Hospice and Health Posts

Early Signs of Dementia

Posted on May 22, 2017

Early Signs of Dementia

Memory loss is the most commonly thought of symptom associated with dementia. However, this doesn’t mean dementia is the cause of all memory loss in elderly people. In order for dementia to be the true cause, there needs to be memory loss and trouble with one of the following issues:

  • Focus
  • Reasoning
  • Language
  • Communication

There are many early signs of dementia you can be looking out for. If you start to notice any of the following signs with your loved ones, talk with your doctor about what you can do to slow the progression of dementia.

Short-term Memory Loss

It may not be very obvious when it starts, but pay attention to times that they can’t remember things they did the day before or even earlier today. Odds are they’ll be able to recall events from the past easily, but more recent events will be hard to recollect.

Finding the Right Word

We’ve all had those moments when the right word seems to escape us. These moments will become more and more common as dementia progresses. Conversations may start to take longer because your loved one is frequently having trouble finding the words they need to explain what they’re thinking.

Mood Swings

If your loved one is typically shy, but then suddenly becomes very outgoing, it might be a sign of dementia. This condition affects judgment, so major mood swings and personality changes are typical.

Apathy

Hobbies and activities that used to really interest them might suddenly seem boring. They might not have the energy or desire to get out and do activities anymore.

Comprehension

One of the tell-tale signs of dementia is difficulty understanding stories and conversations. This happens because they’re having trouble understanding the meaning of the words being used and can’t understand what’s happening.

Repetition and Collection

Repeating daily tasks, like showering, and collecting random objects are both strong signs of dementia setting in. Typically, patients do this because they don’t remember showering the first time.

While there’s no cure for dementia, it can be mitigated, especially if it’s caught early. Use these signs to spot dementia before it takes full effect.  

  

How to Plan a Funeral

Posted on May 18, 2017

Funeral

We understand planning a funeral for a loved one can be incredibly overwhelming. No matter how sudden or expected the death is, making all the arrangements can be very stressful. This is why we created a step by step guide to help families plan after the loss of a loved one.

Slow Down- Unless you’re under a religious or cultural obligation to have the funeral within a certain timeframe, there’s no hurry to have the funeral. You certainly don’t want to drag it out, but you shouldn’t feel pressure to make all the arrangements immediately.
Check for a Will- If your loved one had a last will and testament, you’ll want to check for any funeral preferences listed in the will. If there any wishes, it will give you some guidance on what to do.
Pick a Funeral Home- This is possibly one of the most important steps, as a good funeral home should take a lot of the work off your shoulders. Once you’ve selected which home you want to work with, you’ll need to arrange for transportation of the body to the funeral home.
Report the Death- There’s a legal process to report a death to the government. Typically, you’ll just need to file the certificate of death the attending physician gives you with the state. The funeral home can also assist with this process.
Interment Method- Providing there are no specifications given in the will, you’ll need to decide between burial and cremation. The funeral home will be able to assist you in finding a casket or urns.
Plan the Service- Some opt for a more formal and traditional service while others go for a more informal memorial service. When planning the service you’ll want to consider what your loved one would have wanted as well as what will help you and friends and family cope with the loss.
Let People Know- With modern technology, notifying people is easier than it used to be. There’s no need to send formal invitations in the mail for a funeral, although you can if you wish, phone calls, text messages, emails, and social media posts are all appropriate ways to inform friends.

Planning a funeral doesn’t have to be a stressful process. We know this is a hard time, but we hope these steps will help you through it. 

The Importance of Hospice Formulary

Posted on May 10, 2017

Hospice Formulary

A formulary is a term that applies to hospices, hospitals, and any other facility capable of offering prescription medication. The term refers to the list of medications a hospice will keep on hand and can offer to their patients. When a patient is in need of prescription medication, the doctor will check the formulary to see what the options are, and prescribe the appropriate medication. 

A larger formulary is better for patients because it gives them more options for medication. At Cura-HPC, we have an open formulary. This means our medical director can go outside of the predefined list of medications if they feel it’s best for the patient. 

This is great news for our patients because they’ll never be restricted to a list of medications that are covered by the hospice benefit. We can offer medications from multiple brands, suppliers, and vendors. We strongly feel this is in the patient’s best interest, and that’s why we offer this service. 

Under a closed formulary, patients might have to settle for less than optimal medication because the formulary doesn’t include the best medication for them. When considering a hospice provider for your loved one, a large, or preferably open, formulary needs to be on your list of criteria. 

Although medication is only a small part of the hospice service, it will have a large impact on the quality of life your loved one will experience while receiving hospice care. If you’re in search of a hospice provider, or have questions about how a formulary can affect patients, call Cura-HPC today. 

How Loneliness Affects the Elderly

Posted on May 04, 2017

If you live long enough, you’ll likely experience some form of loneliness at some point. Sadly, it’s those who have lived the longest who experience loneliness more than anyone else. According to recent studies, one-fifth of all Americans claim to experience loneliness. This number was drastically higher among elderly populations.

Loneliness might seem fairly innocuous, but new data is showing it might be more harmful than obesity. The mortality rate among lonely people is 50% higher than non-lonely people, compared to an 18% increase in mortality rate with obese versus non-obese.

The effects of loneliness on the elderly aren’t limited to emotional symptoms, as some might think. While depression and fatigue are part of the equation, there are several physical manifestations of loneliness as well. Lonely seniors will typically see a decline in functional activities such as –

  • Dressing
  • Bathing
  • Upper extremity capabilities
  • Walking
  • Climbing stairs

Loneliness also increases the risk of several common medical conditions the elderly face.

  • Hypertension increased by 3%
  • Diabetes increased by 2%
  • Heart disease increased by 5%
  • Depression increased by 26%

As we age, more and more of our friends and families will inevitably die, leaving less and less people to connect with. This can create a cycle of isolation, that only perpetuates negative thoughts about the late stages of life.

This is why it’s so important for seniors to stay active and social. By making new connections and staying in touch with friends and family, seniors can break the loneliness cycle and hopefully avoid the above-mentioned complications.  

Is There a Wrong Way to Grieve?

Posted on Apr 27, 2017

Many persons who have suffered loss ask the question, “Is there a wrong way to grieve?” This question is common, because we often assume that our grief experience must conform to a map we already have in our minds. It is important to remember that there is no one “right way” to grieve, and that our personal expectations are based on maps that are the generalized depictions of the journeys of others.

The truth is, there is no “wrong” way to grieve. Your personal grief journey will likely be a unique blend of different grief styles. Even when grieving the same loss, people express their individual grief at different places on the grief spectrum. One grieving style is not “better” than any other. Whether for ourselves or for others, honoring and validating the expressions and needs of the different grieving styles promotes individual healing.

The road that leads back to normalcy and recovery, will look different for everyone. This road can also change directions with very little notice. You never know how long it will take or what roadblocks will appear. The only thing you can do is accept that you’re grieving and do your best to deal with today’s problems. Although it might not seem like it, there is an end to this journey and you’ll get there soon.

Know that we continue to pray for and think about you, and all of your loved ones. We hope you will find this to be encouraging and helpful to you. If you would like to speak to someone personally, please do not hesitate to contact our Bereavement Coordinator, Thomas Schwartz. He can be reached at 918-994-4807. God bless and keep you!

Hospice Emergency Kits

Posted on Apr 10, 2017

hospice emergency kit

When a patient is in hospice care, their symptoms don’t adhere to an 8 to 5 schedule. Some patients will qualify for 24/7 care, but for those who don’t, an emergency kit is used to treat symptoms that might flare up after hours. These kits will typically contain medication and other treatment methods that will prevent symptoms from happening and quickly treat symptoms when they do happen.

The exact contents of a kit will depend on the unique needs of each patient, but the common symptoms that are covered in most hospice emergency kits are:

Pain- It’s very common for hospice patients to experience severe pain in some form or another. To treat pain that occurs when a doctor is not available to write a prescription, kits might contain some form of morphine.

Anxiety- Going through end of life treatment can understandably cause some stress and anxiety. To ease these symptoms, medication such as Valium can be packed in an emergency kit.

Secretions- Some conditions will cause patients to have uncontrolled secretions (like drooling), which can cause saliva to pool in the back of the patient’s throat. Several medications, as well as extra gauze, can be in a kit to treat these symptoms.

Vomiting- Symptoms of vomiting, or even just constant nausea, can make patients incredibly uncomfortable. Thankfully there are many medications to treat vomiting and nausea that can be included in a hospice emergency kit.

These kits are a lot like car insurance – you hope you never have to use it, but it gives you peace of mind just knowing you have it. The name and contents of a hospice emergency kit will be different from hospice to hospice, but each kit is designed to be a safety net patients can use when their medical director is unavailable.

What is a Hospice Discharge?

Posted on Apr 27, 2017

hospice discharge

It might come as a surprise, but hospice discharges really do happen. These events don’t happen every day, but they’re certainly not unheard of. A patient can be discharged from hospice when their condition improves and they no longer qualify for the hospice benefit. This can happen for one of two reasons:

The patient’s condition no longer has the required six-month diagnosis.
The patient’s condition improved and they no longer meet hospice criteria

Before a patient is discharged there will be a meeting with all members of the patient’s treatment team (medical director, nurses, aides, social worker, and bereavement coordinator). In this meeting, they will discuss the patient’s progress and current condition. If the topic of discharge comes up, they will also consult the family to get their perspective.

In the event of a discharge, the family will be notified and the hospice will begin the discharge process. This process takes some time to be official, and if the patient’s condition changes and is found to be eligible for hospice care, the discharge process will stop.

When a patient is discharged, we will do our best to facilitate a smooth transition back to the medical treatment the patient was receiving prior to hospice care. We will also do occasional check-ins with the patient to see how they’re doing. Once a patient has transitioned out of hospice care, they can come back to hospice at any point (provided their condition meets the qualifications).

When Should You Call a Hospice?

Posted on Apr 17, 2017

hospice

Knowing when it’s time to enroll a loved one in hospice care can seem like a complicated decision. Due to stigmas and misconceptions, people can be hesitant to place their loved one in hospice care. However, almost any experienced caregiver will recommend enrolling in hospice as soon as possible.

The best way to know it’s time to call a hospice company is when the attending physician gives a diagnosis of six months to live. Although this is never good news to get, it will qualify your loved one for hospice care. This means their medical care will be completely paid for by Medicare and they can receive 24/7 care in some cases.

Some might still be hesitant to enroll after getting the 6 months diagnosis, because they feel like they’re giving up on their loved one, but this isn’t true. Hospice doesn’t mean giving up and hospice isn’t hopeless. It’s one of the best levels of medical care a patient can have. Hospice employees are trained to meet the unique needs of a patient in the end of life stages.

Issues like pain management, wound care, and bereavement, can all greatly improve the quality of life for the patient and their family. The goal of hospice care is to make the patient as comfortable as possible. One way we accomplish this is by treating the patient in their own home. Getting treatment in a hospital or other healthcare facilities can be intimidating and incredibly inconvenient. By allowing the patient to remain in their own home, it removes the stress and strain of traveling to and from treatment facilities.

This higher caliber of care and increased level of patient comfort are two great reasons to call a hospice as soon as your loved one qualifies. If you’re questioning whether they meet the qualifications for hospice care, call one of our transition coordinators and they will be more than happy to assist you. 

Becoming a Caregiver for Your Parent

Posted on Apr 03, 2017

Medical advances have increased the life expectancy for many Americans, which is a wonderful thing. However, this does create a problem for many families about what to do with their aging parents. As the eldest generation of the family advances in years, their health will deteriorate, and they will eventually require assistance with day-to-day tasks. When this moment hits, families are often left questioning whether it’s time to find a care facility, hire a home health aide, or assume the role a family caregiver.

When you’re questioning if you should become the primary caregiver for your parent, here are a few things to consider.

Their Medical Condition  

The first question you should ask yourself is, “how bad is their medical condition?” This will let you know if being there caregiver is even an option. Often, even though adult children are willing to assume this role, their parent’s condition requires a level of medical care they cannot provide themselves. Think about their symptoms, medication, treatment, and cognitive condition, and make sure you know what you’re getting yourself into.

Their Living Situation  

If you decide to become the caregiver, will that require your parent to move in with you? It’s very common for a parent to move in with their kids when the parent’s health begins to fade. Think about what that will logistically look like. Do you have an extra room for them, or will you need to add some square footage to the house?

Physical Requirements

Being a caregiver will involve a variety of physically demanding tasks, and you need to be prepared for the toll that it will take on your body. Help in and out of chairs, bathing, dressing, feeding, and bathroom trips are all in the job description of a caregiver.

Emotional Toll

Seeing your parent in an ailing state every day can be hard for a lot of people. Caregiving is also incredibly time consuming, which can often cause a great deal of stress. Combined, these two factors make for a very emotionally trying job.

There’s no doubt about it, caregiving is an incredibly difficult job, but, for many, it’s all worth it. Before you decide to be the primary caregiver for your parent, just make sure it’s the right decision for your parent and for you.

The Role of Hospice Social Workers

Posted on Mar 27, 2017

As we’ve discussed before, hospice care is provided by an interdisciplinary team consisting of a medical director, nurses, aides, volunteers, chaplains, and social workers. Today we’ll be taking a closer look at the role of the social worker. Most people either have no idea what a hospice social worker does, or they have negative connotations associated with the term.

The truth is, a good social worker will be your best friend when your loved one is in hospice care. Social workers are intended to be your main point of contact for anything you need during this time. As most people have never experienced hospice care, having someone who can educate you about the mechanics of the hospice benefit, assist in creating advanced health care directives, make funeral arrangements, and provide emotional support will be incredibly helpful.

If there’s ever a question the social worker can’t answer, they’ll be able to get you in touch with someone who can answer your questions. One of the biggest roles the social worker will play is filling in any gaps you or your family needs. If you ever have any problems and don’t know where to go or who to ask, the social worker is a great place to start.

At Cura-HPC, our social workers are dedicated to helping our patients and their families in whatever way they can. They are a vital part of our team and we greatly appreciate the work they do. If you have any questions about social workers, the hospice team, or just about hospice in general, please don’t hesitate to call one of our transition specialists. 

What to Expect from Home Hospice

Posted on Mar 22, 2017

With all the myths and misconceptions surrounding the hospice industry, most people have no idea what to expect when the time comes to enroll their loved one in hospice care. This is a very confusing time, and it’s hard to know what you need to do and what the hospice will take care of. This kind of reaction is understandable, and very common. When you enroll a loved one in hospice care at Cura-HPC, here’s what you can expect.

First, you’ll have a meeting with one of our transition coordinators. Once we get word you need our services, we try to schedule this meeting as soon as possible. This meeting can take place at your home, the hospital, a coffee shop, or any other place that’s convenient for you. During this meeting, we’ll explain every step to you and answer any questions you have.

The goal of this meeting is to thoroughly explain the hospice benefit and take care of the necessary paperwork required for hospice admission.

Once your loved one is officially enrolled, different members of the hospice team will begin meeting with you and the patient as soon as possible. A hospice care team is made up of a medical director, nurses, aids, social workers, volunteers, and chaplains. This team will create an individualized care plan based on the needs of the patient and the family.

When the care plan is completed, supplies will be ordered and delivered to where ever the patient is located. The hospice benefit covers practically every expense. This includes things like medication, wheelchairs, beds, bandages, and other related supplies.

A regular schedule of care will be created, but this plan is subject to change as the conditions of the patient changes. Hospice care is available 24/7 every day of the year, so we’ll be able to meet the patient’s need under any circumstances.

One of the most unique features of hospice care is that we provide care for the family as well as the patient. While your loved one is in hospice care, and for 12 months after they pass, grief and bereavement counseling will be available to you. This is intended to treat the emotional symptoms associated with the death of a loved one.

If you have any more questions regarding hospice care, or if you’re wondering if your loved one will qualify for hospice care, call us today and we’ll be more than happy to assist you in whatever way we can. 

What to Say When a Friend is Grieving

Posted on Mar 16, 2017

Grieving

When a friend experiences a loss, it’s hard to know what to say. These situations can be awkward and stressful. You want so badly to comfort and help your friend, but you’re overcome by the inability to find the right words. This is normal and somewhat expected. Remember that the mere fact you’re worried about trying to find the perfect way to comfort your friend is a sign you really care.

They say actions speak louder than words, and this certainly applies to times of grief. When someone is grieving they’ll typically have a hard time identifying their needs. So when you ask how you can help, they may not be able to articulate what they really need. This doesn’t mean you shouldn’t offer, it’s always good to let them know they can come to you if they think of anything. However, sometimes it’s just best to meet needs has you see them. If the trash is full, take it out. If the lawn is overgrown, mow it. If they don’t have the energy to cook, bring them meals.

When it does come time to talk, keep this in mind:

  • Don’t try to fix the situation
  • Focus on what they’re feeling
  • Recognize the loss
  • Don’t try to rationalize or mitigate the loss
  • Don’t put a timeline on the grief
  • Keep the focus on them
  • Don’t tell them what to do or how to feel

Helping someone through the grieving process will have many twists and turns. Some days they might need you there and others they might need space. Be flexible and sensitive to their changing needs, and don't get discouraged if they have a bad day or two. Just being constantly available is one of the best ways you can help. 

A Guide to Hospice Terminology

Posted on Mar 09, 2017

A Guide to Hospice Terminology

Like any other industry, hospice and palliative care have their own set of special terms and jargon. Although these terms can be confusing, they aren’t meant to be. It’s important to remember that it’s okay to ask questions if you don’t understand what a term means. You should never feel embarrassed about asking a hospice employee for clarification, it’s normal to experience a little confusion.  To help you understand some of these terms, we put together a list of a few commonly used hospice terms.

Apnea- This condition causes a patient to stop breathing for short periods of time. The gap between breaths could be between 10 and 60 seconds.

Buccal- Medication placed on the inside of the cheek.

Bereavement- Grief counseling made available to the family of the deceased loved one. This program will be available for 13 months after the loved one dies.

Continuous/concentrated Care- The level of care provided when the patient’s symptoms are not under control. Nurses can be assigned to the patient’s bedside for eight-hour shifts.

Dysphagia- A condition when the patient has difficulty swallowing.

GIP- This stands for general inpatient care, which is the level of care provided when the patient requires hospitalization.

IDT- An interdisciplinary team is made up of nurses, volunteers, social workers, doctors, CNAs, health aids, and a few more depending on the circumstances.

Mottling- When the skin turns a bluish color due to poor circulation.

Palliative Care- When the patient is no longer trying to cure the sickness. Instead, treatment is focused on making the patient comfortable.

Recertification- A written notice from a certified doctor that the patient still qualifies for hospice benefits.

Respite Stay- A five-day period that is used to give rest to the patient and caregiver. These are awarded on a case-by-case basis and can only be used once every 30 days.

Transdermal Patch- A small patched adhered to the skin of the patient that gives a controlled release of medication.

There are plenty more hospice terms, but this is a good start. If you have questions about hospice care or a hospice term please reach out and we’d be happy to speak with you. 

Responding to Sympathy Notes

Posted on Mar 03, 2017

After a loved one passes you’ll likely receive a fair amount of letters, cards, emails, texts, and social media posts from friends and family expressing their sympathy. These will come in all shapes and sizes, some are short and sweet and others will be more long form recalling past memories and stories. Between all these displays of sympathy flooding in and being flooded with emotions of shock and grief, it’s hard to know what to do.

The first question to answer is, which of, if any, these sympathy notes need a response? The simple answer is that you shouldn’t feel socially obligated to respond to any of these notes. Odds are no one will be offended if you don’t respond to their letters or texts. Most will understand that you’re going through a lot and probably don’t have the time or emotional capacity to answer all these notes.

However, if you do wish to respond to some or all of these, there are a few options. First, most funeral homes will have small thank you notes you can get. These cards can be used for handwritten notes, or you can even print a generic response.

Sometimes it can be therapeutic to respond to these letters, but sometimes it can be overwhelming. It’s okay if you start responding to some, but can’t get through all of them. Remember that no one will be offended if someone else gets a thank you note and they don’t. Don’t feel obligated to finish the entire list just because you started. Do what you can without overwhelming yourself.

Everyone grieves differently, so don’t feel like you need to react the same way your friends or family members do. If others want to respond and you’re not up to it, that’s okay.

Responding to sympathy notes should never be viewed as a burden or something you “have to do.” If you choose to respond, do it in a way that helps you cope with the grief you’re feeling. 

How to Talk with a Loved One with Dementia

Posted on Feb 23, 2017

Few things in end-of-life care are more heartbreaking, stressful, and scary than trying to communicate with a loved one who has dementia. When a loved one can’t remember your name or who you are it can be devastating and terrifying. This added level of emotion makes a challenging situation worse.

However, as frustrating as it can be, regular communication with dementia patients is critical to their health and treatment. If you’re struggling to communicate with a dementia patient, consider the following.

Be Positive- Even when you do get frustrated, do your best to not show it in front of your loved one. Remember that the majority of communication is nonverbal, so use your tone, body language, and facial expressions to keep things positive.  
Remove Distractions- TVs, radios, outside noises, and busy settings can all be very distracting. When the time comes to have a conversation you need to remove all possible distractions. Close the doors and windows, shut the blinds, and turn off all electronics. This will keep the focus on the conversation and reduce the risk of your loved one getting distracted.
Listen Well- It’s common for dementia patients to struggle to find words and answer questions. Be on the lookout for this, and be ready to listen with your ears and eyes. When they are struggling to find the right words or appear confused, don’t be afraid to make suggestions. It’s also helpful to read between the lines and try to figure out the meaning or feeling they’re trying to tell you.
Keep it Simple- Always ask simple questions and don’t ask more than one question at a time. Instead of asking open ended questions, give two or three options or just stick to yes or no questions.
Be Reassuring- Remember that your loved one is probably just as frustrated, if not more so, as you. If they start getting flustered give them a reassuring physical touch and let them know it’s okay. Reassure them that you’re here to help and that no one is mad at them.

Communicating with dementia patients is inevitably hard, so the most important thing to remember is that it’s normal to be frustrated. The staff at Cura-HPC is trained to help facilitate communication between dementia patients and their family. It’s just one of the ways we treat both the patient and the family.

Hospice Care vs Home Health

Posted on Feb 15, 2017

Hospice Care vs Home Health

When you have a loved one who is deteriorating in health, you’ll inevitably come across some terms you’re not familiar with. Two terms that you’ll probably hear frequently are home health and hospice (sometimes called home hospice). Unfortunately, these two terms get used interchangeably a lot, which adds to the confusion. Home health and hospice refer to two very different services for two very different scenarios.

Home Health

A patient receives home health services when they need occasional medical services. This can include: physical therapy, speech pathology, occupational therapy, or nursing care. The patient’s doctor will be in charge of overseeing treatment from the various members of the home health team. Regardless of the treatment provided, all progress will be carefully documented to chart any improvement or decline in the health of the patient.

Home health care can be provided for as long as the doctor in charge feels it is working. Once the doctor feels the patient is no longer responding well to home health care, they will recommend the patient be transferred into the care of a hospice provider. This transition isn’t an abrupt or sudden change, often there’s an overlapping period when the home health and hospice agencies are working together to ensure a smooth transition.

Hospice

In order to qualify for hospice care, a patient must have a diagnosis of less than six months from a certified doctor. In most situations, hospice care will be provided at a patient’s home from a Medicare-certified provider. A hospice care team will of some combination of a: social worker, doctor, chaplain, bereavement specialist, volunteer, nurse, and hospice aid.

Although hospice patients are required to have a six-month prognosis, patients can receive care for longer than six months if their physician continues to give a limited life expectancy prognosis. Another big difference between hospice and home health is that Medicare can cover 100% of hospice costs including personal care and equipment, and hospice is available for 24/7 care.

We hope this clears up some confusion, and we hope you’ll consider using Cura-HPC when the time comes for one of your loved ones to enter hospice care. 

The Different Kinds of Power of Attorney

Posted on Feb 10, 2017

power of attorney

Most people have heard the term “power of attorney” before, but a lot of people don’t know that there are actually two different kinds – medical and financial. It’s important to designate both, because only designating a financial power of attorney will not allow your representative to make health care decisions, and vice versa. Laws concerning power of attorney vary from state to state so it’s always a good idea to consult a skilled estate planning lawyer when making these sort of plans.

What Does Power of Attorney Do?

This document allows you to guarantee your medical and financial desires are adhered to in the event you are incapacitated. This is done through a trusted person you elect to carry out your final wishes and make any necessary decisions.

Medical Power of Attorney

A medical power of attorney gives your representative the ability to make decisions about your treatment options and when to remove feeding tubes and ventilators. This person will be charged with making any decision that is not covered in an advance directive.

Financial Power of Attorney

A financial power of attorney will have control of paying bills and selling any assets. They will also have access to any banking and investment accounts, and can make withdraws in order to pay for necessary goods and services.

It is possible to designate the same person as both medical and financial power of attorney, and this is actually quite common. The person you choose could be a friend, family member, or even a lawyer, all that matters is that you pick a competent person you can trust. Once you’ve decided who is right for each role, give a copy of your advance directive if you have one, and go over it to see if they have any questions. 

What to Know About Dementia

Posted on Feb 03, 2017

Dementia is a word most are familiar with, but few fully understand. The majority of people probably think of dementia as a condition that affects memory. While this is part of dementia, it’s not a full and accurate view of the disease. Dementia is actually a fatal disease for which there is no cure.

There are three primary stages of dementia and it’s best for people with older loved ones to be aware of all three stages to spot the early signs of the disease.

Early Stage- The first signs of early stage dementia are small memory lapses like frequently losing or misplacing things. They might also struggle to remember names or words in conversation. Many may try to write this off as a natural consequence of getting older, but if you notice these signs there are early treatment methods that might be beneficial.
Middle Stage- As dementia progresses, individuals will have trouble remembering where they are and what they’re doing. Planning and organizing their days will become increasingly harder as well. Changes in personality or sleep patterns are also very common for this phase.
Late Stage- Once they enter late stage dementia, the individual will require round the clock care. Taking care of themselves, dressing, and eating will all require the assistance of someone else. During this stage, they are also incredibly susceptible to infections and other diseases so keeping up proper hygiene is very important.

How Can Hospice Help?

Once a dementia patient reaches the point that they qualify for hospice care, there are many ways a trained hospice caregiver can help. Typically, in late stage dementia communication is very limited, so it can be hard to understand what the patient needs to be comfortable. Our staff is trained to understand and treat the needs of dementia patients. We can also help family members understand what their loved one is going through and how they can best offer support. 

How to Deal with Anticipatory Grief

Posted on Jan 27, 2017

When a loved one enters into end of life care, it’s natural for family members to experience a reaction known as anticipatory grief. This refers to feeling grief before an impending loss. The emotions associated with anticipatory grief can be hard to understand and manage, but it’s important to remember that this is a natural and common reaction to an approaching loss of a loved one. When going through anticipatory grief here are a few helpful things to keep in mind.

Acknowledge Your Grief- A very common tendency when experiencing anticipatory grief is trying to suppress the grief because you’re loved one is still alive. It’s important to let yourself start the grieving process and not feel like you need to hide your grief. Try to find ways to express your grief in healthy ways like journaling or art.

Reach Out- Odds are you’re not the only one in your family or group of friends who is having anticipatory grief. Don’t be afraid to reach out and talk about what you’re going through with other friends or family. If you’re not ready to talk with people you know yet, find an online forum or a grief counselor to talk with.

It’s Not Giving Up- Just because you accept your grief and are dealing with it doesn’t mean you’re giving up on your loved one. You can still be there to support them, love them, and care for them. Don’t feel like you’re losing all hope of recovery or accepting the inevitable. It’s okay to experience grief and still be hopeful at the same time.

Cherish the Remaining Time- Do your best to enjoy the time you have left with your loved one. When you’re with them, don’t focus on the grief just make the most of the time. Think about how they would want to spend time with you and try to make it happen.

Take Care of Yourself- Greif, even anticipatory grief, can take a huge toll on you. Make sure you’re still sticking to your regular diet and exercise schedule. Avoid the temptation to stay cooped up at home all day. Even in small doses, human interaction and fresh air will go a long way.

The biggest thing to remember is that anticipatory grief is normal, so don’t feel like you need to hide from it. If you feel like the grief is getting to be too much to handle, find an experienced grief counselor to help you work through it. 

Managing Long-distance Caregiving

Posted on Jan 23, 2017

Trying to manage end of life care for a loved one when you’re hundreds or even thousands of miles away presents a set of problems few know how to deal with. While this is certainly a difficult time, there are a few things you can do to make it more bearable.

Have an Emergency Plan

Make sure you have a written plan for emergencies your care provider can follow when needed. Having this plan will greatly reduce the stress you feel for not being there when an emergency happens. This plan should include advance directive and power of attorney for medical and financial decisions that might need to be made. A list of contacts for doctors, pharmacies, and lawyers should be included as well. In addition to this plan, ear mark some money for last minute travels and let your employer know you might need to take some time off soon.

Find the Right People

Since you can’t be there, assemble a team of people you trust to take care of your loved one’s needs. Create a list of local friends and family members who can help check in on your loved one from time to time. See if they would also be willing to meet with healthcare providers to ensure your loved one is getting the best possible care.

Maximize Visits

When you’re caring long-distance, the few moments of in person time is incredibly valuable. To make the most of every visit it’s best to talk to the healthcare provider before visiting to get an update on the condition of the loved one. Also ask if there are any appointments that will need to happen while you’re visiting. While you’re there try to take inventory of supplies in the house and double check that all bills are being paid. It’s also important to be intentional about assessing the needs of your loved one to see if their care program needs to be adjusted.

Providing end of life care via long-distance is never easy, but you can make it better. One of the best ways to facilitate long-distance care is to partner with an experienced hospice care facility like Cura-HPC. Our staff will guide you through this process and help make this difficult time easier. 

How To Explain Hospice Care To Kids

Posted on Jan 11, 2017

How To Explain Hospice Care To Kids

Wrapping your head around moving a loved one into hospice care can take some time, and this goes double for explaining hospice care to kids. When you’re explaining hospice care to your child here are a few things to keep in mind.

Just Start Talking- One of the biggest hurdles to overcome is often starting the conversation. It’s easy to keep waiting for the “right time”, but the reality is there will never be the perfect moment. Once you start the conversation, try to get to the point as soon as possible. Kids don’t have long attention spans, so try to not waste time beating around the bush. It’s also a good idea to use small words and avoid using complicated medical terms.

Defining Hospice- When explaining why you’re moving grandma or grandpa from the hospital into palliative or hospice care, the main points you need to communicate is how this will help the sick family member. Let your child know that this will make them much more comfortable and increase their quality of life.

Check For Misunderstanding- After you finish talking, ask if they have any questions about what’s happening. You might need to ask this in a few different ways to make sure they fully understand everything that’s happening. While you’re checking for questions, take time to reiterate that it’s okay to be sad and upset about this. Let them know you’re sad too and they can talk with you about what they’re feeling.

Watch for Cues- Finally, in the coming days watch out for certain cues that will show how well your child is dealing with everything. If they exhibit loss of appetite, mood swings, or loss of interest in things that use to excite them, it might be time for a follow up talk.

Explaining hospice care to kids isn’t something any parent is ever ready to do, but with these steps any parent can handle it. At CURA-HPC we want to be a resource to you and your family as you go through this difficult time. Our staff is highly skilled in taking care of both the medical and emotional aspects of end of life care.  

Grieving During the Holiday Season: Tips for How to Cope

Posted on Dec 09, 2016

Family Christmas

The first holiday while grieving for a loved one is always the most difficult. Remember that grief doesn't start after death, but rather when you start to accept death as a looming inevitability. Understanding these key details about grief will help you cope with it through a difficult holiday season. 

If you, or a loved one, are dealing with grief this holiday season, the following tips can help you make it through. 

Be realistic

The reason that it's important to understand the difficulty of coping with grief is that it will help you set realistic expectations for yourself. You may not be able to handle all of your typical holiday responsibilities. Between cooking, shopping, traveling and other annual holiday responsibilities, it's a stressful time for everyone. When you're also coping with grief, and potentialy providing care to an ailing loved one, there's not enough time to get everything done. Don't be ashamed to ask for help, and take others up on their offers. Think about upcoming events and decide if you want to attend them, or if alternate plans should be made. 

Let loved ones help

Whether they're there to help, or just there to provide comfort and fellowship, it's important to surround yourself with family and friends. These are the people that both care about you, and understand the grief you're currently experiencing. If you need to change your typicaly holiday plans, talk to your loved ones so they can still spend time with you. Don't cancel plans and try to spend too much time alone. Also, don't be afraid to share memories about the individual who is sick or recently passed away. These memories can often be a source of comfort. 

Let yourself be emotional

Especially when you're spending time around family that may also be grieving during the holidays, it's common to try to stifle your natural emotions and grieve the same way others are. No one grieves the same way, however. Your needs will be different than even those in your own family. While some will feel sadness, or even anger during the grieving process, others will want to share memories, laugh and feel joy. Neither of these methods are wrong. Neither mean you've forgotten or dishonored the recently deceased. Let yourself grieve your own way, and let others grieve their own way. 

Don't forget self care

If your grieving process includes prolonged periods of sadness, it can also lead to an abandonment of self care. Proper hygiene can be forgotten for days at a time, and you may become more sedentary. Physical exercise can often be an anti-depressant, and sometimes getting out of the house just to run an errand can make you feel better too. Be aware of how you're feeling, however, and avoid crowded places or a hectic schedule when you start to feel overwhelmed. Avoid self-medicating with alcohol, food, or other substances. Overall, simply be aware of your own well-being and do what is best for you. 

The holidays can be difficult when you're grieving, but when you have a plan and a support group of loved ones to help you, you can enjoy them.

At Cura-HPC, we know about grief and provide bereavement support to families of our patients for 13 months following death. If you or a loved one are in need of hospice care, contact us at 800-797-3839.  

How to Provide Effective Support to Those Experiencing Greif

Posted on Dec 05, 2016

Grief Support

Hospice care extends far beyond the medical care of the patient. A number of other services that benefit both the patient themselves and their family and loved ones are available and part of a typical care plan. One of these is bereavement care, which is provided to loved ones for 13 months following the patient's death. 

Grief and mourning is a natural part of this process, but often one that is difficult not only for the individual experiencing it, but also for those around them who want to help. Here are some thoughts on grief and mourning that might help you be of service to someone close to you who has recently experienced a loved one's death. 

What you need to help someone who's grieving

It can be difficult to help a friend who is grieving for a number of reasons. You can't bring back their loved one. And the uncomfortableness of death makes it hard for many of us to find the right words or actions to bring relief. Additionally, everyone grieves and mourns differently. So what is right for one person may not be comforting to another. There are some common things that everyone needs when helping a mourning friend, however. That includes plenty of time so you can be available to them and not make them feel rushed or like an inconvenience. You'll also need patience, perserverance, flexibility, optimism, understanding, warmth, and of course, compassion. You do not have to always know the perfect thing to say, or the perfect thing to do. Just being present, not judging, and trying to identify with the mourner is enough. 

Grief doesn't only begin after death

Many associate grief with the loss of a loved one, but for many, grief begins with the anticipation of loss. That can be as early as a terminal diagnosis is given as family begin to accept death as an inevitable outcome soon to occur. This grief combines not only the emotions that come with the loss of a family member, but also the physical and mental fatigue and general overwhelmed feeling that comes with caregiving. Understanding these finer details of grief can help you offer better support to those in need. 

Keys to successful support of somone who's grieving

As mentioned, everyone grieves in different ways. Each situation will be unique, but each will share a need for these keys of support. 

To offer support, you should be present. That means both physically present and mentally present. Put everything else on hold and put your phone away in order to support the needs of the mourner. 

Be able to demonstrate that you care for the person greiving. That can be done in a variety of ways, and being able to demonstrate this using the connection the two of you share will be especially meaningful. 

Be able to honor the journey through grief. This means not being judgmental and fully supporting the ways in which the individual chooses to grieve. That includes honoring and supporting family, cultural and religious traditions that may be involved in the grieving process. 

Your ultimate goal should be to help maintain the physical health, and emotional stability of the individual grieving. 

If you have questions about hospice care, the benefits it provides to both patients and their families, or end of life care in general, please contact us at Cura-HPC- 800-797-3839. 

Palliative Care Provides Better Quality of Life When Started Early

Posted on Sep 09, 2016

Nurse helping patient

Multiple studies have concluded that patients who enter hospice earlier, and spend more time in hospice care before death experience greater benefits. Now, a recent study has found that palliative care can have similar effects when initiated early in treatment. 

A research team at the Center for Psychiatric Oncology & Behavioral Sciences at Massachusetts General Hospital studied a group of patients with advanced lung and gastrointenstinal cancers to determine the effect palliative care had on their quality of life and coping abilities. The conclusion the team made at the end of the study was that early intervention of palliative care improved both of those metrics. 

Researchers began by organizing a group of 350 patients, who had recently been diagnosed with cancer. In doing so, they hoped to discover what palliative care administered early in treatment could do, as opposed to starting palliative care well after diagnosis. Randomly, this group was split with half set to receive palliative care, and the other half receiving usual care. 

In order to evaluate quality of life and mood, the patients were asked to complete questionnaires at intervals throughout the study. At the outset of the study, at 12 weeks, and at 24 weeks, the Functional Assessment of Cancer Therapy, and the Patient Health Quesionnaire were completed. The Brief COPE was also used in order to measure the patients' acceptance of their diagnosis, and their use of emotional support. 

These surveys showed that the group receiving palliative care felt they had a better quality of life and were experiencing less depression by 24 weeks. At the previous two intervals, the two groups were comparable on these two metrics. 

The palliative care group also were shown to be more likely to use active and engaging coping methods after 24 weeks of treatment than the group receiving usual care. 

Perhaps most interesting, the group in palliative care was more likely to have discussed end of life care options with family members and physicians than the group in usual care. That despite the fact that both groups contained a similar number of patients who considered their cancer unlikely to be cured. 

Researchers are confident that even though this study focused on specific types of cancer, the model of introducing palliative care early in treatment would prove to be similarly beneficial to other cancer patients, and likely patients with other illnesses as well. 

At Cura-HPC, we provide hospice and palliative care to patients throughout the Tulsa area, and Northeastern Oklahoma. If you have questions about end of life care for yourself or a loved one, we'd love for you to contact us at 800-797-3839. 

Research Determines Which Hospice Practices Are Most Beneficial To Patients

Posted on Jul 14, 2016

Discussing end of life care options

Too little research has been performed to determine exactly what hospice practices and services make the biggest impact on patient outcomes. While the Affordable Care Act requires hospices to report on specific practices being used, they do not require information on how these practices ultimately affect patients. A research team at the Icahn School of Medicine at Mount Sinai recently set out to determine how these hospice practices influenced patients' hospitilzations and which were the most beneficial. 

To begin, the researchers segmented a group of about 150 thousand Medicare beneficiaries enrolled in hospices throughout the US. Those that were studied entered hospice between 2008 and 2011 and were tracked until their deaths. The team noted each patient's hospital admittal, both emergency department visits and intensive care unit stays, and the location of each death. 

They studied six hospice practices, but of that group, only two were determined to make a significant impact on a patient's need for hospital admittance. 

First, hospices that talked to their patients about their preference on dying at home versus in a hospital or nursing facility reported lower odds of hospital deaths for their patients. Interestingly, those hospices also were determined to have lower odds of emergency department visits while a patient was enrolled in hospice care. 

Second, hospices that regularly monitored a patient's symptoms, at intervals at least every few days, showed lower odds of patients being admitted to the ICU. 

Neither of these are complex processes, but these findings suggesting they can have a significant impact on a patient's end of life care and quality of life can be used by hospices nationwide to lower hospitalization costs and improve the quality of care for patients. 

Ensuring that all hospices deliver these beneficial practices to each patient would have an enormous impact due to the growing rate of hospice use in the US. Hospice enrollment has grown by 20% over the past decade, and about 45 percent of terminally ill patients in the US die under hospice care. 

The results of this study suggest that not every hospice is created equal, and that the specific services and practices offered should be a determinant for individual's before enrolling themselves or their loved ones. 

To learn about our practices, goals, and philosophy of care at Cura-HPC, we invite you to contact us to schedule a consultation: (800) 797-3839. 

Hospice Care and Care Costs the Focus of Recent Study

Posted on May 19, 2016

Group of seniors in nursing facility

Recently, the true cost of hospice care has been a point of debate. Not only is the cost of care a concern for individuals and their families, but it's also a concern for government officials who must regulate the money spent through Medicare and Medicaid and ensure it's being spent honestly and with a valuable return. A recent study looked into how hospice care for nursing home patients impacted their care costs. Here's an overview of the findings from the research team from Indiana University's Center for Aging Research and the Regenstrief Institute. 

The team began by examining 2,510 long stay nursing home residents, of which a third received hospice care. According to their research, age, race and gender had no bearing on the findings concerning care costs and hospice care. 

They concluded that, even in cases where hospice care is provided for a prolonged amount of time, hospice services don't increase care costs for nursing home residents over the last six months of life. 

The primary factor that appears to allow hospice services to be administered without significantly raising care costs is that hospice patients are typically able to avoid costly hospitilization and the post-acute care that follows it late in life. 

While many may believe that hospice is given to patients in their own homes, and that is often the case, hospice care also takes place in nursing homes with specially trained hospice nurses and other staff come to the facility the same way they'd come to a patient's home. There are some additional obstacles and concerns when administering hospice and palliative care in nursing facilities. Namely, that it can be difficult to determine when residents with some diagnoses enter into the last few months of their life. 

These obstacles may be why many have questioned whether Medicare's hospice benefit is being used appropriately specifically for nursing facilty residents. The research conducted by Indiana University, however, found no evidence of cost shifting or dishonest spending. 

In most cases, there was little to no difference found between those in nursing facilities that elected to begin hospice care, and those that decided to forego hospice care. Two exceptions, cancer patients and advanced dementia patients, were found to elect hospice care more often than average. These findings are consistent with hospice statistics for patients outside of nursing facilities, as well. 

It's also important to note that the individuals studies in this research were predominantly disproportionately poor, non-white, and had been characterized by high health care costs. These individuals are rarely included in healthcare utilization studies. 

If you have questions about whether or not hospice and palliative care is right for you or a loved one, please contact us at Cura-HPC in Tulsa, Oklahoma: 800-797-3839. 

The Importance of a Conversation About Death and Dying

Posted on May 11, 2016

Senior couple conversation

We often urge people to begin planning for end of life care, and researching care options like hospice and palliative care well before they or their loved ones actually need it. This way, your research can be conducted with less stress, and you can take your time interviewing medical professionals, discussing your options with your family, and ensuring you're making the right choices. That process typically begins with an open conversation about death and dying, which is a topic that many of us shy away from for as long as possible. Death isn't seen as a fun topic to discuss, but a conversation with your loved ones about your wishes, needs, and hopes is extremely valuable. Here are a few reasons why. 

Make choices 

There are typically two groups that are in desperate need of a frank, open discussion about death. First is the individuals who have thought about it themselves, made some decisions, but haven't communicated those choices to their family or doctor. This group risks becoming ill and not being able to tell those around them how they'd like to be treated. The other group is the individuals who have completely avoided thinking about death, end of life medical care, and other arrangements. This group risks creating a stressful, confusing experience for their loved ones when they near death. Both groups need to plan a discussion about their death, but what should be discussed and decided? Run through these common questions and communicate your choices: 

  • Do I have a will in place? 
  • Do I have plans or specific wishes for my funeral? 
  • What type of medical care do I want to receive? 
  • Do I want to be an organ donor? 
  • Have I planned for financial and tax issues?
  • Am I properly insured? 
  • Have I put these wishes in writing, and communicated them to my family and physician? 

Find opportunities

Thinking about these topics and discussing them isn't only about planning for your death. There's also the benefit that thinking along these lines can illuminate opportunities that help you live better. You may begin to put more emphasis on having buket list type experiences. You may stop putting off that once in a lifetime trip, or finally learn a skill you've been dreaming about. Talking about death and dying can help you see clearly what regrets you'd have if your life ended today. If that leads to amazing experiences, or reconnecting with loved ones you've lost touched with, it makes your conversation about death well worth it. 

Reduce stress

When an individual gets ill, it's often a stressful time for everyone involved. Making these plans ahead of time, and discussing them with your loved ones, greatly reduces these stressful moments for you and your family. Having this conversation can even help to identify concerns that you or others may already be stressed about. Once identified, you can be sure to make plans and alleviate that stress. Then, once your decisions are needed, your family will already have plans in place and can spend more time with you and less time scrambling to make arrangements. 

To learn about hospice and palliative care in Oklahoma, contact us at Cura-HPC: 800-797-3839. 

The Mediterranean Diet Shows Promising Health Benefits

Posted on May 04, 2016

Salmon with vegetables

You likely already know that your diet has a significant effect on your health. Not only does the food we eat influence how we feel today, but it also influences our long term health. Research conducted by a European project, NU-AGE, recently looked into the Mediterranean diet and it's health benefits in the long term. Their findings suggest that sticking to a strict Mediterranean diet could slow down the aging process and keep bones healthier as we age. 

First, a few notes on the Mediterranean diet. The most notable emphasis is a limitation of red meat. Those following the diet include red meat in their meals only a handful of times each month. Instead, fish is eaten on a regular basis, especially species that are rich in omega-3 fatty acids, which includes salmon, mackerel, albacore tuna and trout. Additional protein is taken from legumes and nuts. Fruits, vegetables, and whole grains are also prioritized in each meal. Butter is ideally removed completely and healthy fats like olive oil are used as alternatives. Salt is also removed or extremely limited and food is instead flavored with herbs and spices. 

Previous studies have revealed that this type of diet reduces the risk of many varieties of heart disease, but NU-AGE also concluded that C-reactive protein, an inflammatory marker linked with ageing, significantly decreased. The rate of bone loss for those with osteoporosis was also reduced. 

To reach these findings researchers recruited 1142 participants over the age of 65 across five European countries, France, Italy, Netherlands, Poland and the UK. Each individual was instructed to follow a personally tailored Mediterranean style diet. 

In addition to findings directly related to health, researchers also learned of significant differences between nutrition education that exists between residents of different countries and in different socio-economic groups. For example, more than 70 percent of French and British participants responded that their nutrition knowledge was high, whereas only about 30 percent said the same in Poland. Participants from the UK and Netherlands scored the highest on the understanding of nutrition information and food labels, while Italian participants scored the lowest. 

While this particular study exposed differences in European countries, similar conclusions can be drawn about different groups in the US. There certainly exists a different understanding and trust of food labels in different parts of the country. This lack of nutrition education can increase the likelihood of unhealthy diets, which raises the risks for a number of health issues later in life. 

At Cura-HPC, we provide hospice and palliative care to those with life-limiting illnesses. To learn more about the services we provide and gain insight into whether they're right for you or a loved one, contact us at (800)797-3839. 

Hospice Care Shown To Reduce Symptoms in Older Adults

Posted on Apr 27, 2016

Senior woman potting flowers

There have been multiple studies that attempt to quantify the positive effects hospice care has on patients in the last weeks and months of their lives. While some have focused on the amount of time a patient may enjoy in hospice care, a study conducted by Yale researchers has been used to show how quality of life is impacted by hopsice through decreased symptoms. The Precipitating Events Project, PEP, enrolled 754 adults over the age of 70, who lived in the community, rather than an in-patient facility or nursing home, and were not disabled. These participants were interviewed monthly until their death about their health. The results of this study have allowed for a number of subsequent studies into what impacts a person's life and health in the months before death. Here, we focus on a study recently published in the American Journal of Medicine, which tracked the monthly occurrence of symptoms in these individuals and how those symptoms changed after enrollment in hospice care. 

The results of this study show two things. First, for most individuals, hospice care was reserved for a time when the number and prevelence of symptoms that restrict daily activity increased sharply. For example, the mean number of activity limiting symptoms rose from one to three over a three month period immediately prior to hospice enrollment. The prevelence of any activity limiting symptom rose from about 25-percent to over 50-percent in the same time period. 

Second, the data shows that following hospice enrollment, these same metrics decreased sharply and nearly returned to the levels of four months prior to enrollment. Over the first 90 days in hospice care, the number of symptoms fell to less than two. In the same period, the prevelence of symptoms dropped more than 20-percent. It should be noted that patients typically required up to a month to begin seeing significant reductions in their acitivity limiting symptoms. 

The first takeaway is not surprising. Families and patients typically wait to enroll in hospice until the quality of life of the patient has been significant affected. The Hospice Medicare benefit also doesn't allow for enrollment until a patient receives a diagnosis with a life expectancy of 6 months or less. 

Even so, the mean time from admission in hospice care to death was only about 15 days. This means that many patients both don't receive the full benefit of hospice care, and spend an unnecessary amount of time battling limiting symptoms before enrolling in hospice. 

The second takeaway is made even more meaningful when you examine the specific symptoms that hospice helps to reduce. The most common symptoms affected by hospice for participants in this study were fatigue, depression, anxiety, and arm or leg weakness. Each of these directly contributes to a patient's quality of life, and, as they improve, introduce opportunities to enjoy activities they otherwise would have missed out on. 

In addition to these findings, the PEP data has been instrumental in other research, including disability trajectories in the last year of life, and the prevelence of dyspnea in older adults in the last year of life. 

If you or a loved one are in need of hospice or palliative care, or if you'd like to research these care options, please contact us at Cura-HPC by calling 1-800-797-3839. 

Two Categories of Advancement in Early Alzheimer's Detection

Posted on Apr 22, 2016

Doctor studying brain scan

Alzheimer's disease leads to cognitive decline and mental deterioration that significantly impacts an individual's personal life, and health. While there's not currently a cure for Alzheimer's, a great deal of research is being conducted to get closer to finding one. In the meantime, treatment and management of this disease improves greatly when it's caught in its early stages. Recent breakthroughs in testing have allowed for earlier diagnoses. Here are the details of two of these advances. 

Biomarkers

Also referred to as their full name, biological markers, these genes or molecules represent a tremendous opportunity in Alzheimer's research because of their unique ability to detect when something is wrong within a human system. By studying biomarkers, experts are able to discern when physiological damage or a disease is present within an individual, and can even categorize the specific issue. Biomarker research has concluded that it would be possible to detect Alzheimer's disease in its earliest stages, and potentially before any other type of detection currently available. To date, however, specific biomarkers for Alzheimer's haven't been identified or clinically validated. Research is headed in this direction by studying brain imaging and cerebral spinal fluid protein, while also utilizing genetic risk profiling. 

Brain Imaging

Because of the nature of Alzheimer's disease and its affect on the brain, brain imaging is another promising option for early detection. This would be the MRI, CT, or PET scans that have become common to perform when diagnosing any type of disorder to issue that's related to the brain. As Alzheimer's develops, amyloid plaque begins to build up in the brain, which shows up in brain imaging scans. Amyloid plaque can also be an indication of other disorders. Research seems to be farther along with brain imaging and closer to being able to implement more early detection testing in real world applications. There are even new brain imaging processes in the works that will help doctors identify Alzheimer's specifically without the use of radiation, and at a fraction of the cost of other brain scans. One such technique called arterial spin labeling, or ASL-MRI, requires about 20 additional minutes than a typical MRI, and is able to pinpoint changes in blood flow and increases in blood sugars that would be a symptom of Alzheimer's disease. 

Alzheimer's patients are among the individuals we commonly treat under hospice and palliative care at Cura-HPC. To learn more about our care options, contact us at 1-800-797-3839. 

4 Common Mistakes Made When Planning For End of Life Care

Posted on Apr 14, 2016

Couple discussing advance directives

For most of us, researching hospice care, and other care options for ourselves or aging, or ill relatives, only happens when there's an immediate need. Too often, creating a care plan for ourselves is neglected and forgotten until it's the situation becomes dire. Recent research has revealed, however, that those that create a definitive plan for their care near the end of their life also spend less time in the hospital, and receive fewer intensive treatments. Overall, the quality of life for those with advanced directives in place is generally better than those that have no plan in place. Despite this knowledge, less than 30 percent of Americans have put their treatment wishes in writing. It's important for adults at any age to begin to take their end of life care options into consideration. When you do, here are some common mistakes to avoid. 

The Wrong Proxy

One reason why it's important to have a detailed care plan in writing is that you may be incapacitated or unable to speak when you need medical care. In that case, having a plan will help guide your treatment, but you'll also need to choose a healthcare proxy who can ensure your wishes are carried out and make any decisions that aren't explicit in your plan. This proxy can be a friend, relative, or anyone you trust, but it should be chosen carefully. You'll need someone who is strong enough to stand up to those who may oppose your wishes, whether that's your physician or your family. It's typically easier if your proxy agrees with the choices you've made, or at least respects your decisions. And, the current age and health of your prospective proxy should also be taken into consideration to ensure they're physically and mentally able to handle the job when you need them. 

Bogged Down in Details

As soon as you begin to consider your treatment options, you'll likely realize that there is an endless number of potential decisions and scenarios to consider. Trying to make individual choices based on certain outcomes is a waste of time, and it's unlikely that you'll cover all the possibilities anyway. Instead, start from the end and answer broader questions. For example, what details are important to you about your death. That includes where you'd like to be, who you'd like to be around, how aggressive your treatments should be leading up to that day, and similar considerations. Once you've answered that question, decisions on smaller details will fall into place as well. 

Not Involving Your Doctor

There's a good chance that your doctor knows more about your illness and overall health than even you do. Not only that, but in most cases, your doctor will be the one expected to provide the treatments that are important to you, or to oversee your care in some fashion. If you don't involve your doctor in your care plans, it increases the risk that your wishes won't be carried out properly. Only about 25 percent of individuals who have an advanced directive in place involved their physician in creating it, or even informed their doctor that paperwork existed. By meeting with your doctor when you're creating these documents, you'll have more information about the care choices you're considering, and your doctor will know what the plan is, and what to do when this scenario occurs. 

Not Communicating With Loved Ones

Just as you need to have your doctor's involvement in your advanced planning, you also need the involvement of your loved ones. A recent survey revealed that nearly everyone would agree that it's important to discuss end of life care plans with their family, less than a third of these individuals had actually had these conversations. This lack of communication can lead to disagreements, fights, and your wishes not being followed correctly. Gather those closest to you, ideally all at once, and explain to them what choices you've made, and give each of them a copy of your advance directive. This way, they all have the same information and can work together to help you get the treatment you want. 

In addition to this advice, it's important that you revisit your care options documents periodically. As you age, and as your situations changes, and the situations of those around you, you'll want to update and revise your decisions. 

For help gathering information about hospice and palliative care, and making informed decisions about your end of life treatment, contact us at Cura-HPC. 

Associations Found Between Diet and Cancer Risks

Posted on Apr 07, 2016

Woman eating salad

Many of the patients we provide hospice and palliative care for are battling cancer. While there are multiple causes of cancer, one recent study found how your diet directly influences your risk of certain types of cancer. Completed by a PhD student at NYU, research discovered certain foods that could triple the risk of developing prostate cancer, and other foods that help reduce the risk of developing breast cancer by two-thirds. Here's an overview of the study and its findings. 

Researchers in the health field have found repeatedly that health risks like heart disease, weight gain, and others can be directly tied to the over-consumption of refined, processed carbohydrates. Additionally, this study at NYU found that these unhealthy carbs also greatly increase the risk of prostate cancer. 

To reach this conclusion, data from 3100 individuals was collected by conducting questionnaires about each individual's eating habits. The food sources the individuals consumed were divided between glycemic index (GI) and glycemic load (GL). 

GI is a measure of a carbohydrates quality, as determined by its impact on blood sugar levels compared to another food for a point of reference. 

GL is a measure of both the quality and the quantity of carbs found in a specific food. 

With these categories lined out for each individual's diet, researchers were able to find correlations between cancer rates, and the intake of carbs. Specifically, regular foods with a high GL led to an 88 percent higher risk of prostate cancer. 

Meanwhile, regular consumption of foods with a low GI was found to be associated with a 67 percent lower risk of breast cancer. 

This second, positive distinction stemmed from the discovery that females in the study with higher proportion of their total diet made up of carbs also had a lower occurrence of breast cancer. Those whose diets included the largest quantity of carbs also included the largest quantity of quality carbs like fruits, vegetables, whole grains and legumes.

This led to the conclusion that the type of carbs consumed is more important than the sheer volume. While eating a diet filled with healthy carbs can help to lower the risk of many health issues, consuming unhealthy carbs like pizza, burgers, and processed lunch foods has the opposite effect.

Changing your diet now could very well help you avoid cancer. 

If you or a loved one are already battling this debilitating disease and want to explore care options, contact us at Cura-HPC at (800)797-3839. 

Five Early Warning Signs of Depression in Seniors

Posted on Mar 29, 2016

Senior couple with doctor

Depression in older adults can occur for a variety of reasons. It can stem from physical health problems, a lack of social interaction, grief or a number of other factors. For caregivers and loved ones, it's important to recognize the warning signs associated with depression and intervene as early as possible. Here are a few of the most common signs of depression in seniors. 

Sadness

Most of us associate depression with extended periods of sadness, particularly when the cause of the sadness isn't evident. This sadness may be caused by an individual not feeling useful, or not having purpose. But, many seniors suffering from depression also report an absence of sadness. Instead, you should also watch for signs of low motivation, or a lack of energy. 

Fatigue

That lack of energy, or excessive fatigue, can be a serious problem. This fatigue can lead to exacerbated symptoms like a lack of exercise, and lack of interaction with others. Seniors who feel tired at all times may resist going outside, or attending family get togethers, which only further complicates their depression. This is a particularly important symptom to watch for in seniors because not only can it be a sign of depression, but also of a number of other illnesses and maladies that should be investigated by a doctor. 

Isolation

Staying away from loved ones, and staying isolated, doesn't have to involve fatigue. In some cases, depression causes seniors to avoid social interactions for other reasons. Sometimes, for no clear reason at all. This can also come with feelings of anxiety, worry, or irritability. Staying isolated creates more problems, however, so it's generally important to get help that allows your loved one to resume activities they enjoy. 

Loss of appetite 

In many instances of senior depression, an individual will suddenly show little to no interest in food. Obviously, this leads to a lack of proper nutrition, which can cause a number of other health problems. This is often an early symptom of developing depression, so intervening at this phase could help to prevent further symptoms. In addition to enlisting the help of a professional, loss of appetite can be helped in the short term by encouraging your loved one to eat several smaller meals or snacks throughout the day, rather than three larger meals at traditional meal times. 

Irregular sleep

Sleep patterns can be a clear sign that a senior is struggling with depression, or other health issues. Depression, specifically, can impact an individual's sleep in different ways, however. For some, they experience a difficulty falling asleep, or wake up constantly throughout the night. For others, they sleep more, often oversleeping, or falling asleep during the day after long periods of rest at night. These irregular sleep patterns contribute to the other symptoms discussed here and warrant an appointment with a medical professional.  

These are just a few of the common symptoms that could indicate a senior is struggling with depression. 

At Cura-HPC, we offer assistance and care that helps to identify and prevent depression and other common issues that occur during end of life care. To learn more about palliative care and hospice care, contact us by calling 800-797-3839. 

Research Shows Link Between Exercise and Brain Aging

Posted on Mar 24, 2016

Seniors lifting weights

The link between exercise and cognitive decline has been well researched and documented. One recent study found that any amount of exercise can reduce an individual's risk of Alzheimer's disease by 50 percent. A similar study found that regular exercise for individuals in middle age and up was able to keep their brains healthier, particularly in areas of the brain linked to memory. The most recent study in this area was conducted at the University of Miami, Florida and researched how exercise impacted thinking skills in individuals over the age of 50. 

The Miami study, headed up by Dr. Clinton B. Wright, began with gathering data for 876 adults over the age of 50 with an average age of 71. None of these individuals had pre-existing cognitive issues. Initially, participants were surveyed to discover their exercise habits. 

About 90 percent of the participants reported engaging in no exercise, or light exercise, in the previous two weeks. Yoga or walking would be classified as light exercise for the purpose of this study. 

The remaining 10 percent reported engaging in activities like running or aerobics, which this study classified as moderate to high intensity exercise. 

After seven years, participants underwent MRIs for brain imaging, and took tests for memory and thinking. Similar tests were given again another five years later, 12 years after the initial survey. 

The findings of the cognitive testing drew a stark difference between those in the 'no exercise' group and those in the 'moderate exercise' group. When compared to those who regularly participated in at least moderate exercise, the individuals who did not exercise regularly aged about twice as fast. As the study puts it,

"Those who did light or no exercise demonstrated a decline in memory and thinking skills over a 5 year period that was comparable to 10 years of aging."

The research team then went to work to eliminate other factors that could be causing these results. Those factors included alcohol consumption, smoking status, body mass index and blood pressure. After accounting for these factors, the link to a lack of exercise and an increased rate of cognitive decline remained. 

These results are not meant to suggest that exercise cures cognitive impairment, or even stops it completely. This study only concludes that moderate to high intensity exercise in older adults often slows the rate of cognitive decline and delays the aging of the brain. And, as Dr. Wright notes, more research is needed to confirm these results. 

For the time being, it seems clear that regular exercise can be extremely beneficial for seniors and have lasting impacts on their mental and physical health. 

If you or a loved one are experiencing health issues, it may be a good time to explore care options. Call us at Cura HPC to learn more about our palliative care and hospice services now, before your need becomes dire. 

Inconsistencies In Medical Care For Seniors Found

Posted on Mar 16, 2016

Senior couple with physician

A recent study conducted by The Dartmouth Institute for Health Policy and Clinical Practice set out to grade healthcare quality for seniors across the US. By comparing Medicare data for beneficiaries in different regions, the researchers discovered that where you live has a profound impact on the type of treatment your receive, and the quality of that treatment. Here is an overview of some of the key differences found when studying location and medical care for seniors. 

Though the study began by issuing a report card by region, the findings suggested wildly different levels of care from city to city, even in the same region. 

For seniors living in Manhattan, the average for time spent on doctor visits or in a hospital was 25 days per year. In Lebanon, New Hampshire, a city of about 14 thousand, that average dipped to less than 10 days per year. 

Of York, Pennsylvania seniors, about 73 percent used their primary care physician as their predominant healthcare provider and trusted them to coordinate their care. That's the highest such percentage in the nation, according to the study. The lowest, 42.6 percent, was found in Metarie, Louisiana. The national average came in at just under 57 percent. 

Those numbers are particularly important because research has also shown that when primary care physicians are more involved with care, patients benefit in a number of ways. Areas in this study with higher percentages of seniors using their primary care physician to coordinate their care tended to also have lower costs, higher quality, and lower rates of hospitalization. 

Under the Affordable Care Act, Medicare enrollees are entitled to a free preventative check-up each year. This can include personalized prevention planning, an assessment of the patient's functional ability, and a review of their risk factors for depression. In 2012, only 10.7 percent of Medicare beneficaries took advantage of this benefit. That includes a national low of just 1.2 percent in Meridian, Mississippi, and a national high of 26.1 percent of seniors in Clearwater, Florida. 

Typically, when a patient sees more clinicians, there's a higher risk of miscommunication, duplication of services, and misuse, or overuse of care. In most cases, the fewer medical professionals involved in treatment of a single individual, the better the quality of their care will be. That's obviously not always the case, and not realistic for every patient to limit their care to one or two clinicians, but for this study, a lower number of clinicians was regarded as the better option. The national average for seniors was 3.4 clinicians seen in a single year. In Fort Lauderdale, Florida, patients saw nearly 5 clinicians annually on average. Meanwhile, in Bangor, Maine, patients visited 2.4 clinicians on average each year. 

In 2008, the US Preventative Services Task Force recommended that prostrate cancer screenings should not be done for males over the age of 75. The belief is that the harm outweighs the benefits. There are concerns over invasive follow up testing, treatments and their side effects, and the stress and worry false-positives can inflict. Partly due to these recommendations, by 2012, the national average for these screenings on males over 75 dropped to under 20 percent of the qualifying US population. It was as low as 9.9 percent in Casper, Wyoming, but in Miami, Florida, 30 percent of males over 75 were still being screened for prostate cancer. 

In a similar case, research has shown that feeding tubes don't prolong life or improve outcomes for patients with advanced dementia. Despite this, more than 14 percent of advanced dementia patients in Lake Charles, Louisiana received a feeding tube. That's far above the national average of 6 percent, and the lowest rate in the nation of 1.3 percent, found in Portland, Oregon. 

Experts interpret these findings as proof that, as seniors develop multiple ailments and illnesses, and more care is required, it becomes increasingly important to have a coordinating physician or medical professional to oversee comprehensive care in order to ensure that all care is coordinated correctly and successfully. This will also help ensure that current best practices become more wide spread and are used throughout the country, rather than sporadically in some areas. 

At Cura-HPC, we help coordinate palliative and hospice care for patients with life limiting illnesses. To learn more about our services, call us at (800)797-3839.  

Proper Nutrition Tips and Essential Nutrients For Seniors

Posted on Mar 09, 2016

Elderly couple drinking water

As we age, our nutritional needs change. By adapting, you help your body stay healthy and fight off diseases. Whether you yourself is facing this issue, or you're helping to care for an elderly relative, it's important to understand the vitamins, minerals and nutrients that seniors require. In some cases, older individuals need additional vitamins, while in other cases, they need to cut back on certain foods. Here's a look at the dietary needs of seniors. 

Calcium

It's essential that we increase our calcium intake as we age, just as it's essential for children to get more calcium as they grow. Our bone system becomes more brittle over time, and the risk of serious injuries increases. Without the necessary intake of calcium, you run an increased risk of arthritis and osteoporosis. While it's recommended that individuals over the age of 55 get at least 1200 milligrams of calcium each day, it's also important where they get their calcium. Diversity is important, so you shouldn't only be relying on dairy products for calcium. You can also reach your daily requirement through leafy greens, soy, supplements, and many other foods and beverages. 

Omega 3 fatty acids

Your body requires these fats to function, but it doesn't produce them internally. So, it's vital that all of us get plenty of Omega 3s for a number of health benefits, including lowering your risk for arthritis, depression, Alzheimer's and dementia. Omega 3s are most commonly found in various types of fish, and as we age, it's important that we consume at least 3 servings of fish each week. Additionally, walnuts, flaxseed oil, and canola oil can supplement additional Omega 3s. 

Sodium

There are a number of foods that are high in sodium, namely pre-packaged and processed foods. Sodium is also directly related to hypertension, and a number of other heart diseases. Because seniors already have an increased risk for these issues, it's important to decrease the amount of sodium in their diet before problems start. Of course, if an individual already has high blood pressure, sodium levels should be decreased regardless of their age. 

Water

It may seem like a simple thing to stay hydrated, but many seniors experience serious health problems related to dehydration. As we age, our hydration requirements don't necessarily change much from when we're younger, but the potential risks involved with dehydration grow. Additionally, hydration isn't much of a concern for many, so it's easy to fail to make drinking water a priority. In addition to water, other liquids like soups, juices and teas, can help with hydration. Signs of dehydration in seniors to watch for include dizziness, headaches, rapid heart rate and confusion. When these symptoms appear, it's likely that serious dehydration has already occurred, which could require the use of an IV to regain fluids. 

If you're caring for an elderly relative, it's important for you to help them make care plans for the future. Contact us at Cura-HPC for answers to your questions about hospice and palliative care. 

4 Questions About Hospice Care From Patients and Families

Posted on Mar 02, 2016

Elderly couple and caregiver

The best time to start researching options for medical care is right now, before you or your loved one is in a dire situation where care is needed immediately. That allows you to carefully assess your choices, interview potential providers and physicians and make an informed decision. To help get you started, here are a few common questions we hear from families while they're learning about end of life care options like our hospice care services. 

Where do referrals for hospice care come from? 

A common misconception about hospice care is that patients need a physician's referral to begin care. In actuality, anyone involved in the patient's care can suggest that they begin hospice care. That includes family members, friends, clergy and other caregivers. The primary requirement for a patient to qualify for hospice care is that they've been diagnosed with a terminal illness. That diagnosis must come from a physician, and state that the life expectancy for the patient is six months or less. That does not mean the physician must then refer the patient to a hospice provider, however. It also doesn't mean the patient can only receive hospice care for six months. 

What is the cost of hospice care? 

The cost related to hospice care does not need to be a concern for most patients. Those with Medicare have the costs of care related to their illness completely covered. That includes hospice services, as well as prescription medication specifically for their diagnosis and its related symptoms, medical equipment and medical supplies. Those without Medicare are invited to consult with us at Cura-HPC to explore alternative options. 

Where is the hospice facility? 

This question stems from a misunderstanding of hospice care. Hospice isn't a physical location and there is no dedicated facility we use to administer care. That relates to one of the primary benefits of hospice services. Rather than having to be in a medical facility, most patients are able to stay in their own homes and have services and medical professionals come to them. This enhances the comfort of the patient as they stay in familiar surroundings, and often makes it easier for friends and family to visit and spend more time with them. It also provides the opportunity to provide additional, non-traditional care or allow patients to have experiences they wouldn't be able to from a hospital bed. 

Does starting hospice care mean you're giving up? 

This concern is often the primary reason a family or individual patient holds off on starting hospice services. They think that hospice care is only for those that are ready to die. While patients in hospice care have terminal illnesses, and hospice services are intended to provide end of life care, the benefits hospice provides improve the quality of life for patients. Rather than giving up, hospice gives patients an opportunity to fully live during the time they have remaining. Rather than spending that time in a haze created by prescription medicine, or in pain due to aggressive treatments, they're able to be conscious and alert, often pain free, and able to enjoy their loved ones and their favorite activities. 

If you have additional questions about hospice care, please contact us at Cura-HPC by calling 800-797-3839. 

The Stigma Around Palliative Care and The Truth You Should Know

Posted on Feb 24, 2016

Palliative care focuses on relieving the discomfort and distress associated with serious illnesses. It's recommended by primary physicians in a variety of situations, whether the illness is likely to be fatal or not. Many medical professionals regard palliative care as something that should be a routine part of a patient's care, but patients and their families often balk at the suggestion that they recieve it. This is likely due to the misconception that palliative care is only applicable for those near the end of their lives. But palliative care is not a stage or phase. While it shares many characteristics of hospice care, it's not synonymous with hospice and has some key differences. 

The benefits of palliative care are numerous. Concerns over pain, and other symptoms that may not be part of your regular conversations with a specialist, are part of a typical conversation with doctors and nurses administering palliative care. Additional help can even be supplied from social workers to help coordinate schedules, help organize insurance, or just answer additional questions. Individuals receiving palliative care also typically enjoy a higher quality of life than those receiving standard care. Depression affects fewer palliative care patients, as well. 

Palliative care became an approved medical specialty in 2007, and since then it has become an offered service in more than 70-percent of US hospitals. That number explodes to 90-percent of hospitals with more than 300 beds. 

Because of the belief that palliative care signals the end of a patient's life expectancy, and the stigma associated with the term 'palliative care', some facilities have started referring to it by a euphemistic name, such as "the symptom management service". This helps to take the fear out of palliative care while also being able to administer the beneficial services patients need. 

Those benefits have been proven through a number of studies. One such study, a 2010 randomized trial of 151 lung cancer patients, found that those starting palliative care early in their treatment were less likely to receive aggressive treatments like chemotherapy in their final weeks, but were also found to survive several months longer on average when compared to patients receiving standard treatment. This study also found that, because aggressive treatments were not as prominently used, palliative care patients also enjoyed a much higher quality of life and fewer suffered from depression. 

Similar studies have concluded that palliative care patients are less likely to spend time in intensive care units, have greater satisfaction with care, and higher spiritual well-being. For those with lung disease, palliative care patients also reported greater relief from breathlessness. 

The key in most of the research conducted has been the length of time a patient spends in palliative care. Typically, the longer the time in palliative care, the more beneficial the care can be. A study of patients in their 60s and 70s found that those who stayed in palliative care for at least 90 days were significantly less likely to have late-life hospitalizations, visit the ICU, or ER. 

The reduced hospital visits for most palliative care patients translates into thousand of dollars in savings per patient. That can be attributed to a variety of factors, but namely is due to the pain and symptom management and the increase in quality of life. When patients are comfortable, they're typically less likely to require emergency medical help. 

Despite all of this, only about a third of eligible patients ever begin palliative care. For some, they may not be recommended it by their physician, but many others opt not to explore that option due to misconceptions about what palliative care is, and what it means for their prognosis. And that inappropriate association exists even in the mind of many medical professionals. 

In reality, about 40-percent of palliative care patients experience improvement in health, and either "graduate" to other treatment options, or no longer need treatment at all. 

If you or a loved one are facing a serious illness, call us at Cura-HPC to learn more about palliative care and how it could prove to be beneficial. We can also answer your questions about hospice care, so you can make the best care choices. 

Advance Care Planning: Communicate Your End Of Life Care Wishes

Posted on Feb 18, 2016

Senior couple and medical professional

There are a number of options for end of life care, and a number of considerations to make when deciding which is right for you or your loved one. These decisions are difficult to make, and are made even more difficult when time is a significant factor and treatment is needed right away. That's why advanced care planning is so important. It allows you to make decisions for yourself well ahead of the crucial time when you'll need them. This also lays out a clear plan of care for your loved ones should you be incapable of communicating these wishes when they're needed. This ensures that your end of life care goes how you envision it, rather than being forced into facilities due to timing and circumstances. Here's some good information on advanced care planning that everyone should know. The best time to start planning is right now, before you need to. 

Advance Care Planning Statistics

The California HealthCare Foundation completed a survey in 2012 that found, while many understand that planning for care is important, it's a topic and task that is often ignored. A majority of the participants in the survey rated "making sure family isn't burdened by touch decisions" as "extremely important". However, a similar majority admitted they haven't communicated their end of life wishes to anyone. Only 23-percent of respondents had put anything in writing regarding their care wishes, despite 82-percent believing that it was important to do so. And, only 7-precent had talked to their primary physician, or any other medical professional, about end of life care. It's not an easy conversation to have, but it's an extremely valuable and important one. 

Topics To Discuss

Talking about end of life care with your family and medical professionals can be made easier through some planning of what topics need to be covered. First should be your physical needs and the environment you'd like to be in. Preferences on dying at home versus in a nursing facility or hospital should be clearly expressed. So too should be who you want around in your final days. Family members should know if you'd like their help, or company, so they don't feel in the way when that time comes. Additionally, let them know if you want the help of paid caregivers, or if you'd like to spend time alone or with a spouse. Funeral plans should come next on your list. You'll need to decide between burial or cremation, and organ donation. You'll also want to express any specific wishes you have for the funeral ceremony. There are also legal and financial matters to cover, including preparing your will, assigning co-signers to bank accounts, and guardianship arrangements. Finally, consider any other personal matters that may be important to you during your end of life care. For example, some patients want to experience their favorite hobby one more time, or to take one last trip. For wishes or unfinished business, it's important that your family and physician are aware and able to help you. 

Documents Needed

While communicating your plans is important, you also need to include them in writing in specific documents. This ensures that you're legally protected and that the end of life care you've drawn out is what you receive. Start with a living will. This acts as a blueprint for your medical care and will include specific instructions to follow for certain healthcare circumstances. If you are unconcsious or otherwise unable to communicate, this document will provide guidance for your family and doctors. A Healthcare Proxy is another document you'll need to complete. This is where you'll select your durable power of attorney, or healthcare surrogate, who will be able to make medical decisions for you when you're not able to, and when direction isn't specified in your living will. Rules for notarizing and requirements for witnesses for these documents vary by state, so be sure you investigate these rules before completing these documents. 

At Cura-HPC, we invite families to meet with us for consultation on end of life care options and ask questions about hospice and palliative care. Contact us at (800)797-3839. 

Defining 3 Common Forms of Dementia and Their Symptoms

Posted on Feb 11, 2016

For many, dementia is an all-encompassing term that covers all occurrences of cognitive decline. For those in the medical community, however, there are specific types of dementia that have significant, and sometimes subtle differences. It's important to make the distinction between these different types of dementia because there will be different care recommendations and treatments for each, not to mention different expectations for caregivers and family members. Here are three major types of dementia that account for the majority of diagnoses. 

  • Common symptoms

Before getting to the differences between diagnoses, it's important to understand the commonalities displayed in all dementia types. Memory loss is the most widely known symptom of dementia and is typically the first complaint of patients and their families. In many cases, however, memory loss is confused with other cognitive difficulties. For example, taking longer to process information, shorter attention spans, and difficulties with language can resemble memory loss. These symptoms are often accompanied by confusion around familiar people and places, difficulty with complex tasks orientation issues related to time and place. These cognitive changes are present in all types of dementia, but there are differences within them that help make a specific diagnosis. 

  • Alzheimer's Disease

About 60 to 80 percent of all dementia cases are attributed to Alzheimer's Disease. As of 2015, it was the sixth leading cause of the death in the US. Alzheimer's is slow progressing, and typically the first noticeable symptom is memory loss. Over time, impairment of other cognitive functions becomes more significant. Paranoia is also commonly observed in Alzheimer's patients, as well as accusatory behavior of caregivers and even family members. It's important to specifically diagnose Alzheimer's Disease because it's one of the few forms of dementia that responds to treatment with certain medications. The progression of symptoms has been slowed through the use of acetylcholinesterase inhibitors, Rivastigmine, and a multi-receptor antagonist known as memantine. 

  • Vascular Dementia

Complications relating to blood vessels, most commonly a series of strokes, results in this type of dementia. Historically, Vascular Dementia has been referred to as post-stroke, or post-infarct dementia, but strokes are not the only cause. Lifestyle choices that result in the blockage of vessels can also be to blame, which could include unhealthy diet, lack of exercise, or smoking. Vascular Dementia only accounts for about 10-percent of all dementia cases, but also has the potential for prevention. While memory loss can be a part of Vascular Dementia, it's often other symptoms that present themselves first. This is typically impairment in judgment and reasoning. The treatment and prevention of Vascular Dementia is closely related. Making healthier lifestyle choices has been shown to lower your risk and to slow the rate of cognitive decline. 

  • Lewy Body Dementia

This type of dementia combines cognitive changes with problems with movement, which can include walking and stability or the occurrence of tremors. Visual hallucinations are also typically pary of Lewy Body Dementia. While many are not familiar with Lewy Body Dementia, it is the second most common dementia diagnosis in the US. In addition to the symptoms, patients also exhibit more variation than those with other forms of dementia. Alertness and memory can exhibit significant changes in a short amount of time. Again, it's important to diagnose Lewy Body Dementia to ensure the correct treatments are being administered. When prescribing medications, it's important to know that about half of Lewy Body Dementia patients experience worsening cognitive ability, heavy sedation and the possibility of neuroleptic malignant syndrome when treated with antipsychotics. Lewy Body Dementia is also one of the fastest progressing forms of dementia with an average life expectancy of five years after diagnosis. 

It's important to understand these different forms of dementia if you have a loved one experiencing cognitive decline, or have a history of dementia in your family. Knowing this information can also help to prevent dementia in some cases. 

If you'd like to make plans for your future care, or have a loved one in need of end of life care, contact us at Cura-HPC to learn about our services and the benefits of hospice and palliative care. 

Exploring Common Objections To Starting Hospice Care

Posted on Feb 04, 2016

Hospice nurse and elderly couple

Choosing care options for a loved one with a life-limiting illness is, of course, extremely difficult. Particularly when multiple family members are involved, there are a number of differing opinions and emotions to deal with. When it comes to hospice care specifically, there are two common objections that are mentioned more than any others. Here is a brief explanation and exploration of each. 

  • Not ready for hospice

This argument against starting a patient in hospice care can stem from a medical concern, emotional concern, or a combination of the two. The family may feel that their loved one's prognosis isn't severe enough yet to warrant hospice care. Or, they may not want their loved one to think that the family, or the patient themselves, is giving up. Of course, hospice care isn't about giving up and some education about its benefits can be helpful in this case. There are even studies to point to that suggest that hospice care improves quality of life, reduces the stress on families, and, in some cases, has even prolonged life. There are similar studies that counter objections over the severity of a patient's illness. Most notably, that patients who receive hospice care for longer typically enjoy more benefits from it. Again, education can be key. Hospice care doesn't have to begin when a patient only has days left to live. Instead, it can be used for several months to ensure a patient is able to enjoy a high quality of life for the time they have left. 

  • My loved one will die sooner

This is a related objection and typically stems from the belief that hospice care is akin to giving up. While the treatment plan under hospice care is likely less aggressive than the treatment received in a hospital, research supports hospice's ability to prolong patients' lives in many cases. This can be attributed to a lower stress environment, the management of pain and symptoms, and the comfort of being at home and around family. Rather than abandoning hope when electing to start hospice care, patients are able to redefine goals for treatment and fully embrace their situation. That often means they're able to attend a special event, like a family wedding, or enjoy one last boat ride or enjoyable experience, that otherwise would have been impossible. This approach to end of life care prioritizes the patient's wishes and comfort in order to provide them with days well spent. 

If you'd like to learn more about hospice care, we invite you to contact us at Cura-HPC. Our experienced staff of medical professionals would be happy to help you decide whether hospice and palliative care is right for your loved one, or to help you develop a plan for your own end of life care. Call us at (800)797-3839. 

Research Shows Higher Patient Satisfaction From Hospice Care

Posted on Jan 28, 2016

Hospice nurse and patient

Hospice care can be a good fit for a variety of patients, and a variety of illnesses. Many associate hospice care with only the elderly, or only cancer patients, but in reality hospice is beneficial for almost any patient facing a life-limiting illness and even offer benefits to their families. A recent study concentrated specifically on the benefits for cancer patients in hospice and found that both quality of care, and quality of life were improved in hospice care compared to a hospital's intensive care unit. Here are the details of that study conducted by researchers at Harvard Medical School. 

The research team began by collecting data on more than 1,100 cancer patients, who had all died by the end of 2011. The reports from surviving relatives overwhelmingly support the hypothesis that hospice offers better end of life care and creates a higher quality of life for cancer patients than does a hospital. 

Only 42-percent of families rated end of life care as "excellent" when a patient spent their last days in a hospital. For the family of hospice patients, however, 57-percent rated care as "excellent". 

The amount of time a patient spent in hospice care also influenced the satisfaction with their end of life care, which suggests that better advanced planning is needed to allow patients and their families to make decisions before the situation is dire. Those patients who received hospice care for more than 3-days were reported to have had higher quality care than those who began hospice less than 3-days before dying. 

Those receiving hospice care for more than 3-days also had family report that they died in their preferred location at an overwhelming rate. 73-percent of families agreed that their loved one died where they preferred when receiving hospice care. Compare that to only 40-percent saying the same when a patient did not receive hospice care. 

In a related study conducted at the University of Washington, only one in five family members said that care was consistent with wishes for their loved one in the ICU. 

Medical professionals agree that "patients who have access to hospice care have a better quality of death and a more peaceful death than patients in hospitals." This can be attributed to hospice's efforts to consider patients' values and goals when recommending treatment options, and the added layer of support for their families. 

In many cases, however, the primary reason that hospice care is considered a better alternative to hospital care is because of the option for most hospice patients to receive treatments in their own home, and die in their own home. 

Allowing patients to experience a poor quality of death has been deemed unacceptable by many medical professionals. 

To learn more about how hospice benefits patients and their families, don't wait. Contact us at Cura-HPC today and make plans for your end of life care. 

Recent Studies Reveal Doctors' Own End Of Life Treatment Choices

Posted on Jan 21, 2016

Senior doctor

A pair of recent studies seem to suggest that doctors and other medical professionals make different end of life choices than many of their patients. This is significant because it may also suggest that more education is needed to inform patients about the positives and negatives of care options, particularly the difficulties involved in aggressive treatments with small success rates. If those with the best understanding of medicine are choosing less aggressive care at the end of their life, they may be doing so because they better understand their circumstances. 

The first study concluded that doctors facing the end of their lives were less likely to choose aggressive treatments like surgery, or be treated in an intensive care unit. It also found that doctors were less likely to die in a hospital than the general public, which suggests they may recognize when these aggressive treatments have done all they can soon than a typical individual. 

To reach this conclusion, Medicare beneficiaries in Massachusetts, Michigan, Utah and Vermont were studied. Each was over the age of 66 and died between 2004 and 2011. They recorded each patient's choices over the last 6-months of their lives and measured the intensity of their care by tracking five care options: surgery, hospice care, ICU admissions, death in the hospital, and total cost of care. 

The results found that doctors were less likely to choose many of the more aggressive care options in their final 6-months of life than the general population. They were less likely to die in a hospital, less likely to undergo surgery and less likely to be admitted to the ICU. Each difference only accounted for a few percentage points, but were statistically significant. 

The second study involved the same research team and compared the location of death for physicians with that of other medical professionals, individuals with higher education, and the general population. 

Of each of these four groups, doctors were found to be the least likely to die in any type of care facility. When specifically looking at hospital deaths, the general population was found to be more likely to die there than any of the other groups. 

Across the board, researchers found that those who were most familiar with medical treatments, and those with better education, were more likely to choose less aggressive treatments for the end of their life. 

While more research is needed before any far-reaching conclusions can be drawn from studies like these, these findings underscore the importance of education about end of life treatment options. It's important to begin research well ahead of need. 

To learn more about the benefits of hospice and palliative care, including who is eligible for care, contact us at Cura-HPC by calling 800-797-3839. 

4 Signs Your Loved One Needs Extra Assistance At Home

Posted on Jan 12, 2016

Elderly woman and loved one

Hospice care is designed for patients with life-limiting illnesses. In many cases, it allows these patients to avoid prolonged hospital stays and spend their final months comfortably in their own home. Depending on their situation, they may even be able to remain largely independent. Situations for patients with serious illnesses, and elderly adults, can change quickly, however. It's important for families and care givers to be mindful of warning signs that might suggest extra help around the house is needed. Here are a few of those warning signs. 

Mail piling up

When day to day tasks become more difficult, many individuals begin ignoring daily chores, or just forgetting about them completely. That could mean that mail goes unchecked and left in the mailbox for weeks at a time, or that mail piles up unopened. Similarly, bills may go unpaid and past the due dates, which can lead to water or power being turned off, or possibly evictions. You can also watch for signs of cognitive decline if a loved one struggles with reading or understanding mail, for example, being unable to identify clear junk mail. 

Untidy house

Some people keep a cleaner house than others, so the fact that a home is cluttered doesn't necessarily mean anything. When there's a sudden change in the cleaning habits of an individual, however, it could signal a problem. If you notice that a usually clean individual has stopped vacuuming, or has allowed clutter to accumulate, it could be a sign that they need help around the house keeping up with chores. You may also notice a reluctance to get rid of items, or even to take out trash. All of these should be considered warning signs. 

Refrigerator change

Another area to keep an eye on is the refrigerator. If mobility is limited, making trips to the grocery store can be a daunting task. That often leads to a lack of food in the fridge, and expired food items remaining in the house. It's vital that you keep an eye out for a lack of fresh food because that also signals that your loved one may not be eating enough. Watching their refrigerator allows you to take action before weight loss becomes apparent and dangerous. 

Memory lapses

Being easily distracted or showing short-term memory lapses can be a sign of cognitive decline. There are a number of things around the house that could help you identify this issue. Forgetting to take medication is perhaps the most serious. Help your loved one organize their medication into pill boxes so you can both easily tell when medication hasn't been taken. You can also look for signs of household accidents, like allowing food to burn by forgetting pots on the stove. If it's an isolated incident, it could mean nothing, but if it happens repeatedly, it could be a warning sign. 

Additionally, always be aware of signs of depression in adults who live alone. Even if there are no other issues present, depression can be debiliatating and, as we age, our risk increases. Signs of depression could include phone calls at odd hours, a reluctance to leave the house, odd sleeping patterns or a loss of interest in their favorite activities. 

If you think hospice care could benefit you or a loved one, we at Cura-HPC invite you to contact us to learn more. For answers to your questions about hospice and treatment options, call us at 800-797-3839. 

6 Home Safety Precautions For Independent Seniors

Posted on Jan 07, 2016

Hand rail on bathtub

Being able to live in your own home is a privilege many individuals lose as they get older. Safety concerns, decreased mobility, illness or decreased cognitive function causes many seniors to be forced into hospitals or nursing facilities. At Cura HPC, we work to help our patients stay in their home whenever possible while receiving hospice care. Whether your loved one is in need of hospice care, or just in need of some additional safety precautions. here are some areas to check and additions to make in order to make a senior's home safer. 

Lighting

Proper lighting is important in any home. We need to be able to see well enough to walk through a room with running into or tripping over obstacles. This is especially important for seniors who may have diminished eye sight and balance. Because a fall can be so catastrophic, you should take every precaution possible to prevent one. That means arranging a senior's home so light switches or lamps are close to the entryway of a room. Also, put in nightlights in outlets along the way from the bedroom to the bathroom for those dark, late-night trips. 

Fire safety

Another tip that applies to anyone is making sure there are working smoke detectors throughout the home. For seniors, this could mean helping them test them regularly and replacing batteries each year. This goes for carbon monoxide detectors also. With these warning systems in place, you can move on to fire extinguishers to actually put out small fires. Ideally, these won't need to be used, but it's important that one is available. A fire extinguisher is always necessary in the kitchen, and it's a good idea to keep another extinguisher elsewhere in the home, especially if there's a second story. Help your elderly relative keep these fire extinguishers charged, and make sure they know how to use them and are capable. 

Handrails

In order to help seniors keep their balance, it's beneficial to install handrails in certain areas of their home. If there are stairs, or even just a few steps, be sure there are sturdy handrails available to help them balance. The bathroom is another area that's essential to have handrails. Put them around the toilet to help seniors stand, by the tub to help them get in and out, and, in larger bathrooms, along the wall in case floors get wet and slippery. This could also make handrails handy in the kitchen where floors could also become slippery. Finally, consider installing a handrail by your loved ones favorite seat. It could be difficult to stand if they sit for too long. 

Flooring

Rather than adding anything in this case, it's important to check the flooring at a senior's home. Is the carpet, tile or wood floor in good condition? If not, try to identify any areas that could cause a trip and fall. These would include loose boards, loose edges of the carpet, loose tile, or any holes, rips or tears in flooring. This would also be a good time to look around the floor for other objects that could cause problems. You may consider removing any throw rugs, electrical cords, or other obstacles that could easily cause a trip. 

Daily routine

​There are some items in your loved one's home that they'll need easy access to every day. It can be extremely helpful to walk through their daily routine with them and make sure that each of these essentials is easily within reach. That may mean moving some things to lower shelves and cabinets, or even moving items from a room upstairs, to one downstairs. In some cases, you can simply buy a second, duplicate item so it doesn't have to be lugged up and down stairs or all over the house. Hopefully, you can completely eliminate the need for a step-stool or small ladder, but if one is still necessary, make sure it's stable, doesn't wobble and has sturdy ground to sit on. 

Phone

Finally, it's important to place phones around a senior's home so they can always reach one in an emergency. Having a cell phone is helpful in many situations, but there's always the possibility that it isn't charged, has been damaged in a fall, or isn't on their person when needed. A good rule of thumb is to always be able to see a phone from anywhere in the house. Even that might not be enough, however. Consider a situation where your elderly relative fell and couldn't get off the floor. They wouldn't be able to reach phones on walls or counters. So, also think about putting phones on lower shelves or even the floor in some rooms in case of emergencies. 

When precautions like these are taken, it becomes safer for seniors to remain independent and living in their own homes. 

If you or a loved one become ill and would like to learn about the benefits of hospice care, contact us at Cura-HPC: (800)797-3839. 

Keys To Avoiding Injuries During Exercise For Seniors

Posted on Dec 28, 2015

Senior man at the gym

Exercise is important for individuals at any age. As we grow older, however, it becomes increasingly vital and offers more and more benefits. Exercise unfortunately also holds risks for injury for seniors who may not have the strength or balance to complete some work outs. With the new year fast approaching, many of us will be starting new workout regimens in an attempt to be healthier. Before doing so, be sure to consult a doctor to better understand what will be beneficial to you and what could be dangerous. Here are some other precautions to consider also. 

Dress properly

The proper attire for exercise will help a great deal when it comes to staying safe. That starts with choosing the proper footwear. No matter what the activity, your shoes should offer plenty of grip and support. If it's your first time wearing a new pair of shoes, try to break them in and get a feel for them before attempting any strenuous activity. This will minimize the risk of a slip or fall during your workout. Your clothes should be chosen carefully too. First, be sure no article of clothing is too loose so it doesn't get caught on anything or cause you to trip. Second, dress accordingly for the weather. When it's cold out, be sure to dress in warm layers, and when it's hot out, wear breathable clothing and be sure to protect yourself from the sun. 

Inspect equipment

If you'll be using exercise equipment, a bicycle, or any other type of equipment, don't be in a hurry to take off. Make time to carefully inspect your equipment before each workout to be sure it's in working order. You should be able to spot any obvious issues. This will also help if you share equipment with others since you'll be able to double-check the amount of weight it's currently set to, or spot wet spots that could result in slipping. This is a simple task that can make a big difference. 

Stay hydrated

This could be the most important tip on this list. Dehydration can cause dizziness, nausea, light headedness, and loss of consciousness. That risk can be exacerbated when you're around heavy objects like weights that you could hit your head on in the event of a fall. Staying hydrated starts well before your workout. Ideally, you'll begin hydrating the day before, then continue drinking plenty of water up to your workout, throughout your workout, and after your workout. As we age, we become less susceptible to thirst, which means our body isn't as good about warning us when we begin to become dehydrated. So, don't rely on thirst to tell you when to drink. Bring a water bottle with you everywhere and drink from it often. 

Warm up and cool down

Finally, a key to avoiding injury during exercise is to properly warm up and cool down your body. That means stretching thoroughly before your workout, then starting out slow and working up to more strenuous activity. Then, you'll want to ramp down the activity and stretch again afterward. Not only will this help you to avoid injury during the workout, but it also helps keep your muscles from becoming sore and cramping, which could lead to falls well after your workout. 

At Cura-HPC, we're dedicated to health for individuals of any age. We offer hospice care to those with life-limiting illnesses in order to increase comfort and improve quality of life. If you'd like to learn more about hospice services for yourself or a loved one, please contact us at 800-797-3839. 

How To Help Grieving Loved Ones This Holiday Season

Posted on Dec 21, 2015

Family at home with Christmas gifts

Grief is a powerful emotion that can be exacerbated during certain times of the year. Milestones like birthdays and anniversaries can be particularly difficult. So too can the holiday season. Because so many of our holiday memories prominently feature loved ones, spending the holidays without those familiar faces can be extremely difficult. If you know of someone who has recently lost a loved one, these tips may be helpful for helping them through a difficult time. 

  • Be flexible

Many of us think that including family members coping with grief and loss in our normal, established traditions will be best for them. That's not always the case, however. It's important not to force anything on any individual. For some, those traditions will be comforting and help them feel normal. But for others, those traditions will only call attention to the fact that someone special isn't there to share them. So, be flexible during holiday gatherings and open to changing the usual routine. 

  • Volunteer

An alternative to the normal holiday traditions is to volunteer to help those less fortunate. This can be a wonderful activity for those who have recently lost a loved one. It allows them to stay busy, while doing something truly meaningful and worthwhile. It's also a great way to strengthen the bond between the grieving individual and yourself. When you're finished volunteering, you'll likely find that both of your spirits have been lifted. 

  • Remember

Another common mistake made when attempting to help a grieving loved one is to avoid talking about or remembering the recently deceased. In actuality, it can be an integral part of the healing process. Think of it this way. When someone dies, we don't want to forget them. We can actually be strengthened by realizing that they'll never be forgotten. It can be painful at first, but if the grieving individual is ready, it can be a wonderful experience to take some time to talk about memories of the deceased, look at old pictures of them, or just let them know that you're thinking about both of them. This will often lead to the individual wanting to share their feelings with you. That's when it's important to be ready to listen. 

  • Follow-up

There's often an outpouring of support just after someone has died for their surviving relatives. After a few weeks, however, most of us have returned to our normal routines. A similar process tends to take place around the holidays. Because we recognize this season can be difficult, we place a special emphasis on helping our friend or family member with their loss. After the holidays, however, we often go back to our routine, leaving that individual alone again. Making time for a grieving loved one this holiday season is important, but so too is continuing to help them even after the holidays. Make plans to check back in after a few days to see how they're doing. Try to follow up with them periodically just to chat, or to offer to help them with chores or errands. 

At Cura-HPC, we value the opportunity we have to impact the quality of our patients' lives, and the lives of their loved ones. Our hospice services include helping the families of our patients prepare and cope with loss. To learn more or to find out if hospice care is right for you or a loved one, contact us at 800-797-3839. 

Educate Yourself On The Symptoms and Causes Of Strokes

Posted on Dec 17, 2015

Stop stroke sign

A stroke can be debilitating and life altering for both the victim and their family. Stokes occur when brain is deprived of oxygen because of a lack of blood flowing to the brain, which causes brain cells to die. It's important for an individual suffering a stroke to immediately seek medical help. That's why it's also important to learn about the warning signs and causes of strokes so you can act quickly when needed. Here's what everyone should know. 

Warning signs and symptoms

Because the brain is being deprived of oxygen, the longer you wait to get medical attention when a stroke occurs, the more brain cells die and the more severe the effects. One of the most recognizable symptoms is sudden, slurred speech. For the victims of a stroke, you may also find it difficult to understand what others are saying to you. For some victims, there will also be a pounding headache, dizziness or vomiting. Vision is also impaired by a stroke. This could include blurred vision, or the complete loss of vision in one or both eyes. Physical motor skills are often affected as the victim will have trouble standing or walking, and have difficulty with balance. Finally, watch for localized paralysis in certain areas of the body. This is commonly seen in one side of the face, an arm or a leg. 

Categories and causes

There are three primary categories of stroke that all caused by slightly different events in the body. Ischemic strokes occur when an artery in the brain is blocked or narrowed, which prevents proper blood flow and oxygen to reach the brain. Typically, this is caused by a blood clot forming in the brain's artery, or forms elsewhere in the body, but travels in the blood stream until it's lodged in the brain's artery. There are also Transient Ischemic Attacks, TIA or mini-strokes, which also are caused by a blockage of blood flow in the brain. These are only temporary, however, and typically last less than 5-minutes. In these cases, a blood clot or other debris blocks the artery, but is small enough to be moved by normal blood flow eventually. Victims of TIA strokes should seek medical attention, however, because it signals an increased risk of additional strokes. Finally, Hemorrhagic strokes are caused by burst or leaking blood vessels in the brain. This is usually brought on by head trauma, high blood pressure or can be a congenital issue. 

Risk factors

Certain factors put you at an increased risk of stroke. It's important to identify these factors and take precautions through medical care to work to lower your risk. A lack of exercise and being overweight significanlty increases your risk of having a stroke. So too do other unhealthy habits like smoking cigarettes, drinking alcohol or using recreational drugs. Medical factors, like heart disease, high blood pressure, diabetes, high cholesterol and sleep apnea can also increase your risk of having a stroke. Men over the age of 55 are typically at the highest risk, but if your family has a history of strokes or heart attacks, that can affect the likelihood that you'll be the victim of a stroke, as well. 

At Cura-HPC, we provide hospice care for a variety of patients, including those who have recently suffered a stroke. If you have a loved one in need of care, or you'd like to learn more about hospice, we'd love you to contact us at 800-797-3839. 

5 Ways To Make A Hospice Patient's Holidays Merry

Posted on Dec 10, 2015

Grandparents with granddaughter at Christmas

The holidays are typically a joyous time spent with loved ones. For some, however, holidays are a difficult time of year. Particularly those with health issues, the holidays can sometimes make them feel isolated, or leave them longing for days when they were more able to get out and do their favorite holiday activities. For individuals in hospice care, there are a number of ways to keep their spirits bright throughout the holidays. If you have a loved on in hospice care, consider some of these activities. 

Bring holiday events to them

Feelings of isolation can be accentuated when an individual is unable to attend a family get-together. Whenever possible, try to plan gatherings around a hospice patient in order to include them. For some, that may mean simply moving festivities from an out-of-state location, to one in town. For others, it may mean bringing at least part of the group into the patient's home. Be sure to talk it over with your loved one to help them prepare and to find out what they're most comfortable with. They may like you to help clean up before family arrives, or request that only a small number of guests come to visit. Going through this process, even if it only results in a few minutes together, will go a long way. 

Help them decorate

For many of us, it's just not the holidays without the festive decorations. This remains true for many hospice patients, even when they're unable to decorate their home themselves. Ask if your ill or elderly relatives would like help hanging lights, putting up a tree or putting up other decorations around their home. This effort makes them feel more comfortable and brings some normalcy to the season. 

Write their holiday cards

Annual holiday cards being sent is an honored tradition for many. If your loved one enjoys sending out holiday cards, take some time to help them this year. You may write the cards while they dictate what to say, or you may just help with addressing envelopes. You may even just volunteer to help them read through the holiday cards they've received from others. Even if you don't offer much assistance, your time spent with a hospice patient will be greatly appreciated. 

Bake them treats

Another favorite tradition might be to to prepare a favorite dessert or sweet treat. For some, you may simply offer to assist them while they bake. Others may need more help, but they'll still enjoy the smells and sounds of activity in the kitchen. Again, this can make their holidays seem more normal and familiar, which can bring great comfort. 

Reminisce with them

The holidays have a way of conjuring up memories from the past. The simple gesture of sitting and talking with your loved one about past holidays and family members will have great meaning. Bring a photo album to flip through to help remember some of those favorite holiday experiences. This can be a wonderful experience for anyone, and is particularly beneficial for those suffering from dementia and Alzheimer's disease. 

This holiday season, think about your loved ones currently in hospice care and consider what cherished holiday traditions they may be missing out on. 

For more information about hospice care, and our philosophy at Cura-HPC, contact us at 800-797-3839. 

Could Walking Slowly Be A Sign Of Alzheimer's?

Posted on Dec 03, 2015

Elderly couple walking

There are many current studies being conducted that attempt to find a link between certain behaviors and the onset of Alzheimer's disease. The hope is that by finding these associations, we can begin to better understand what causes Alzheimer's and more accurately diagnose it in its early phases. One recently concluded study conducted the Center of Excellence in Neurodegeneration of Toulouse, France hypothesized that the walking speed of seniors could be used as an early warning signal of Alzheimer's disease. 

Specifically, researcher Dr. Natalia de Campo believed that slow walking speed could signal the build-up of amyloid plaque in the brain. In Alzheimer's patients, an excess of amyloid plaque occurs in the brain and is believed to be responsible for the damage that occurs there. These plaques are present in the brain even before any external symptoms of Alzheimer's are present. 

Amyloid plaques are clumps of short fragments of APP, or amyloid precursor protein. APP occurs throughout the body, but one hyposthesis suggests that a fault develops in the brain that causes incomplete segments to be produced. These fragments clump together and accumulate and begin to disrupt and destroy nerve cells, which is believed to cause Alzheimer's disease. 

Dr. de Campo's study began with 128 participants averaging 76-years of age. Each participant had experienced memory problems, but none had been diagnosed with Alzheimer's or dementia. After administering PET scans to each individual, nearly half of the participants were found to have amyloid plaque in the brain at a level associated with Alzheimer's disease. 

Thinking and memory tests were then administered to determine the participants current cognitive abilities. Again, nearly half showed mild cognitive impairment, which is often a signal of the start of dementia. 

Finally, walking speed tests were used to measure each individual's pace when walking about 13-feet. The average for this test is 3.48 feet per second. All but two of the participants finished with a walking pace within the normal range.

Even with most participants walking at close to an average pace, researchers still found an association between amyloid plaque levels in the brain and slight differences in walking speed. Those with significant amyloid plaque build-up were observed to walk up to 9-percent slower than those without such build-up. These findings were also independent of an individual's age, education level or current memory problems. 

Because amyloid plaque in participants with slower walking speed's was often found in the area of the brain significantly involved with motor function, it's believed to cause damage similar to the damage that leads to memory loss and dementia in other areas of the brain. 

Dr. de Campo stresses that this research found only an association between amyloid plaques and slow walking speed, and there are many other factors that can contribute to slow walking speeds in seniors. Still, the findings are significant and are likely to trigger further research. 

At Cura-HPC, we provide hospice care for patients struggling with life-limiting illnesses, including Alzheimer's and dementia. To learn more about our services and our philosophy of care, contact us at 800-797-3839. 

Study Links Hospice Care To Reduced Depression Risk In Spouses

Posted on Nov 24, 2015

It's been widely accepted that patients receive a number of health and spiritual benefits from hospice care. Numerous studies have focused on the individual patient and the effect that hospice care typically has. There's been much less focus on the surviving family members and whether or not hospice care for their loved one has an effect on their well-being. A recent study completed by researchers at the Icahn School of Medicine at Mount Sinai set out to discover how hospice care helped surviving spouses of the patients. What they found is that hospice care often makes a significant, positive impact on the spouses' mental health. 

Researchers began by studying data from more than 1-thousand now deceased patients with surviving spouses. The spouses were tracked for up to two years to record their mental and physical health record after bereavement. All individuals included in the study were over the age of 50 and all patients began hospice care due to a serious illness. 

The patients analyzed belonged to two groups, one group of hospice care patients, and one group that was never under hospice care. 

Spouses of patients who received hospice care showed definitively that they were less likely to experience depression symptoms than spouses of the patients not in hospice care. These results were at their most pronounced one year after a patient's death. 

It's unknown if there's a specific service provided under hospice that has this positive affect on surviving family members. The patients in this particular study received services including medical services, symptom management, spiritual counseling, social services and bereavement counseling. 

Perhaps the most amazing part of the researchers discovery is that a reduced risk of depression was evident even in spouses of patients who were in hospice care for only three days. 

This is a significant study given that the risk of depression is typically at its highest following the loss of a spouse. Being able to show a significantly reduced risk during this time makes this benefit even more pronounced. 

Currently, about 45-percent of terminally ill patients are under hospice care when they die, which is marks a 20-percent increase over the past decade. 

To learn more about how hospice care benefits the patient and the family, contact us at Cura-HPC of Tulsa. 

The Choice Between A Nursing Home and Hospice Care

Posted on Nov 06, 2015

Hospice patient and relative

Many seniors and their families face an important choice for end of life care. A common situation is a discharge from the hospital and a decision for where to go next. While most prefer to go home, extenuating circumstances often make that decision complicated and families end up choosing to place them in a nursing home instead. Here is a detailed look about what should go into this decision between a nursing facility or hospice care received at home for end of life care.

Monitoring versus Comfort

The reason many families believe that a nursing facility is the best choice for their elderly loved one is the belief that they require 24/7 monitoring of vital signs and other round the clock nursing services. In some cases, the individual patient may in fact require these services. But, when providing end of life care, most individuals favor the level of comfort and support provided by in-home hospice care. It’s important to recognize the distinction between the two and choose the option that best fits the individual’s needs. If it is a true end of life situation, comfort should likely be the primary concern, rather than treatment.

The problem with both

There are many examples of patients receiving hospice care while in a nursing home, but this isn’t a viable option for everyone. Taking advantage of both care options is cost-prohibitive for most families. Medicare will cover the cost of a skilled-nursing facility, or the cost of hospice care, for many patients, but only rarely will they cover both at the same time. This means a family will face the cost of the nursing home stay without assistance, which often equals hundreds of dollars per day. Because few families have the means to comfortably afford a care option without any type of assistance, they’re lead back to having to choose one or the other.

Final 6-month study

The National Health and Retirement Study was conducted between 1994 and 2007 and examined more than 5-thousand seniors. All of members of this group studied lived independently before a hospital stay and not in a nursing facility. After their hospital stay or illness necessitated choosing an end of life care option, about a third of them chose to stay at a nursing facility. That group was typically over the age of 85 and near death. More than 40-percent of that group died in the nursing home, while nearly 40-percent died in a hospital. About 10-percent were able to go home before passing away.

Compare that to the rest of the group who decided against a nursing facility. Of that group, more than 40-percent died in their own home. They received professional, dedicated end of life care rather than the expensive, and lower quality care offered by a nursing facility. As a doctor involved in the study pointed out, the nursing facilities aren’t intended to provide end of life care. Instead, they are meant for rehabilitation and the goal is for patients to be able to return home.

For information about hospice care for yourself or a loved one, contact us at Cura-HPC. We provide end of life care that focuses on comfort and support for both the patient and their family. 

Key Differences Between Hospice Care and Palliative Care

Posted on Nov 12, 2015

elderly woman holding hands with younger woman

The terms hospice care and palliative care are similar in meaning and are often used interchangeably. While they share many of the same services and philosophies, there are also some fundamental differences, however. Here are a few of the most noteworthy differences between the two.

Place

In most cases, hospice services are administered to a patient in their own home. Palliative care, on the other hand, is normally given at the medical facility where the patient receives treatment. This line is often blurred because hospice care can also be given in some cases in a nursing home, hospice facility or even a hospital. Palliative care, likewise, is occasionally administered away from medical facilities. The reason hospice is often more flexible on location is because it relies on a hospice nurse and the family caregiver, while a palliative care team relies on doctors, nurses and other medical caregivers.

Timing

Most individuals understand that patients are typically referred to hospice care when they have a terminal disease. While most patients enter hospice when they’ve been given six-months or less to live, there is no specific time limit for their care. Palliative care also has no time limits, but also is far less limited on the types of patients it accepts. Regardless of the stage or nature of an illness, a patient may be accepted by palliative care.

Treatment

Hospice services concentrate on a patient’s comfort rather than on aggressive treatments. While these treatments could slightly prolong life, they also greatly reduce the quality of it. While it isn’t required that a patient stops treatment when beginning hospice care, it is often the case to enable them to enjoy their remaining time without negative side-effects. Palliative care, conversely, typically works alongside other treatment plans. It is used to increase a patient’s comfort during any phase of their disease and treatment, but not at the expense of the other treatment methods in place.

What is confusing to many is the exceptions to these differences that make hospice care and palliative care even more similar.

To learn more about both, or to find out if one is right for you or a loved one, contact us at Cura-HPC. 

3 Common Situations Caregivers Encounter With Dementia Patients

Posted on Nov 16, 2015

Elderly hospice patient with caregiver

Many of the seniors in hospice care across the country are suffering with mid or late stage dementia or Alzheimer’s disease. This can present challenges to their caregivers and their family as their behavior changes and their cognitive abilities fade. If you have a loved one suffering from dementia or Alzheimer’s, follow these tips for the acceptable handling of some common situations.

Aggressive behavior

As Alzheimer’s advances, individuals tend to exhibit more aggressive speech and behaviors. This can be caused by physical discomfort, a lack of communication ability or just a fear and misunderstanding of their current surroundings. The key for caregivers is to identify what’s causing this aggression and calmly remove the problem or help to shift the focus. It’s important to avoid engaging in an argument because that tends to escalate the situation.

Time and place confusion

Often, patients feel a loss of control when dealing with dementia, which can be what leads them to being confused about where they are, why they’re there and what year it is. They may simply desire to be back in a time of their lives when they felt more in control. This behavior can be particularly heartbreaking for loved ones, however. One option is to redirect the person rather than answering and contradicting them. The Alzheimer’s Association suggests that you give simple explanations with photos or tangible reminders to bring them back to the present. The primary goal is to answer in a way that makes the individual feel safe and assured. That means avoiding long explanations and reason.

Poor judgment

Common examples of poor judgment are accusations against family members or nursing home staff, repetition of certain tasks or unexplained hoarding. This is caused by the deterioration of brain cells, which often leads to delusions. Because the patient believes something is true, it leads them to out of character behaviors. It’s important not to outright question this behavior, however. Instead, offer help in tasks they seem to be struggling with, or try to get to the reason behind the behavior by having a casual conversation. Through communication, the individual may voluntarily admit to having trouble in certain areas, which you can then volunteer to help with.

Moving those suffering from dementia or Alzheimer’s out of their homes can lead to further decline and more confusion. At Cura HPC, our hospice care services are able to help care for Alzheimer’s patients in the comfort of their own home with compassion and dignity. Contact us to learn more. 

Fundamental Tips For Hospice Volunteers

Posted on Oct 02, 2015

hospice patient and hospice volunteer

Hospice volunteers are given a rewarding opportunity to help a patient and family during an important time. While volunteers don’t typically assist with any type of medical care, they are essential to a patient’s comfort. By reading, visiting and assisting both the patient and their family, volunteers are able to offer an important service. If you’re interested in volunteering, contact us at Cura-HPC. Here are some basic tips for how to be an effective volunteer.

Preliminary visit

Before any additional tasks are undertaken, an important first step is to learn about the patient, their situations and environment and their needs. In some cases, a preliminary visit can illustrate that you aren’t a good fit for a particular patient. In that case, it’s important to assure them that a more suitable replacement will be found and to then inform the volunteer coordinator of the reason you weren’t a fit. Otherwise, give the patient and the family the option to set-up a return visit when you can start helping with more tasks.

Read and write

Whether or not a patient is able to comfortably read to themselves, having a visitor read a book, magazine or letters from loved ones is especially comforting. As you learn more about a patient, you can begin to proactively find material they’ll enjoy reading. Remember to be sensitive to their limitations and ask periodically if they’d like to continue reading or if they’re tired. Additionally, offering to write for patients is an often overlooked, but valued service. They may like to respond to letters or emails, or have stories or messages they’d like recorded that can be passed on upon their death.

Assistance

Each patient and every situation is unique. While some will require a great deal of assistance, others will crave independence, while still others will need some encouragement to try to perform tasks themselves. You’ll gradually learn which type of situation you find yourself in, but in the meantime be as helpful as you can. Ask if they’d like help and try to remember what they do and do not need your assistance with.

Housekeeping

Because of the nature of hospice, the patient’s home has usually been neglected for some time. While that is understood, some patients will feel self-conscious about it or just feel more comfortable in a clean, organized environment. This is a perfect opportunity for volunteers to help out. You can tidy up under their supervision, or do some light cleaning while they rest. Be available to help with yardwork also to save the family the time and trouble.

Regardless of how you spend your time with the patient, remember that you are there to help. Some patients need to be reminded that you don’t need to be entertained. If they simply want to sit quietly and watch TV, you can sit with them or read on your own. Be available if they need your help or want some company, but don’t force them into anything.

At Cura-HPC, we value our volunteers and have a number of amazing patients for you to work with. Contact us at (800) 797-3839. 

Hospital Stays and Cognitive Decline Linked In Elderly Patients

Posted on Oct 02, 2015

Hospital room

When an accident, fall or other event causes the need for an elderly loved one to be admitted to the hospital, it can be a stressful, worrisome time for the family. In addition to concerns about their recovery from primary injuries or illnesses, research has shown there are also concerns over deteriorating mental health and cognitive ability brought on by the hospital stay itself. Though the cause is unclear and there are many potential factors, recent studies have concluded that hospitalization causes a much higher risk of developing or increasing cognitive problems in elderly patients.

One specific study published in 2012 examined the data of more than 1300 individuals age 65 and older of various backgrounds and ethnicities. Each of these individuals had experienced a hospital stay and had been interviewed at least once before the stay, and at least twice afterwards at 3-year intervals.

Researchers discovered that the rate of cognitive decline more than doubled for these patients after their stay in a hospital. Thinking and memory were found to have declined dramatically across the board.

The lead researcher on the project, Dr. Robert Wilson, said “it’s as if people became 10-years older, from a cognitive standpoint, than they actually were before hospitalization.”

The individuals at the highest risk for rapid cognitive decline were those who started experiencing worsening memory or thinking problems before their hospital stay. The length of their stay in the hospital also made an impact as those with more serious health issues who were admitted for longer stays were also more likely to exhibit cognitive decline.

While not every elderly patient leaves the hospital with previously unidentified cognitive problems, for many, a hospital stay serves to “unmask and accelerate” these issues.

Previous research had already revealed that hospital stays interfere with physical functioning for the elderly. Daily activities like bathing, toileting and dressing have all been impaired for many older patients after leaving the hospital.

One potential cause of both physical and mental changes brought about by a hospital stay is delirium, which is estimated to occur in one in five hospital patients. Rather than a transient, temporary condition, delirium is now regarded more as a brain injury, which can produce fast manifestation of symptoms like confusion, disorientation, agitation and unresponsiveness, and can forever alter mental health and have residual effects well after a supposed recovery.

Another potential mechanism is the medication given to acutely ill patients in intensive care. The long-lasting effects of these medications, specifically on mental health, is severely lacking in research.

Finally, the environment of the hospital itself may be to blame. Because cognitive ability in seniors greatly relies on physical exercise and mental stimulation, being stuck in a bed in a room with little to no stimulation can greatly influence mental health.

All of these potential issues can be addressed and avoided, but families should be aware of potential problems when a loved one is admitted to the hospital. Understand that increased care and support may be necessary after a hospital stay and a rapid cognitive decline could occur.

For alternatives to traditional hospital stays, contact us at Cura-HPC. We offer hospice and palliative care to a variety of patients to provide them a more comfortable, caring environment. 

5 Questions to Ask Potential Hospice Providers

Posted on Oct 02, 2015

Group of medical professionals

At some point in our lives, almost all of us would benefit from hospice care. But how do you decide which hospice provider to choose when they all seem so similar? The American Hospice Foundation put together a list of questions you can use to find out if your needs and situation match-up with the capabilities and services provided by a specific hospice provider. Here’s what to ask in order to make an informed decision.

How long have they been in operation?

The takeaway from this question is to find out if the hospice provider is relatively new to your area. If this is the case, they lack the stability of other providers who have years of proven service. New providers also introduce the possibility that they won’t still be around when you need them, or that they’ll halt operations while your loved one is still under their care. Be wary of hospice providers with less than 6-months of history.

What are their references?

Another reason newer hospice providers are risky is because it’s more difficult to talk to physicians and families who have worked with them in the past. Without these references, it’s extremely difficult to rely on these providers with confidence. Before you make a decision, be sure to ask around and find out what others’ impressions are.

What is a typical response time for nights and weekends?

Illness doesn’t work a typical work schedule so it’s important for your provider to be available and respond quickly any time you might need them. A qualified hospice will ask their clients about response times and whether their staff was adequately available to the family and patient. That means the provider you’re speaking with should already know what their response is like. For many, this can be a make or break question so be sure you have a quoted response time for any provider you’re considering.

What are treatment limitations?

Depending on the hospice provider being considered and a patient’s illness, there may be a disconnect between the treatments currently being done for a patient that could not be considered by the hospice team. In many cases, the patient can simply continue seeing their own doctor, but it’s important to understand these limitations before making any changes in care.

What are their accreditations and certifications?

If the patient considering hospice care is a Medicare beneficiary, it’s essential that the provider they choose is Medicare-certified in order to permit reimbursement. For many patients, this consideration alone can help to narrow the list of provider options. Additionally, some states require their own licensure for hospice providers, so if you live in one of these states, be sure a provider is compliant. JCAHO or CHAP accreditations are not required, however they could give you peace of mind. Knowing that a provider has an accreditation lets you know that they’ve been reviewed and determined to provide a reasonable standard of care.

Don’t wait until a crisis to begin researching and interviewing hospice providers. If care needs to begin immediately, it can be difficult to properly assess your options. If possible, start your research at the first signs of a serious illness, or when a loved one reaches a certain age. Even if you don’t need a hospice providers for another few years, the information you gathered will come in handy.

To learn more about Cura-HPC, our services, philosophy and capabilities, don’t hesitate to contact us at (800)797-3839. 

Dispelling 3 Common Myths About Hospice

Posted on Oct 02, 2015

Hospice fact or myth graphic

While hospice care has been adopted by more and more individuals, there remain a number of myths and misconceptions about the hospice philosophy and the facts about palliative care. Unfortunately, these misconceptions can lead to patients and their families missing out on beneficial services. As with any type of medical treatment and care, education is important in order to allow patients to make the best decisions for them. With that in mind, here are three of the most common and detrimental myths about hospice care and the truth behind them.

Time limits

Medicare uses benefit periods, which last 90 days. This practice has led to the belief that hospice care has a time limit and is only for patience with 6-months or less left to live. This time frame comes from a typical Medicare estimate that hospice patience only need two benefit periods. What many people don’t know, however, is that Medicare allows you to receive an unlimited amount of 60-day benefit periods after that initial 6-months should you need it. Palliative care isn’t designed to shorten or lengthn life, but the reduction of stress and increase in comfort often affects health in a positive way. It’s even an option to go off hospice care and come back when it’s needed. At no point would a patient be refused care, however, due to the length of time they’ve received hospice.

Hospice centers

No one is quite sure where this myth comes from, but it states that hospice care is administered at a specific facility and patients are required to go there to receive care. This is completely untrue. Rather than a physical location, hospice is a philosophy that allows patients to make choices for their end of life. That means a patient could be in a hospital, nursing home, or in their own home and still be a candidate for hospice care. Services are provided 24/7 and are even available when the patient’s finances are depleted. The idea of hospice is to make patients more comfortable and to work with their needs, so requiring them to visit a specific facility or make a specific choice is outside the philosophy.

No medications

While it’s already been mentioned that hospice is a relief-based approach, rather than a curative one, the decision to go off medications is left up to the patient. Some medications can be a cause of discomfort and it may be the recommendation of the hospice provider that the patient discontinue use of it, but to say that hospice requires patients to stop taking medications is inaccurate. In order to receive the maximum benefit from palliative care, recommendations are made to increase comfort and reduce stress. Sometimes that coincides with going off medication, but sometimes the patient prefers to continue medications and other recommendations and considerations are made.

Once you understand that hospice care is a philosophy focused on making patients more comfortable, many of the myths associated with hospice are easy to discern.

To learn more about hospice care or to find out if you or a loved one is right for it, contact us at Cura-HPC. 

4 Ways To Improve Your Relationship With Your Physician

Posted on Oct 02, 2015

hospice patient and physician

Building a strong relationship with your physician is important for any individual. Within the context of hospice, it becomes particularly important, and not just for the patient but also for the family. Your physician will be having difficult conversations with you and making recommendations. Taking the time to build that relationship helps them know you better, which allows them to make more meaningful recommendations. For a better overall experience with your physician, here are a few tips for how to effectively build a stronger relationship.

Be prepared

Before your appointment, you likely already have a good idea of what will be asked. Take a few minutes to prepare by listing your symptoms and how long each has been present. Or list exactly what’s been troubling you and make sure that each reason for the visit is addressed. Knowing each prescription and non-prescription medication you’re taking is also extremely helpful.

Be honest

Without full disclosure, your physician can’t be expected to effectively treat you. It’s important that you are completely honest about your lifestyle, symptoms and needs. Many patients feel embarrassed or self-conscious during doctor visits, but holding back can lead to dangerous situations. Let your physician help you to the best of their abilities by telling them everything.

Understand your care plan and follow it

Don’t leave your doctor’s office if you have any questions or uncertainties about the care plan they’ve outlined. Understanding exactly what is expected of you is important for the plan to be successful and ensure maximum comfort and healing. Once the care plan is explained satisfactorily, follow it exactly. Failure to take medications on time or in the correct dosage, or not monitoring blood sugar and other aspects causes the plan to fail. This can lead to changes in the plan that aren’t necessary. Eventually, this is a great deal of time lost.

Bring a companion

Researchers have found that those that see their physician along with a friend or family member are significantly more satisfied with their visit. Having a trusted individual in the room with you helps put you at ease. It also means there’s an extra set of ears there to absorb the doctor’s information. If possible, enlist one individual to attend physician’s appointments with you and rely on them to help keep you organized and on-track.

Additionally, communication with your physician is key. Your doctor is here to help, but they need your help to know exactly how to treat you. The more you know and can tell them about your situation, the better they’ll be able to help you.

At Cura-HPC, we work closely with a number of amazing physicians and medical professionals. We are dedicated to providing hospice care to patients who need it and provide services to their families as well. Contact us to learn more about our hospice and palliative care capabilities.