VITAS Brings Hospice Care Home to Assisted Living Facilities

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

The Intersection of Post-Traumatic Stress Disorder (PTSD) and End-of-Life Care: How Hospice Can HelpPTSD is a mental health condition that can develop after exposure to a traumatic event. While often associated with veterans, PTSD can affect anyone at any age, including the elderly. This population may have experienced war, accidents, violence, or other traumas throughout their lives, leaving them vulnerable to PTSD symptoms at the end-of-life stage. Hospice care, with its holistic approach, is uniquely positioned to support patients with both the physical and emotional challenges of PTSD alongside the dying process.PTSD in the Aging PopulationResearch suggests a potential overlap between PTSD and age-related cognitive decline [1]. Symptoms like flashbacks, nightmares, and hypervigilance can be particularly distressing for elderly patients already facing anxieties about mortality. Furthermore, social isolation, a common consequence of PTSD, can be exacerbated by the physical limitations often experienced in later life.How Hospice Can HelpHospice care offers a comprehensive support system that can significantly benefit patients with PTSD: Symptom Management: Hospice providers can address physical symptoms that may worsen PTSD, such as pain and insomnia, allowing for better emotional regulation. Psychological Support: Hospice teams often include social workers and chaplains who can provide individual and group therapy to help patients process trauma and develop coping mechanisms. Spiritual Care: Hospice chaplains can offer spiritual guidance and support, fostering a sense of peace and acceptance for patients struggling with trauma. Family Support: Hospice programs educate and support families on how to best care for their loved ones with PTSD, fostering open communication and reducing caregiver burden. PTSD can be a significant challenge at the end of life. Hospice care, with its focus on comprehensive symptom management, emotional support, and spiritual guidance, is uniquely equipped to address the complex needs of patients with PTSD. By partnering with hospice care, medical professionals can ensure their aging patients with PTSD receive the compassionate and holistic care they deserve in their final journey.References: [1] Schnurr, PP & McNally, RJ (2005). PTSD in late life: Theory, research, and treatment implications. The American Journal of Psychiatry, 162(2), 131-148. (https://academic.oup.com/edited-volume/34728/chapter/296497498) 

As the warmth of summer envelopes us and nature bursts into full bloom, we are reminded of the beauty and inevitability of change. Just as the seasons transition from the chill of spring to the heat of summer, so too does technology seem to experience constant changes. For many older adults, these changes can seem daunting. However, by embracing these shifts, much like we do with the changing seasons, we can not only adapt but also thrive in this technologically driven era. Nature offers us countless examples of rapid change. Consider the transformation of a caterpillar into a butterfly, a process that is both remarkable and essential for the butterfly's survival, the sudden bloom of flowers in spring leading to the lush greenery of summer, or the emergence of the recent cicada broods.  Did you know that once a cicada nymph emerges from the ground it begins to molt within 15-30 minutes and within only an hour the newly emerged nymph has transformed into a fully formed adult. Talk about rapid change! These natural processes illustrate that change, while sometimes challenging, sudden, and rapid, is necessary for growth and adaptation. In much the same way, technology undergoes constant evolution and rapid change, presenting new opportunities and challenges for users of all ages. From the introduction of personal computers to the widespread adoption of smartphones and tablets, the digital landscape has transformed dramatically and rapidly in a relatively short period. The world of technology is truly evolving at an unprecedented pace. While these advancements may initially appear overwhelming, they also offer tremendous potential for learning, growth, and connection. According to a report by the Pew Research Center, the percentage of adults aged 65 and older who own a smartphone has increased from 18% in 2013 to 61% in 2021. This statistic highlights a significant shift in the adoption of new technologies among older generations. Yet, for many, the rapid pace of technological advancement can feel overwhelming. Despite the initial discomfort, there are numerous benefits to embracing these changes. For instance, smartphones and tablets offer a plethora of applications designed to simplify daily tasks, enhance communication with loved ones, and provide access to a wealth of information and entertainment. Learning to use these devices can significantly improve ones quality of life, offering greater independence and connectivity. The key to adapting to technological changes is to start small and build a foundational knowledge. Just as you wouldnt attempt to run a marathon without first learning to walk, its important to take incremental steps when familiarizing yourself with new technology. Begin with the Basics: One of the first steps in adapting to technological change is recognizing the value of building a foundation of knowledge. Much like the roots of a tree provide stability and nourishment, a basic understanding of technology can serve as a solid footing for further learning and exploration. Start with the fundamentals, such as familiarizing yourself with your existing devices and their functions. Learn how to turn them on and off, charge them and navigate their home screens. Learn how to navigate the internet, send emails, and use basic applications. As you become more comfortable, you can gradually expand your skills and explore new possibilities. Seek Out Resources: Many local libraries and community centers offer classes specifically designed to teach older adults how to use technology. Additionally, there are numerous online tutorials and user-friendly guides available as well as local companies that specialize in supporting older adults with their use of technology. Much like natures adaptive strategies, embracing a positive mindset towards technological change is crucial. Accept that learning something new takes time and patience. Celebrate small victories along the way, and dont be afraid to ask for help. According to a study published in the Journal of Medical Internet Research, older adults who received support and training were more likely to adopt and continue using new technologies. The benefits of embracing technology are manifold. Telemedicine, for example, has revolutionized healthcare, making it easier for older adults to consult with doctors from the comfort of their homes. According to the American Telemedicine Association, telehealth visits increased by 154% during the first quarter of 2020 compared to the same period in 2019, largely driven by the COVID-19 pandemic. This shift not only reduces the need for travel but also provides timely medical advice and monitoring. Similarly, smart home devices can enhance safety and convenience. Voice-activated assistants like Amazons Alexa or Google Home can set reminders for medications, control home lighting, and even call for help in emergencies. Learning to use these devices can greatly enhance ones sense of security and independence. Despite the clear advantages, there is still a significant digital divide among older adults. The same Pew Research Center report indicates that 34% of adults aged 65 and older do not use the internet. Bridging this gap is essential for ensuring that all seniors can benefit from technological advancements. Community initiatives play a vital role in this endeavor. Programs that offer free or subsidized devices, coupled with training and support, can make a significant difference. Additionally, family members can help by encouraging and assisting their older relatives in learning and using new technologies. Just as we prepare for and adapt to the changing seasons, we must also embrace the rapid changes in technology. By starting small, maintaining a positive mindset, and seeking out resources and support, older adults can build a solid foundation upon which to thrive in this digital age. Nature teaches us that change is not only inevitable but also essential for growth. Similarly, by embracing technological change, we open ourselves up to a world of possibilities that can enhance our lives in meaningful ways. As the days grow longer and summer unfolds its warmth and vibrancy, let us welcome the changing tides of technology with the same spirit of adaptation and renewal. The possibilities are endless, and the adventure awaits!