Hospice

Childhood Cancer Awareness Month

September 15, 2020 Kellie Holloran Bereavement, Blog, Hospice, Palliative

September is a month of many things- the unofficial and official start of fall, back to school month, a super fun song by Earth, Wind & Fire, and the official month of the Virgo. Most importantly, its Childhood Cancer Awareness Month.

Childhood cancer is the leading cause of death by disease for children under age 14, according to St. Jude’s website. We all know of a child or family that has been directly impacted by this horrible disease.

We’ve put together some facts about childhood cancer to help raise awareness.

The awareness ribbon for childhood cancer is gold.

43 children in the US are diagnosed with cancer every day.

Around the world, at least 300,000 children and teens are diagnosed with cancer every year. That is over 800 children and teens diagnosed daily.

It is estimated that 10% of children with cancer developed it due to a genetic mutation.

Childhood cancer survivors are twice as likely to suffer from chronic health conditions into adulthood.

1 in 285 children will be diagnosed with cancer by the age of 20.

Childhood cancer research only receives 4% of the budget from the National Cancer Institute.

(facts sourced from- https://www.alexslemonade.org/childhood-cancer/about-childhood-cancer/facts and https://www.stjude.org)

Children with cancer can receive concurrent care, which is aggressive treatment along with palliative care. This type of care ensures the child is kept comfortable while fighting their cancer.

If you or someone you know needs extra help in symptom management, please give us a call at (270) 826-2326.

Pain Management Awareness Month

September 14, 2020 Kellie Holloran Blog, Hospice, Myths, Palliative

The month of September is Pain Management Awareness Month! It was first declared this in 2001 when the American Chronic Pain Association (ACPA) led a partnership of groups to establish such.

Pain management is one of the primary goals of hospice care- keeping patients comfortable and managing symptoms to ensure the highest quality of life for as long as they may live. Not all patients experience pain near the end of life but treating pain and other symptoms effectively is crucial. The hospice care team continues to evaluate the patient’s pain at every visit. They use pain rating scales as well as monitoring the nonverbal signs of pain.

How Pain is Determined

How many times have you been to the doctor or hospital where he/she asks you “on a scale of 1-10, what your pain level?” This is a common and universal communication tool in healthcare. It allows patients to rate their pain or point to one of the faces to help the clinician understand the patient’s pain level and better manage it. Below is an example of the commonly used/seen pain scale chart. The chart ranges from no pain whatsoever to the worst pain possible.

Image from Google image search- “pain scale”

If there is a nonverbal patient, hospice clinicians can look at how a patient is acting to assess pain level. For example, a nonresponsive or sleeping patient may grimace, his/her chin may quiver, jaw may be clenched, he/she may be kicking their legs or tensing them up, he/she could squirm, moan or whimper or cry, or he/she could be difficult to comfort or be extremely distracted. St. Anthony’s Hospice wants all patients to be comfortable and have the highest quality of life in a patient’s final months, weeks, days, hours, and minutes.

Pain signs for Caregivers

When caring for a loved one who has been diagnosed with a serious illness, the caregiver must know what to look for. Here are some signs to look for:

Increased breathing rate
Tightly closed eyes or rapid blinking
An increase in the patient’s systolic blood pressure from their baseline
Holding arm or leg muscles tightly or a rigid body posture
Rocking, fidgeting, or pacing
Resisting care or guarding certain areas of the body when turning
Becoming withdrawn
Becoming more aggressive or easily angered
Crying
Increased confusion
Vocalizations such as moaning, calling out, sighing, and asking for help.

Pain Management Misconceptions

One common misconception about hospice care is that hospice clinicians medicate the patient so much that he/she is constantly sleeping or “out of it.” While hospice care does involve medication to keep the patient comfortable, that’s just it. We want the patient to be comfortable and pain-free and still able to interact with loved ones, if the patient still can. Hospice care utilizes opioids to ensure the patient is pain-free. Hospice nurses educate the caregiver on how to administer the medication to the patient. All hospice patients and caregivers are informed of and sign our opioid medication protocol. Opioid addiction is not a concern at the end of life; often there is not enough time to develop an addiction in 6 months or less. Addiction for the patient should not be a concern, rather using the effective tools is more important. Controlled substances do not hasten death. Studies have proven the opposite! These medications do not prolong life however if a patient’s symptoms are properly managed, quality of life increases thus increasing quantity of life!

Emotional, Spiritual, and Social Pain

We’ve often said that hospice care treats all types of pain. But what does this mean? Physical pain is what we most often think of when we think of pain. Emotional, spiritual, and social types of pain are huge players in increasing quality of life. Emotional pain, like anxiety or depression, can increase a person’s physical pain and vice versa. Emotional pain is treated both with medications such as Ativan, and regular visits from the patient’s social worker and chaplain, who also works to treat the patient’s spiritual pain. Social pain is eased by interacting with people other than the primary caregiver. Social pain is especially important to treat during the COVID-19 pandemic. St. Anthony’s Hospice is taking precautions to ensure our patients and staff are staying negative.

Family members and caregivers should be careful to not add to the patient’s stress and anxiety by arguing with or in front of the patient.

What if I have a loved one who is experiencing a lot of pain?

If you or a loved one needs pain managed due to a serious illness, give St. Anthony’s a call- (270) 826-2326. Our clinicians work hard to ensure our patients have the best quality of life by controlling all types of pain.

Saying Goodbye on the Phone

September 9, 2020 Kellie Holloran Bereavement, Blog, Hospice

In an ideal world, family and loved ones would pass away quietly, in their sleep. They would be surrounded by loved ones and comfortable until the end. Sometimes with visitor restrictions or social distancing, we must tell loved ones “goodbye” over the phone or FaceTime.

This is the farthest thing from ideal. Many hospitals, nursing facilities, assisted living facilities, etc. try to accommodate family members who cannot be in the room when a loved one is imminent. Staff members will hold a phone up to the patient’s ear, use speakerphone, or turn on FaceTime to allow loved ones to say goodbye when they cannot be in the room.

How to Say Goodbye Over the Phone

Stay focused. Focus on your loved one and your relationship with him/her. Block out others in the room and talk specifically to your loved one.

Share the phone. If more people are needing to say goodbye, be sure everyone gets the amount of time they need. Allow others to have their moment.

“I love you” goes a long way. Three words pack a ton of meaning and emotion into them. Don’t hold back, say them as much as you want.

Thank them. It’s likely you’re on the phone because the person had a deep influence on your life. When you say thank you to them, you are letting them know how much of an influence they had on your life. Thank them for the love they have showed you or things they taught you.

Ask for forgiveness. Relationships are hard. We can hurt someone we love in large or small ways. Don’t dwell on the small things. However if something is weighing on you, be sure to apologize for it. Just keep in mind your loved one may respond positively, negatively, or not at all. Take ownership of your faults and know you did what you could to right the wrong(s).

Forgive. Your loved one may ask you for forgiveness for any pain they may have caused. They may not be able to speak due to advance in their state. Regardless of words or actions, you can tell your loved one that you forgive them and free yourself from carrying that burden for the rest of your life.

Relive memories. If you have time to move outside of the love, thankfulness, and forgiveness to relive some memories you two share. Talk about special holidays, trips you’ve taken together, favorite recipes, weddings, or outings you took together Laugh about inside jokes and particular memories. If you’re not alone on the phone, allow others to join in and share memories you all share together. It’s always important to surround your loved one with love and laughter, even in their final moments.

Last conversations are never easy, but they are something you take with you for the rest of your life. It’s always harder when you can’t be with your loved one in the end and you have to have your final conversation over the phone or FaceTime. Just reminding your loved one how much they mean to you, how loved they are, and that they will always be remembered in your heart goes the longest way.

If you or a loved one is in need of hospice, palliative, or bereavement care, please contact us at (270) 826-2326 to learn more.

Advance Care Planning

September 4, 2020 Kellie Holloran Bereavement, Blog, Hospice, Palliative

Having your wishes heard and honored is always important, especially during a pandemic. Advance care planning is making decisions about the care you wish to receive, if you become unable to speak for yourself. These decisions are usually in writing and provided to family and your healthcare provider. The decisions you make about your care are put in an “Advanced Directive” which is a legal document that takes effect only if you become unable to communicate your wishes or speak for yourself. One could become unable to communicate healthcare wished due to serious injury or disease, regardless of one’s age. The legal documents help loved ones make decisions for you and help your healthcare provider know what type of medical care you wish to receive.

There are a few types of Advanced Directives one should have in place while healthy and of sound mind to make such important decisions. These documents include a Living Will and Healthcare (or Medical) Power of Attorney. A Living Will allows a person document his/her wishes regarding medical treatments at the end of life. A Healthcare (or Medical) Power of Attorney allows a person to appoint a surrogate or person he/she trusts to be the healthcare agent, who is authorized to make medical decisions on the person’s behalf.

Prior to your Living Will guiding your medical care, two physicians must certify that you are unable to make medical decisions, you are in the medical condition stated in the document (i.e.- terminal illness or incapacitated), or the state the document was prepared in/person’s residence could have other requirements.

Prior to your Healthcare (or Medical) Power of Attorney going into effect, your physician must certify you are unable to make decisions and if you regain the ability to make decisions, the surrogate cannot continue to make decisions and other requirements required by the state the document was prepared in/person’s residence.

St. Anthony’s Hospice has social workers who can assist patients and family with these documents. While our social workers are not attorneys, they do have the knowledge to make the legal documents easier for the average person to understand. They can also assist the family and patients with funeral arrangements, if they need help with that.

If we can help you or a loved one feel more comfortable or getting advanced directives in place, please call us at (270) 826-2326 or visit our website at https://stanthonyshospice.org/referral/.

Healing as a Person

September 2, 2020 Kellie Holloran Blog, Hospice, Palliative

“’Palliative care’ means patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering.” -definition from CMS webpage

What does “suffering” mean to you or a loved one facing a serious illness? Is it being in physical pain? Is it being lonely? Or is it something else?

What does quality of life mean to you or a loved one facing a serious illness? Increased comfort? Emotional happiness? Or something else?

Healthcare today treats illnesses and not a patient’s suffering. While we are grateful there are professionals who treat illnesses, perform surgeries, and cure diseases, we also want our suffering treated. There is not a person on this earth who has not felt suffering. When a baby is born, he/she comes out crying. Kids, teens, adults, and elders have also all experienced a form of suffering- whether emotional, physical, spiritual, or another form.

Palliative care is the part of healthcare and more specifically, hospice care, that is designed to manage the suffering a patient typically feels with his/her terminal diagnosis. Palliative care improves quality of life in all dimensions of the phrase. Palliative care is a huge part of hospice care.

Why do we overtreat in healthcare, to the point where hospice and palliative care are used in a patient’s final days to hours of life? If everyone agreed that quality of life is the most important thing, healthcare would be better than it already is.

We have not failed when a patient cannot be cured. If a person cannot be cured, it is time to heal the person. One can go into the healthcare system completely broken and come out fixed. This is always fantastic when it can happen! When you go into the healthcare system and cannot be fixed, hospice care and palliative care can heal you. Your body may be failing, but your quality of life and your dignity are healed.

If you or a loved one is needing extra help in treating suffering, please call St. Anthony’s Hospice at (270) 826-2326.

Source: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-12-48.pdf

When is it time for hospice?

August 31, 2020 Kellie Holloran Blog, Hospice

Living with a life-limiting illness is never what you have in mind for yourself or a loved one. What if you are told that a cure is no longer attainable? Where do you go from there? Where do you want to be?

When the possibility of a cure is gone, hope is not. Through hospice care, there is still hope for no pain or suffering; hope for a peaceful death; hope to be at home for your final months, weeks, days, hours, and minutes; and hope to be surrounded by loved ones and pets.

“While there isn’t one specific point in an illness when a person should ask about hospice care, many hospice professionals would suggest that a person think about hospice long before he or she is in a medical crisis,” advises J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization. “In fact, learning about palliative care and hospice as options is something that should happen early in the course of a serious illness and not just in the final days.”

Hospice is not a place. Hospice is provided wherever the patient calls home- house, apartment, nursing home, assisted living facility, or our hospice inpatient unit, the Lucy Smith King Care Center. Hospice care involves an interdisciplinary team of clinicians and trained volunteers to ensure all of the patient’s needs are being met and all types of pain are being treated- physical, psychological, social, financial, and spiritual. Each patient has his/her own care plan tailored to his/her individual needs.

Hospice care not only helps patient maintain their dignity and independence as well as increase quality of life, it also helps the family as well.

“Hospice professionals can be important resources for patients and families, they can help a person figure out what goals are important and help them get their arms around the fact that their life may be coming to a close,” noted Schumacher.

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.

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 However, 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!

According to the NHPCO 2020 facts and figures data, in 2018 1.55 million Medicare beneficiaries received hospice care, which is a 4% increase from 2017 (1.49 million beneficiaries). Also according to the NHPCO in 2018, 1.1 million Medicare beneficiaries died while enrolled in hospice care. Over half of the deaths occurred in the patient’s home and more than 1/3 was split between nursing homes, hospice inpatient facilities, and assisted living facilities.

Facts about hospice care

The majority of hospice care is provided in the patient’s home. Hospice care is also provided in skilled nursing facilities, assisted living facilities, and hospice inpatient units.
Hospice care is 100% covered by Medicare, Medicaid, and some private insurances. Anthony’s Hospice will not turn anyone away based on inability to pay.
It is a common myth that hospice care only treats cancer patients. However, hospice care treats anyone diagnosed with any life-limiting illness. These life-limiting illnesses can include, but are not limited to, various cancers, COPD or other respiratory illnesses, CHF or other heart illnesses, COVID-19, sepsis, kidney illnesses, Alzheimer’s Disease, ALS, MS, many neurological conditions, cirrhosis or other liver diseases, and AIDS.
Not only does hospice include the interdisciplinary team, it includes durable medical equipment, medical supplies, and medications related to the patient’s hospice diagnosis.
While a physician does not have to make the hospice referral, one does have to certify that the patient is seriously ill and the patient has a life expectancy of 6 months or less, should the disease run its normal course. This does not mean that the patient will die in 6 months or less.
Hospice also offers bereavement services for the patient’s family. St. Anthony’s Hospice offers grief support for 15 months after the loss of their loved one. Bereavement services are offered to anyone, regardless if they had a loved one pass with St. Anthony’s or not.

“Ideally, an individual would receive hospice care for the final months of life – not just the final days,” stated Schumacher. “One of the most common sentiments from families who have been helped by hospice care is that they wish they had known about hospice or been referred to hospice sooner.”

Hospice care is available 24/7! While the patient’s care team won’t be in the home with him/her all day, every day; a hospice nurse is available to a patient at any time of any day. If the patient had a fall at 2am, has trouble breathing at 7pm, or passes away at 5:30am, a nurse is one phone call away. The hospice nurse will come assist the patient and family. One of the main goals of hospice care is to keep the patient where he/she wants to be, and not in the hospital.

The longer a patient is with hospice care, the more benefits the patient receives. Hospice care does not mean you or a loved one is “giving up”. Hospice care is hope for the patient and family, as well as help.

If you or a loved one needs extra help managing a serious illness or has any questions, please call St. Anthony’s Hospice at (270) 826-2326.

Sources: file: https://www.nhpco.org/wp-content/uploads/NHPCO-Facts-Figures-2020-edition.pdf
https://www.prnewswire.com/news-releases/when-is-it-time-for-hospice-111451104.html

Hospice & Palliative Care Videos

August 28, 2020 Kellie Holloran Blog, Hospice, Palliative

Our Business Development Coordinator, Riley Hamilton, made a couple of videos for a recent virtual health fair we participated in. We wanted to share her videos with all of you!

Hospice Care video- https://youtu.be/XOG1advPxao

Palliative Care video- https://youtu.be/Ov_I9Dw48Wg

If you have any questions, please call our office at (270) 826-2326.

Hospice Is…

August 4, 2020 Kellie Holloran Blog, Hospice

Hospice is…

Hospice is about quality of life, not death.
Hospice is about keeping your dignity, even after you’ve passed away.
Hospice is support and extra help when the patient and family need it.
Hospice is comfort in all definitions of the word for the patient.

Give us a call to see how we can help your loved one at (270) 826-2326!

Image may contain: text that says 'Hospice 1s... Helping Others Simply Pass Into Calm Eternity By Kelly Kise'

Physician Barriers to Hospice Referrals

June 24, 2020 Kendra Marsh Blog, Hospice, Myths, Professionals

Physicians are here to save lives and cure diseases. However, this is not always possible, and your physician may break some bad news to you- a cure is not attainable for your disease.

In an ideal world after receiving this news, your physician will refer you to hospice services early enough so you can benefit from all aspects of hospice care and your family/caregiver(s) will receive the necessary support.

Too often physicians run into barriers in referring a patient to hospice care because the family doesn’t understand what all hospice can do for their loved one and even the support services for the family. We have complied a list of some common barriers physicians may experience and some ways to conquer them.

Family Doesn’t Understand What Hospice Can Do.
One of the biggest barriers to hospice care is a lack of understanding about what hospice is and what it can do. Many families and members of the community think hospice is only used in the last days and hours of life. Contrary to popular belief, patients are eligible for hospice services when he/she receives a terminal diagnosis and a life expectancy of 6 months or less should the disease run its normal course.

Families don’t realize how much support they receive when their loved one is in hospice care. Patients in hospice care receive regular nurse, aide, social worker, and chaplain visits. Patients also have the opportunity to request volunteer visits. Volunteers can provide companionship to the patient, give the family a little break from caregiving, and can even do activities with the patient. The patient’s care team meets regularly to update the patient’s care plan and ensure the patient is receiving exceptional care.

Family Wants to Keep Patient Home.
Good news- hospice care is provided wherever the patient calls home! This can be in the patient’s/caregiver’s house, apartment, assisted living facility, nursing home, or the Lucy Smith King Care Center. If the patient wants to be home, we will provide the appropriate support the family needs to keep their loved one home.

Family Isn’t Ready for Hospice.
Hearing your loved one has a terminal diagnosis with six months or less to live (should the disease run its course) can be devastating. Many think that the “hospice diagnosis” means their loved one will pass away soon. It’s important for the physician to explain that hospice isn’t a “last resort” and with a terminal diagnosis, the patient needs the expert symptom management and support that hospice provides.

Family is Concerned About the Cost of Hospice.
Another answer with good news- hospice is covered 100% under Medicare, Medicaid, and some private insurances! Durable medical equipment, medications pertaining to the hospice diagnosis, medical supplies, nurse visits, aide visits, chaplain visits, social worker visits, volunteer visits, and bereavement care for the family are all covered! All of these supplies and visits are provided wherever the patient calls home (with the exception of bereavement which can be provided in the home but isn’t always).

Beginning hospice care does not take the place of the patient’s primary care physician. Rather, hospice care works in conjunction with the patient’s physician to ensure the patient is getting the best care possible.

(270) 826-2326 or visit our website at https://stanthonyshospice.org/referral/.

Happy National CNA Week!

June 23, 2020 Kendra Marsh Blog, Hospice, Palliative

June 18-25 is National CNA Week! Here at St. Anthony’s Hospice, we are blessed with the best CNAs! Our aides are there for our patients and help them and our nurses with so much. They are compassionate, caring, helpful, comforting, important, and amazing.

“If the job of a CNA was easy, there wouldn’t be a shortage of them. But there is. If the job of a CNA was just wiping butts, they wouldn’t know their patient’s favorite foods, or when they prefer coffee over tea, but they do. If the job of a CNA was insignificant, Supervisors and Charge Nurses wouldn’t rely on them to spot changes out of their “normal,” but they do. If the job of a CNA was to just get vitals, they would have time to sit down and talk with each patient for a good thirty minutes each shift, but they don’t. If the job of a CNA was to just show up and dress them, perform their assigned duties, then go home, they wouldn’t leave work in tears knowing one of our patients might not make it, but they do. If the job of a CNA was appreciated by their peers,colleagues, they wouldn’t feel as unvalidated, but it’s not.” (taken from Facebook posts)

Happy CNA Week to all the awesome CNAs out there!

Childhood Cancer Awareness Month

Pain Management Awareness Month

Saying Goodbye on the Phone

Advance Care Planning

Healing as a Person

When is it time for hospice?

Hospice & Palliative Care Videos

Hospice Is…

Physician Barriers to Hospice Referrals

Happy National CNA Week!

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Happy National CNA Week!