Adoration Hospice (formerly Grane Hospice)

Transitioning Alzheimers Patients to HospiceMaking the Transition to Hospice with Alzheimers and Other Forms of DementiaAlzheimers disease and other forms of dementia are progressive diseases that eventually lead to end of life for those suffering. When your loved one reaches more challenging stages of dementia, hospice care is extremely valuable.  Hospice is a specialized type of care that focuses on comfort and quality of life for patients who are terminally illwith a prognosis of six months or less if their disease runs its normal course.How to Transition to Hospice Care with Ease and Peace of MindTransitioning to hospice care can be a difficult decision, but it can also be a relief for both patients and caregivers. Hospice care can provide your loved one with the support and care they need during their final months of life.  You do not need to wait until the very end to initiate hospicewhich is a common misconception. To transition to hospice care with ease and peace of mind, here are a few tips:Talk to your loved ones Primary Care Physician (PCP). If your loved one does not have a Primary Care Physician, we can help you obtain an order for hospice care.  The PCP will write an order to initiate hospice.  This is step one.Get to know the hospice team.Once you meet with us, you will be assigned a team of caregivers who will work with you to create a care plan for your loved one. The hospice team will include nurses, social workers, aides, and other professionals who are skilled in caring for people with dementia.Let us take care of the rest!We will bring in all necessary supplies and durable medical equipment (DME) that your loved one will need to be safe and comfortable in the place they call home.More Ways We Can HelpOur Hospice agency can provide a variety of services to help you and your loved one transition to hospice care. These services may include:Caregiver support. Hospice offer a variety of support services for caregivers, such as respite care, support groups, and counseling.Symptom management. Hospice will help manage your loved ones symptoms, such as pain, nausea, and anxiety.Spiritual support. Hospice offers spiritual support for patients and their families, regardless of their religious beliefs.Volunteers.  Hospice volunteers are a vital part of our program and offer a variety of services to you and your loved one.If you are considering hospice care for your loved one with Alzheimers or another form of dementia, please contact us today. We make the process simple, letting you focus on what matters most!

Now What? Your Post-Caregiving Grief Guide By Gary Bruland, Bereavement Counselor - Grane Hospice HarrisburgNow what?  You may be asking yourself this question if you served as your late loved ones primary caregiver. You dedicated your time and talents, lovingly and sacrificially giving yourself, having offered your heart, soul, mind, and strength. You put your own needs and interests on hold.  Now that your loved one or friend has died, you may feel sadness, loneliness, and an enormous void left by the loved one. But you may also feel a measure of relief. Youre not only grieving the loved one or friend that was lost, but you are also at a loss. Youre likely grappling with two basic post-caregiving questions:  Who am I after having been a caregiver? What shall I do now?       While grief often seems like a long and solitary journey, be assured that you are not alone. According to the AARP Public Policy Institute from 2017, there were an estimated 40 million caregivers in the US caring for another adult, such as a parent, spouse, sibling, son, daughter, other relative, friend, or neighbor.   Today, many of these 40 million Americans are now former caregivers who are walking their own post-caregiving grief journey. What follows are some strategies for journeying through grief for you who have served as compassionate caregivers. In our Harrisburg-area Growing through Grief sessions, we focus on the four tasks of healthy grieving as set forth by Dr. J. William Worden. One of these tasks involves an effort to identify who you are as an individual apart from your late loved one. In other words, you will want to begin to reinvest your life in ways consistent with your own personal interests, vision, and values. But how do you do this? You can begin to identify who you are apart from your loved one by asking yourself three questions: Who were you before your loved one came into your life? Who were you when he/she was in your life? Who are you now without that person in your life? Asking yourself these questions to help determine who you are as an independent person is an essential part of making it through your journey of grief. Borrowing a principle from career counseling may also be helpful in your grief recovery. This principle asserts that you can find your new calling or new identity at the intersection of your strengths, your interests, and what most benefits others. Work on finding this intersection, as you drive the detour of grief, and you may very well discover ways to reinvest your life.  Others may come alongside you to give care, comfort, and support for a time. But your grief journey will continue until you define and redefine yourself after their death. Death changes the roles we play, and these roles help to define us. Another factor in identifying who you are independent of your loved one involves reviewing the various interests and activities you may have participated in because of, or with, your loved one. Will you continue to do these things without your loved one? As you work on your grief recoveryand as you work on finding a new sense of purpose post-caregivinglet me close with a word of encouragement. You may still be feeling mad, sad, or bad about your loved ones death; or, you may feel as if you died with them; or, you may still feel that youll never adjust to a new normal without them.  While feeling adrift or at a loss, Now what? is a perfectly natural and, sometimes necessary, response.     You can be assured that as you do your grief work, the heaviness of your grief in these days will lessen and get lighter in days to come. The fog of grief will lift. You may discover that part of your new purpose in life is to be an advocate for a special cause. New advocacy or activism on behalf of an important issue or cause may become a powerful and positive part of your growing through grief. It may help you heal from your pain and loss. Be assured, youll always remember your loved one. Youll also remember your grief and pain, but as you work through your grief on this long journey, the pain will decrease and not be as intense.  In time, you will heal.   In time, you will move into a new normal, enjoying a revitalized life. In his booklet Rebuilding and Remembering, Kenneth Haugk talks about rebuilding your life: Give yourself permission to live again, to laugh again, to enjoy life again. Living again affirms your loved one, who would want the best for you.  Susan Zonnebelt-Smeenge and Robert DeVries in their book, Traveling Through Grief, offer some helpful insights for you to consider: How can you know you are done grieving? While there are many evidences which suggest that your grief journey is drawing to a close, here are four major evidences youll want to look for:   You are able to talk about your deceased loved one and recall special memories without strong emotional reactions like breaking down crying or feeling significant pain. You have dealt with all the feelings (such as anger, guilt, or sadness) that you may have felt about your relationship with the deceased.  You can be by yourself and not feel intense loneliness or yearning for your deceased loved one. You made decisions about the disposition of their things and have chosen few keepsakes, having sorted and stored special memories to be retrieved and reviewed.   You feel confident as a complete and whole person in yourself.  You are able to smile again, and you feel you have positive things to contribute to others. On behalf of the compassionate staff of Grane Hospice Care, I wish you well as you continue in your journey of growing through post-caregiving.  Gary Bruland, Bereavement Counselor, Grane Hospice Harrisburg

As a hospice care provider, we understand the complexities and challenges of managing end-stage heart conditions. These advanced stages of heart disease can significantly impact the quality of life, making it essential to consider supportive care options that prioritize comfort and dignity. Common End-Stage Heart Conditions Congestive Heart Failure (CHF): Advanced CHF often includes symptoms such as persistent fluid retention, severe fatigue, and difficulty breathing, even at rest. Coronary Artery Disease (CAD): When CAD progresses to frequent angina (chest pain) and limitations in daily activity, the condition may be nearing its final stages. Valvular Heart Disease: Severe valve dysfunction leading to heart failure or recurrent infections may indicate the need for advanced care. Cardiomyopathy: End-stage cardiomyopathy can result in arrhythmias, significant heart enlargement, and a decline in heart function. Pulmonary Hypertension: As pulmonary hypertension worsens, it can lead to right-sided heart failure and a marked decline in physical capabilities. Signs It May Be Time for Hospice Care Frequent hospitalizations or emergency room visits for heart-related symptoms. Progressively worsening symptoms, such as shortness of breath, fatigue, or swelling, despite maximum medical therapy. Dependency on assistive devices like oxygen or a ventricular assist device (VAD). Decline in physical function, including the inability to perform daily activities. Presence of co-existing illnesses or significant weight loss (cachexia). According to the Centers for Medicare & Medicaid Services (CMS), patients with heart disease qualify for hospice care if their life expectancy is six months or less, as certified by a physician (CMS, 2022). How Hospice Care Helps Symptom Management: Hospice provides expert care to alleviate symptoms such as pain, dyspnea, and fatigue. Emotional and Spiritual Support: Patients and families receive guidance and support to navigate the emotional challenges of end-stage heart conditions. Care Coordination: Hospice teams work closely with cardiologists, primary care providers, and family members to ensure continuity of care. Respite Care for Families: Caregiving can be overwhelming; hospice provides temporary relief to family members. Why Hospice is a Win for End-Stage Heart Conditions Quality Over Quantity: Hospice shifts the focus to quality of life, helping patients find comfort and peace in their remaining days. Reduced Hospitalizations: Studies show that hospice care reduces hospital admissions and emergency department visits for patients with heart failure (Gelfman et al., 2021). Patient and Family Satisfaction: Families often report higher satisfaction with care when hospice is involved, as it addresses physical, emotional, and spiritual needs. Cost-Effective Care: Hospice care can reduce healthcare costs by avoiding unnecessary treatments and hospital stays (Connor, 2021). Statistics to Consider Nearly 6.2 million adults in the U.S. live with heart failure, and approximately 50% of these individuals will not survive more than five years after diagnosis (American Heart Association, 2021). Hospice care reduces healthcare costs by an average of $9,000 per patient during the last 30 days of life (National Hospice and Palliative Care Organization, 2022). Next Steps If you or a loved one is living with an advanced heart condition, consider how hospice care can help maintain dignity, comfort, and peace during this challenging time. Our team is here to provide expert care and guidance every step of the way. Contact us today to learn more about hospice services for patients with end-stage heart conditions. Let us help you make the most of every moment. Contact us for details. References American Heart Association. (2021). Heart disease and stroke statistics2021 update. https://www.heart.org Centers for Medicare & Medicaid Services. (2022). Hospice care eligibility. https://www.cms.gov Connor, S. R. (2021). Hospice cost savings in the U.S.: Evidence and implications. Journal of Palliative Medicine, 24(5), 698-703. Gelfman, L. P., Kavalieratos, D., Teuteberg, W. G., & Lala, A. (2021). Hospice and palliative care for heart failure patients: Evidence and future directions. Journal of Cardiac Failure, 27(7), 888-897.

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) 

Comparing Palliative & Hospice Care Understanding Palliative Care Compared to Hospice CareSome older adults and people with serious illnesses, unfortunately, experience the end of life in certain healthcare settings that do not align with their desired wishes. If you have a serious illness or are a caregiver of someone planning end-of-life care, knowing the difference between palliative care and hospice care can help you make an informed decision when the time comes to transition to one of these healthcare settings.What Is Palliative Care?Palliative care is a form of care that focuses on improving your quality of life and that of your family when you are living with a serious illness. It focuses on your whole-person health rather than only on your condition. If you are receiving palliative care, your treatment plan may focus on reducing symptoms of your illness and on improving secondary conditions such as depression, sleep deprivation, and side effects of medications.Palliative care may be given in various healthcare settings, such as at the hospital, a residential care facility, or your home. Anyone can receive this type of care regardless of age or the severity of their condition.If you receive palliative care, you may work with and be treated by various healthcare professionals, including doctors, nurses, social workers, pharmacists, physical therapists, counselors, and nutritionists. If you need spiritual care, your palliative care team may even include a chaplain. The healthcare professionals that make up your palliative care team will depend mainly on your recovery needs and level of care.Studies show that palliative care offers many benefits, including:Reduction in pain, nausea, and shortness of breathImproved communication among patients, their loved ones, and their healthcare providersIncreased emotional supportHigh-quality care that aligns with the patients wishesReduction in stressIncreased confidence surrounding decision-making related to careAbility to meet the emotional and spiritual needs of the patients and their loved ones What Is Hospice Care? Hospice care focuses on improving your comfort and quality of life when you are nearing the end of your life. This type of care is usually given in circumstances in which an illness continues to progress despite treatment or when the patient chooses not to receive certain treatments. Hospice care is similar to palliative care in that it provides comfort care and support for the family. However, treatments are not given to improve the illness. Like palliative care, hospice care can be given in many different healthcare settings, though it is most frequently given at your home, where you can be most comfortable and spend quality time with your loved ones. In addition, it is typically given when your healthcare provider believes you have no more than six months to live. Some benefits of hospice care include 24/7 access to nurses and healthcare workers who can address and relieve symptoms and side effects and access to medical equipment and medications that can reduce your discomfort. Many of the same types of healthcare professionals that make up a palliative care team will also be part of your hospice care team. This includes doctors, nurses, social workers, chaplains, and volunteers who dedicate their time to giving you the support you need and making you feel as comfortable as possible during your final months. To be eligible for hospice care, you will discontinue aggressive treatment efforts to combat your terminal illness (such as experimental surgeries, aggressive chemotherapy, or other treatments that require prolonged hospitalization and recovery).   However, you may continue to receive treatments for other conditions, such as antidepressants to treat depression or insulin medicines to control Diabetes.    What Is Comfort Care and End-of-Life Care? Comfort care and end-of-life care are both terms that describe the type of care you receive when you are near the end of your life and are no longer receiving treatment for your illness. It is highly similar to palliative care in providing you with whole-person care that focuses on your physical, social, emotional, and spiritual health. Comfort care and end-of-life care may include palliative care or hospice care, or a combination of both. What Are the Main Differences Between Palliative Care and Hospice Care? Sometimes, palliative care is given as part of hospice care, and both types share many similarities. For instance, the goal of both palliative and hospice care is to improve your quality of life and help you find relief from painful and severe symptoms and side effects of treatment. Both types of care also focus on whole-person health. However, there remain many differences between palliative care and hospice care. Some of these differences are: Palliative care can be given to anyone with a serious illness, regardless of the stage of their disease. In comparison, hospice care is typically only given when a person has less than six months to live and is at the end of their life. Palliative care can be given simultaneously when the patient receives other treatments for their condition, such as chemotherapy or radiation therapy. Hospice care is usually given when treatment for the illness has stopped, and the goal of care is to manage the patients symptoms for the remainder of life. The healthcare professionals on a palliative care team work separately from the patients primary care team that is treating the illness. In comparison, the healthcare professionals on a hospice care team handle the majority of the care and collaborate with the patients primary care team as necessary.  Who Should Consider Palliative Care? You may want to consider palliative care if you or your loved one has a serious illness or chronic condition that requires long, intensive care or that causes severe physical symptoms and/or emotional distress. For example, cancer, heart disease, AIDS, and kidney failure are some of the many conditions that can benefit from palliative care. Additionally, palliative care may benefit you if you: Want relief from severe physical pain you are experiencing due to your illness Are experiencing emotional pain or psychological conditions that you are unable to control Want to continue to receive treatment for your condition Want tips and guidance on how to effectively manage your condition Need guidance with choosing the best treatment Need help understanding your illness Want to receive treatment at home or outside of a traditional hospital setting Have loved ones who are involved with your treatment Need help transitioning from one treatment setting to another When Would Someone Transition From Palliative Care To Hospice Care? A person may transition from palliative care to hospice care if their doctor thinks they have no longer than six months to live. Sometimes, it can be difficult for doctors to predict exactly how long it will take for a particular disease to run its course or how long a person has left to live if their health is in decline. In these circumstances, its important to consider how transitioning to hospice care could improve your quality of life during your final months. According to the National Library of Medicine (NLM), doctors should strongly consider referring chronically ill patients to hospice care if they spend more than half their time in bed, are unable to function efficiently, and are experiencing both physical and psychological distress. The NLM adds that hospice referrals are usually necessary when the patients condition has progressively declined to the point that their highest priority is to take control of their healthcare and achieve the greatest possible comfort in their homes as they near the end of life. Talk to your doctor if you think you may need hospice care but arent sure when you should transition out of palliative care. Your doctor can talk to you at length about your options and the benefits of transitioning to hospice care based on your condition and unique circumstances. Taking advantage of hospice care as soon as its needed could result in access to quality care and lots of extra quality time to spend with your loved ones. Additionally, studies show that patients who plan their care in advance are more likely to be satisfied with their care, given how they can make decisions that align with their end-of-life wishes. How to Get Palliative Care or Hospice Care Consult with your healthcare provider if you or your loved one is interested in learning more about palliative care or hospice care. Your doctor can refer you to a palliative or hospice care specialist who can answer all your questions and help you determine which of these services may be more ideal. Palliative care and hospice care are covered by many major health insurance providers, including Medicare. The exact benefits covered will vary based on your health plan. Benefits covered may include medical equipment and supplies, skilled nursing care, bereavement support, and medications to provide comfort, among many others. Hospice At Your Side has resources for home health and hospice services throughout the United States. Specialty services we offer include diabetes care, orthopedics, and pain management. Call us today to learn more about our many home healthcare services.

Ensuring Safety in Hospice Care: A Commitment to Excellence The importance of safety in the workplace for healthcare providers cannot be overstated. As we approach OSHAs Safe and Sound Week in August, it is an opportune moment to highlight the critical measures we undertake to ensure a safe work environment for our staff and patients. This communication aims to inform our referral sources about our safety protocols and provide valuable tips that medical professionals may find beneficial for maintaining safety in their workplaces. Our Commitment to Safety In hospice care, where the environment can be unpredictable and emotionally charged, maintaining rigorous safety standards is paramount. Our commitment to safety is evidenced by our comprehensive safety programs, continuous staff training, and adherence to OSHA guidelines. According to the Bureau of Labor Statistics (2023), healthcare workers face a higher rate of workplace injuries than workers in most other sectors, with nearly 5.5 injuries per 100 full-time workers annually. This statistic underscores the importance of our ongoing efforts to mitigate risks and promote a culture of safety. Staff Training and Education Ongoing Training: All our staff undergo regular training sessions that cover the latest safety protocols, emergency procedures, and the proper use of personal protective equipment (PPE). Research has shown that continuous education significantly reduces the incidence of workplace injuries (Smith et al., 2022). Ergonomic Interventions Proper Lifting Techniques: Back injuries are a common concern in healthcare settings. We emphasize training on proper lifting techniques and the use of mechanical lifts when necessary to prevent musculoskeletal injuries (Anderson et al., 2020). Infection Control Measures Strict Hygiene Protocols: Adherence to stringent hygiene protocols, including regular handwashing, use of sanitizers, and appropriate use of PPE, is mandatory. These measures are crucial in preventing the spread of infections among staff and patients (CDC, 2022). Mental Health Support Counseling Services: Recognizing the emotional toll that hospice work can take, we offer counseling services to support our staffs mental health. Studies have indicated that mental health support reduces burnout and improves job satisfaction among healthcare workers (Jones et al., 2021). Safety Tips for Medical Professionals While our safety protocols are robust, there are additional tips that medical professionals may find useful in enhancing their safety at work: Use Technology Wisely Telehealth Services: Where appropriate, leverage telehealth services to reduce the need for physical interactions, thereby minimizing exposure to infectious diseases. Stay Informed Continuing Education: Keep abreast of the latest safety guidelines and best practices through continuing education programs. This knowledge is vital for adapting to new challenges and improving workplace safety. Promote a Safety Culture Open Communication: Foster an environment where staff feel comfortable reporting safety concerns without fear of retribution. An open communication culture is essential for identifying and addressing potential hazards promptly (Davis et al., 2019). Personal Protective Equipment (PPE) Proper Use and Disposal: Ensure the correct use and disposal of PPE. Improper handling can negate the benefits and increase the risk of contamination. Safety in the workplace is a fundamental aspect of providing high-quality hospice care. By implementing rigorous safety measures and continuously educating our staff, we strive to create a secure environment for both our employees and patients. We encourage our referral sources to adopt similar practices to enhance safety within their own organizations. Together, we can build a safer healthcare system for everyone.  Call us today to learn more!   References Anderson, J., Williams, M., & Smith, T. (2020). Ergonomic interventions in healthcare: A review of the evidence. Journal of Occupational Health, 62(4), 311-319. https://doi.org/10.1002/joh.22023 Centers for Disease Control and Prevention (CDC). (2022). Infection control in healthcare settings. Retrieved from https://www.cdc.gov/infectioncontrol/index.html Davis, K., Turner, M., & Wrenn, G. (2019). Promoting a culture of safety in healthcare. Healthcare Management Review, 44(2), 123-135. https://doi.org/10.1097/HMR.0000000000000199 Jones, A., Phillips, R., & Brown, L. (2021). Mental health support for healthcare workers: A systematic review. Journal of Occupational and Environmental Medicine, 63(1), 54-62. https://doi.org/10.1097/JOM.0000000000002025 Smith, R., Johnson, P., & Martinez, S. (2022). The impact of continuous education on workplace safety in healthcare. American Journal of Industrial Medicine, 65(3), 233-245. https://doi.org/10.1002/ajim.23394 U.S. Bureau of Labor Statistics. (2023). Occupational injuries and illnesses among healthcare workers. Retrieved from https://www.bls.gov/iif/

Hospice Eligibility for Stroke PatientsSome of the most common misconceptions about hospice care involve when its appropriate for a patient to elect hospice services and what diagnoses qualify a patient for hospice. People often assume hospice is only for cancer patients, but that is simply not true. You may be surprised to learn that stroke patients also qualify for hospice services.What is a Stroke?Strokes are the number five cause of death and a leading cause if disability in the United States. A stroke is defined as a disease that impacts the arteries leading to and within the brain. It occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or ruptures. When this happens, part of the brain cannot get the blood and oxygen it needs, causing it and brain cells to die.Stroke Warning SignsThe American Stroke Association uses F.A.S.T to help us identify warning signs of a stroke.F = Face DroopingIf one side of the face is drooping or numb, this can be a common sign of a stroke. One way to help to determine this is by asking the person to smile. If their smile is uneven, that is an indication of face drooping caused by a stroke.A = Arm WeaknessAnother sign can be if one arm feels weak or numb. Ask the person to raise both their arms. If one arm drifts downward, it could be a sign of a stroke.S = Speech DifficultySlurred speech is a third sign of a stroke.T = Time to Call 911If someone is showing these three warning signs of a stroke, call 911 immediately.Other Signs and SymptomsOther signs and symptoms of a stroke can include:Numbness or weakness in the face, arm, or leg (especially on one side of the body)Confusion, including difficulty speaking or understanding speechDifficulty seeing in one or both eyesDifficulty walking, including dizziness or loss of balance or coordinationSevere headache with no known causeStroke Risk FactorsGiven the danger of strokes, its important to understand the different risk factors, including both those within and out of your control.Risk Factors You Can ControlSome risk factors of stroke are within your control. These can include:High blood pressure is the leading cause of strokeSmoking may double stroke risk, specifically for African AmericansDiabetesDiets high in saturated fat, trans fat, and cholesterol can raise blood pressure and increase your risk of a strokePhysical inactivityObesityHigh blood cholesterolOther heart diseasesSickle cell diseaseRisk Factors Beyond Your ControlAs with anything else, some stroke risk factors are beyond your control. These can include:Age. The risk of having a stroke increases with age.Family history. You may be at higher risk of having a stroke if your parent, grandparent, or sibling has had a stroke.Race. African Americans have a much higher risk of death from a stroke due to a higher risk of high blood pressure, diabetes, and obesity.Gender. Women are known to have more strokes than men.Prior stroke, TIA, or heart attack. A person who has had a stroke before is at a much higher risk of having another.Hospice QualifiersHospice can benefit patients who are in the terminal stages of a stroke. The following criteria could be indicators that it may be a good time to consider the additional support of hospice.Received a Palliative Performance Score or Karnofsky score of 40% or less from a primary care physicianMainly bed or wheelchair boundIncreasingly impaired functional status, requiring assistance remembering daily tasks or routinesRequires assistance with activities of daily living (ADLs)Unable to maintain sufficient fluid and caloric intake with a decrease in eating or drinkingDemonstrates progressive weight lossIf you are still unsure if your loved one qualifies for hospice, or if you have any questions about hospice for stroke patients, please dont hesitate to contact us.

Navigating Stress in Chronic Conditions: A Guide for Patients and CaregiversLiving with a chronic condition, or caring for someone who does, can be a profound and life-changing experience. Both roles come with their unique sets of challenges, stresses, and rewards. Its vital to find effective ways to manage stress to maintain both physical health and emotional well-being. This guide explores practical strategies for individuals with chronic conditions and their caregivers to manage stress and improve their quality of life.Mindfulness and Emotional SupportFor Individuals with Chronic Conditions Embrace Mindfulness: Integrating mindfulness exercises into your daily routine can enhance awareness of your physical and emotional state, leading to better stress management. Simple practices like deep breathing, going on a mindful walk, listening to wise teachers (like Alan Watts or Joseph Goldstein), or even mindfully eating can significantly impact your day. The key is to focus on any particular sensation youve never noticed before, like the sensations in your feet as you walk or the unique texture of a certain food. Journaling: Keeping a journal allows you to express and process your emotions, fears, and hopes. Writing can be a therapeutic activity, helping you to navigate your feelings and reduce stress. They key to journaling is to write for yourself and no one else. Dont read what you wrote just write. Then, after a few weeks, reflecting on previous entries can offer valuable insights into challenges youve surmounted, which once seemed insurmountable. For Caregivers Finding Community: Engaging in support group can connect you with individuals facing similar challenges. Sharing experiences and coping strategies can alleviate feelings of isolation and burnout. Practice Self-Compassion: Recognize and honor the hard work and love you put into caregiving. Allowing yourself to feel pride in your resilience and contributions can strengthen your emotional well-being. Being a caregiver is among the worlds most demanding roles, closely paralleling the responsibilities of parenting. Its essential to acknowle3dge and celebrate your personal growth and the skills youve developed throughout your caregiving journey. This recognition not only affirms your invaluable work but also bolsters your emotional health, enabling you to continue providing compassionate care. Physical Wellness and ActivitiesFor Individuals with Chronic Conditions Incorporate Gentle Exercise: Activities like walking, stretching, or yoga can elevate your mood, improve sleep quality, and boost energy levels, enhancing your overall well-being. Nutrition Matters: Adopting a balanced diet can help manage symptoms more effectively. Consulting a nutritionist can provide personalized dietary advice to support your health. A valuable piece of advice from Integrative Medicine Expert, Dr. Andrew Weil, emphasizes the significance of a colorful diet: Its important to eat the rainbow. For Caregivers Take Time for Yourself: Regularly scheduled breaks are essential. Whether its a few minutes of quiet time or engaging in a hobby, breaks can rejuvenate your spirit and energy. Moreover, they redirect your focus toward fulfilling activities, nurturing a sense of gratitude for the simple pleasures in life. Exercise together: If possible, participating in physical activities with your loved one can benefit you both physically and emotionally, fostering a stronger bond. Start small by going on a walk together. Practical Support and Resources Professional Assistance: Dont hesitate to seek help from mental health professionals when needed. They can offer strategies and support to navigate stress effectively. Learn and Educate: Understanding the chronic condition and effective caregiving techniques can empower both the individual and the caregiver. Knowledge can demystify the care process, making it less daunting. Conclusion Managing stress is crucial for both individuals with chronic conditions and their caregivers. By embracing mindfulness, focusing on physical wellness, and utilizing available resources, its possible to navigate these challenges with grace and resilience. Remember, self-care is not an act of selfishness but a necessity, enabling you to provide the best care for your loved one.

Caregiver Stress Awareness in Hospice CareBy: Joelle Jean, FNPCaring for a loved one who is terminally ill and on hospice is emotionally and physically taxing. In 2015, an estimated 39.8 million caregivers provided unpaid care to an adult with a disability or illness. The estimated value of the service supplied by caregivers is up to $470 billion since 2013.Caregivers may deny help from others, perhaps out of guilt or obligation. However, 1 out of 6 caregivers report not being asked what they need to care for themselves. Caregivers can work up to 8.3 hours per day or 66 hours per week during their loved ones last days of life. Often, this is in addition to working a full-time job and caring for their own immediate family.Caregivers are at risk for depression, severe fatigue, or burnout, or even health issues such as hypertension, stroke, obesity, or weight loss due to stress.What is a caregiver?A caregiver, also known as an informal caregiver, is an unpaid individual or group of individuals who provide care to a loved one. Caregivers can be a spouse, family members, partner, friend, neighbor, or combination of these individuals.A caregiver assists their loved ones with activities of daily living which include:BathingDressingEatingToiletingShoppingHousekeepingTransportationMedical tasks such as giving medications, changing wound dressings, and managing painA caregiver can also play a significant role in coordinating care for their loved ones. Many are appointed power of attorney or the primary decision maker for their loved ones, managing finances, property, and most suitable medical care for the individual.    What causes caregiver stress or burnout?There is no clear definition of caregiver stress. The Merriam-Webster dictionary defines stress as a physical, chemical, or emotional factor that causes bodily or mental tension and may be a factor in disease causation. Burnout can be a response to stress, defined as extreme emotional exhaustion. According to stress.org, stages of burnout are:EnthusiasmStagnationFrustrationApathy or loss of interestA caregiver with stress or burnout exhibits signs of feeling overloaded, overwhelmed, emotionally drained, tiredness, detachment from the person they are caring for, and a reduced sense of accomplishment.Who is most affected by caregiver stress?Caregiver stress affects the person or people directly caring for their loved one. Stress can also affect caregivers in different ways. For example, one caregiver may find specific tasks stressful or overwhelming while another caregiver may find the task relaxing and rewarding.What are the signs and symptoms of caregiver stress?Often, caregivers are not aware of their stress or feeling of burnout. Signs and symptoms of caregiver stress can be subtle or obvious. It is important to identify caregiver stress so it can be eased.AnxietyAnxiety is a stress response, activating the fight or flight response that happens chemically in the brain. Physically, anxiety can be described as:Increased heart rateFeelings of doom or hopelessnessStomach pain and or spasmsHeadacheSweatingHeavy breathingFeeling weak or tiredWorryFatigueCaregivers suffering from stress may not realize they are fatigued. Fatigue is the bodys response to burnout and can be physical, emotional, or psychological.Weight changesStress can cause weight changes and affect eating patterns. Weight change can occur when dealing with caregiver stress. Rapid weight gain or unexplained weight loss is a warning sign of caregiver stress and should be addressed appropriately.IrritabilityCaregivers may become easily annoyed or short-tempered with loved ones, family members, or friends. Feeling irritable may be a warning sign of caregiver stress.Feelings of being overwhelmedFeeling overwhelmed or anxious is normal. Caregivers may become overwhelmed with the amount of care needed to provide to their loved ones. Trouble concentrating, changes in sleep patterns, and changes in eating habits may occur.DepressionLosing interest in activities can be a sign of depression due to the demanding responsibilities of caregiving. Signs of depression include:Little interest or pleasure in doing thingsFeeling down or hopelessChange in sleep patternsFatigue and tirednessThoughts of death or suicidePotential health risks as a result of caregiver stressChronic stress (or stress lasting for more than six weeks) can have lasting health problems. Caregivers exhibiting signs and symptoms of stress and burnout have a higher chance of developing health risks.High blood pressureCaregivers can suffer from high blood pressure due to the stress of caring for a loved one in hospice. If caregivers have already been diagnosed with high blood pressure, stress can make the disease worse. Uncontrolled high blood pressure puts caregivers at higher risk for:StrokeAtherosclerosis or disease of the arteriesHeart attackOrgan damageWeakened immune systemThe immune system is in place to protect the body from illness and disease. Stress can cause a weakened immune system. With a weakened immune system, caregivers can become sick or develop chronic illnesses such as:Inflammation throughout the bodyIncrease in fat in the blood and bodyChronic painFrequent colds and infections Short term memory lossStudies have shown that a symptom of chronic stress is the shrinking of the brain. Shrinking of the brain causes short-term memory loss. Short term memory loss affects learning, judgement, and memory process. Headaches and body painsStress can cause headaches and body pains. On a hormonal level, the increase of cortisol causes headaches even at rest. The physical nature of caring for a loved one on hospice- lifting, standing, walking, and rotating- can cause severe body pain or injury. How to relieve or prevent caregiver stress and burnoutSelf-care is imperative for caregivers caring for their loved ones in hospice. Self-care means caring for yourself, so you can improve your health to care for others.Exercise regularlyFinding the time and the energy to exercise might sound difficult. However, even carving out 30 minutes a day has positive effects on your health. Exercising whether it is running, walking, swimming, or doing yoga will lower blood pressure, increase energy, and improve mood.Asking and accepting help from othersAccepting help can be difficult for some caregivers. It is important to ask and accept help so that you are available for your loved one mentally and physically.Under most insurances and Medicare, respite care is available to relieve the burden of caregiver stress. Respite care will give short term caregiver relief to those who are in need.Eat and sleep wellEating and sleeping well are fundamental in protecting your physical and mental health. A well-balanced meal of fruits, vegetables, and plant-based foods is important for physical and mental well-being. Adding vitamins such as a multivitamin, vitamin D, or vitamin B-12 can also help improve your mood and energy.Having a good nights sleep has many health benefits. Feeling well-rested and energized will only benefit you, as the caregiver, and your loved one. Improved memory, mood, and overall well-being are all benefits of quality sleep.Seek out support groupsSupport groups add immense value to caregivers who are caring for loved ones in hospice. Joining support groups reassures caregivers that they arent alone. Support groups:Allow you to talk about your feelingsHelp you realize others are going through the same situationReduces stress and depressionTeaches coping skills and ways to divert stressMaintain personal relationshipsMaintaining personal relationships is as important as joining support groups. Meeting up with friends or family members allows you to relax. It also allows you to take time for yourself and time away from your loved one. Awareness of caregivers stress and burnout must be addressed and acknowledged for caregivers to feel supported and recognized for their challenging work. The hospice team and its services are a fundamental part of bringing this awareness to the forefront.

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 Importance of Vaccinations for Frail AdultsAs a trusted home health partner, we understand the critical role that vaccinations play in safeguarding the health of frail adults. During National Immunization Awareness Month this August, we emphasize the importance of immunizations in preventing severe illnesses and complications, particularly among vulnerable populations.The Role of Vaccinations in Frail AdultsVaccinations are a cornerstone of preventive healthcare, particularly for frail adults who are at a higher risk of complications from infectious diseases. Immunizations help to: Prevent Disease: Vaccines prevent diseases such as influenza, pneumonia, and shingles, which can be particularly severe in older and frail adults. Reduce Hospitalizations: Immunizations reduce the incidence of hospitalizations due to vaccine-preventable diseases, decreasing the burden on healthcare systems and improving patient outcomes. Enhance Quality of Life: By preventing disease, vaccines help maintain the quality of life for frail adults, allowing them to remain more independent and active. Community Immunity: Vaccinating frail adults contributes to herd immunity, protecting those who are unable to be vaccinated due to medical conditions. Key Statistics on the Impact of Vaccinations Influenza: Each year, influenza vaccination prevents an estimated 3.2 million medical visits and 79,000 hospitalizations among adults aged 65 and older (Centers for Disease Control and Prevention [CDC], 2020). Pneumococcal Disease: Vaccination against pneumococcal disease has been shown to reduce the risk of invasive pneumococcal disease by 60-70% in older adults (Jackson et al., 2003). Shingles: The shingles vaccine reduces the incidence of shingles by 51% and postherpetic neuralgia by 67% in adults aged 60 years and older (Oxman et al., 2005). Our Commitment to Vaccine Education and RemindersAs your partner in home health care, we are committed to working collaboratively with you to ensure that your patients are well-informed about the importance of vaccinations. Our services include: Educational Outreach: Providing patients with information on the benefits of vaccines and addressing any concerns or misconceptions they may have. Personalized Vaccine Schedules: Assisting in the creation of personalized vaccine schedules tailored to each patients health status and medical history. Timely Reminders: Sending reminders for upcoming vaccinations to ensure patients receive their immunizations on schedule. Coordination with Healthcare Providers: Collaborating with healthcare providers to ensure seamless vaccine administration and follow-up care. By partnering with us, you can enhance your patients health and wellbeing through comprehensive vaccination education and support. Together, we can make a significant impact in preventing disease and improving health outcomes for frail adults.For more information on how we can support your patients immunization needs, please contact us.ReferencesCenters for Disease Control and Prevention. (2020). Estimated influenza illnesses, medical visits, hospitalizations, and deaths in the United States 20192020 influenza season. Retrieved from https://www.cdc.gov/flu/about/burden/2019-2020.htmlJackson, L. A., Neuzil, K. M., Yu, O., Benson, P., Barlow, W. E., Adams, A. L., & Thompson, R. S. (2003). Effectiveness of pneumococcal polysaccharide vaccine in older adults. New England Journal of Medicine, 348(18), 1747-1755. https://doi.org/10.1056/NEJMoa022678Oxman, M. N., Levin, M. J., Johnson, G. R., Schmader, K. E., Straus, S. E., Gelb, L. D., & Shingles Prevention Study Group. (2005). A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. New England Journal of Medicine, 352(22), 2271-2284. https://doi.org/10.1056/NEJMoa051016

Hospice Care for Pancreatic Cancer: Providing Comfort in End-Stage Disease Understanding Pancreatic Cancer Progression Pancreatic cancer is often diagnosed at an advanced stage due to its subtle symptoms and aggressive nature. Unfortunately, this often leads to a terminal prognosis. The median survival rate for patients with metastatic pancreatic cancer is approximately 3 to 6 months from diagnosis, with overall 5-year survival rates remaining below 10% (Siegel et al., 2024). These statistics highlight the critical need for timely conversations about end-of-life care options, including hospice. The Role of Hospice in Pancreatic Cancer Care Hospice care can be introduced when curative treatments are no longer effective, and the goal shifts to comfort and quality of life. For patients with advanced pancreatic cancer, hospice focuses on managing symptoms such as severe pain, digestive issues, and weight loss, which are common as the disease progresses. Hospice teams offer: Pain and Symptom Management: Specialized care to control debilitating pain, nausea, and other distressing symptoms. Emotional and Spiritual Support: Counseling for patients and families to help navigate the emotional complexities of end-of-life care. Coordination of Care: A multidisciplinary team works with medical providers to ensure seamless transitions and comprehensive care. In-Home Support: Care is delivered in the patients home or a familiar setting, allowing them to remain where they feel most comfortable.   Impact of Hospice on Quality of Life Studies show that patients with advanced cancer, including pancreatic cancer, who receive hospice care experience better symptom control and a more dignified end-of-life experience. A report from the National Hospice and Palliative Care Organization found that 85% of families reported high satisfaction with hospice services in the final days of life (NHPCO, 2023). When to Refer to Hospice for Pancreatic Cancer Early hospice referral can significantly improve the quality of life for patients with terminal pancreatic cancer. Medical professionals should consider hospice when patients: Experience uncontrolled pain despite aggressive management. Have lost the ability to perform daily activities. Face recurrent hospitalizations due to disease complications. Hospice care for pancreatic cancer is not about giving upits about prioritizing the comfort and dignity of your patients. To refer a patient or learn more about how we can support your team, contact our hospice team today. Our care coordinators are ready to assist in providing compassionate, expert care for your pancreatic cancer patients. References National Hospice and Palliative Care Organization (NHPCO). (2023). Family satisfaction with end-of-life care. Siegel, R. L., Miller, K. D., Fuchs, H. E., & Jemal, A. (2024). Cancer statistics, 2024. CA: A Cancer Journal for Clinicians, 74(1), 7-33.