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Palliative

Managing Your Pain

Having a serious illness is often accompanied by physical pain. Living with this pain can make simple tasks hard to do- such as eating, sleeping, and basic household chores. Many people experiencing this pain often lose hope that their pain can be properly managed. 

Pain is often difficult to control because it affects everyone differently. One person may have a higher “pain tolerance” as opposed to another. It’s always important to communicate your pain level with your doctor and/or nurse, as well as your caregiver. This will help in the future if you are unable to clearly say how much pain you are experiencing.

Enter hospice care! A team of experts who knows how to recognize the non-verbal and verbal pain signs, communicate among your hospice care team, and manages the patient’s pain so they can live the best quality of life! Freedom from pain and suffering is every patient’s right. Your pain can be managed. You do not need to suffer in silence or alone. St. Anthony’s Hospice cares for you and your pain.

Treatment Options

Chronic and serious pain are often treated with prescription medications. St. Anthony’s Hospice will take all factors into consideration (allergies, wishes, etc.) when creating the patient’s care plan. 

Type: We choose the type of medication(s) based on the kind and level of pain, and how the pain affects the patient’s daily life. If one medication does not work well, we can try another or a combination. The pain medicine can be given by pill, liquid, injection, IV (at the Lucy Smith King Care Center), suppository, or patch.

Dose: Just like how people have different pain level tolerances, each person reacts differently to different doses of pain medication. The initial dose is based on the patient’s weight, height, age, level of pain, and medicines already being used. After the initial pain dose, the dosage can be adjusted to appropriately manage the patient’s pain level.

Schedule: Longer-acting medications can be taken on a schedule to treat pain over a length of time. “Breakthrough” or fast-acting medications can be taken as needed. Think of these fast-acting medicines as you taking an ibuprofen or acetaminophen for a headache.

There are several non-medication options you can use for pain. These include heat, ice, massage, stretches, or some light exercises. Other treatments that can help the mental side of pain include meditation, pet therapy, music therapy, aromatherapy, spiritual care, etc. 

What can I do to keep my pain managed?

Always take your pain medication as prescribed. Even if you begin feeling better, don’t skip a dose! The goal of pain management is to be ahead of the pain, not fall behind and have to continuously catch up. Waiting for the pain to begin, may make it harder to manage.

Contact your St. Anthony’s Hospice nurse prior to taking other medications. This includes over-the-counter medicines, vitamins, or supplements.

Avoid alcohol when taking pain medication.

Appropriately store your medications. Keep medications in a locked drawer and away from children, pets, and others. Properly dispose of medications. You can ask your nurse for a medication disposal kit! 

Keep notes to track your pain management plan and symptoms. Be sure to include when you take each dose, which medication and dose you take, side effects, location and type of your pain, rate pain before medication and 60 minutes after dosage.

Talk to your nurse!  If your pain medicine either isn’t working or if you are experiencing odd mental side-effects, let your nurse know so they can work with your provider to change your medication.

Hospice Myth

Two common myths come around when talking about hospice care and pain management. “Hospice care takes away all your medications” and “hospice care just gives you morphine, so you are out of it the whole time.”

Hospice takes away all medications. Hospice care is all about managing pain and symptoms, which the most common way is with medications. This does not  mean that hospice providers over-medicate their patients or remove all medications. While many patients are over medicated prior to coming into hospice care, and your hospice physician and nurse will look at your prescription medication list and remove some medications, we do not remove them all. This “de-prescribing” is used to reduce medicines that have heavy side effects of ones that are not benefitting the patient, thus decreasing their quality of life. We dove deeper into this myth in a previous blog post that you can find here

Hospice care just gives your morphine, so you remain out of it or unconscious the whole time. While morphine is a commonly used hospice pain management medication, it is not over-used. When morphine and other pain management medications are used as prescribed and for medical reasons, patients will have the much-needed relief without the “out of it” or “loopy” feelings. 

If your or a loved one has been diagnosed with a serious illness and you are needing extra care, please call St. Anthony’s Hospice or Palliative Care at (270) 826-2326. You can also make an online referral here.

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Palliative Care- Myth vs. Fact

What is Palliative Care? How is it different from Hospice Care?

While both provide effective symptom management during the patient’s serious illness and the goal of both is to keep the patient out of the hospital, palliative and hospice care are different. 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, or assisted living facility. 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.

While all of the above sounds the same as hospice, let’s point out a few differences. Palliative Care is not hospice care. While both palliative and hospice use a team of experts to manage symptoms and improve quality of life, palliative care can be used with traditional, curative treatments. You read that right! Adding palliative care with home health, chemotherapy, radiation, dialysis, and other curative options for your serious illness(es) can improve quality of life. Hospice care is provided when the main focus is comfort care, and is not provided at the same time as curative options. Hospice care begins when a cure is not attainable and with a life expectancy of 6 months or less, should a disease run its normal course.

Does having a referral to palliative or hospice care mean the physician is giving up on the patient? NO! If a physician refers a patient into palliative or hospice care, he/she is wanting the patient to have the best quality of life possible. Providers trust the comfort, symptom management, and physical, emotional, and spiritual care and support that our team of end-of-life care experts provides. They refer to St. Anthony’s Hospice and Palliative Care to ensure their patients can be as comfortable as possible.

If you have questions about St. Anthony’s palliative or hospice programs or think you or a loved one would benefit, please call us today at (270) 826-2326.

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Palliative and Hospice Care Interdisciplinary Team

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.

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Liver Disease and Failure

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.

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Stages of Heart Failure

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.

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Healthcare Decisions Day 2021

For over 10 years, the day after Tax Day is National Healthcare Decisions Day. After getting your taxes filed, it’s usually a good idea to discuss the wishes of your family. From April 2020-April 2021, these decisions have looked a little different and the way we have been living has been really changed. How many Americans look at advance directives has taken more of a profound meaning.

With the impacts of COVID-19, you never know what is going to happen. Remember last January and February before COVID became so widespread? We all had plans for 2020; some awesome resolutions, weddings, graduations, proms, homecomings, big birthday parties, vacations, and so much more. Then COVID hit and hit hard. All plans came to a screeching halt. Stay at home orders were invoked, along with mask mandates. Unfortunately, many Americans contracted COVID and some never recovered and passed away. Many of those people passed away without advance directives in place, which left family members trying to honor wishes that were not communicated.

Having advance directives is certainly not a new idea, but COVID did force everyone to look at what they want at the end of life and talk about their wishes with loved ones. There are huge benefits to the patient and family by having advance directives in place prior to hospitalization. These can include peace of mind for the patient because they know they will get their wishes honored and peace of mind for the family knowing they don’t have to guess or worry in this stressful time. After a loved one becomes chronically ill or unable to speak, these advance directives will come in handy! Your wishes will be crystal clear to medical professionals and loved ones.

St. Anthony’s Hospice and Palliative care helps patients get their wishes in order! Not only do we have copies of the 5 Wishes booklet to help you get started (for free), we can also help witness and notarize your documents, as well as help you get in contact with an estate attorney to draft the documents for you. We also honor end of life wishes by allowing the patient to be at home and ensuring all patients will have the highest quality of life and are able to die with dignity.

Call us today at (270) 826-2326 or make an online referral to see how hospice or palliative care can help you.

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What is Palliative Care?

You can make a referral to palliative or hospice care by calling (270) 826-2326 or filling out this online form.

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Stages of Chronic Kidney Disease

Chronic Kidney Disease (or CKD) refers to lasting kidney damage that progressively worsens over time and all 5 stages of kidney damage. These stages range from very mild (stage 1) to complete kidney failure (stage 5) The stages of CKD are based on the kidney’s ability to filter waste and extra fluid from the bloodstream. In the early stages, a person’s kidneys can still filter waste but in the later stages, your kidneys will have to work harder to get rid of waste or may not be able to do so at all. Over 30million people in the United States are living with CKD. How your physician measures your kidney function is by the estimated glomerular filtration rate (or eGFR). The eGFR is a number based on your creatinine levels, which is a waste product in your blood.

While anyone can be diagnosed with CKD, some risk factors that increase your risk include:
1. Diabetes
2. High Blood Pressure
3. Heart Disease
4. Family History of CKD
5. Being African American, Hispanic, Native American, or Asian
6. Being over 60 years old

Understanding the different stages of CKD can help a patient be more educated on the disease process and make appropriate healthcare decisions. We wanted to help you learn more about this disease.

Stage 1
In stage 1 CKD, you have mild kidney damage and an eGFR of 90 or greater. Most of the time, this means your kidneys are healthy and functioning well but you do have other signs of kidney damage. These signs of kidney damage can include protein in your urine or actual physical damage to your kidneys. Some ways to slow the progression of CKD if you are in stage 1 include:
– Controlling your blood sugar if you are diabetic
– Control your blood pressure
– Maintain a healthy diet
– Don’t smoke/vape or use smokeless tobacco
– Strive for 30 minutes of exercise at least 5 days per week
– Maintain a healthy weight
– Talk to your doctor about medications or vitamins to help protect your kidney function
– Get an appointment with a kidney doctor, or nephrologist, even though you have a primary care provider

Stage 2
In stage 2 CKD, you have mild kidney damage an eGFR between 60%-89%. Most of the time, this means your kidneys are healthy and functioning well but you do have other signs of kidney damage. These signs of kidney damage can include protein in your urine or actual physical damage to your kidneys.

Some ways to slow the progression of CKD if you are in stage 2 include:
– Controlling your blood sugar if you are diabetic
– Control your blood pressure
– Maintain a healthy diet
– Don’t smoke/vape or use smokeless tobacco
– Strive for 30 minutes of exercise at least 5 days per week
– Maintain a healthy weight
– Talk to your doctor about medications or vitamins to help protect your kidney function
– Get an appointment with a kidney doctor, or nephrologist, even though you have a primary care provider

Stage 3
Stage 3 is split into 2 stages, Stage 3a and Stage 3b. In Stage 3a, you have an eGFR between 45%-59%. In Stage 3b means you have an eGFR between 30%-44%. This means there is some damage to your kidneys and they are not functioning as well as they should be.

Many people do not exhibit symptoms in Stage 3, but if you are exhibiting symptoms they can be:
– Swelling in the hands and/or feet
– Back pain
– Urinating more or less than normal

Also in Stage 3, a person is more likely to start having health complications as waste builds up in your body. These can include:
– High blood pressure
– Anemia, or a low number of red blood cells
– Bone disease related to hyperphosphatemia or high levels of phosphorus in the blood

To prevent Stage 3 CKD from progressing, you can:
– Control your blood sugar if diabetic
– Control your blood pressure
– Don’t smoke/vape or use smokeless tobacco
– Eat a healthy diet and meet with a dietitian
– Exercise for at least 30 minutes, 5 days per week
– Get to and maintain a healthy weight
– Visit a nephrologist in addition to your primary care provider
– Ask your physician about medications to control your blood pressure and those to improve kidney function

Stage 4
Stage 4 CKD means you have an eGFR between 15%-29%. This means your kidneys are moderately to severely damaged and not working as well as they should. Stage 4 is the last stage before kidney failure and should be taken very seriously. Stage 4 is where palliative care can benefit the patient!

Many people begin to exhibit symptoms in Stage 4, which can include:
– Swelling in the hands and/or feet
– Back pain
– Urinating more or less than normal

Also in Stage 4, you will likely have health complications as waste builds up in your body. These can include:
– High blood pressure
– Anemia, or a low number of red blood cells
– Bone disease related to hyperphosphatemia or high levels of phosphorus in the blood

To prevent your Stage 4 CKD from progressing to complete kidney failure, you should:
– Regularly see your nephrologist
– Meet with a dietitian to help with your healthy diet
– Regularly take blood pressure medications as prescribed by your doctor

In Stage 4 it is time to begin talking with your nephrologist about the starting dialysis or preparing for a kidney transplant.

Stage 5
Stage 5 CKD means you have an eGFR less than 15%. This means your kidneys are either getting very close to failure or they have completely failed. If your kidneys fail, waste will build up in your blood which makes you very ill. Stage 5 is where hospice or palliative can help!

Some of the symptoms of kidney failure include:
– Itching
– Muscle Cramps
– Nausea & vomiting
– Not feeling hungry
– Swollen hands and feet
– Back pain
– Urinating more or less than normal
– Trouble breathing
– Insomnia (or trouble sleeping)

Once your kidneys have failed, kidney transplantation or dialysis are your treatment options. However, should you choose quality of life, hospice can help! If you choose quality of life in tandem with your treatment, palliative care can help! A kidney transplant is when a donor kidney is taken and transplanted into your body. If you can find a living donor, you may be able to plan for a kidney transplant and palliative care earlier. Dialysis assists your body in removing excess water and waste from the blood when your kidneys can no longer do it themselves. Palliative care can be used in conjunction with a kidney transplant and/or dialysis.

Palliative Care and Chronic Kidney Disease
When a patient is facing late-stage kidney disease (stage 4 or 5), St. Anthony’s Palliative Care team can help to manage symptoms and bridge the gap between the patient and their physician/nephrologist by providing an extra set of eyes and ears in the home. Palliative care can also help the patient access additional resources and support in the community.

Our palliative care team helps patients match their care plan to their personal goals as the patient explores options from transplant to dialysis to comfort care only.

To learn more about St. Anthony’s Hospice or Palliative Care, please call us at (270) 826-2326 or make a referral online.

 

 

Resources for this article found here.

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When Enough Is Enough

Have  you ever paid attention to how your provider talks about treatments and how much like war-talk there is?

Really think about it…
“We’re going to win this battle with cancer.”
“Let’s rally behind Aunt Sally for her battle with breast cancer.”
“The infection has infiltrated his kidneys.”
“She’s having a heart attack.”

Ultimately life is not a battle to be won; nobody comes out alive. But don’t think about it in a negative light. Life is a gift! A beautiful gift given to each and every one of us that allows us to make a difference. Using your senses to explore the world is a privilege.

For religious people, life does not just end at death. Some believe in reincarnation. Some believe in an eternal afterlife. Some believe we only continue to exist in memories. Regardless of the differences in beliefs, death is a mysterious part of life that nobody really knows what happens when that time comes.

How do you know when to switch from the “warfront” of traditional medicine to embracing what is to come and living out the remainder of your life with the best quality care?

Dying comes in stages- denial, anger, bargaining, depression, and acceptance. Not everyone experiences all 5 steps or  even in that order. If one of these steps has been a person’s mindset their entire life, there is a bigger chance they will go out that way. For example, if a person has been angry their whole life, they may approach death feeling angry. Same goes for denial, depression, bargaining, and acceptance.

Whatever the person’s mood or however close they are to accepting their inevitable fate, we always face the question, “when do I stop aggressive treatment? when do I shift to hospice care?” Shifting from fighting for a longer life to a fuller life is never easy but hospice care is there to help.

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.

Hospice care uses an interdisciplinary team approach. This means we treat the whole person, from their physical symptoms to psychological to social to spiritual, and everything in between. Hospice care allows patients to keep their current physician, should their physician choose to follow, and their current caregiver! We don’t force loved ones to stop caring for the hospice patient, we encourage them to continue and empower them by teaching valuable skills and educating on the disease and dying processes.

“Human beings are physical, psychological, spiritual, and social entities and ought not to be reduced to any one dimension. The notion of totality of a holistic approach to the person is critical in all dimensions of health care.” -Ron Hamel, Making Health Care Decisions.

When initially diagnosed with a life-limiting illness, our focus should be completely on curing the patient and/or defeating the disease. At this point, the patient should consider a palliative care referral. Visit our website here to learn about the difference in hospice and palliative care.

We should always have those “what ifs” in the back of our mind to be realistic.
“What if we get to a point where the treatments aren’t working?”
“What if my quality of life is really taking a hit with these treatments?”
Be prepared and pay attention to look for the signs that your quality of life is taking a hit. Check out an article on quality indicators for end of life care here. Or just think about it- can you tolerate more treatments without being sick or extremely weak? Do I feel up to doing things I have always loved like going out to eat, going on a walk, gardening, visiting with friends or family or pets, etc.?

Encourage your loved one to listen to that internal voice that says “I’m done” or “Enough is enough.” Once you hear that voice, it’s time to shift the focus from treating the disease to treating the person. Always remember, when you are told “there’s nothing more that can be done,” there is always more that can be done! Meaning it’s time to focus on quality of life!

A dying person is still a person. They can still hear, feel, love, cry, see, etc. They are just a person with a shorter life expectancy. Grant your loved one’s wishes. Go to the beach one last time. Take a boat ride. Go for a picnic in the park. Just sit and listen to stories about their life. Focus on increasing that quality of life! Even under St. Anthony’s Hospice care, we don’t limit you to being homebound. We help our patients honor their last wishes and travel. Now, that doesn’t mean we pay for it, but we do help find the help the patient needs. For example, if your loved one wants to go to Florida for vacation, we contact a hospice provider wherever you go in Florida to be sure the patient is still getting the quality care needed while traveling.

Hospice care is exceptional end of life care. It’s not admitting defeat or giving up. Hospice gives the patient the quality of life and dignity they so deserve.

If you know me personally, you know I’m a big Queen fan. I wanted to close this out with some lyrics from “Who Wants to Live Forever” that I think pertain really well to focusing on quality of life and not fearing death.
“Who wants to live forever
There’s no chance for us
It’s all decided for us
This world has only one sweet moment set aside for us
Who wants to live forever”
Our fate has already been decided for us. We aren’t promised another day, so many every day count.

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

 

 

Sources for this blog post- https://www.bmj.com/content/bmj/291/6511/1820.full.pdf and
CareNotes “Hospice Care: When Enough is Enough” by Fr. Dick Sparks, C.S.P., Ph.D.

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Age-Related Macular Degeneration Awareness Month

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

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