Webinar | Challenges of Hospice Care During a Pandemic

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) 

The aging process often begins subtly, with gradual changes that seem manageable. One day, your parent is fully independent, taking care of daily tasks without issue. Then, suddenly, it feels as though the aging process accelerates, bringing new challenges all at once. This rapid shift can be difficult for family members, especially if they haven't planned ahead.Why Aging Can Seem to Happen SuddenlyWhile aging typically unfolds slowly, research suggests it doesnt always progress in a straight line. A study published in Nature Aging found that aging tends to occur in bursts, where rapid changes in areas like metabolism, immune health, and muscle strength happen. These bursts often occur around the age of 60, potentially leading to abrupt physical declines (SciTech Daily)(AARP).If you or your loved one wait too long to prepare, you may find yourselves scrambling to deal with the sudden onset of new health challenges. This lack of preparation often leaves caregivers feeling overwhelmed, under-equipped, and burned out.The Pitfalls of Delaying PreparationMany families delay planning for their parents aging, assuming they'll manage when the time comes. Others might avoid the topic altogether because it can be emotionally challenging to discuss. Unfortunately, this wait-and-see approach often leads to caregiver burnout and strained relationships, as families are forced to juggle urgent medical needs, emotional stress, and time-consuming responsibilities without a solid plan in place.If youre struggling to discuss getting help with your aging parent, check out some of our tips here. Remember, asking for assistance during the aging process doesnt mean youre powerless!How Naborforce Can Help You Plan AheadRather than waiting for a health crisis, Naborforce provides consistent support for families throughout the aging journey. As seniors age, they often need help with simple taskslike grocery shopping or getting to appointmentsthat can quickly become time-consuming for loved ones. With Naborforce, you can arrange for a friendly Nabor to assist, allowing your parent to stay independent longer while giving you peace of mind.By building a relationship with Naborforce early, your parent will already be accustomed to receiving help. When aging accelerates, youll have a reliable support system in placesomeone familiar with your parent who can step in to help with everyday tasks. This helps ease your parents transition while giving you the time and space to focus on your own responsibilities.The Importance of Having a PlanThe key to supporting your parent as they age is to start planning before their needs become urgent. With Naborforce, you can establish a flexible plan that evolves as your parents needs change. Whether its an occasional visit or regular check-ins, Naborforce can tailor its services to fit your schedule and your parents preferences. By starting early, you ensure that you and your parent have the right support in place before bigger challenges arise.Naborforce is just one of many resources available to help with the aging process. Other tools include financial planning, setting up a trust and estate plan, maintaining a healthy lifestyle, using technology designed for senior living, and understanding the care continuum.Getting Started with NaborforceIts easy to get started with Naborforce. You can customize the level of support you need, from occasional assistance to more regular visits. Take the proactive step of setting up care before it becomes urgent, so your parent can stay comfortable, independent, and supported as they age.A Helping Hand for Older Adults - Naborforce 844-696-2267 Were Naborforce. We match older adults who need a little help and kindness with Nabors eager to provide it, strengthening the communities we serve.Everyone can use a little help. Help around the house. Help running errands. Help preparing a meal. Help by just being a friend! Our goal is to promote joyous and independent aging and living while providing peace of mind to families.