Living with or Caring for Someone with Chronic Illness

Is hospice really a place sick people go and never come back? Once someone goes into hospice, does that mean the family never gets to see him or her again? Isnt hospice some sort of religious practice?The answers to these hospice myths are no, no and no. These are the facts::Hospice is not a place. Those who choose hospice services near the end of life do not go into hospice, but receive services where they live. This could be a private residence, assisted living community or nursing home. Some hospitals have hospice beds; however, the intention of hospice is to deliver hospice services to the patient wherever he/she calls home.Loved ones and relatives are not kept from participating in caring for the hospice patient. In fact, theyre a part of the team. Every patient has an interdisciplinary team that starts with the patient and family: patient, family caregiver, physician, nurse, social worker, chaplain, hospice aid, bereavement specialist, and volunteer. A plan of care is created that family and loved ones carry out at home to the extent they are willing and able.Hospice is not a last resort. When medical treatments can no longer cure a disease, hospice professionals can do many things to control pain, reduce anxiety, offer spiritual and emotional support, and improve quality of life for terminally ill people and their families.Hospice has no religious affiliation. Hospice provides chaplains and other spiritual counselors from all faiths and no faith. They respect all cultures and points of view and are there to lend support and discuss the patients and the familys feelings.Hospice is not just for cancer patients. Certainly cancer patients make up a large number of hospice patients. However, anyone who has a terminal illness, whether its heart disease, COPD, liver disease, kidney failure, stroke, ALS, Alzheimers disease, multiple sclerosis, AIDS or any life-limiting condition, is eligible for hospice care.Hospice care is not expensive. Hospice is usually less expensive than conventional care during the last six months of life. Hospice is an all-inclusive benefit covered by Medicare, Medicaid, Medi-Cal and most private insurance companies. Under Medicare there are no co-pays for physician visits, nursing care, medications, hospice equipment or medical supplies related to the patients primary illness.The patients personal doctor is not excluded. A patients personal physician can choose to be part of the hospice care team. Hospice doctors have extensive training in end-of-life care and will work closely with a patients personal physician to ensure the patient is as comfortable as possible.Hospice does not forego medications or treatments. On the contrary, hospice takes advantage of state-of-the-art medications and palliative treatments to relieve pain and symptoms to keep patients comfortable.Families are not shielded from the hospice patient. Hospice professionals believe that when family membersincluding childrenexperience the dying process in a caring environment, it helps to counteract the fear of their own mortality and the loss of their loved one.Hospice does not mean anyone has failed the patient. Hospice is a mode of medical therapy that may be more appropriate than curative procedures for people with terminal illness. Hospice focuses on symptom management, controlling pain and addressing spiritual, emotional and psychological comfort.Hospice is not about giving up; its about living in comfort and dignity for the time one has left.Hospice does not make death come sooner. The goal of hospice is neither to prolong life nor hasten death, but to make the quality of the patients life the best it can be in their final months, weeks and days. There are no studies that indicate that hospice can hasten death, but there have been studies showing that some patients live longer when receiving hospice services.Hospice is not the same as euthanasia. Death is a natural part of the cycle of life, and hospice neither prolongs life nor hastens death. The goal of hospice is to provide pain control, symptom management and spiritual and emotional support to help seriously ill people live in comfort and dignity until they die. Euthanasia (youth-en-asia) is purposeful mercy killing to end suffering. It is not provided by hospice.A hospice death is not the same as a physician-assisted death. In hospice, a patients terminal disease state is allowed to progress to its natural conclusion. In a physician-assisted death, a physician, at the request of the patient, provides the means for the patient to end life early.Morphine prescribed to a hospice patient does not cause premature death. Hospice physicians are specially trained in the use of morphine and administer only the dose necessary to alleviate a patients pain or help them breathe. When administered correctly, morphine helps terminally ill patients enjoy a better quality of life at the end of life.Hospice may withhold nutrition and/or hydration at some point in the dying process. There are many things to consider when it comes to nutrition and hydration for patients near the end of life. Since the natural progression of a patients disease interferes with the bodys ability to process foods and fluids, it is expected that terminally ill patients will begin to eat and drink less and less.A nasogastric tube (a feeding tube through the nose and throat and into the stomach) or gastrostomy tube (a feeding tube that goes through the abdominal wall and into the stomach) can be put in place to provide nutrients when a patient cannot eat. But these can be painful/uncomfortable medical procedures with potential complications, including infections, electrolyte and mineral imbalances, vomiting and diarrhea.Artificial nutrition and hydration do not usually help the hospice patient feel better, feel stronger or live longer. Most dying patients do not experience hunger. Those who do feel hunger are satisfied with small amounts offered upon request. Hospice physicians are specially trained to know when it is appropriate to intervene with artificial nutrition and hydration support.Contact us at VITAS to learn more.

Understanding the Difference Between Home Health and Private Duty CareOne of the most common questions we receive is, Whats the difference between Home Health and Private Duty care? While both services provide essential support for individuals in need of care at home, they differ significantly in purpose, structure, and funding. Understanding these differences can help you make informed decisions about the best care options for your loved ones.What Is Home Health Care?Home Health Care is a medical service that focuses on helping individuals recover from illness, injury, surgery, or often following a hospital stay. This type of care is typically short-term and is designed to restore or improve a patients ability to function independently.Key Characteristics of Home Health Care1.        Payor Source: Home Health is usually covered by health insurance, Medicare, or Medicaid. To qualify, a patient must meet specific requirements, including a qualifying event (e.g., hospital discharge or significant change in health status) and a physicians order to initiate services.2.        Goal-Oriented: The primary aim of Home Health is to improve the patients condition within a defined time frame. For example, physical therapy may be provided to help regain mobility after surgery, or a nurse may assist in managing medications during recovery.3.        Medical Focus: Home Health includes skilled medical services such as wound care, injections, monitoring vital signs, and therapy (physical, occupational, or speech).4.        Short-Term Duration: Services typically last a few weeks to a few months depending on the patients progress and medical needs.What Is Private Duty Care?In contrast, Private Duty Care provides non-medical support that is tailored to meet the individuals daily living needs. This care is designed to enhance quality of life and allow individuals to age in place or remain safely at home for as long as possible.Key Characteristics of Private Duty Care1.        Payor Source: Private Duty care is primarily funded out-of-pocket by individuals or families. In some cases, long-term care insurance may cover services, but this varies by policy.2.        Flexible and Personalized: Private Duty care offers tremendous flexibility, accommodating everything from a few hours a week to 24/7 care. Services are customized to the specific needs of the client and their family.3.        Non-Medical Support: Services include assistance with activities of daily living (ADLs) such as bathing, dressing, meal preparation, light housekeeping, companionship, and transportation to appointments.4.        Long-Term Option: Unlike Home Health, Private Duty care can be a long-term solution supporting individuals for months or years as their needs evolve.How They Work TogetherWhile Home Health and Private Duty care serve different purposes, they often complement each other. For instance, a patient may receive Home Health services after surgery to address medical needs but transition to Private Duty care for ongoing support with daily tasks once Home Health ends.Advantages of Danville Private DutyCareAt Danville Support Services, we are proud to offer high-quality Private Duty care tailored to your loved ones needs. Here are some of the unique benefits we provide:1.        Bridging the Gap After Home Health: When Home Health services conclude, families may feel overwhelmed by the responsibilities of caregiving. Our Private Duty caregivers can step in to fill this gap ensuring your loved one continues to receive the support they need.2.        Peace of Mind for Families: Private Duty care allows family caregivers to take a much-needed break. Whether youre planning a vacation, attending work, or managing personal commitments, you can rest assured that your loved one is in capable hands.3.        Long-Term Care Insurance: If your private duty care provider has a home health license, they may take long-term care insurance. With this payment option, the client is reimbursed for the cost of their care by their insurance provider.  4.        Reduced Hospital Readmissions: With consistent care and monitoring, our services help prevent complications that could lead to hospital readmissions.5.        Licensed and Insured: We adhere to the highest standards of care, ensuring all our caregivers are licensed, insured, and well-trained.6.        Continuous Training for Caregivers: Our caregivers undergo regular training to stay up to date with best practices ensuring the highest level of service.7.        Nursing Services Available: In addition to non-medical care, we offer nursing services for clients who require occasional medical oversight in Salt Lake City.8.        Serving Multiple Locations: We proudly serve Salt Lake City, Park City, and St. George, making it convenient for families across these regions to access our care.Why Choose Private Duty Care?Private Duty care provides a holistic approach to caregiving. It not only supports the physical well-being of individuals but also enhances their emotional and social health. Our caregivers provide companionship reducing feelings of isolation and loneliness which are common among older adults.In addition, Private Duty care is an excellent resource for families. The emotional and physical demands of caregiving can be overwhelming leading to burnout. By entrusting us with caregiving responsibilities, families can focus on building meaningful relationships with their loved ones without the stress of day-to-day tasks.Customizing Care for Your Loved OneAt Danville Support Services, we recognize that every individual has unique needs. Thats why we take the time to create personalized care plans for each client. Whether your loved one requires occasional assistance or round-the-clock care, well work with you to design a solution that fits your situation. You can reach us at 801-363-1521. Contact Us TodayIf youre navigating the complexities of Home Health versus Private Duty care, were here to help. Contact Danville Support Services to learn more about how we can support your family and provide the peace of mind you deserve or danvillesupportservices.com.  Check out our Sandy Location List at Danville Support Services, or call us at (801) 363-1521.    

What Are the Four Stages of Congestive Heart Failure? A diagnosis of congestive heart failure can feel overwhelming. If you or a loved one has recently received this diagnosis, you may have many questions. Learning more about congestive heart failure can help you understand what to expect. It can be especially helpful to understand what the four stages of congestive heart failure are, along with your options for care. Understanding Congestive Heart Failure: An Overview Congestive heart failure, also called simply heart failure or CHF, is a chronic health condition caused by weakened heart muscle. If healthy, your heart squeezes with enough force during each heartbeat to pump enough blood for your body to function normally. In congestive heart failure, blood is not pushed out of the heart with enough force, causing other health problems. According to the Centers for Disease Control and Prevention (CDC), more than 6 million adults in the United States have congestive heart failure. People who are smokers, have obesity, coronary artery disease (CAD), valvular heart disease, diabetes or high blood pressure are all at increased risk for CHF. Congestive heart failure can cause many symptoms that lead to poor quality of life. These symptoms include:  Shortness of breath Swelling of body tissues due to fluid buildup Chronic coughing and/or wheezing Decreased appetite and nausea Fatigue Elevated heart rate Confusion and problems with thinking Sudden weight changes  The Four Stages of Congestive Heart Failure ExplainedCongestive heart failure is a progressive disease, meaning it does not go away or reverse course and gradually worsens over time. The American Heart Association has defined four stages of congestive heart failure, beginning with pre-heart heart failure or stage A, through the final or end-stage of heart failure. Stage A: Pre-Heart Failure People diagnosed with Stage A heart failure dont have a problem with their hearts structure but are at risk for developing the later stages of heart failure. Treatment at this stage is focused on preventing new problems. Patients are educated on healthy lifestyle choices that can help prevent coronary artery disease and sometimes may be prescribed medications that reduce their risk for developing heart problems. Stage B: Asymptomatic Heart Failure In Stage B heart failure, the heart has begun to show signs of structural changes. For example, this can be an enlarged left ventricle (a section of the heart), along with a decreased ejection fraction (EF), which measures how much blood the heart pumps. In Stage B there are not any symptoms of heart failure (and there have not been in the past). Treatment at this stage includes preventing symptoms from beginning and treating with medications called beta blockers and ace inhibitors (or angiotensin-receptor blockers) as appropriate to reduce the rate of heart structure changes, as well as lifestyle changes that will prevent worsening of further structural changes in the heart. Treatment may also include surgery, such as coronary artery bypass grafting (CABG) or valve replacement if it is determined that a blocked coronary artery or defective heart valve is the cause of structural changes in the heart. Stage C: Symptomatic Heart Failure Stage C heart failure results in symptoms of heart failure, either in the past or currently. Treatment at this stage includes reducing or controlling symptoms and improving quality of life. It can also work to control any other health conditions that can worsen heart failure. Medications that reduce extra fluid in the body and other complications of heart failure may be added. In some cases, implanted devices such as a pacemaker or cardioverter defibrillator, may be used to support the heart. Stage D: End-Stage Heart Failure During Stage D, or end-stage heart failure, symptoms are uncomfortable and always present, even during rest. Treatment in this stage includes improving quality of life, reducing symptoms, reducing trips to the hospital and making end-of-life goals and plans. For some, a heart transplant may be an option. Early-Stage Heart Failure: Knowing Your Options For those living with Stage C heart failure, day-to-day care can sometimes feel challenging. Hospitalizations may be a worry, and managing stability and quality of life at home requires lifestyle changes, medications and a good plan of care. Home health support for heart failure can help you learn how to monitor symptoms and manage your condition at home, avoiding hospital stays. Home health care can provide: Education about medications and lifestyle modifications to reduce the risk factors and help promote clinical stability. Proper diet and nutrition information Techniques for improvements in strength and mobility Daily exercise routines Help to monitor vital signs Monitoring heart failure symptoms Weight monitoring and management Tips on what to do if symptoms worsen  These supports and resources can help improve your quality of life and reduce symptoms during Stage C heart failure. End-Stage Heart Failure: Knowing Your Options Because heart failure is not reversible, end-stage heart failure can escalate the need for decisions about care and end of life if you havent already had these conversations with your loved ones and care team. People living with end-stage heart failure often have symptoms and problems that can lead to hospitalizations and emergencies.Understanding the four stages of heart failure and discussing your long-term goals and wishes in the early stages can help you avoid unwanted and potentially unnecessary treatments. Palliative Care and Heart Failure Palliative care is a helpful option for those living with heart failure. The focus of palliative care is on quality of life, symptom management and setting goals for care so that your wishes are honored, and your treatment matches what you desire.Palliative care can be started at any stage of a diagnosis. As you progress into the later stages of heart failure, you may meet more often with your palliative care team to discuss symptom management and to plan for possible changes to your health and care. The palliative care team can also help you decide when to begin hospice care during Stage D heart failure. Hospice Care: Compassion During the Final Stage During hospice care, people living with heart failure transition from aggressive forms of treatment to comfort-centered, end-of-life care. An interdisciplinary hospice care team helps patients and their families to manage heart failure at home as best as possible. Specialized hospice care for heart failure can further support those in end-stage heart failure, with evidence-based guidelines and best practices to keep patients as comfortable as possible where they most want to be. During end-stage heart failure, hospice care provides: Pain and symptom management Caregiver support Emotional and spiritual support End-of-life planning (also called advance care planning) Bereavement support 24/7 nurse availability for emergencies Psychosocial support Assistance with activities of daily living Respite care  Managing the Four Stages of Congestive Heart Failure with Amedisys  If youre not sure where to begin with heart failure care at home, an Amedisys care center near you can help. Whether you enroll in our home health heart failure program, meet with a palliative care team or are considering hospice, contact Amedisys Hospice at 251-343-0989 for more information