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“What We Don’t Know We Don’t Know in
Health Care:”
The Importance
of Keeping Our Loved One Comfortable Towards End of Life, and Why It’s Often Not
Done.
Introduction:
Maintaining comfort and peace in individuals that are
nearing the end of life is so important, yet too often I do not see this being
done. I was recently privy to a situation where, per family report, their aging
loved one was in a facility and restless for ‘days on end’ without any
intervention. I mentioned to the family that they may want to ask for some
medication to relieve their loved ones’ restlessness. One of the family members
reported back that within hours of our conversation, their loved one received
such a medication. The family stated after receiving this medication that he
was the most peaceful he had been ‘in over a week.’ I could feel the relief in
their voices. Unfortunately, I have seen this so often that it was the impetus
for my next blog subject.
Factors:
I see multiple factors accounting for why individuals
approaching the end of life are not made as comfortable as they should and could
be. At facilities, one common reason is due to the transitional period that
occurs once an individual or family decides they want to move from aggressive
treatment to hospice or palliative care. Generally, once these wishes are
expressed, a hospice consult is placed. It often takes time (sometimes up to a
day) for the hospice team to evaluate the individual. Unfortunately, facility staff
often wait until the evaluation is complete prior to initiating comfort
care protocols. This does not need to be the case. Staff can initiate comfort
protocols by reaching out to a practitioner to request orders. Many staff
either do not appear to realize that they can initiate this order set or are
too busy to do so. The bottom line is
that if the individual and/or family has consented to comfort measures and no
aggressive treatment, protocols can and should be implemented right then
and there. It often takes probing from an advocate or a family member to do so.
Another reason individuals do not receive comfort medication
at end of life is due to the practitioner being unaware of their discomfort.
With the overburdened medical system, practitioners often do not get to spend
ample time with their patients. They often only have a few minutes to round and
hence may be unaware of their patients’ pain, agitation, or restlessness. This
is where it can be helpful to have an advocate or loved one relay to a
practitioner the observation that the senior individual is in distress. Much
like a mother is attuned to her infant, often family members or others
intimately familiar with an individual’s behavior are the ones that pick up on
subtle cues of discomfort or distress. In the situation I described above, the family
of the restless individual stated the health care team appeared unaware of the
individual's discomfort. One of the family members was with the loved one for
hours on end, and she stated that his restlessness was very intermittent. With that being the case, the restlessness
could easily be overlooked by staff. In addition, facility staff are extremely
busy and may not take the additional time to communicate restlessness to
practitioners unless asked to do so by an advocate or loved one.
One final reason I see individuals at end of life not
receive adequate comfort medication is due to reluctance of staff to provide adequate
comfort medication. Many nurses are hesitant to administer reasonable amounts
of such medicine for fear of ‘hastening’ death or ‘euthanizing’ someone. I
generally do not see this with hospice or palliative care staff as they have
ample education on the importance of maintaining comfort in end of life and how
to do so. I instead see this with general facility staff who may not have the
training or experience in palliative/hospice care. Years ago I was sitting with
family in a hospital room of their loved one as he was passing. The individual
was clearly restless: pulling at his tubing and attempting to get out of bed. I
was concerned not only for the discomfort of the individual but also the toll
his discomfort was taking on family. No one should have to witness a loved one
near the end of life suffer if it’s possible for the suffering to be
alleviated. I asked the nurse if she
could administer more medication to relieve the individuals’ discomfort and she
replied that she didn’t have an order to do so. I kindly asked that nurse to communicate
to the attending MD that the medication provided was insufficient for this
individual and request a dose increase or another medication. She did so and
the individual ended up receiving the appropriate amount of medication needed
to pass away peacefully.
Conclusion:
The bottom line is that we all deserve to be comfortable at
the end of life. It often takes an advocate or loved one willing to speak up to
ensure that this gets done. Promoting comfort not only provides dignity and
peace to the dying individual but also priceless peace of mind to the loved
ones involved. I am a passionate, vocal advocate regarding the importance of
ensuring this for families and their loved ones. Any questions please do not
hesitate to contact me.
Navigating Hospital Stays and Rehabilitation for Parkinsons Patients. This article is part of The Parkinsons Care Compass: A Caregiving Roadmap Guiding Families Through Every Stage, an educational series presented by At Your Home Caregiving of Texas. We are honored to walk beside families, offering specialized in-home care solutions to support every step of the Parkinsons journey. Hospital stays are a stressful experience for any family, but for individuals living with Parkinsons disease, hospitalization poses unique challenges that can significantly impact recovery and long-term health. When a Parkinsons patient requires surgery, treatment for complications, or recovery after a fall, family caregivers must act as advocates, organizers, and partners in care. Being prepared and informed is the key to ensuring a safe hospital stay and a smooth transition back home.At Your Home Caregiving of Texas understands these complexities and stands ready to help families through every step of the journey, providing expert support for rehabilitation and home-based recovery.Unique Hospitalization Challenges for Parkinsons PatientsParkinsons disease complicates hospital care in several critical ways: Medication Management: Parkinsons medications must be administered on a strict schedule to manage symptoms effectively. Delays or missed doses can lead to severe motor symptoms, confusion, and even hospitalization complications. Mobility and Fall Risks: Hospital environments are unfamiliar, and Parkinsons patients face an increased risk of falls due to balance issues and muscle rigidity. Cognitive Changes: Hospitalization can sometimes trigger or worsen confusion, memory problems, or delirium, especially in older adults with Parkinsons. Communication Difficulties: Some patients experience soft speech (hypophonia) or facial masking, making it difficult to express needs clearly to hospital staff unfamiliar with Parkinsons care. Being aware of these risks allows families to take a proactive role during the hospital stay, minimizing complications and ensuring the best possible outcome.Preparing for a Hospital Stay: Advocacy and PlanningIf hospitalization is scheduled (for surgery or planned treatments), preparation can make a significant difference:1. Create a Hospital Parkinsons PlanPrepare a simple one-page document outlining your loved ones: Current medications and exact times for administration Mobility limitations and fall risk status Communication needs Cognitive changes or dementia symptoms Preferences for therapy, rehabilitation, and home care after discharge Provide this information to the hospital staff immediately upon admission.2. Bring Medications to the HospitalBring a full list and ideally the actual medications in their original containers. In some hospitals, families can administer Parkinsons medications if theres a risk of delays.3. Assign an AdvocateDesignate a family member or professional caregiver to be present as much as possible, especially during medication times, shift changes, and physician rounds. Having a consistent advocate can prevent critical mistakes and advocate for the patients specialized needs.The Importance of Medication TimingOne of the biggest risks for Parkinsons patients in the hospital is missed or mistimed medications. Parkinsons medications like carbidopa-levodopa must be administered exactly as prescribed, sometimes multiple times a day, to prevent a sudden worsening of motor and non-motor symptoms.Tips for ensuring proper medication administration: Clearly document the medication schedule and insist it be incorporated into the hospitals care orders. Politely but firmly remind nursing staff of the critical importance of on-time dosing. Advocate for medication self-administration if allowed by hospital policy. Watch for any substitutions generic or alternate medications can sometimes affect symptom control. Families should feel empowered to respectfully advocate for their loved ones medical needs. Delay in Parkinsons medication can lead to avoidable setbacks in recovery.Understanding Rehabilitation OptionsAfter hospitalization, rehabilitation is essential for helping Parkinsons patients regain strength, balance, and function. Depending on the situation, rehabilitation may occur in: Inpatient Rehabilitation Facilities (IRFs): Specialized centers offering intensive physical, occupational, and speech therapy. Skilled Nursing Facilities (SNFs): Short-term stays focused on medical monitoring and therapy. Home-Based Rehabilitation: Therapy provided at home, which may be the best option for patients with significant mobility challenges or those at high risk of hospital-acquired infections. At Your Home Caregiving of Texas partners with rehabilitation therapists to support continuity of care at home, ensuring that exercises, safety measures, and care plans are followed consistently.Key Rehabilitation Goals for Parkinsons Patients Improving strength and flexibility Reducing fall risk through balance and gait training Enhancing fine motor skills (handwriting, eating, dressing) Improving swallowing and speech if affected Maintaining independence as much as possible Early rehabilitation after hospitalization is crucial for Parkinsons patients. Without it, the risk of decline, injury, and readmission significantly increases.Transitioning Safely Back HomeThe transition from hospital to home is a vulnerable time. Planning ahead is critical to prevent setbacks.Steps for a Successful Transition: Arrange Home Care Services Early: Schedule in-home caregiving services to assist with mobility, medication reminders, and personal care. Conduct a Home Safety Evaluation: Adapt the home environment to minimize fall risks remove tripping hazards, install grab bars, ensure proper lighting, and use assistive devices. Coordinate Medication Management: Update prescriptions, confirm medication supply, and create a clear medication schedule. Schedule Follow-Up Appointments: Ensure post-discharge physician and therapy visits are scheduled before leaving the hospital. Implement a Rehabilitation Plan: Continue physical therapy and exercise routines at home, guided by professional caregivers and therapists. At Your Home Caregiving of Texas specializes in providing comprehensive transitional care for Parkinsons patients. Our caregivers work alongside families and healthcare professionals to ensure that recovery continues safely and effectively at home.How At Your Home Caregiving of Texas Supports RecoveryFamilies managing Parkinsons care dont have to do it alone. Our services are designed to ease the burden of post-hospitalization recovery by providing: Personalized Care Plans: Tailored to the individuals stage of Parkinsons and rehabilitation needs. Medication Reminders and Assistance: Helping maintain the critical medication schedule. Mobility Support: Assisting with walking, transferring, and exercises to rebuild strength and prevent falls. Nutrition and Meal Support: Preparing nutritious meals that support energy and healing. Companionship and Emotional Support: Reducing anxiety, confusion, and isolation during the recovery process. Coordination with Healthcare Providers: Keeping families informed and ensuring therapy recommendations are carried out at home. We work hard to create an environment where patients can heal comfortably, maintain dignity, and reduce the risk of hospital readmission.Final ThoughtsHospital stays are never easy, especially when Parkinsons disease adds another layer of complexity. But with the right preparation, strong advocacy, and a smooth rehabilitation plan, families can help their loved ones achieve the best possible recovery.At Your Home Caregiving of Texas stands beside you every step of the way from hospital bedside to a safe and healing home environment. Our specialized Parkinsons care services ensure that patients get the compassionate, expert support they need to regain strength, confidence, and independence.When its time to transition home after hospitalization, trust At Your Home Caregiving of Texas to be your partner in care and recovery. At Your Home Caregiving of Texas is proud to support families living with Parkinsons disease through compassionate, expert care. For more resources and personalized caregiving solutions, explore the full Parkinsons Care Compass series or contact us today at 469-830-8414. Together, we can create a safer, stronger path to recovery one step at a time. If someone you care about is facing the challenges of Parkinson's, know that you're not alonewe're always here to help.
Navigating the complexities of aging can feel overwhelming. Whether you're a senior making plans for your future or a family caregiver trying to provide the best care for a loved one, knowing where to turn for reliable help is critical. Thats where a Senior Care Advocate steps inyour trusted partner in managing aging-related decisions, healthcare planning, and long-term support.What is a Senior Care Advocate?A Senior Care Advocate is a professional who specializes in supporting older adults and their families as they face the many challenges of aging. Their role is part guide, part liaison, and part problem-solver. Whether it's managing healthcare appointments, understanding confusing medical diagnoses, or finding the right long-term care options, a Senior Care Advocate is there to help every step of the way.These advocates bring years of experience in elder care, healthcare systems, and long-term care planning. They often have backgrounds in social work, nursing, gerontology, or senior services. But more importantly, they understand the emotional weight that comes with caregiving and agingand they offer compassion alongside their professional expertise.Do I Need a Senior Care Advocate?One of the most common questions families ask is: How do I know if I need a Senior Care Advocate? The answer depends on your unique situation, but here are a few telltale signs: Youre overwhelmed with coordinating medical care and doctor appointments. You're unsure about long-term care options like assisted living, memory care, or skilled nursing. Youre facing legal, financial, or insurance questions you dont know how to answer. Youre a long-distance caregiver who cant always be present. Youre worried about the safety or well-being of a loved one who lives alone. In all these situations, a Senior Care Advocate can provide guidance, coordinate services, and even represent you or your loved one at medical appointments or facility meetings.What Services Does a Senior Care Advocate Provide?Senior Care Advocates wear many hats and offer a wide range of services, including:1. In-Home Care CoordinationIf remaining at home is a priority, an advocate can help make it happen safely. They evaluate care needs, hire and supervise caregivers, and provide training for both families and professionals. They ensure that home care is not just availablebut effective, compassionate, and tailored to the individual.2. Medical Support and NavigationUnderstanding the healthcare system can be confusing, especially when dealing with chronic illness or multiple diagnoses. A Senior Care Advocate will: Arrange and attend medical appointments. Help interpret diagnoses and treatment plans. Coordinate testing, therapies, and even emergency room visits. Act as a liaison between seniors, family members, and healthcare providers. Their support can be life-changing, particularly for seniors managing complex conditions or families trying to stay informed.3. Long-Term Care Planning and TransitionsWhen living at home is no longer possible, finding the right long-term care community is essential. A Care Advocate knows the ins and outs of senior living optionsfrom assisted living to memory care and nursing homes. Theyll arrange facility tours, help with admissions paperwork, and even assist with the physical move.After the transition, they continue providing oversight to ensure your loved one is safe, comfortable, and receiving quality care.4. Benefit Application AssistanceUnderstanding what financial and medical benefits you qualify for can be overwhelming. Senior Care Advocates help determine eligibility and assist with applications for: Veterans benefits Social Security and SSDI Medicaid/Medical Assistance Private insurance coverage This process is often time-consuming and complex, but an experienced advocate can streamline it and ensure nothing is missed.What to Look for in a Senior Care AdvocateNot all advocates are the same. When choosing one, ask about their background, training, and areas of specialization. Dont hesitate to request references or testimonials from other families.A qualified Senior Care Advocate should have: Experience in elder care or healthcare systems Knowledge of local resources and support programs A compassionate and proactive communication style Clear professional boundaries and confidentiality standards Real Support for Real FamiliesAt Solutions for Independence, we understand how emotionally and physically demanding caregiving can be. For over 20 years, we've helped hundreds of seniors and their families navigate the aging journey with confidence. Whether its in-home care planning, crisis management, or senior housing transitions, we provide the kind of expert support that brings peace of mind.We believe in providing Care, Advocacy, and Compassion as a Professionbecause every older adult deserves to age with dignity, and every caregiver deserves support.Why Senior Care Advocacy Matters More Than EverTodays aging population is living longer but often with more complex health needs. Family caregivers are often juggling full-time jobs, raising children, and managing their own health. The role of a Senior Care Advocate is no longer a luxuryits becoming a necessity.By working with a trusted advocate, families can: Avoid caregiver burnout. Prevent medical or financial crises. Make informed choices about care options. Save time, money, and emotional energy. Whether youre planning ahead or in the middle of a crisis, a Senior Care Advocate can be your greatest ally. They provide the tools, knowledge, and hands-on support you need to make the best decisions for yourself or your loved one. If youre feeling uncertain or overwhelmed, remember this: You dont have to do it alone. Let an expert advocate help you find clarity, confidence, and comfort in every stage of the aging journey.At Solutions for Independence we have specialized in and provided Care Advocacy and long-term care planning services for over 20 years and have helped hundreds of seniors and families. Give us a call today at 412.999.7892.
Making the decision to move a loved one into senior living is never easy. Its a choice that often comes with a swirl of emotionsgrief, guilt, uncertainty, and even relief. For many families, it marks the beginning of a new chapter that is both necessary and deeply emotional.At Assisted Living Locators, we understand the complexity of this transition. We're not just here to help you find the right placewere here to walk alongside you as you navigate the feelings, questions, and challenges that come with it.The Emotional Weight of the DecisionMoving a parent or loved one out of their homewhere memories were made and independence was cherishedcan feel like a loss. Even when its the right time, the reality of change can be overwhelming.Families often struggle with questions like: Are we doing the right thing? Will they feel abandoned? How do we even begin to choose the right place? These are not just logistical concerns. They're emotional ones. And theyre completely valid.You Are Not AloneEvery family has a unique story, and no two transitions look the same. Thats why a one-size-fits-all approach doesnt work. At Assisted Living Locators, we start by listeningreally listeningto your concerns, your hopes, and your loved ones needs.We help you: Understand the options available, from independent and assisted living to memory care and beyond. Navigate conversations with compassion, helping your loved one feel heard and included in the decision-making process. Find peace of mind in knowing that a knowledgeable, local expert is by your side. More Than a Placement ServiceWhat sets us apart is that were not just matching families to facilities. Were guiding people through one of lifes most sensitive and significant transitions. We offer not only practical guidance, but emotional supporthelping you make decisions with confidence, clarity, and care.Well tour communities with you, ask the hard questions, and advocate for what matters most to your family. And we do it all at no cost to you.A Step Toward Peace of MindIts okay to feel the weight of this moment. It's okay to need help. And it's okay to prioritize both your loved ones well-being and your own peace of mind.Let us be a trusted partner in this journeyso you dont have to walk it alone.Contact us today at pghassistedliving.com or (724) 972 -3202 to take the first step. Were here to help with heart, knowledge, and unwavering support.
Are you feeling overwhelmed by the complexities and difficulties associated with aging? Have the responsibilities in caring for your loved one become unmanageable? Do you live far away and are unable to provide reliable senior care management? If you answered yes to any of the above questions, you may want to consider hiring an eldercare manager. Hi, my name is Laura. I have been a Registered Nurse (RN) for over 20 years and have witnessed firsthand the challenges and complications that aging presents. It affects not only the aging themselves but also their families and loved ones. Health care is complex, and in this increasingly fragmented and overburdened system, it can be extremely helpful to have a professional oversee all aspects of care. As your eldercare manager, I will comprehensively assess the needs of your loved one and we will work together in establishing a care plan. I will assist you and your family with difficult decisions and help promote healthy communication on issues that are often difficult to address and navigate. An expanded version of my core services are summarized below: MANAGE health care needs, chronic conditions, illnesses, and coordination of careOPTIMIZE health outcomes via my extensive knowledge and experience in the healthcare system. I provide necessary education on chronic diseases and treatment plans, promote collaboration and communication amongst the health care team, ask the right questions of health care personnel, and any other needed activities in order to promote the safety and wellness of my clientsNAVIGATE the complex health system ADVOCATE for individuals to receive high quality care. I do this by such actions as asking the right questions of health care personnel, requesting a referral, second opinion, or further resources when appropriate, and anticipating/ planning for future health care needsTRANSITION clients to appropriate living conditions and proper levels of care. This may be from out of a private home into independent or residential living. It can also entail transition to a skilled nursing facility, assisted living, long term acute care, and hospice. There are many factors and variables to be considered when making these changes, and I provide assistance and support. The above services represent the bulk of my client/family needs. Some other services provided are:Comprehensive health status assessmentAssistance with medication complianceAssessing safety of the home and providing measures to reduce falls Helping clients/ families make difficult health decisions while navigating familydynamics and promoting effective communicationBeing present with client during doctor appointments etc. to ask the rightquestions and help assimilate health informationVisiting and interacting with clients at hospitals and facilities to assess healthstatus, monitor progress, and assist with any needs upon discharge or transfer Contact me today for a free 20-minute consultation!
Are you feeling overwhelmed by the complexities and difficulties associated with aging? Have the responsibilities in caring for your loved one become unmanageable? Do you live far away and are unable to provide reliable senior care management? If you answered yes to any of the above questions, you may want to consider hiring an eldercare manager. Hi, my name is Laura. I have been a Registered Nurse (RN) for over 20 years and have witnessed firsthand the challenges and complications that aging presents. It affects not only the aging themselves but also their families and loved ones. Health care is complex, and in this increasingly fragmented and overburdened system, it can be extremely helpful to have a professional oversee all aspects of care. As your eldercare manager, I will comprehensively assess the needs of your loved one and we will work together in establishing a care plan. I will assist you and your family with difficult decisions and help promote healthy communication on issues that are often difficult to address and navigate. An expanded version of my core services are summarized below: MANAGE health care needs, chronic conditions, illnesses, and coordination of careOPTIMIZE health outcomes via my extensive knowledge and experience in the healthcare system. I provide necessary education on chronic diseases and treatment plans, promote collaboration and communication amongst the health care team, ask the right questions of health care personnel, and any other needed activities in order to promote the safety and wellness of my clientsNAVIGATE the complex health system ADVOCATE for individuals to receive high quality care. I do this by such actions as asking the right questions of health care personnel, requesting a referral, second opinion, or further resources when appropriate, and anticipating/ planning for future health care needsTRANSITION clients to appropriate living conditions and proper levels of care. This may be from out of a private home into independent or residential living. It can also entail transition to a skilled nursing facility, assisted living, long term acute care, and hospice. There are many factors and variables to be considered when making these changes, and I provide assistance and support. The above services represent the bulk of my client/family needs. Some other services provided are:Comprehensive health status assessmentAssistance with medication complianceAssessing safety of the home and providing measures to reduce falls Helping clients/ families make difficult health decisions while navigating familydynamics and promoting effective communicationBeing present with client during doctor appointments etc. to ask the rightquestions and help assimilate health informationVisiting and interacting with clients at hospitals and facilities to assess healthstatus, monitor progress, and assist with any needs upon discharge or transfer Contact me today for a free 20-minute consultation!