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Common Myths About Hospice

March 23, 2021 Kellie Holloran Blog, Hospice, Myths

Choosing hospice care can be a difficult decision, especially with all the misconceptions surrounding the service. As a result, many who need quality pain and symptom control, as well as social and emotional care, do not take advantage of hospice care. St. Anthony’s Hospice wants you to have the facts so you can make the best decision for you and your loved one. There are so many myths that surround hospice care. We have listed a few as well as the facts that dispel these.

Myth: Families/patients must wait for their physician to suggest hospice care.
Fact: St. Anthony’s Hospice encourages all people to be advocates and explore all their healthcare choices. Anyone can call our office to refer a patient at (270) 826- 2326. We have a referral specialist standing by to answer all your questions and contact your physician for the referral orders, if appropriate.

Myth: Hospice should be called only in the last moments of life.
Fact: The earlier hospice is used, the more benefits patients and families get from the program! Pain and symptom management is more effective when delivered earlier in the disease process. Our number one complaint is that families wish they called St. Anthony’s sooner!

Myth: Hospice is only for the dying patient.
Fact: St. Anthony’s Hospice focuses on the grieving family as much as the patient. We have a team of professionals, including chaplains and social workers, who help with the bereavement process and a variety of other services that benefit the patient’s loved ones before and after their passing.

Myth: My doctor will no longer be my doctor if I become a hospice patient.
Fact: If he/she is willing, your doctor will remain your attending and will become part of the St. Anthony’s Hospice team in caring for you. Our St. Anthony’s staff physicians can also provide care if your doctor is unable to do so.

Myth: Hospice is only for cancer patients.
Fact: Any patient with an end-stage diagnosis can benefit from hospice. These examples include, but are not limited to: HIV/AIDS, end-stage kidney disease, congestive heart failure (CHF), Alzheimer’s/Dementia, cirrhosis, stroke/CVA, chronic obstructive pulmonary disease (COPD), septicemia (sepsis), and others.

Myth: Hospice is expensive.
Fact: Hospice is a benefit under Medicare part A; some private insurances and Medicaid will also cover services. In addition, durable medical equipment, disposable medical equipment, and prescriptions related to the life-limiting condition are covered under these benefits, easing the financial burden on the patients and their families. No person is turned away from St. Anthony’s Hospice due to inability to pay.

Myth: Hospice care is only provided in the patient’s house.
Fact: While many patients who live alone, or with family, receive care in their homes, hospice services are available wherever the patient calls “home.” This means services can be provided in the patient’s house, a nursing home, or assisted living facility. In addition, we also provide services at the Lucy Smith King Care Center, our hospice hospital.

Myth: Hospice is about dying.
Fact: Hospice is about quality of life! When pain and symptoms are managed properly, patients make the most of the time they have left. They are able to spend time with friends, family, and pets in the comfort of their own home while being in control of the care they are receiving. Choosing hospice does not mean the patient is giving up hope or that death is coming soon. Patients often live longer under hospice care since pain and symptoms are under control.

Myth: All hospices are the same.
Fact: While the federal regulations governing hospice programs require the same standard services, that does not mean they are all the same. St. Anthony’s Hospice has been serving the residents of Henderson, Union, and Webster counties since 1982. In 2016, we began our Palliative Care program for those who seek pain and symptom control, while still seeking curative treatments.

Myth: Hospice means I’m going to die soon.
Fact: Many studies have shown the exact opposite! With your symptoms under expert management, studies have shown you can live longer with hospice care (if you are enrolled early enough). Hospice does not hasten death nor does it prolong life. These studies have proven hospice effective in improving quality of life which can sometimes improve quantity of life, compared to those with the same illness but not receiving hospice care.

Myth: Once enrolled in hospice, you cannot get out except when you die.
Fact: You can decide to leave hospice care at any time to pursue aggressive treatments. On the other hand, we have patients who get better with the symptom management and “graduate” from hospice! If you decide to re-enroll in hospice care and still qualify, you can always come back.

Myth: Hospice takes away all medications.
Fact: Hospice care is all about managing symptoms, which we do with medications. This does not mean that hospice care over-medicates patients or removes all medicines. In some cases, we do de-prescribe to reduce the amount of medication the patient will be taking. This is used to reduce medicines with heavy side effects or ones that are simply not benefitting the patient or increasing their quality of life.

If you or a loved one is in need of hospice or palliative care, please call us at (270) 826-2326 or make a referral here.

End of Life Patients Reported Happier at Home

March 2, 2021 Kellie Holloran Blog, Caregivers, Hospice

By now you’ve seen all the times we’ve said “hospice and palliative care can help improve quality of life” or “hospice and palliative care helps keep patients where they want to be- home.” How many times have you read that and wondered “where’s some research to back this up?”

Well, this is your lucky day! A study by the National Health and Aging Trends Study found that “older adults’ preference for place of death should be a central component of advance care planning, and the receipt of hospice care may be a key to achieving that preference.”

According to the CDC, around 80% of people in the US state that they would prefer to die in their own homes. However, approximately 60% pass away in hospitals and 20% pass in skilled nursing facilities. Think about this, when you are close to the end of your life, where would you rather be? Personally, I want to be home in a familiar environment with my pets and family; free of the sound of machines beeping and the hustle and bustle of hospitals and nursing homes.

The above-mentioned study also found patients with cognitive impairments who elected the Hospice Benefit under Medicare were 14.5x more likely to die at home than in a hospital and 3.4x more likely to die at home than in a nursing home! Patients without cognitive impairments were 6x more likely to die at home as opposed to a hospital and more than twice as likely to die at home rather than a nursing home.

Also, families of patients who passed away at home reported higher satisfaction with their loved one’s care in the home, as opposed to a lower satisfaction with their care in a hospital. By the way, did you know that St. Anthony’s Hospice consistently above the national average of hospices when it comes to the care of our patients?

“’In recent years, there has been a growing awareness in end-of-life care research that place of death may be an indicator of quality care,’ according to the study. ‘Interest in this relationship was largely prompted by the [fi]nding that, while older adults prefer to die at home, the majority of older Americans die in hospitals or nursing homes.’” (quoted from article below).

Having end of life conversations are always difficult. Nobody wants to think about either a loved one dying or themselves passing away. However, if you have your plans in place for what your wishes are, including when you prefer to be when you pass away, things are easier for you and your loved ones. Likely you already contribute to a 401k, so why not set other future plans up?

Always remember with hospice care, there is always more to be done! More compassion. More quality of life. More time with your loved one where they are happiest- home. Hospice care treats the patient, rather than the disease. This means the patient’s quality of life is greatly improved and there is tremendous help for the caregiver. Hospice is about keeping the dignity of our patients, even after death. Hospice is support and help for the patient, caregiver, and family. Hospice is comfort for the patient in all definitions of the word.

If you or a loved one is in need of the care hospice or palliative care provides to keep you at home, please call us at (270) 826-2326 or make a referral here.

Source: https://hospicenews.com/2021/01/25/home-based-patients-report-higher-satisfaction-with-end-of-life-care/

Age-Related Macular Degeneration Awareness Month

February 19, 2021 Kellie Holloran Blog, Hospice, Palliative

In addition to February being Heart Disease Awareness Month, its also Age-Related Macular Degeneration (AMD) Awareness Month.

A very common condition, Age-Related Macular Degeneration (AMD) is the leading cause of vision loss in people age 50 and older. AMD is a disease of the eye that blurs the central, sharp vision needed for daily activities like reading, driving, and watching television. If you break down the name of the condition into its parts, “age-related” means it happens most often in older people, “macular” means it affects the macula of the eye, and “degeneration” means the deterioration and loss of function in cells of a tissue or organ.

Where is the “macula” of the eye?

AMD doesn’t cause complete blindness, rather it makes it difficult to do things that require close-up focus, like recognizing faces or cook. It happens rather slowly in some people. Even if you have early AMD, you may not lose your vision for a long time. For others, it progresses faster and can lead to vision loss in one or both eyes.

Symptoms of Age-Related Macular Degeneration
Blurry area near center of vision, which may get bigger over time, or you see blank spots. Some may notice straight lines that look wavy, this can be a warning sign of late onset AMD.

Risk Factors of Age-Related Macular Degeneration
Your risk of developing AMD increases as you get older. People 60+ are more likely to have it. Your risk also increases if:

You have a family history of AMD

You are Caucasian

You smoke

Please remember to get regular eye exams if you have any risk for developing AMD. Early AMD doesn’t have any symptoms, so don’t wait for your vision to blur!

How to lower your risk of developing AMD
Quit smoking, or don’t start

Exercise regularly

Maintain healthy blood pressure and cholesterol

Eat healthy foods- including leafy greens and fish

How does my doctor find if I have AMD?
A dilated eye exam! Your eye doctor will give you some eye drops to dilate, or widen, your pupil and check your eyes for AMD and other eye problems.

What’s the treatment?
Unfortunately, there is no treatment for AMD. Your eye doctor will keep track of how your eyes are doing via regular exams.

There are some dietary supplements that may be able to stop AMD from progressing.

For those with “wet” or neovascular AMD, there are some treatments that may help slow or even stop further vision loss. These treatments can include anti-VEGF drugs that are injected directly into the eye or photodynamic therapy (PDT) which is commonly referred to as laser therapy.

Always be sure to visit your eye doctor and primary care physician to get regular check ups! And if St. Anthony’s Hospice or Palliative care can benefit you, please call us at (270) 826-2326.

Source: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration

Why Choose Hospice Care?

February 18, 2021 Kellie Holloran Blog, Hospice

Family caregivers are most reluctant to choose, or even discuss hospice care. Nobody wants to think about losing a loved one; which makes the topic of “hospice care” so difficult to think or even talk about. Whether or not a loved one is enrolled in hospice care, his/her terminal illness will still progress. Choosing hospice care does not speed this up, rather it prolongs the patient’s quality of life. And hospice care is a benefit under Medicare, Medicaid, and some private insurances so why not take advantage of it?

Why hospice?

Nearing the end of life does not necessarily mean the patient is close to death. While hospice care is for patients with a life-limiting illness that should the illness run it’s normal course, the patient has a life expectancy of 6 months or less. A patient must meet hospice eligibility requirements set by the Centers for Medicare and Medicaid Services. You can see a list of general eligibility requirements here.

We’ve said it so many times, hospice does not hasten death! Rather, when a patient’s physical, psychological, spiritual, financial, and social symptoms are properly managed, a patient can live for much longer. If hospice care is started early in the disease process, a patient receives more benefits!

Beginning hospice care early in the terminal diagnosis, ensure all symptoms are expertly managed which improves quality of life and can even improve quantity of life. The patient receives care from nurses, aides, social workers, and chaplains in the location of their choosing. Many patients receive care in their own home or in an assisted living facility, skilled nursing facility, or the Lucy Smith King Care Center. Hospice care is considered to be the ideal model for the most compassionate, highest quality care for those nearing the end of life. It offers the services and support that most Americans want when facing a life-limiting illness.

Benefits of Hospice Care

When a physician tells you “there’s nothing more than can be done”, remember that with hospice care, there is always more to be done! In addition to the regular visits by our clinicians who are experts in pain and symptom management, prescription medications related to the patient’s primary diagnosis, durable medical equipment, and medical supplies needed to care for the patient, all at no cost!

Who pays for hospice?

Hospice care is a benefit under Medicare, Medicaid, and some private insurances!

Plus St. Anthony’s Hospice does not turn away patients based on inability to pay.

The most important thing to remember when deciding on hospice care for you or a loved one is you are choosing to do more. Hospice care is more care and more comfort which leads to more quality time with your loved ones. To refer yourself or a loved one to St. Anthony’s Hospice care, please call us at (270) 826-2326 or fill out our referral form here.

February is Heart Disease Awareness Month

February 5, 2021 Kellie Holloran Blog, Hospice, Palliative

We all have a special woman in our life- mom, grandma, great grandma, aunt, cousin, sister, wife, fiancée, girlfriend, daughter, step-daughter, friend, etc. We want them to be healthy, feel loved, and happy! February is Heart Disease Awareness Month and did you know that it accounts for approximately 1 in 5 deaths among women?

Let’s talk about this silent killer and ways you can help the women (and men) in your life reduce their chances of developing heart disease and some signs to look for.

The term “heart disease” refers to many types of heart conditions from heart attacks to coronary artery disease to heart failure.

Typically thought of as a disease that primarily affects men, almost as many women pass away from heart disease.

“Despite increases in awareness over the past decades, only about half (56%) of women recognize that heart disease is their number 1 killer.” -CDC

“Heart disease is the leading cause of death for women in the United States, killing 299,578 women in 2017—or about 1 in every 5 female deaths.” -CDC

Heart disease is also the leading cause of death for men in the United States, “killing 357,761 men in 2019—that’s about 1 in every 4 male deaths.” -CDC

Heart disease affects women of all races. It is the leading cause of death for African American and white women. It ties for top killer with cancer of American Indian and Alaska Native women. It’s the second killer of Hispanic and Asian or Pacific Islander women, right behind cancer.

Heart disease affects men of all races. It is the leading cause of death for men of most racial and ethnic groups in the US, including African Americans, whites, American Indians, Alaska Natives, and Hispanics. It is second to cancer for Asian American and Pacific Islander men.

What are some symptoms of heart disease?
Angina, which is dull and heavy or sharp chest pain, discomfort
Pain in the neck, jaw, or throat
Pain in the upper abdomen or back
Nausea
Vomiting
Fatigue
Sometimes symptoms can remain silent until you have a medical emergency. Here are the most common heart-related emergencies and some common symptoms.
Heart Attack: Chest pain/discomfort, upper back/neck pain, indigestion, heartburn, nausea/vomiting, extreme fatigue, upper body pain/discomfort, dizziness, shortness of breath, pain on the left side of the body
Arrhythmia: “fluttering” feelings in your chest, heart palpitations
Heart Failure: shortness of breath, fatigue, swelling of feet/ankles/legs/abdomen/neck veins
If you are experiencing any of these symptoms, please call 9-1-1 or go to your emergency room right away!

What are some risk factors of heart disease?
Hypertension
High cholesterol
Smoking
Diabetes
Overweight/Obesity
Unhealthy Diet
Physical Inactivity
Excessive alcohol consumption

How can I reduce my risk of heart disease?
Know and monitor your blood pressure
Get tested for pre-diabetes and diabetes
Stop smoking
Get your cholesterol and triglycerides checked
Make healthier food choices, and consume less junk food and fast food
Exercise
Limit alcohol consumption
Manage stress levels

If you or a loved one is exhibiting any signs of heart disease, please contact 9-1-1 or visit your emergency room ASAP! Please consult your physician for tests and more ways to reduce your risk of heart disease. As always, if you or a loved one is in need of hospice or palliative care, please call St. Anthony’s at (270) 826-2326.

Sources:
https://www.cdc.gov/heartdisease/women.htm?fbclid=IwAR37DjkfBy3o21q6-Re1EmdZuGsYlsZ6oakTZDCEq9bFE0vq8uVsih3aUjI
https://www.cdc.gov/heartdisease/men.htm

What exactly IS hospice care?

February 4, 2021 Kellie Holloran Blog, Hospice

By now, you’ve heard us say “hospice is help for the patient and family” and “hospice treats the 5 types of pain.” But have you thought to yourself, “what does that even mean?”

Read below and we will tell you more about it!

A hospice referral begins when a patient, family/friend, physician, case manager, nurse, whomever calls St. Anthony’s Hospice, right? Actually, the very beginning of a hospice referral is when a patient is diagnosed with a serious illness with a life expectancy of 6 months or less should the disease run its normal course. When you are diagnosed or you have gone through treatment and are told “there’s nothing more that can be done,” always remember with hospice care, there is always more that can be done! The official referral process begins with a call to (270) 826-2326 and an appointment will be set for one of our Admissions Nurses to come talk to the patient and family/caregiver to determine your goals of care and if hospice care is appropriate for you. If hospice care aligns with your goals and the patient is eligible, a few documents will be signed and you are now a patient of St. Anthony’s Hospice!

Once you are a patient, you have an interdisciplinary team that surrounds you and helps you develop a care plan and treat the 5 types of pain. Now here is where your questions can be answered.

Who makes up a hospice patient’s interdisciplinary team?
Your primary care physician and/or our St. Anthony’s Hospice medical director(s)
Hospice nurse
Hospice care aide/CNA
Social Worker
Our St. Anthony’s Hospice Nurse Practitioner
Hospice chaplain
Volunteers
Your normal caregiver

What are the 5 types of pain and how does St. Anthony’s treat them?
Physical: Physical pain is what you think of when you think of pain. This pain is managed by medication designed to control your pain and symptoms associated with your serious illness. Our nurses are expert in physical pain and symptom management; they work closely with your primary care physician, our medical director(s), and our nurse practitioner to ensure your physical pain and symptoms are properly controlled. Your nurse will visit at least once per week, but you have access to a nurse 24 hours per day, 7 days per week!

Spiritual: Our hospice Chaplains are available to give you spiritual support during this difficult time in your life. This does not mean they are there to force religion on you or “Bible beat” you. Rather, they are there to help patients have meaningful discussions about hope, forgiveness, and peace. Our chaplains also host bereavement support groups, open to anyone in the community, to help with grief once a loved one has passed.

Social: Many times a hospice patient is in need of interaction with a person other than his/her caregiver. Not only will the patient receive a volunteer to help the caregiver with short-term things like sitting with the patient while the caregiver runs some errands or takes some “me time” to unwind, the volunteer is there to do activities with the patient and to tend to some needs like making a snack! In addition to this volunteer, the patient will also have visits from his/her nurse, social worker, chaplain, and hospice care aide/CNA. These visits offer relief to the caregiver and companionship for the patient.

Financial: Healthcare costs can be scary. Fortunately, hospice care is a benefit under Medicare, Medicaid, and some private insurances! Yup, you read that right! In the hospice benefit, you receive an interdisciplinary team to help with your disease-related needs, durable medical equipment, medical supplies, and medication related to managing symptoms of the hospice diagnosis. And if the patient does not have health insurance? St. Anthony’s does not turn away a patient due to inability to pay!

Psychological: Every patient has a social worker to provide much-needed psychological pain. While social workers typically get a bad reputation, our social workers are there to assist patients and families with confusing insurance forms or other legal documents such as Powers of Attorney, Living Wills, etc. They also can assist with funeral plans and grief counseling, if needed.

So now you know how hospice care can help you or a loved one! If you have any additional questions or would like to refer a loved one to St. Anthony’s Hospice, please call us at (270) 826-2326 or fill out our referral form.

Photo Source: https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.senioradvice.com%2Fhospice&psig=AOvVaw0pPzoqgG-e9nBjm6cqtDPD&ust=1612551887481000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCOjcuIL20O4CFQAAAAAdAAAAABAD

End of Life Conversations with your Doctor

January 27, 2021 Kellie Holloran Blog, Hospice, Palliative

People generally enjoy talking to others about a variety of topics however, terminal illness and end of life care are not in those enjoyable topics.

But why don’t we normalize talking about these things?

Who should initiate conversations around end of life care and terminal illness?

The patient? Their family? Their physician?

Talking about a loved one’s wishes for end of life care should be a normal thing! Don’t you want to know the kind of care your loved one wants to receive? What if you were unable to speak for yourself? Would you want your loved ones to know the kind of care you desire to receive?

When discussing end of life care and/or terminal illnesses, a person should not depend on his/her physician to initiate these conversations. Talking about end of life decisions is really hard, but not talking about your end of life choices and expecting your physician and family to know is much more difficult.

So think about this, if 80% of people want to talk to their doctor about end of life care, if seriously ill, but only 7% of patients actually have these conversations with their physicians, what is happening?

This is where St. Anthony’s can help!

Start by thinking about these questions:
What is more important to you when faced with serious illness- quality of life or quantity of life?
Where do you want to be when you pass- in a hospital with cords, tubes, ventilation, etc. or at home with loved ones and pets in a familiar environment?
Do you have advance directives in place to help your loved ones if you are unable to make your own decisions?

If you choose quality of life and to be at home during your final months, weeks, or days, we can help! Whether you have advance directives in place or not, our hospice or palliative program can help you obtain optimal quality of life. If you do not have advance directives in place, we have social workers who can help you get those documents set up and understand what they are saying.

St. Anthony’s Hospice and Palliative Care programs are in place to help you! Not only do we help patients achieve optimal quality of life, but we also educate the patient and family on the disease progression and how to have those difficult conversations with family.

Don’t depend on someone else to initiate this conversation, start it yourself! If your or a loved one needs help with a serious illness and/or end of life care, please call us at (270) 826-2326.

Dying Wishes Matter

January 20, 2021 Kellie Holloran Blog, Hospice, Palliative

By now you’ve seen us say how hospice care helps the whole person, including their psychosocial health. This means that we honor your end of life wishes!

Need help with advance directives? We can help!
Need help with funeral plans? We can help!
Need help improving quality of life with a serious illness? That’s our specialty!

Having the end of life conversation with loved ones is never easy. However, studies have shown that having these conversations ensure you receive the kind of care you want when at the end of life. A living will or 5 Wishes can help loved ones know your wishes. Knowing where a loved one stands on whether or not they desire intubation, CPR, and if they have a designated healthcare proxy can all take a huge stressor off family when the end of a patient’s life is near.

St. Anthony’s Hospice can also help you have those difficult conversations with loved ones. Our clinicians know how to approach these sensitive topics and can answer any questions you or family members may have. We want everyone to be educated on his/her disease process and to receive exceptional care when traditional curative treatments are no longer attainable.

If you or a loved one is in need of the exceptional hospice or palliative care we provide, please call us at (270) 826-2326 or visit our online referral form.

Photo and article source: https://www.vitas.com/hospice-and-palliative-care-basics/end-of-life-care-planning/having-a-conversation-about-the-end-of-life/infographic-hospice-honors-your-end-of-life-wishes

Palliative Care and CHF

January 19, 2021 Kellie Holloran Blog, Palliative

Studies have shows that integrating a palliative care program with treatment for Congestive Heart Failure (CHF) can help the patient have a better quality of life, and in some cases even a longer quantity of life!

Palliative care focuses on improving quality of life through stress and symptom relief for patients with chronic illness. Palliative care is usually associated with cancer patients seeking chemotherapy and/or radiation but there is a growing number of patients utilizing palliative care with heart failure. Patients suffering from heart failure often suffer from symptoms like dyspnea, fatigue, pain, nausea, anxiety, and depression. All of these symptoms can lead to psychosocial issues for the patient and caregiver. In order for the heart failure patient’s palliative care treatment to be most effective, when the patient is diagnosed, he/she should be referred to palliative care.

Most people think palliative care is the same as hospice care, when it is not. St. Anthony’s Palliative Care is for when a person is still seeking curative, aggressive treatments. St. Anthony’s Hospice is when a cure is no longer attainable and the patient would like to focus on quality of life. If you or a loved one is in need of palliative or hospice care, please call us at (270) 826-2326.

Source for information: https://www.acc.org/latest-in-cardiology/articles/2016/02/11/08/02/palliative-care-for-patients-with-heart-failure

Photo Source: https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Farticle%2Fpii%2FS0735109717393439&psig=AOvVaw3FGEIVQkbgBTmIBYxVo5c-&ust=1611102993248000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCIiD8Kbgpu4CFQAAAAAdAAAAABAD

How do you feel about Getting Old?

January 15, 2021 Kellie Holloran Blog, Hospice, Palliative

Hospice and palliative care are centered around maintaining a patient’s independence and dying with dignity. But what about aging?

When does a person need to begin thinking about their healthcare options?
When they are diagnosed with a terminal illness?
When they are actively dying?
Or when they are younger, either newly or not yet diagnosed, and can make choices for his/herself to ensure he/she gets what he/she wants out of life?
hint, if you said the last one, you are right!

Nobody wants to think about the possibility of getting sick or getting older, but everyone should begin planning for their future healthcare. Most people already contribute to a 401K, so why put off other future plans?

Once a patient is enrolled in palliative or hospice care, St. Anthony’s social workers can help patients with their advanced directives. We have an amazing team of social workers who can make legal documents easier to understand and help with funeral plans. Just another way St. Anthony’s Hospice helps to ease the psychosocial pain associated with illnesses!

Call us today to see how we can help you age gracefully, (270) 826-2326.

Photo source on picture.

Common Myths About Hospice

End of Life Patients Reported Happier at Home

Age-Related Macular Degeneration Awareness Month

Why Choose Hospice Care?

February is Heart Disease Awareness Month

What exactly IS hospice care?

End of Life Conversations with your Doctor

Dying Wishes Matter

Palliative Care and CHF

How do you feel about Getting Old?

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How do you feel about Getting Old?