent support does not mean that caregivers should neglect their own well-being.Respite care and caregiver support can help families create a more sustainable approach to long-term caregiving.Mercy LIFE of Alabama, located in Mobile, provides comprehensive healthcare and family support through the Program of All-Inclusive Care for the Elderly, commonly called PACE.Through its interdisciplinary team, Mercy LIFE coordinates medical services, personal assistance, transportation, social activities, and other approved support for eligible older adults.The program also recognizes caregivers as important partners in care.Understanding how respite and coordinated support work can help families explore practical ways to protect their loved one's well-being while managing caregiving responsibilities.What Is Respite Care?Respite care refers to temporary care or supervision provided so a regular family caregiver can take a break from caregiving responsibilities.The arrangement may last several hours, part of a day, overnight, or longer, depending on the program.Respite support may allow caregivers to:Attend personal medical appointmentsRest and recoverHandle work responsibilitiesSpend time with other family membersComplete important errandsAttend personal eventsAddress unexpected obligationsTake a planned break from caregivingThe goal is to maintain continuity of appropriate support for the older adult while giving the caregiver time to attend to other needs.Different Forms of Respite CareRespite services may be available through several types of organizations.In-home respite: A qualified caregiver provides temporary assistance in the older adult's residence.Adult day services: A program provides structured activities, supervision, and appropriate support during scheduled hours.Residential respite: A senior living or other authorized facility provides temporary accommodations and assistance.Coordinated caregiver support: A healthcare program 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psychosocial needs.The team develops an individualized plan identifying appropriate healthcare and support services.Caregivers may share concerns and relevant information with the team when the participant agrees or applicable legal arrangements permit.Medical Care CoordinationFamily caregivers sometimes arrange appointments with several different professionals.Mercy LIFE coordinates authorized healthcare through its team and provider network.This may simplify aspects of appointment management, medication coordination, and follow-up care.In-Home Personal AssistanceMercy LIFE advertises support for everyday activities such as:BathingDressingMeal preparationLaundryLight housekeepingThese services may help address practical needs when included in a participant's approved care plan.Families should confirm the frequency and type of assistance authorized.Transportation ServicesMercy LIFE provides transportation to its LIFE Center and authorized medical appointments.This service may reduce 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When Is It Time to Consider Hospice Care in Mobile, AL? A Family Guide

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Symptoms That Are Becoming Harder to ControlPersistent pain, breathlessness, nausea, agitation, or other symptoms may create considerable distress.Hospice professionals specialize in identifying and managing symptoms associated with advanced illness.Their goal is to provide appropriate treatment that supports comfort and respects the patient's preferences.6. Progressive Cognitive or Neurological DeclineAdvanced dementia, Parkinson's disease, and certain neurological conditions can lead to substantial functional changes.Hospice eligibility for these diagnoses depends on the overall clinical picture, not simply the name of the diagnosis.A qualified medical professional can review functional decline, complications, and prognosis.7. 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Does a patient have to be in the final days of life to receive hospice?No. Hospice may be appropriate when a physician certifies a terminal prognosis of six months or less if the illness follows its normal course. Patients may receive services for a longer period when eligibility continues.2. Can someone receive hospice care at home?Yes. Hospice is commonly provided in private homes, assisted living communities, nursing facilities, and other appropriate residential settings. The available arrangement depends on the patient's circumstances.3. Can a patient change their mind after starting hospice?Yes. Patients may revoke hospice and return to other covered treatment options. They may also be evaluated for hospice again when appropriate.4. Who can request a hospice evaluation?Patients, family members, caregivers, and healthcare professionals may initiate questions or request information. Formal eligibility determination and admission follow the provider's process and applicable medical certification requirements.5. Does Medicare pay for hospice care?For eligible beneficiaries who elect the Medicare hospice benefit, most covered hospice services related to the terminal condition are paid under that benefit. Families should ask about any applicable costs or services outside hospice coverage.A More Informed Conversation Can Make a DifferenceDeciding whether to consider hospice is rarely easy.Families may feel uncertain about the prognosis, worried about making the wrong choice, or uncomfortable discussing end-of-life preferences.Reliable information can make those conversations more manageable.Hospice care offers a way to prioritize comfort, meaningful time, personal wishes, and coordinated support during advanced illness.For residents of Mobile County, Amedisys Hospice Mobile is a local resource for learning about hospice eligibility and exploring personalized end-of-life care services.Whether you are beginning to notice changes in a loved one's health or have already received a recommendation to consider hospice, asking questions now can help your family understand the options ahead.Connect With Amedisys Hospice Mobile Through Seniors Blue BookIf your family is exploring hospice care in Mobile County, Alabama, learn more about the services offered by Amedisys Hospice Mobile.Visit SeniorsBlueBook.com to view the company's listing, explore available hospice resources, and connect with the care team.

Care Management - Nonprofit in Mobile, AL

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Organizations use the term differently, so ask what a particular program provides and who will be responsible for follow-up.Public and nonprofit resource systems may offer screening, options counseling, or case management through specific programs. Those services should not be assumed to include continuous personal assistance, medical treatment, or an unrestricted private care manager for every caller.Recognize when coordination is the missing pieceA family may need coordination when tasks overlap, instructions are unclear, or support changes from week to week. Start by listing the responsibilities involved: meals, personal care, household needs, transportation, medicines, and communication with healthcare professionals.Mark which tasks are covered reliably and which are not. Include the older adults priorities and willingness to accept help. This gives a resource professional a clearer picture than a general statement that the family is overwhelmed. AgeSouths role in care coordinationPhone: 251-706-4680 AgeSouths official Medicaid waiver information describes the Elderly and Disabled Waiver as serving eligible older adults and people with disabilities at risk of nursing facility placement. Case managers develop person-centered plans based on medical needs. Depending on the plan, services may include personal care, homemaker assistance, respite, adult day health, companion services, or home-delivered frozen meals. The same page describes the Alabama Community Transition program for qualifying people leaving nursing facilities for home or community settings, and Personal Choices as a self-directed service option. Ask which program, if any, warrants screening for your situation. A service mentioned in a program description is not automatically available to every applicant.Clarify eligibility and the path to enrollmentAgeSouth states that its Medicaid waiver services require financial and medical eligibility and are provided at no cost to qualifying clients. [3] Request current requirements directly rather than applying a general income figure to your household.Ask who completes the assessment, what records are needed, and whether a physician or another professional must provide information. Confirm whether a referral, screening, or application has actually been initiated.Useful questions include:Which program are we discussing?What financial and medical criteria apply?Who completes each part of the review?What happens if the person is not eligible?Are approved services subject to availability or a waiting list?Establish who does whatIf the person enrolls in a program, ask how the plan identifies responsibilities. Clarify what the case manager coordinates, what a service provider delivers, and what remains the familys responsibility.Request instructions for reporting a missed visit, a change in needs, or a concern about the plan. Ask who handles questions outside ordinary office hours and which issues should go directly to the treating healthcare professional.Keep a current list of the organizations involved. Record the service, contact person, schedule, and method for reporting changes. This reduces the chance that family members assume someone else has made a necessary call.Build a plan around the persons dayCoordination works best when it reflects actual routines. Explain when assistance is most important and whether the person is alone during certain periods. Mention access issues, such as steps, pets, or instructions for entering the home.Include what the person can and wants to do independently. A support plan should describe where help is needed without overlooking abilities, preferences, and familiar ways of doing things.Review the arrangement when circumstances changeHospital care, a caregivers illness, or a change in mobility may affect the plan. Ask how reassessment works and what information the program needs when circumstances change.Avoid treating the original service schedule as permanent. Keep notes about uncovered needs and discuss them with the responsible professional. Ask what alternatives can be explored if a requested change is not available through the program.Why this matters locally in MobileFor Mobile households, a coordinated plan may need to fit relatives work schedules, travel across the county, and appointments at different offices. Identify who can respond locally if the usual caregiver cannot be there.Give AgeSouth the address where services would occur and explain transportation limitations. If the older adult is moving between a facility and home, describe the proposed destination and the help that will actually be present there.Weather disruptions can also affect schedules. Ask each organization how cancellations and changes are communicated, then create a family backup plan for tasks that cannot wait.How to get started1. List the older adults daily needs, preferences, and current sources of help.2. Call AgeSouth at 251-706-4680 and ask about screening for appropriate coordination or waiver services.3. Request current program requirements and the document checklist.4. Clarify whether your request is an inquiry, assessment, application, or enrollment.5. Review who will coordinate and deliver any approved support.6. Keep the plan and contact information current as circumstances change.Practical tip: Use a weekly calendar to show existing help and uncovered periods. Share it during planning so the discussion focuses on specific needs rather than a general request for more support. Related categoriesArea Agencies on Aging in MobileNon-Medical Home Care Adult Day Services