The Importance of Preplanning

How Long Can You Be on Hospice Care?One of the most common questions about hospice care is, how long can someone be on hospice? Understanding the duration and criteria for hospice can help patients and their families make informed decisions during challenging times.While most patients only experience its benefits for days and weeks, hospice is available when a patients physician certifies that they have six months or less to live, as explained further below, with recertification available if the patient outlives that six-month period and continues to meet hospice criteria.What is Hospice Care?Hospice is defined as supportive care that focuses on comfort and quality of life. Hospice is available for patients with a terminal illness and a life expectancy of six months or less if their illness runs its normal course, as certified by a physician.Can hospice help?Hospice services include:Skilled nurses making intermittent visits to assess the patient, provide care and coordinate care from other disciplines.Hospice aides to support activities of daily living.Medical social workers to support the patient and family and make connections to community resources.Chaplains for spiritual support.Hospice volunteers for companionship and support.Bereavement support for the family for up to 13 months following the patients passing.Some companies like Amedisys also offer specialized programs to care for certain diagnoses like dementia, heart failure and more. Eligibility Criteria for HospiceUnderstanding how long hospice care can be provided first starts with having a strong grasp of the eligibility criteria.To be eligible for hospice, the patient must be considered terminally ill with a life expectancy of six months or less if the disease runs its normal course, as certified by a physician. The hospice physician uses their clinical expertise and information from a comprehensive assessment to determine life expectancy. Signs the patient is declining from the terminal illness include progressive weight loss, frequency of hospitalizations, increasing weakness or fatigue, difficulty with daily activities and more.The patient must also elect to stop curative treatments in favor of the comfort and quality of life measures hospice provides. The physician will work closely with the hospice care team on a personalized plan of care focused on pain and symptom management and comfort so patients and families can make the most of their remaining time together.How Long Can Patients Receive Hospice Care?Patients can receive the benefits of hospice care as long as they continue to meet the eligibility criteria. If a patient lives longer than the original six-month certification period, physicians can re-certify them to remain on hospice care if the disease progression still indicates a life expectancy of six months or less.Although patients cannot receive curative treatment while on hospice care, if a patients condition improves significantly so that they are no longer considered terminally ill, they will be discharged from hospice care. Patients can also choose to opt out of hospice care at any time during the service.One of the most famous examples of how hospice can extend beyond six months is former President Jimmy Carter. As of this publication, Jimmy Carter has received hospice care for more than a year, spending that precious remaining time with his family in his home. His legacy will be one of normalizing end-of-life conversations, sparking hope that more patients and families will seek out the benefits of hospice and embrace them sooner rather than later.What are the Benefits of Hospice Care?One of the most common phrases we hear from families is, we wish we had chosen hospice sooner. By accepting help early, patients and families can expect a range of benefits at the end of life:Pain and Symptom ManagementPain and symptom management is a central tenant of hospice care, providing comfort and the best quality of life possible for patients at home. Hospice care combines pharmacological and non-medication tactics to manage physical, emotional, psychosocial and spiritual pain for the patient and caregiver.Holistic CareHospice is a unique Medicare benefit providing care with a full, interdisciplinary care team. Holistic care is a patient-centered approach that focuses on caring for the whole person, including their physical, emotional, psychosocial, and spiritual well-being.Supportive Care EnvironmentHaving hospice care at home fosters a sense of security, familiarity and peace, which can contribute to a patients overall sense of well-being.Advance Care PlanningHospice care encourages open communication and advance care planning discussions, allowing patients to express their desires for the final weeks and months of their life. This can help avoid unwanted medical interventions that could diminish quality of life by ensuring patients are getting the care they need and want.How Do You Know When Its Time for Hospice?If youre caring for a loved one with a terminal diagnosis, there are several key signs that it may be time to start talking about hospice care:Their doctor has given a prognosis of six months or less.Their health or disease symptoms are worsening with frequent trips to the hospital or doctors office.They have decreased appetite or pain/nausea interfering with their ability to eat and drink.They sleep more throughout the day and night.There are noticeable behavior changes in mental clarity, confusion, forgetfulness, or irritability.Activities of daily living like feeding oneself, bathing and dressing independently become more difficult.Caregivers are overwhelmed and unable to manage care on their own.What Are the Four Levels of Hospice Care?As you research hospice, you may come across different levels of hospice care. Moving into different levels can be triggered by changing circumstances or needs of the patient or caregiver. Here are the four levels of hospice care all Medicare-certified agencies provide:Routine Home CareThis is the most common type of hospice care. The full team conducts intermittent visits wherever the patient calls home, providing a comfortable and familiar environment.Respite CareRespite care is available when caregivers need a break. Patients are admitted to a long-term care facility or other inpatient facility with 24-hour nursing available. The patient can stay in the facility for up to five days/five nights and returns to routine level of care on day 6. The hospice team coordinates the plan of care and can arrange transport patients to and from the facility as needed.Continuous Home CareThis level of care is for short-term urgent healthcare needs or symptom crises that can still be feasibly addressed at home. The hospice team provides at least eight hours of continuous care within a 24-hour period. When symptoms are controlled, the patient returns back to routine care.General Inpatient CareIf pain and symptoms related to the patients terminal illness can no longer be controlled at home, the patient may be appropriate for General Inpatient (GIP) care. The hospice team facilitates the patients transfer to a hospital, long-term care facility or hospice inpatient unit and will continue coordinating the plan of care. Patients will return home to routine home care once pain and symptoms are managed.How to Get Started with Hospice Care If youre ready to start talking about hospice care with your family, Amedisys is here to support you through every stage. Contact Amedisys Hospice in Mobile, Alabama at 251-343-0989 for more information.

How Much Do You Really Know About Arthritis?Arthritis is a term that many people associate with older adults experiencing pain in their joints. But did you know that arthritis, itself, is not a diagnosis, but a term that describes dozens of diseases and conditions? According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the word arthritis means joint inflammation, and may be used to describe any condition affecting the joints, for people of all ages. In fact, arthritis impacts one in five adults in the United States and is the leading cause of work disability.To help you better understand arthritis, weve posed five questions below that explore common arthritic diseases, who is at risk and how to manage these conditions.    How many types of arthritis are there?There are more than 100 types of arthritic diseases, which can impact the joints, tendons, ligaments and bones by causing stiffness, swelling and pain. According to the Centers for Disease Control and Prevention (CDC), some of the more common types of arthritis include the following:Osteoarthritis. This kind of arthritis occurs when joints in the body break down. Its most commonly experienced in the hands, hips, knees and back.Rheumatoid arthritis. This is an autoimmune disease, meaning the bodys immune system causes deterioration by attacking its own tissues. It can damage the joints in the hands, wrists and knees. Potentially, it could also impact the lungs, heart and eyes.Gout. This type of arthritis tends to impact only one joint at a time. During a flare-up, uric acid crystals form within a joint and cause pain, swelling and tenderness. Often, it impacts the big toe.Fibromyalgia. By causing pain throughout the body, fibromyalgia can have a significant impact on a persons quality of life and ability to work.Juvenile arthritis. Also known as childhood arthritis, this condition impacts nearly 220,000 people younger than 18. Its caused by an immune system that is overactive and results in swelling in the joints. What are signs and symptoms to look for?Because there are so many types of arthritis, and because symptoms may overlap with other conditions, it can be difficult to diagnose. The Arthritis Foundation says that if youre experiencing the following signs and symptoms you should consider talking to a doctor:Tenderness, pain, swelling and/or stiffness in one joint or several jointsRedness on or around a jointA joint that feels warmTrouble moving a joint or engaging in your day-to-day activitiesAny joint symptoms that concern youWho gets arthritis?Anyone can get arthritis, no matter their age, gender or cultural background. However, some groups of people face a higher risk than others for certain types of arthritis. For example, according to the CDC women face a higher risk for fibromyalgia, osteoarthritis and rheumatoid arthritis while men are more likely to develop gout. Further, its not uncommon for people experiencing other chronic conditions, such as obesity, diabetes and heart disease, to also have arthritis.Other risk factors can include:Age, with the risk increasing as you get olderFamily history, with some types of arthritis have a hereditary connection, including rheumatoid arthritis, lupus and ankylosing spondylitisWeight, with people who are overweight or obese facing an increased risk for osteoarthritis impacting the knees and other jointsSmokingCertain infectionsAn injury to a jointService in the military Are there actions you can take to lower your risk for arthritis?Possibly. While there is no magic pill that can protect you from arthritis, some people may be able to reduce their risks or at least delay the onset of certain types of arthritis, according to the Arthritis Foundation. For example, maintaining a healthy weight may help lower your risk for osteoarthritis; quitting (or never starting) smoking may help prevent rheumatoid arthritis; and eating a healthy diet that is low in sugar and alcohol as well as purines (thats a chemical compound that turns into uric acid) may help decrease your risk for gout. What can you do to manage your arthritis?If youve been diagnosed with arthritis, there are a number of steps that you can take that may help to ease pain and decrease inflammation. Those include:See your healthcare provider regularly and follow their advice. They know you best and can help you devise a plan to address your symptoms and help you continue to do the things you enjoy in life.Move more. It may sound counterintuitive, but physical activity may actual help reduce pain and improve the way you feel and move, according to the CDC. Try out a variety of joint-friendly activities, such as cycling, swimming, walking and tai chi. If working out is new to you, talk to your doctor first. With their approval, start small, aiming for five to 10 minutes at a time, and work towards the goal of 150 minutes per week, along with two days of strength-building activities. Manage your weight. Weight can put additional stress on your joints. Aim to reach or maintain a healthy weight through diet and exercise. If youre struggling, ask your doctor for advice.Make healthy eating choices. Research shows that some foods can help control inflammation, while others may contribute to inflammation. People living with arthritis may benefit from an anti-inflammatory diet, which includes fish, nuts, beans, fruits and vegetables (the Mediterranean Diet is a good place to look for guidance, according to the Arthritis Foundation). At the same time, try to limit the foods you eat that cause inflammation, including processed foods like white bread and pastries, fried foods, soda and sugary beverages, red meat and processed meats, along with margarine, shortening and lard. Take care of your mental health. Any chronic condition can take a toll on how youre feeling. And if the condition is limiting your usual activities, as arthritis may do, it can be especially stressful and isolating. If youre feeling hopeless or anxious, or youve lost interest doing the things that once brought you joy, find help. Talk to your primary care provider or connect with a counselor or therapist. A support group might also be useful. The Arthritis Foundation is a good place to start if you think you might benefit from a virtual group.As mentioned, there are more than 100 different types of arthritis, ranging from common to rare. While weve touched on some of the more frequently asked questions, theres still a lot to learn about these conditions. If youre concerned about pain, swelling or tenderness youre experiencing in your joints, talk to your healthcare provider today. To find out more  about Healthcare Insurance Plans that include Medicare, Individual & Family, Health & Dental and Vision, call BlueCross BlueShield of Alabama at 251-344-2115.

Tough Conversations: When Is It Time for Seniors To Stop Driving?Driving is more than just a mode of transportation; its a symbol of independence that many cherish. However, as we age, it becomes crucial to recognize when driving may no longer be safe. The decision to stop driving is significant and depends on a persons ability rather than age. The decision can be influenced by a gradual change in ability or a sudden shift due to illness or other factors.Typical changes caused by aging often affect driving abilities. For example, changes in depth perception are very normal as we age. And many people lose the flexibility that allows them to, for example, turn their head quickly to check the roadway. Others may find their reaction time slowing down. None of these changes are about the personthey are strictly about the aging body.How do we know when its time to stop driving or for our older loved one to stop? Asking this question gets to the heart of the matter: Is it better to keep society safe or for this person to continue driving? Whether youre answering that question for yourself or asking your loved one about their driving, it will help guide the thought process and the conversation. Here are some more tips.Thinking About Ones Own Driving AbilitiesFor some seniors, the realization that its time to hang up the keys comes from self-awareness of their diminishing driving skills. Recognizing signs like difficulty seeing at night can lead to voluntary decisions to limit driving. Many older adults choose to start making changes by avoiding nighttime driving or busy highways. They might also limit themselves to familiar routes or shorter trips, using alternatives for longer distances.Self-regulation is a smart way to stay safe while keeping some independence and a feeling of control. It also makes it easier for seniors to get used to other ways of getting around besides driving.Starting the Conversation With an Older Loved OneTalking to an older loved one about reducing or stopping their driving can be very challenging and should be planned with care. If someone were to tell you that you should stop driving, your natural reaction would likely be that you are losing your independence, and you might become defensive about the issue. You might worry about becoming dependent on others to do the things you want and need to do, and when. After decades of driving, the conversation probably wouldnt sit well with you.A gentle way to start this dialogue with an older loved one is by asking reflective questions that encourage self-assessment. You might ask them, Would you feel comfortable driving your grandchild? Such questions can help older adults realize the potential risks without feeling pressured. Other questions can focus on the car rather than the person. Ask questions about dents or scratches not by asking, How did you do that? but rather, How did that happen? or even Can I help you arrange to get that fixed?Right at Homes RightConversations guide can be an invaluable resource for approaching this sensitive subject. It provides structured advice on how to have important discussions like this without causing offense or distress.Exploring Alternative Transportation OptionsBear in mind that you do want to encourage your older loved one to keep getting out of the house. Losing the ability to drive can have disastrous effects on the social connections and activities we all need for our mental health.Fortunately, giving up driving doesnt mean giving up mobility. Seniors have various alternatives to driving themselves:Public transportation: Buses, trains, and subways can be excellent options for seniors, especially in cities with robust transit systems.Community senior services: Many communities offer shuttle services specifically for seniors, which can be a convenient and safe way to get around.Ride-hailing services and taxis: Services like Uber and Lyft offer convenient, door-to-door service at many locations.Family and friends: They are often more than willing to help by providing rides, especially for important appointments or events. Walking: If health permits and distances are manageable, walking is both practical and healthy.The transition from driving can be challenging, but it opens up new opportunities to explore different and potentially rewarding modes of transport. With the right approach and support, older adults can navigate this change smoothly, maintaining their independence and safety.      Right at Home offers a wide range of services to help seniors remain independent. This includes transportation to appointments, leisure outings, and running errands. Other services include a myriad of homemaking/companion and personal care services. Contact Right at Home in Alabama at 251-459-8672 for more information.