The Crucial Role of Certified Nursing Assistants in Hospice and Palliative Care

Become a Volunteer with St. Joseph Hospice: Make a Difference Today!Volunteering with St. Joseph Hospice is an opportunity to profoundly impact the lives of individuals and families during some of their most challenging moments. As a hospice volunteer, you will help create an environment of hope, courage, and compassion for patients facing terminal illnesses and their loved ones. By dedicating your time and skills, you can provide invaluable emotional support and companionship that makes a lasting difference.Why Join the St. Joseph Hospice Volunteer Team?Volunteers play a vital role in the mission of St. Joseph Hospice. They enrich the lives of patients by offering comfort, assisting with practical needs, and simply being present. Whether you have a knack for planning activities, offering companionship, or providing administrative assistance, there is a place for you on our team.To ensure our volunteers are well-prepared, we offer a comprehensive Hospice Volunteer Training Program. This training equips you to understand the unique needs of hospice patients and their families, preparing you to bring comfort and a sense of normalcy to their lives.What Can You Do as a Volunteer?St. Joseph Hospice volunteers bring diverse skills to a variety of roles. Depending on your interests and experience, you could engage in: Companionship Visits: Spend time with patients, providing a comforting presence. Activity Planning: Organize recreational activities to brighten patients' days. Office Support: Assist with administrative tasks to ensure smooth operations. Health Fairs and Special Events: Help manage outreach events to promote awareness. Special Projects: Contribute your unique talents to meet the needs of patients and staff. Who Should Apply?We welcome individuals with various backgrounds and experiences. Ideal candidates might have experience in nursing home volunteering, direct-care support, or activity coordination. More importantly, we seek compassionate individuals with a genuine desire to help others.Volunteers must meet a few essential qualifications to ensure theyre ready for this meaningful role: Confidentiality: Respecting patients privacy is critical. Volunteers must commit to maintaining confidentiality and sign an agreement to this effect. Good Health: Assignments are tailored to your physical capabilities to ensure your safety and the well-being of those you support. Transportation: Volunteers must have reliable transportation to and from their assignments. Training Completion: Direct-care volunteers are required to complete the St. Joseph Hospice Volunteer Training Program. Flexibility: Volunteers should be able to accommodate a variety of scheduling needs, including short-notice requests.  Ideal candidates have the following experience:         Nursing home volunteer         Direct-care volunteer         Health fair management         Entertainment and activity planning         Office/administrative assistance         Special projectsHow to Get InvolvedBecoming a hospice volunteer is simple. Visit the St. Joseph Hospice website and fill out a Contact Us form to express your interest. You can also explore our locations page to find a branch nearest to you.Volunteering with St. Joseph Hospice is more than just an act of serviceits a chance to bring light and comfort to those who need it most. Join our dedicated team of volunteers and help make a difference, one moment at a time.Contact St. Joseph Hospice at 251-675-7555 or email humanresources@carpenterhealth.net or more information about the volunteer program.  

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

A Delicate Dance: Discussing Food and Comfort at the End of LifeFor referral partners transitioning patients to hospice care, a common source of tension arises: the practice of regular solid food feeding. Families, often driven by love and cultural norms, may struggle to accept that forced feeding can be detrimental to their loved ones comfort in the final stages of life. This article equips medical professionals with talking points to navigate these sensitive conversations, prioritizing the patients well-being while acknowledging familial concerns. The Bodys Changing Needs:The human bodys metabolic needs decrease significantly near death [1]. The digestive system weakens, making food absorption difficult and potentially uncomfortable. Studies have shown that artificial hydration and nutrition dont improve lifespan or patient outcomes [2]. In fact, they can increase the risk of aspiration pneumonia, a serious lung infection caused by inhaling fluids [3].Focus on Comfort, Not Calories:When discussing food with families, emphasize that the goal is comfort, not sustenance. Offer mouth swabs dipped in cool water or flavored ice chips to alleviate dryness. Small, soft food pieces the patient enjoys might be acceptable, but prioritize their wishes. Research by Kelley et al. (2017) suggests focusing on the sensory experience of food, allowing patients to savor familiar tastes without the burden of a full meal [4].Addressing Emotional Concerns:Families often equate food with love and nurturing. Acknowledge these emotions and explain how forcing food can create a negative association. Highlight the importance of spending quality time, holding hands, and offering emotional support [5].Clear Communication is Key:Open communication is paramount. Use clear, concise language, avoiding medical jargon, and answer questions honestly (Gabb et al., 2019) [6]. Explain the physiological changes and potential complications of forced feeding. Shared Decision-Making:Empower families to participate in decision-making. Present the evidence, but respect their cultural and religious beliefs. Guide them towards prioritizing their loved ones comfort while offering emotional support throughout the process [7].Collaboration with the Hospice Team:Hospice nurses and social workers are experts in navigating these discussions. The hospice team will work collaboratively to develop a care plan that aligns with the patients needs and the familys wishes [8].Conversations about food at the end-of-life can be emotionally charged. Equipping medical professionals with clear communication strategies can guide families toward prioritizing patient comfort while respecting their wishes. By focusing on the bodys changing needs and prioritizing comfort over forced feeding, healthcare teams can ensure a peaceful transition for patients and their loved ones during this sensitive time.References: Wright, B. M., & Sinclair, S. (2000). Palliative care for the dying patient. The Lancet, 356(9242), 1658-1661. Sinuff, T. M., & Schenker, Y. (2005). Palliative care: The evidence base for opioid therapy, artificial nutrition and hydration, and other interventions. The Journal of Pain, 6(2), 113-125. Marik, P., & Rivera, D. (2013). Does artificial hydration prolong life in the critically Ill? A systematic review of the literature. Chest Journal, 144(1), 336-345. Kelley, L. M., Mitchell, G. D., & Carlson, L. E. (2017). Oral care and feeding practices at the end of life in long-term care settings: A review of the literature. Journal of Gerontological Nursing, 43(1), 32-40. Ferrell, B. R., Coyle, N., & Paice, J. A. (2010). The Ferrell model of physical symptoms management. Journal of Palliative Care, 26(2), 115-123. Gabb, J. M., Morrison, R. S., & Clayton, J. M. (2019). Communication with families about artificial nutrition and hydration at the end of life. Current Opinion in Supportive and Palliative Care, 13(2), 118-123. Wright, K. J., & Eluchard, J. M. (2015). Shared decision-making at the end of life: A review of the role of communication. Nursing Ethics, 22(4), 444-459. Zimmermann, C. K., Knauf, H., Greer, T. L., & LeClerc, C. M. (2007). The role of hospice and palliative