Hospice

Definition of Hospice

June 14, 2021 Kellie Holloran Blog, Hospice

“Hospice is a comprehensive, holistic program of care and support for terminally ill patients and their families. Hospice care changes the focus to comfort care (palliative care) for pain relief and symptom management instead of care to cure the patient’s illness.” CMS definition (source) here.

Merriam-Webster defines hospice as “a program designed to provide palliative care and emotional support to the terminally ill in a home or homelike setting so that quality of life is maintained and family members may be active participants in care.”

Whichever definition you choose to describe hospice care, it all means the same thing- holistic help for the patient and family. At St. Anthony’s Hospice, our definition includes all of the above plus 15 months of bereavement care once the patient passes away. And our bereavement services are not only for family/caregivers of St. Anthony’s patients. Anyone in our community can engage in bereavement counseling and support groups to help get through the tough time after a loss. If you are interested in bereavement services, please call Thomas Emerson, Bereavement Counselor, at (270) 826-2326.

As far as the medical side to St. Anthony’s Hospice care, a specialized interdisciplinary team consisting of a medical director, nurse practitioner, nurse, chaplain, social worker, aide, and volunteer surrounds the patient and their family to ensure all needs are being met. This team works to manage the 5 types of pain- physical, spiritual, social, financial, and psychological, so the patient and family are receiving superb care to increase quality of life. Each member of the patient’s care team is expertly trained to meet all needs of the patient. Your care team assists with pain and symptom control, medication management, bathing, companionship, wound care, and so much more. In addition to the expert care, patients on hospice receive durable medical equipment, medical supplies, and medications related to their terminal diagnosis at no cost to them.

To give you a more in-depth picture of what the care team will do, keep reading! 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.

Hospice care does not mean you are giving up on your loved one or even giving up on yourself, it is help for all! We want the patient to be comfortable and we want the family to be involved in their care and be comfortable in doing so.

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.

Myth: Hospice Hastens Death

June 7, 2021 Kellie Holloran Blog, Hospice, Myths

“Hospice hastens death” or “Hospice rushes death”.

This myth could not be farther from the truth! While the main purpose of hospice care is neither to prolong life nor hasten death, it does greatly improve quality of life. Studies have shown that hospice care can increase patients’ survival for certain diagnoses, when began early enough in the disease process. This means that when the patient receives optimal symptom management early enough to improve quality of life, this can also increase their quantity of life. Some studies that prove this can be found here and here.

Hospice care encompasses palliative care, which the CMS webpage defines as “patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing, physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information, and choice.” Traditional healthcare treats the illness, rather than the patient. When traditional healthcare can no longer treat an illness and the provider and/or patient decide nothing more can be done, it is time to begin treating the person and improving his/her quality of life.

Having your physical, psychological, social, emotional, and spiritual care properly managed allows the patient to live their best life for however long he/she has. Oh, and did you know not every hospice patient passes away?? Some patients improve so much they actually don’t qualify for hospice care anymore and get discharged. And for cancer patients, you can even refer to hospice care to manage the side effects of chemotherapy, once completed. Having all types of pain properly managed can help the patient regain strength in order to discharge from hospice care and seek more aggressive treatments.

If you or a loved one has been diagnosed with a serious illness and would like symptom management, please call St. Anthony’s Hospice or Palliative Care at (270) 826-2326 or make an online referral.

Palliative and Hospice Care Interdisciplinary Team

May 19, 2021 Kellie Holloran Blog, Hospice, Palliative

Hospice care treats the 5 types of pain- physical, psychological, financial, spiritual, and social- through an interdisciplinary team approach. St. Anthony’s Hospice knows pain! We surround each hospice and palliative patient with a team of experts who work together to develop a personalized care plan for each patient’s need.

Our palliative interdisciplinary team consists of a nurse practitioner, registered nurse, and social worker. This team ensures the patient’s needs are being met and provides medical, emotional, and social support the patient requires. Our patient’s goals are our goals! We work with our patient, their provider(s), and their specialist(s) to develop a care plan to provide relief of the symptoms and stresses that the patient may face; we do not take the place of the patient’s physician(s). Additionally, we provide education to help our patients understand their disease process and treatment options.

Our hospice interdisciplinary team consists of our medical directors (physicians), nurse practitioner, nurses, nurse aides, social workers, chaplains, and volunteers. Also, a patient can keep his/her own physician, should their physician choose to remain a part of the care team. Each member of the patient’s care team is expertly trained to meet all needs of the patient. Your care team assists with pain and symptom control, medication management, bathing, companionship, wound care, and so much more.

Our hospice 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. These are only a small bit of the benefits of the interdisciplinary team!

The longer the patient is in hospice or palliative care, the more the patient will benefit from the interdisciplinary team approach. The patient will be comfortable on all 5 levels and he/she will maintain their dignity and independence for as long as possible.

Hospice care does not mean you are giving up on your loved one. It is extra help to ensure your loved one is comfortable and both you and your loved one have all the help and support you need.

If you or a loved one could benefit from St. Anthony’s expert hospice or palliative care, call us today at (270) 826-2326 or make an online referral, and see how we can help you! Anyone can refer someone to hospice or palliative care, just make the call and we will help you with the rest.

Grief

May 19, 2021 Kellie Holloran Bereavement, Blog, Hospice

Grief comes in all shapes, sizes, feelings, etc. No two people grieve the same, and it’s a very tricky subject to maneuver around.

When a loved one passes away, it often feels as though your whole world collapses. You turn to others for a kind word and they think they are helping, but sometimes their words may get twisted in a way that sounds hurtful; but you know their intentions are good.

If you search online for the “stages of grief” you’ll see the commonly referred to “7 Stages of Grief” nicely listed out.

Shock and denial.
Pain and guilt.
Anger and bargaining.
Depression.
The upward turn.
Reconstruction and working through.
Acceptance and hope.

There are other websites out there that list the 5, 7, or 12 stages out, but we will stick to the 7 stages since they are commonly heard.

With there being 7 “stages”, it appears as though each person experiencing grief will move through these quickly and easily with no chance of backsliding. This is often not the case.

As you can see, some people can get to any stage and either jump forward a stage or two, or even back all the way back down to stage 1. Grief is a healthy way to express your emotions after a traumatic loss, no matter the pattern you take to heal.

Luckily, St. Anthony’s Hospice offers bereavement counseling and support groups to help you through it. And it’s free and open to everyone in the community- not only families of St. Anthony’s patients! Please give us a call at (270) 826-2326 or visit our website here to learn more. In addition, we have some Helpful Bereavement Links on our website.

Hospice Demystified

May 11, 2021 Kellie Holloran Blog, Caregivers, Hospice

One of the most common questions we hear is “did we call you to soon?” No! The sooner after a serious illness diagnosis you call St. Anthony’s Hospice, the more help you get and the better your quality of life will be.

Unlike previously thought, hospice care is not only for the final days or hours, rather hospice is for months of care. Once a patient is diagnosed with an illness that should it run its normal course, has a life expectancy of 6 months or less, let us come evaluate. Hospice care is not a death sentence, rather it is about quality of life no matter the amount of life someone has left. Oh and did you know if enrolled in hospice care sooner, studies have shown that patients can live longer?

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.

While receiving hospice care, patients receive regular visits from members of their care team. Their care team consists of nurses, aides, chaplains, social workers, and volunteers. A patient can keep his/her own physician, should their physician choose to remain a part of the care team. St. Anthony’s Hospice has a full-time Nurse Practitioner on staff, in addition to our Medical Directors. Each member of the patient’s care team is expertly trained to meet all needs of the patient. Your care team assists with pain and symptom control, medication management, bathing, companionship, wound care, and so much more.

In addition to the expert care, patients on hospice receive durable medical equipment, medical supplies, and medications related to their terminal diagnosis at no cost to them.

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.

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 does not mean you are giving up on your loved one. It is extra help to ensure your loved one is comfortable and both you and your loved one have all the help and support you need. If you would like to refer yourself or a loved one to St. Anthony’s Hospice, please call us at (270) 826-2326 or make an online referral.

Liver Disease and Failure

May 7, 2021 Kellie Holloran Blog, Hospice, Palliative

The liver is an organ in the body that is essential for detoxing the blood, production of bile, certain proteins for blood plasma, cholesterol to help carry fats through the body, regulating blood clotting, and many others. It is the largest solid organ (2nd largest in the body, to the skin) and located in the right upper quadrant of the abdomen, under the ribcage.

Liver failure and liver disease are two different things. Liver disease refers to any condition that causes inflammation and/or damage to your liver. Liver disease affects the overall function of the liver. Liver failure is when your liver has lost some to all of its functionality. Liver failure often occurs from the damage caused by liver disease.

One amazing fact about this organ is that it can repair and even regenerate itself, if the damage is caught early enough! Many people with liver disease do not look or feel sick, even though their liver is becoming damaged. At a certain point, the liver damage becomes irreversible and can lead to liver failure, cancer, or death.

Common Causes of Liver Disease

Viruses, such as Hepatitis A, B
Genetics
Certain autoimmune diseases
Excessive alcohol consumption
Poor diet/obesity
Reactions or overuse of certain medications, street drugs, or other chemicals, such as acetaminophen, certain antibiotics, or certain herbal supplements

Symptoms of Acute Liver Failure

Feeling unwell
Fatigue
Nausea or vomiting
Abdominal pain and/or swelling
Jaundice- yellowing of the skin and eyes
Confusion or disorientation

Symptoms of Chronic Liver Failure

Early symptoms

Fatigue
Appetite loss
Nausea or vomiting
Abdominal discomfort and/or pain

Advanced symptoms

Jaundice
Easily bruised or bleeding
Confusion or disorientation
Edema, buildup of fluid in abdomen, arms, or legs
Dark urine
Severe skin itching

Stages of Liver Failure

Damage from liver failure can occur in several stages. Each stage increasingly affects the liver’s ability to function. Just like we previously said, “Liver failure is when your liver has lost some to all of its functionality. Liver failure often occurs from the damage caused by liver disease.”

Inflammation
In the early stages of liver failure, inflammation occurs. This means your liver becomes enlarged and/or inflamed (“a localized physical condition in which part of the body becomes reddened, swollen, hot, and often painful, especially as a reaction to injury or infection”). Many people with inflammation don’t experience symptoms. However, if the inflammation continues, permanent damage occurs. Inflammation can be hard to detect since there are usually no symptoms.

Fibrosis
If no treatment is sought when you are diagnosed with liver inflammation, the liver may begin to scar over. Excessive buildup of scar tissue on the liver is called liver fibrosis. If left untreated over time, the excess scar tissue replaces the healthy, normal liver tissue. As scar tissue replaces normal tissue, this greatly impacts the function of the liver. The buildup of scar tissue can even reduce or stop blood flow through the river. Fibrosis can be difficult to detect because of the lack of symptoms. If a patient with liver fibrosis seeks medical attention and treatment, there is a possibility the liver can heal.

Cirrhosis
Cirrhosis is a late-stage scarring of the liver. This late-stage fibrosis can be caused by excessive alcohol consumption or certain conditions/diseases. Many people begin to notice symptoms once cirrhosis has began. Without treatment, it can worsen and damage can be irreversible. As a result, the liver may stop properly working or may stop functioning at all. Treatment may be able to stop or delay liver damage, you cannot reverse damage caused by cirrhosis.

End-Stage Liver Disease
When a person reaches end-stage liver disease (ESLD), the liver’s function has deteriorated so much that the person requires a liver transplant. Some physicians may refer to this as chronic liver failure. With ESLD, some people may develop ascites (the accumulation of fluid in the abdominal cavity which causes abdominal swelling) and the development of ascites has an average life expectancy of 6 months or less , if it doesn’t respond to treatment.

Palliative and Hospice care can greatly benefit those with liver disease and/or failure. Both work to improve quality of life however with hospice care, the patient is no longer seeking curative treatment and/or a liver transplant. Call St. Anthony’s Hospice or Palliative Care at (270) 826-2326 or make an online referral to see how either program can benefit you or a loved one.

Sources found here, here, and here. Definitions linked on term above. Photo sources here and here.

The death I would prefer is…

May 4, 2021 Kellie Holloran Blog, Hospice

Comfortable?
Easy?
Fast?
Painless?
At home?
In a hospital/facility?
Surrounded by loved ones?
Alone?
Cuddled up with your pet?
Hooked up to tubes and wires?
Free from tubes and wires?

The reality is everyone will eventually pass away. You can run from it as long as you want, but it eventually catches up with all of us. Fill in the blank with your answer and talk about what you want with your loved ones!

With St. Anthony’s Hospice care, we strive to provide exceptional end of life care that helps our patients keep their dignity even past death. Hospice care is not about death, it is about how you live! We want the caregiver and family to be involved in patient care and keep the patient where he/she wants to be- home. Hospice care is not a place, it is a philosophy of care. It treats the person, rather than the disease and manages the 5 types of pain- physical, emotional, psychological, financial, and spiritual. 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.

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.

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 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.

Hospice care does not mean you are giving up on your loved one. It is extra help to ensure your loved one is comfortable and both you and your loved one have all the help and support you need. With St. Anthony’s Hospice care, we believe the end of life is as precious and fragile as the beginning. Call us at (270) 826-2326 or make an online referral to see how hospice care can benefit you or a loved one.

Photo is from Instagram. The account is on the photo.

The Stress of Family Caregiving

April 27, 2021 Kellie Holloran Blog, Caregivers, Hospice

Picture this.
You work full-time. You are caring for your spouse and children, cooking, cleaning house, taking kids to practice, etc. Now one of your elder family members gets diagnosed with a terminal illness and you step up to provide their care after work and on weekends. What free time do you have to do things that relax you?

Focusing on caring for a loved one is a great thing! It shows your loved one how much you love them and want to help them out when he/she needs it most. We actually have some tips on our Caregiver Corner page on our website. At the end of the webpage, there is a link to a booklet with helpful tips.

Family caregivers are incredible, yet they tend to neglect themselves. St. Anthony’s Hospice can help! When you have a loved one diagnosed with a terminal illness, you are doing everything you can to keep them safe and home. With hospice care, you have nurses, aides, chaplains, a nurse practitioner, and social workers who come to the home to ensure your loved one is taken care of, comfortable, and where they want to be. Read all about the benefits of hospice care here.

Also included in the hospice benefit is the Lucy Smith King Care Center. If you are caring for a loved one and going to a vacation, graduation, any other event, or just need a break, the hospice patient can transfer to the Care Center for up to 5 days of respite care. This gives you some time to tend to yourself and your household, without worrying about your loved one. He/she will stay at the Lucy Smith King Care Center and receive around-the-clock care from our expert staff. Also, we have volunteers who can come to the home and sit with your loved one and chat or do activities while you run some errands!

Taking care of a loved one shouldn’t mean neglecting yourself. With your loved one under St. Anthony’s Hospice care, our goal is to keep you as involved in the care of your loved one as you want to be. Hospice care does not come in and take over everything; rather we support family caregivers by providing extra help to the patient and the caregiver. Call us today at (270) 826-2326 or make an online referral here.

Stages of Heart Failure

April 21, 2021 Kellie Holloran Blog, Hospice, Palliative

Heart failure, sometimes known as congestive heart failure or CHF, is a chronic condition in which the heart doesn’t pump blood as well as it should. It can occur if the heart cannot pump blood or fill the chambers adequately. Certain conditions such as coronary artery disease or hypertension, will gradually leave your heart too weak or stiff to fill and pump as it should.

Not all cardiac conditions that lead to heart failure can be reversed. However, some treatments can improve the signs and symptoms of heart failure, which will help you live longer. Some lifestyle changes like regular exercise, reducing sodium in your diet, managing stress, and maintaining a healthy weight can improve heart health and quality of life. One way to prevent heart failure is to prevent and control conditions that directly lead to heart failure. These conditions include but are not limited to coronary artery disease, hypertension, diabetes, or obesity.

Symptoms of Heart Failure

You should see your doctor or call 9-1-1 if you think you are experiencing a heart attack. Please see your doctor to be checked for heart failure if you experience any of the following symptoms.

Shortness of breath, aka dyspnea, when exercising or lying down
Fatigue
Weakness
Swelling (aka edema) in your legs, ankle, and feet
Rapid/irregular heartbeat
Reduced ability to exercise
Persistent cough or wheeze with white or pink colored phlegm
Increase in urination at night
Abdominal swelling (ascites)
Rapid weight gain due to fluid retention
Lack of appetite
Nausea
Difficulty concentrating/decreased alertness
Sudden, severe shortness of breath and coughing up pink, foamy mucus
Chest pain, if your heart failure is caused by a heart attack

Stages of Heart Failure

There are four stages of heart failure 1, 2, 3, or 4. As heart failure progresses through the stages, a person’s survival rate for 5+ years decreases.

Stage 1
Those in stage 1 do not yet have issues with the pumping function of their heart. However, they do have a high risk of developing heart failure due to presence of related conditions like those listed above. People in stage 1 don’t have issues with the structure of their heart or how their heart works. It is rare to experience symptoms in this stage of heart failure. But a person may have symptoms related to other cardiac conditions.

Stage 2
Those in stage 2 of heart failure begin to have a reduced pumping function from the heart. This can lead to an enlarged left ventricle. The left ventricle pumps the blood rich in oxygen through the aortic valve and into the rest of the body. This area builds up while trying to overcompensate for the reduction in pumping function. An enlarged left ventricle can also result from previous heart attack(s). Some people in stage 2 remain asymptomatic.

Stage 3
In stage 3, people will begin to show some of the symptoms above. Most are currently undergoing treatment either before or during stage 3. The symptoms usually appear in this stage due to problems with the pumping chamber of the heart (or left ventricle). The patient may benefit from a referral to palliative care for enhanced symptom management.

Stage 4
People in stage 4 have advanced heart failure and exhibit symptoms even when at rest. This stage is severe and may require advanced, specialized treatment or hospice care, depending on the patient’s treatment plan.

Check out our previous post on how palliative care can benefit patients with heart failure here.

If you or a loved one is in need of St. Anthony’s Palliative or Hospice Care, please call us at (270) 826-2326 or make an online referral.

Sources found here and here.

End of Life Nutrition

April 20, 2021 Kellie Holloran Blog, Caregivers, Hospice

Many physical changes take place to patients at the end of their life, one of the most noticeable is the lack of nutrition the patient requires. When someone is in the process of dying, he/she does not consume food or drink how he/she used to, or even at all. This is completely natural. Sometimes nothing sounds or tastes good, and sometimes the patient has cravings for certain foods. This is often one of the hardest symptoms for caregivers to accept since food is how we nourish the body and spend time with loved ones.

As the body slows down, it can no longer digest and process food the same way as it used to. Expect your loved one to lose weight as this happens. This does not mean the patient is hungry or being “starved” as they refuse nutrition.

Don’t waste your precious moments fighting with your loved one about food and drink; spend those precious moments with him/her! Let the patient guide you on their wishes. He/she will let you know when he/she is hungry or thirsty and if anything specific sounds good. Liquids are often preferred to solids. Sometimes these liquids need to be thickened to prevent aspiration. Small ice chips or frozen fruit juice or cut up popsicles may be refreshing! If the patient is able to swallow, small amounts of fluids given via syringe (without the needle) may be useful.

Sometimes the taste or smell of a familiar food, in small amounts, is comforting. If the patient loved pizza from a specific place, order it! If the patient wishes to have a bite, they may say so. If not, the smell alone will comfort them.

If the patient does not wish to eat, they will tell you if they can still speak. If the patient is no longer able to speak, they may cough, bite the utensil, clamp their mouth closed, turn their head away, or spit the food out to let you know they do not want to eat. Respect your loved one’s wishes and don’t force them to eat or drink. Forcing food and drink to them is not going to prolong their life; it will just cause unnecessary arguments and take away minutes or hours from time you would otherwise enjoy! Also, a patient may appear thirsty when close to death but they are unable to drink. In this situation, you will want to provide oral care to keep the mouth dampened and clean. Remember to shower your loved one with love and respect their wishes and enjoy your time with them.

If you have any questions about end of life care or know someone who might benefit from hospice services, please call St. Anthony’s Hospice at (270) 826-2326 or make an online referral.

Definition of Hospice

Myth: Hospice Hastens Death

Palliative and Hospice Care Interdisciplinary Team

Grief

Hospice Demystified

Liver Disease and Failure

The death I would prefer is…

The Stress of Family Caregiving

Stages of Heart Failure

End of Life Nutrition

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End of Life Nutrition