Do you or someone you know need assistance planning for your future?
Join St. Anthony’s Hospice for a free Advanced Directives planning event! You will walk out with a legal copy of your advanced directives and have the option for financial and estate planning!
Join us on Friday, April 14th from 9:00-2:00 at the Henderson County Public Library. Questions? Give us a call at (270) 826-2326.
Mental health, while underdiscussed, is as important as physical health. Not getting the appropriate support for mental health can create challenges in a person’s life and the medical care for their physical health. When a hospice patient is also diagnosed with mental health challenges, special care is taken to include mental health support.
What are consequences of untreated mental illness in hospice patients?
When a person’s mental health is not cared for like it should be, it can create numerous issues in their life. These can include:
All of these issues can create complications for daily life for an otherwise healthy individual, and a seriously ill hospice patient too.
How does hospice care help manage mental health issues?
Hospice mental health can be very challenging.
Best-case scenario, a hospice patient with a mental health issue will already be receiving good treatment prior to his/her hospice admission. If a mental health treatment is working for the patient, they can continue that treatment while receiving hospice care. For example, if they are taking antidepressants for mental health, their hospice care plans will reflect that, and they can continue taking their medication.
However, every situation is different and not always best-case scenario. Unmanaged or ill-managed mental health can create issues for the hospice care team by adding challenges to provide the care the patient needs. Many patients with undiagnosed or ill-managed serious mental health conditions can’t commit to their goals of care. Often, the patient will change their minds and revoke hospice care. While this is certainly their right, unmanaged or ill-managed symptoms and pain from their serious illness can make the situation more difficult for the patient and their caregiver.
Meeting patients where they are
In healthcare, we need to meet patients where they are. That means we need to respect their choices when it comes to treatment options and circumstances in their lives, and work with them according to their capabilities and limitations.
In hospice care, we work with patients of all capabilities, cultures, care plans, and socio-economic statuses. Our goal is to meet patients where they are and treat the patient, rather than the disease.
With hospice mental health, the hospice care team first must identify if the issue truly is a mental health issue or if it is a symptom of their terminal illness or a side-effect of their medication. Some mental health issues can benefit from a variety of treatments such as meditation, guided imagery, or anti-anxiety medication. The hospice care team can assist with this.
If you or a loved one is in need of help from St. Anthony’s Hospice or Palliative Care, please call us at (270) 826-2326.
In case you haven’t heard, hospice and palliative care can be used for all sorts of serious illnesses. Let’s take a look at Multiple Sclerosis (MS).
Hearing that you or a loved one has MS can be scary and overwhelming. Understanding MS can help, but the most important things to do are to know your options and be there for your loved one.
What is Multiple Sclerosis (MS)?
MS a chronic illness of the central nervous system. The body’s immune system attacks myelin which is the protective layer around nerve fibers. Attacking myelin causes inflammation, scar tissue, and lesions. The symptoms vary from person to person, and each person’s symptoms can vary over time.
The two most common symptoms of MS are fatigue and difficulty walking. Additional symptoms can also include tremors, pain, and cognitive issues. MS is most commonly found when a person is in their 20s or 30s and they begin to experience early symptoms like:
There are several types of MS, but the main diagnosis is typically either relapsing-remitting MS or primary progressive MS. Relapsing-remitting MS is the most common form at onset. There are flare-ups of the disease symptoms followed by remissions periods where symptoms are mild or absent. With primary progressive MS, most people experience their neurological function becoming progressively worse over time. When relapsing-remitting MS transitions into progressive, it is called secondary progressive MS.
While your loved one diagnosed with MS will face challenges from this serious chronic condition, most people with MS are able to live a long life. Palliative care can help provide an extra layer of support for those living with MS and their families.
What’s important to your loved one?
Your loved one just received the news that he/she has been diagnosed with MS; what next? The best thing you can do is to ask what is important to them right now.
Do they want some time to process? Give them space while letting them you are here for them when they are ready.
Do they want to maintain a sense of normalcy? Then keep things normal. Make some time to hang out and do the things you have always done together.
Do they want you to hold their hand while they visit their doctor? Go to their appointment and be their support system.
When a person has a serious illness like MS, they don’t want to feel like they are damaged. They are going to have periods of challenging symptoms, but they are still the person you love with hopes, dreams, and wishes. Be there to support them just as you always have! And when you need extra support for their disease, St. Anthony’s Palliative and Hospice Care programs are there to help you and your loved one navigate this diagnosis.
If you or a loved one is in need of hospice or palliative care, please call us at (270) 826-2326 or make an online referral.
Palliative Care is supportive care for people living with serious illness. We provide an extra layer of support for the patient and their family/caregiver(s). Palliative Care is appropriate for any age and any stage of a serious illness. We work closely with your physicians in the management of your care, no matter what type of treatments you may be receiving. Most clinicians appreciate the extra time and information that St. Anthony’s Palliative Care provides to our patients.
Palliative Care focuses on providing relief of the symptoms and stresses that a patient and their family experience with a serious illness. In addition, we provide education to help our patient understand their disease process, treatment options and develop goals of care. St. Anthony’s Palliative Care is provided in the patient’s home, apartment, assisted living facility, and select skilled nursing facilities.
Palliative Care Services Typically Include:
Palliative Care isn’t hospice care, but hospice care is palliative care. Simply put, palliative care is comfort care and hospice care is all about comfort when curing is no longer an option. Palliative care is available to you at any stage of a serious illness, while hospice care is available when a cure is no longer attainable. You can receive palliative care while receiving curative and/or aggressive treatments.
Both palliative and hospice care are important when diagnosed with a serious illness. Let St. Anthony’s help manage symptoms and allow you or a loved one to live the highest quality of life!
If you have any questions about Hospice Care or Palliative Care or want to see if you or a loved one qualify, call us at (270) 826-2326 or make an online referral here.
Pulmonary disease is always present, especially in this new COVID-centered world. Chronic Obstructive Pulmonary Disease, or COPD, is a “chronic inflammatory lung disease that causes obstructed airflow to the lungs” (Mayo Clinic). COPD damage is irreversible but the condition is treatable. With proper symptom management, people living with COPD can attain a good quality of life and reduce the risk of developing other associated conditions. COPD is the 3rd leading cause of death in the United States, affecting over 11 million people. Often those with pulmonary disease aren’t aware they have it until symptoms progress; and the early warning signs are often dismissed as a normal part of aging. How can you know when to refer to hospice or palliative care?
Palliative Referral
St. Anthony’s Palliative care is a great place to start when your loved one’s COPD is declining. We have a Nurse Practitioner, RN, and Social Worker who are an extra set of eyes and ears in the home to help manage symptoms and communicate with patient’s physician and/or specialist. Our Palliative Care team will visit in the patient’s home, cutting down on doctor and hospital visits.
If you or a loved one are in and out of the ER, hospital, or doctor’s office for exacerbation and can “bounce back” to their normal, this is your ideal palliative patient. This patient is having difficulty performing daily tasks, numerous hospitalizations in the last 6 months, and still wanting to seek treatment (and the treatment options are helping). This patient is needing help creating a care plan and needs more education on their disease. St. Anthony’s Palliative Care can help navigate the waters of COPD, all while receiving treatment.
Hospice Referral
When the patient’s condition declines and their physician expects they have 6 months left to live, the patient is eligible for the added benefits of hospice care. However, this does not mean the patient will only live for 6 months if on hospice care; only that the patient’s life expectancy is 6 months or less should the disease run its normal course.
Once admitted to hospice care, the patient is instantly surrounded by a team of experts who work together to care for the patient’s pain and symptoms and spiritual needs. Additionally, the patient and family receive much-needed emotional support.
If you or a loved one are in and out of the ER, hospital, or doctor’s office for exacerbation and are not able to “bounce back” to their normal, this is a hospice patient. These patients have dyspnea at rest, oxygen saturation ≤88% on room air, significant unintentional weight loss, and an overall decline. This patient is not responding to treatments, needs more education on their disease, and should the disease run it’s normal course, the patient has a life expectancy of 6 months or less.
More information about hospice eligibility can be found here.
More information about palliative eligibility can be found here.
If you have any questions or would like to learn more about St. Anthony’s Hospice or Palliative Care or make a referral, please contact us at (270) 826-2326 or make an online referral.
As we age, our skin loses elasticity, becomes thinner, and dries out. All of these make it easier to damage skin in the elderly through improper cleaning, pressure sores, and sweat; which can lead to sores and rashes.
When the elderly population has a reduction in mobility and spends the majority of their time in bed or sitting in a chair, it is very important for family caregivers to take the time to properly care for their older loved one’s skin.
Where to Check for Sores and Rashes in Elderly People
Rashes in elderly people can appear anywhere. Some of the most common areas to check include skin folds and the creases in armpits, elbows, knees, ankles, toes, and the groin area. If you see a rash, please contact your loved one’s medical provider.
Pressure sores/ulcers commonly occur in areas where a person connects with a piece of furniture he/she is laying or sitting on. The most common areas include the lower back, hit and buttock area, shoulders, back of their head and ears, elbows, inner knee, and heels.
Pressure sores/ulcers start out looking like a red or pink spot in the skin, but can progress to a wound that looks like the skin has been stripped away, even times they can go all the way to the bone underneath. As they form, the skin may be swollen, warmer, and can feel different than the surrounding skin (softer or firmer).
How to Prevent Pressure Sores and Skin Rashes in the Elderly
You can help to prevent pressure sores by carefully turning your loved one every two hours. Please turn your loved one with care to prevent skin tears or additional injuries. Ask your hospice nurse or aide to show you the proper way to turn a loved one! If you see signs of a pressure sore, please alert your medical provider or hospice nurse right away. They can properly advise treatment options.
To prevent rashes and other skin injuries, keep your loved one’s skin clean, moisturized, and dry.
When bathing a loved one, use a gentle soap without fragrance added. Wash their skin gently and pat them dry with a towel, instead of rubbing (which can cause more tears). Follow up with a gentle moisturizer. If their skin is extra dry, use a protective barrier cream like Aquaphor to help prevent tears and rashes.
Do not moisturize areas that are prone to excess moisture like skin folds and the groin area. Added moisture can cause rashes and infections. Rather, keep this area dry and use a powder to keep moisture at bay.
If your loved one is incontinent or has an accident, be sure to change them quickly into clean, dry clothes and briefs.
Another way to prevent rashes is to use a gentle and fragrance-free laundry detergent when washing clothes and bedsheets.
If you or a loved one is in need of hospice, palliative, or grief care, please call St. Anthony’s Hospice at (270) 826-2326 or make an online referral here.
The majority of people are so afraid of death that they are unprepared for their own death, and the deaths of loved ones. Most people don’t know how to even begin planning for the type of healthcare they would want when approaching the end of life. In addition, people don’t think about the financial and legal implications of their own end of life for loved ones, so many of the legal preparations are tossed to the side. Emotionally, it’s very difficult to prepare for the death of a loved one which can make grieving more difficult when the person passes.
So what can you do to help prepare for your death, or help a loved one prepare for theirs?
Talk about death and dying! As painful as this subject can be, simply having a conversation to learn a loved one’s wishes or have your loved ones learn yours. Once your wishes have been discussed with caregivers and loved ones, you can work to get the legal, financial, and healthcare documents in place to help make things a little easier for when you pass.
Hospice can help! St. Anthony’s Hospice has incredible Social Workers who can help patients get those documents in place, assist with funeral plans, and be sure your needs are met, from a psychosocial standpoint. Even in St. Anthony’s Palliative Care, we work to ensure your advance directives are in place and help with difficult conversations surrounding end of life between patients and their loved ones.
Check out this article from the Washington Post on “Are You Prepared to Die?…” This article details one man’s journey to death preparation through the COVID-19 pandemic.
Or if you have a shorter attention span, or just like videos, HospiceNurseJulie on TikTok does a phenomenal job explaining the different topics surrounding death & dying. Check out her profile here.
If you or a loved one is in need of hospice or palliative care, please call us at (270) 826-2326 or make an online referral.
Having a loved one who needs extra care can be difficult, especially when it comes to exploring all the options available. Whether for you or a loved one, you want to choose the right fit for the situation. One question you may be asking yourself is “what is the difference in hospice care and nursing home care?”
What is Hospice Care?
Hospice care is specialized care for individuals and their families living with a life-limiting illness. It treats the person, rather than the disease, and focuses on improving quality of life. Healthcare today focuses mainly on curing an illness. What if you were told there was nothing more that could be done? In hospice care, there is always more that can be done. Hospice care is compassionate. It focuses on comfort, dignity for the patient, and meaning. It’s not about counting the days you have left; it’s about making each day count.
St. Anthony’s Hospice manages symptoms and controls pain to give our patients the highest quality of life for however long they are with us. Ensuring each patient has the highest quality of life allows them to share more moments and memories with loved ones and allows them to say everything they need to say.
Care is provided wherever the patient calls home. This can be in their own home/apartment, an assisted living facility, the Lucy Smith King Care Center, or in a nursing home/skilled nursing facility. All medication, durable medical equipment, and medical supplies related to the patient’s primary diagnosis are covered under the Medicare/Medicaid hospice benefit and by most private insurances.
What is a Nursing Home or Skilled Nursing Facility?
A nursing home, or skilled nursing facility, is a residential facility that provides 24-hour care which includes meals, personal care, and medical care. It is often used as a place to recover from serious illness or surgery before returning home, for an individual who doesn’t need hospital care but cannot be cared for at home.
All nursing homes are different, so it is important to consider what all you desire for yourself or a loved one and do some research to find one that fits most of all of your needs. Some are set up more like a hospital, while others offer a more home-like feel. Medicare has a fantastic nursing home compare website where you can look at different nursing homes in your area and find the best fit for you. Check it out here.
In addition to online research of nursing homes, contact your top options and ask about the style of care, cost, and waiting list. Even better and if possible, ask to take a tour of the facility in advance and meet with the admissions director, director of nursing, or assistant director of nursing.
Hospice vs. Nursing Home
There are several notable differences in hospice care and nursing home care. First, nursing homes are physical places where care is provided while hospice is a type of healthcare than can be provided anywhere- including nursing homes. Much like a seriously ill patient at home, one in a nursing home also requires more care. The team at St. Anthony’s Hospice will bring their specialized end-of-life care to add to the care and support that the nursing home care is already providing.
Another difference is hospice care is covered 100% under Medicare, Medicaid, and some private insurances. While Medicare generally doesn’t cover long-term stays in a nursing home, depending on your/your loved one’s financial situation private pay is an option, in addition to Medicaid and long-term care insurance.
While there are several differences between hospice and nursing home care, families don’t necessarily have to choose between the two. If you or a loved one have a terminal illness and require the 24-hour care of a nursing home, hospice care can be added to that at no additional cost to the family.
If you or a loved one is in need of the extra care and support that hospice care can provide, please call us at (270) 826-2326 or fill out an online referral.
“We wish we had hospice sooner!”
“I didn’t realize hospice care was so much help, not only for dad but for us!”
When facing a serious illness, there may come a time when a cure is no longer attainable, or goals may change from curative to comfort. This is when hospice care can help. When hearing the word “hospice”, many associate this with dying or simply giving up. The goals of hospice care are to improve quality of life for however long the patient has and allows the patient to preserve their dignity and independence.
What are the benefits of hospice care for patients?
Hospice care is specialized care for individuals and their families living with a life-limiting illness. It treats the person, rather than the disease, and focuses on improving quality of life. Traditional healthcare today focuses mainly on curing an illness, while hospice care focuses on treating the person. What if you were told there was nothing more that could be done? In hospice care, there is always more that can be done! Hospice care is compassionate. It focuses on comfort, dignity for the patient, and meaning. It’s not about counting the days you have left; it’s about making each day count.
Hospice care is provided wherever the patient calls home. This can be in their house, apartment, assisted living facility, nursing home, or our inpatient unit, the Lucy Smith King Care Center. Caring for a patient in his/her home allows the patient to be comfortable, surrounded by loved ones and familiar sights, and keeps him/her out of the hospital.
Another benefit of hospice care is that each patient is assigned an interdisciplinary team to support the patient’s physical, emotional, and spiritual needs. This interdisciplinary team consists of nurses, aides, social workers, chaplains, volunteers, and the hospice medical director/patient’s primary care physician. They all work in conjunction to meet the patient’s needs and treat the patient, rather than his/her disease.
St. Anthony’s Hospice also takes the time to recognize those who have served our country. We do a Veteran’s Pinning Ceremony to honor the patient’s service to our country. Each ceremony is performed by one of our chaplains and volunteers who are also Veterans. This ceremony is part of caring for the whole patient, as well as thanking a Veteran and their family for the sacrifices he/she has made for our freedom.
What are the benefits of hospice care for families?
Patients are not the only ones facing a terminal illness. Family and caregivers face it alongside the patient. St. Anthony’s Hospice helps families provide excellent care for their loved one by providing professionals who recognize the signs of pain and unmanaged symptoms and provide the necessary medical care to care for their loved one, without an unneeded trip to the emergency room or hospital.
Hospice care is covered 100% under Medicare, Medicaid, and most private insurances.
Our nurses will fill pill planners, educate caregivers on how to administer medications, provide wound care, and educate on the disease process. Our aides will assist in bathing the patient, as well as any grooming or everyday needs the patient may have. Our chaplains and social workers will help you work through any stress or negative emotions you might have. Our social workers can even help with funeral arrangements and legal documents such as Powers of Attorney, Living Wills, Do Not Resuscitate orders, etc. We understand that caring for a seriously ill loved one is a full-time and extremely demanding job. That’s why we offer respite care! You can request a volunteer to come into the home and provide some respite for a couple hours, or request for your loved one to stay up to 5 days at the Lucy Smith King Care Center. Respite care is covered 100% under the patient’s Medicare hospice benefit. We also offer bereavement services that go on for 15 months after your loved one passes away. We do not abandon the family after your loved one passes.
We often hear how families wish they knew about the benefits of hospice care sooner. It’s never too early to call St. Anthony’s! If you would like to learn more or make a referral, please call us at (270) 826-2326 or make an online referral.
St. Anthony’s Hospice is fortunate to receive a very informative quarterly newsletter entitled “Quality of Life Matters.” This latest publication has an article titled “Seriously Ill Patients Want Most to be Heard and to Participate in Care Decisions, National Survey Finds” and we had to share it with you!
SERIOUSLY ILL PATIENTS WANT MOST TO BE HEARD AND TO PARTICIPATE IN CARE DECISIONS, NATIONAL SURVEY FINDS
“Patient-physician communication and collaboration were the two most important aspects of high-quality serious illness care identified by U.S. adults. Patients want to know they are listened to and understood, according to a survey and qualitative research conducted in 2021 and released in October by the Massachusetts Coalition for Serious Illness Care.
“People are telling us loud and clear what they want from the healthcare system: to be heard,” says Atul Gawande, MD, MPH, Coalition co-chair and surgeon at Brigham and Women’s Hospital, Boston.
However, patients with serious illness, racial/ethnic minorities, and people with lower income levels were more likely than their counterparts to feel their clinicians did not understand their priorities and to leave a medical visit feeling uncertain about the next steps in their care, the survey found.
In a multi-phase project aimed at improving care for people with serious illness and their families, Coalition researchers surveyed a nationally representative sample of 1,854 adults, with oversampling for Blacks, Hispanics, people with low income, and seriously ill or disabled people and their caregivers. Subsequently, researchers engaged with 580 adults from across the nation and aligned with the U.S. census in online community forums. Asian adults were also included in the survey, but the sample size was too small to support confident interpretation, the authors of the report note.
Overall:
Definition of quality care
Researchers found that the definition of quality care resonating the most among all participants was “Good quality care is collaborative with me.” Participants felt this included having clinicians who took time to learn about them so their healthcare would be the best possible fit.
For Black and Hispanic participants, the best definition was “Good quality care is kind, empathic, patient, non-judgmental, treating me (and everyone) as important and worthy of care.” This definition also ranked highly across all demographic groups.
From among a dozen theoretical clinician-conversation statements, forum participants in the qualitative research phase overwhelmingly selected “We’ll figure this out together” as being what mattered most for quality care. The top five statements that resonated as most important to them were:
Areas in need of improvement:
“Across all groups… a noticeable contingent had positive healthcare experiences that stemmed from doctors and staff showing empathy, kindness, competency, efficiency, good communication, attentive listening, and making the effort to understand the individual as a human being,” according to the authors of the report.
Most of the reported negative experiences were perceived by participants as due to a combination of clinicians’ discriminatory attitude, lack of empathy, poor communication and/or poor listening skills, and patients’ frustration with or anxiety about navigating the healthcare system. Patients also mentioned being hesitant to ask the cost of a treatment, for fear they would not receive the best care.
Speaking up was selected by participants across all groups as the most impactful action patients can take to improve their health and well-being. “As people age, they feel more prepared and willing to advocate for themselves,” states the report. “There is a sense of having more control and that they need to stand up for themselves and ask for what they need.”
Advance care planning
Despite the COVID-19 pandemic and nationwide attention on documenting care wishes, research shows that rates of advance care planning (ACP) completion nationwide decreased slightly from 2017 to 2021, notes the report. Discussions of serious illness between patients and family/ friends also fell slightly, while conversations with clinicians rose slightly. However, while 60% of Black and Hispanic adults in 2017 said they would want to talk to a physician about care wishes, only 40% in 2021 said they were willing to do so.
Informed by the Coalition’s 2020 messaging research project to understand how the public perceives terms used to describe ACP, the 2021 research focused on what was found to resonate most strongly with people: the “relational aspects of care, communication, and shared decision-making long before any serious illness diagnosis.”
Suggested improvement efforts include public engagement campaigns that empower and guide patients to speak up and share what matters most to them, and system-level programs or training for clinicians in trust-building: asking, listening, and ensuring patients feel heard and understood.
“There are many things we need to do differently to dismantle inequities in healthcare experiences,” says Gawande, who is also a professor at Harvard T.H. Chan School of Public Health and the founder and chair of Ariadne Labs in Boston. “These data are showing us that a clear place to start is investing in systematic approaches to improving the communication and connection that seriously ill patients and clinicians both want.”
The report, entitled “2020-2021 Public Experience Research Findings,” is available for download at no charge by visiting www.maseriouscare.org/research.”
This entire article was copied directly from the Quality of Life Matters issue Q2 2022 newsletter. St. Anthony’s Hospice did not write this article, we are only sharing for your information and benefit. We did bold some points that stood out the most to us.
Always remember to ask your provider for all of your options and what will give you the best quality of life! If you have a serious illness and are wanting help understanding the disease and managing symptoms, please call St. Anthony’s Hospice or Palliative Care at (270) 826-2326 or fill out our secure online referral form.
